Sample records for fractures short history

  1. Early history of scapular fractures. (United States)

    Bartoníček, Jan; Kozánek, Michal; Jupiter, Jesse B


    The first to use the term Scapula was Vesalius (1514-1564) and thus it has remained ever since. Probably the oldest injured scapula, from 250 million years ago, was described by Chinese authors of a skeletal examination of a fossilised remains of a dinosaur Yangchuanosaurus hepingensis. In humans, the oldest known scapular fractures date back to the prehistoric and early historic times. In ancient times, a fracture of acromion was described in the treatises of Hippocrates. Early modern history of the treatment of scapular fractures is closely interlinked with the history of the French surgery. The first to point out the existence of these fractures were Petit, Du Verney and Desault in the 18th century. The first study devoted solely to scapular fractures was published by Traugott Karl August Vogt in 1799. Thomas Callaway published in 1849 an extensive dissertation on injuries to the shoulder girdle, in which he discussed a number of cases known at that time. The first radiograph of a scapular fracture was published by Petty in 1907. Mayo Robson (1884), Lambotte (1913) and Lane (1914) were pioneers in the surgical treatment of these fractures, followed in 1923 by the French surgeons Lenormat, Dujarrier and Basset. The first internal fixation of the glenoid fossa, including a radiograph, was published by Fischer in 1939.

  2. IUTAM a short history

    CERN Document Server

    Juhasz, Stephen


    This book presents extensive information related to the history of IUTAM. The initial chapters focus on IUTAM’s history and selected organizational aspects. Subsequent chapters provide extensive data and statistics, while the closing section showcases photos from all periods of the Union’s history. The history of IUTAM, the International Union on Theoretical and Applied Mechanics, began at a conference in 1922 in Innsbruck, Austria, where von Kármán put forward the idea of an international congress including the whole domain of applied mechanics. In 1946 IUTAM was then formally launched in Paris/France. IUTAM has since time organized more than 24 world congresses and 380 symposia, representing all fields of mechanics and highlighting advances by prominent international researchers. The efforts of IUTAM and its about 50 member countries serve to promote the mechanical sciences and the advancement of human society, addressing many key challenges. In this context, IUTAM preserves important traditions while...

  3. [Short history of mixed states]. (United States)

    Cermolacce, M; Belzeaux, R; Corréard, N; Dassa, D; Dubois, M; Micoulaud-Franchi, J-A; Pringuey, D; Fakra, E; Maurel, M; Azorin, J-M


    The notion of mixed states is classically associated with descriptions and categories inherited from Kraepelin. However, simultaneous descriptions of depressive and manic manifestations can be traced back to ancient times. Semiology and definitions of these clinical associations have evolved across the times. We provide here a short insight on four distinct periods: Greek authors from ancient times, pre-Kraepelinian psychiatry (18th and 19th centuries), Kraepelin's conceptualization, and contemporary psychiatry (20th and 21st centuries). Copyright © 2013 Sociedade Brasileira de Farmacognosia. Published by Elsevier Masson SAS.. All rights reserved.

  4. Feasibility of progressive strength training shortly after hip fracture surgery

    DEFF Research Database (Denmark)

    Overgaard, Jan; Kristensen, Morten T


    To investigate the feasibility of a 6-wk progressive strength-training programme commenced shortly after hip fracture surgery in community-dwelling patients.......To investigate the feasibility of a 6-wk progressive strength-training programme commenced shortly after hip fracture surgery in community-dwelling patients....

  5. Short Global History of Fountains

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    Petri S. Juuti


    Full Text Available Water fountains are part of every human settlement, and historical and mythological stories. They are the source from which life-sustaining water was distributed to people until piped systems started providing fresh tap water inside buildings. In many places, people visit fountains to experience the freshness of running water, to prepare for prayers, or to make a wish. Fountains have also provided water for the people of cities under siege, and purified believers as part of holy rites. The Castalia shrine in Delphi, Greece, for its part, is a spot where various groups of people come to socialize, which greatly improves the quality of their lives. This paper is a look back through the history of fountains in various parts of the world. Experts from various areas have identified the historic, cultural, and ritualistic aspects of fountains and their findings are summarized. The paper concludes by providing a glimpse into the role of fountains in modern society and their continued influence in our lives today.

  6. Short incomplete sagittal fractures of the proximal phalanx in ten horses not used for racing. (United States)

    Kuemmerle, Jan M; Auer, Jörg A; Rademacher, Nathalie; Lischer, Christoph J; Bettschart-Wolfensberger, Regula; Fürst, Anton E


    To describe short incomplete sagittal fractures of the proximal phalanx (type Ia P1 fractures) in horses not used for racing and report outcome. Retrospective study. Horses (n=10) with type Ia P1 fractures. Retrieved data of horses with type Ia P1 fractures were signalment, history and results of orthopedic examination. Radiographs were re-evaluated for position and length of the fracture line, presence of osteoarthritis or subchondral cystic lesions (SCL), periosteal new bone formation and subchondral sclerosis. Conservative treatment (n=4) included box confinement for 2 months followed by 1 month of hand walking. Surgical therapy (n=6) consisted of internal fixation by screws inserted in lag fashion in 5 horses. Concurrent SCL were debrided by curettage via a transcortical drilling approach. In 1 horse, only SCL curettage but not internal fixation was performed. Outcome was assessed on a clinical and radiographic follow-up examination in all horses. Mean follow-up time was 27 months (median, 13.5 months; range, 9 months to 9 years). All horses treated with internal fixation were sound at follow-up and had radiographic fracture healing. Of the 4 horses managed conservatively, 3 remained lame and only 1 horse had radiographic evidence of fracture healing. Catastrophic fracture propagation occurred in 2 horses not treated by internal fixation, 20 and 30 months after diagnosis, respectively. Horses with a type Ia P1 fracture treated surgically had a better outcome than those managed conservatively and lack of fracture healing seemingly increases the risk of later catastrophic fracture. Surgical repair of type Ia P1 fractures should be considered to optimize healing and return to athletic use.

  7. Short Segment Fixation Versus Short Segment Fixation With Pedicle Screws at the Fracture Level for Thoracolumbar Burst Fracture

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    Anghel S


    Full Text Available Objective: The most prevailing surgical procedure in the treatment of thoracolumbar burst fractures, Short Segment Fixation (SSF, is often followed by loss of correction or hardware failure which may be significant enough to require another surgical intervention. In order to take advantage of its benefits but to avoid or diminish the risk and impact of associated drawbacks, some other alternatives have been lately developed among which we refer to short segment fixation with intermediate screws (SSF+IS. This article provides a comparative picture over the effectiveness of the two above-mentioned surgical treatments, focusing on their potential to prevent the loss of correction.

  8. Fracture behavior of short circumferentially surface-cracked pipe

    Energy Technology Data Exchange (ETDEWEB)

    Krishnaswamy, P.; Scott, P.; Mohan, R. [Battelle, Columbus, OH (United States)] [and others


    This topical report summarizes the work performed for the Nuclear Regulatory Comniission`s (NRC) research program entitled ``Short Cracks in Piping and Piping Welds`` that specifically focuses on pipes with short, circumferential surface cracks. The following details are provided in this report: (i) material property deteminations, (ii) pipe fracture experiments, (iii) development, modification and validation of fracture analysis methods, and (iv) impact of this work on the ASME Section XI Flaw Evaluation Procedures. The material properties developed and used in the analysis of the experiments are included in this report and have been implemented into the NRC`s PIFRAC database. Six full-scale pipe experiments were conducted during this program. The analyses methods reported here fall into three categories (i) limit-load approaches, (ii) design criteria, and (iii) elastic-plastic fracture methods. These methods were evaluated by comparing the analytical predictions with experimental data. The results, using 44 pipe experiments from this and other programs, showed that the SC.TNP1 and DPZP analyses were the most accurate in predicting maximum load. New Z-factors were developed using these methods. These are being considered for updating the ASME Section XI criteria.

  9. A Short History of the Movies. Second Edition. (United States)

    Mast, Gerald

    This second edition of "A Short History of the Movies" includes expanded information and judgments about some of the "old masters" of film; an updated discussion of the "new masters"; and new sections on Japanese, Indian, and Czech cinema. In general, this history reveals significant trends in film history. American films are the primary focus,…

  10. Fractured reservoir history matching improved based on artificial intelligent

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    Sayyed Hadi Riazi


    Full Text Available In this paper, a new robust approach based on Least Square Support Vector Machine (LSSVM as a proxy model is used for an automatic fractured reservoir history matching. The proxy model is made to model the history match objective function (mismatch values based on the history data of the field. This model is then used to minimize the objective function through Particle Swarm Optimization (PSO and Imperialist Competitive Algorithm (ICA. In automatic history matching, sensitive analysis is often performed on full simulation model. In this work, to get new range of the uncertain parameters (matching parameters in which the objective function has a minimum value, sensitivity analysis is also performed on the proxy model. By applying the modified ranges to the optimization methods, optimization of the objective function will be faster and outputs of the optimization methods (matching parameters are produced in less time and with high precision. This procedure leads to matching of history of the field in which a set of reservoir parameters is used. The final sets of parameters are then applied for the full simulation model to validate the technique. The obtained results show that the present procedure in this work is effective for history matching process due to its robust dependability and fast convergence speed. Due to high speed and need for small data sets, LSSVM is the best tool to build a proxy model. Also the comparison of PSO and ICA shows that PSO is less time-consuming and more effective.

  11. Molecular beam epitaxy a short history

    CERN Document Server

    Orton, J W


    This volume describes the development of molecular beam epitaxy from its origins in the 1960s through to the present day. It begins with a short historical account of other methods of crystal growth, both bulk and epitaxial, to set the subject in context, emphasising the wide range of semiconductor materials employed. This is followed by an introduction to molecular beams and their use in the Stern-Gerlach experiment and the development of the microwave MASER.

  12. [Oral communication: short history and some rules]. (United States)

    Panini, Roberta; Fiorini, Fulvio


    The verbal communication represents the first human communication, that even more used and one most immediate. History and the development of communication is divided into historical periods, is complex and is bound to the period contingencies and to the social reference community. The oral communication is never isolated but is always taken by the not verbal one, including the silences, the position and the spaces (c.d. proxemics). The good communicator stimulates the cooperation through the conversation rule respect (qualities, amounts, way and relation) and reduces the possible asymmetry between broadcaster and receiver fitting its code to that of the interlocutor.

  13. A short history of biological warfare. (United States)

    Metcalfe, Neil


    Biological weapons have been used in war from the start of recorded history. This article reviews the history of the subject, including the outbreak of the Black Death and the use of smallpox against American Indians. The new science of microbiology was misused from soon after its start and, despite the 1925 Geneva Protocol, the Japanese experimented extensively on prisoners in China. The Allies carried out extensive research during the Second World War, notably the United Kingdom into anthrax on Gruinard Island and the United States into a variety of agents. Despite the 1972 Biological Weapons Convention (BWC), a major programme continued in the former Soviet Union (leading to an accidental outbreak of anthrax). Most recently Iraq was revealed as having an extensive programme, with weaponization of large amounts of various agents, and several terrorists groups have attempted to use biological agents as weapons. Modern developments in biotechnology could lead to even more serious developments, and effective preventive measures, including strengthening of the BWC, are imperative.

  14. Ebola virus disease. Short history, long impact

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    Mª Teófila Vicente-Herrero


    Full Text Available Ebola Virus infection is at present times a growing worldwide concern, although its history goes back to 1967, with subsequent outbreaks in 1979, 1980 and 1987, all of them by contact in workers in affected areas. The concern of the scientific community about this issue is partially reflected in publications included in MEDLINE (PUBMED database and in which, taking as a keyword in the search box “Ebola virus”, 2.151 publications are found, belonging 984 of them to the last 5 years (45.7% and 527 of these publications (53.5% to the years 2014-2015. The earliest publication dates back to 1977, attaching no listed authors either reference abstract, and the most recent to January of current year 2015. This means Ebola infection is a global problem and that concern the international scientific community. A review of some of the studies published in this matter, considered of interest and discussed by the authors, is performed in this work.

  15. The history of astronomy a very short introduction

    CERN Document Server

    Hoskin, Michael


    The History of Astronomy: A Very Short Introduction traces the history of Western astronomy, from prehistoric times to the origins of astrophysics in the mid-nineteenth century and the technical developments since the Second World War. Astronomy, perhaps the first of the sciences, was already well developed by the time of Christ — the arithmetical astronomy of the Babylonians was merged with the Greek geometrical approach. This legacy was transmitted to the West via Islam and led to the Copernican revolution, which in turn led to Kepler and Newton, who provided the principles on which the exploration of the solar system and the stars continued in the eighteenth- and nineteenth centuries.

  16. Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures

    Institute of Scientific and Technical Information of China (English)

    HE Qing-yi; XU Jian-zhong


    To evaluate the short-term outcomes of short segmental pedicle screw fixation combined with per-cutaneous vertebroplasty in treatment of nonadjacent tho-racolumbar fractures. Methods: Twenty patients who suffered from nonadja-cent thoracolumbar fractures were treated by short segmental pedicle screw fixation for burst fracture and by percutane-ous vertebroplasty for compression fracture. X-rays, CT and MRI scans were conducted using the same protocol before and after surgery and during follow-up. Pre- and post-operative American Spinal Injury Association (ASIA) grades, fusion of fracture sites, visual analog scale (VAS) of back pain, and Oswestry disability index (ODI) were accessed. Results: All patients were followed up for an average period of 12 months. The sagittal profile of the thoracolum-bar spine was restored satisfactorily. No patient had neuro-logic deterioration after surgery, and 9 patients with incom-plete lesions improved postoperatively by at least one ASIA grade. The fusion rate was 100%. The average VAS of back pain was 7.6 preoperatively and 3.2 postoperatively. The average ODI was 72.5 preoperatively and 35.5 postoperatively. Conclusions: Short segmental pedicle screw fixation combined with percutaneous vertebroplasty in treatment of nonadjacent thoracolumbar fractures exhibits such advan-tages as preserving functional segment units, reliable fixation, good neurologic recovery and early mobilization and, therefore, is suitable for treating nonadjacent thora-columbar fractures.

  17. Management of dental implant fractures. A case history. (United States)

    Al Quran, Firas A M; Rashan, Bashar A; Al-Dwairi, Ziad N


    The widespread use of endosseous osseointegrated implants to replace missing natural teeth increases the chances of implant complications and failures, despite the high initial success rate reported in the literature. Implant fracture is one possible complication that results in ultimate failure of the dental implant. Such a complication poses a management crisis even for the most experienced clinician. This article reports on a case of implant fracture, its possible causes, and how the case was managed.

  18. Characterization of short-fibre reinforced thermoplastics for fracture fixation devices. (United States)

    Brown, S A; Hastings, R S; Mason, J J; Moet, A


    This study focuses on determining the effects of clinically relevant procedures on the flexural and fracture toughness properties of three short-fibre thermoplastic composites for potential application as fracture fixation devices. The procedures included sterilization, heat contouring and saline soaking. The three materials tested were polysulphone, polybutylene terephthalate and polyetheretherketone, all reinforced with 30% short carbon fibres. The polysulphone composite showed significant degradation in mechanical properties due to saline soaking. The polybutylene terephthalate exhibited significant degradation of mechanical properties following both contouring and saline soaking. The polyetheretherketone composite, however, exhibited no degradation in mechanical properties. The results demonstrated that flexion and fracture toughness testing were effective for determining the response of the composites to different applied conditions and demonstrated the stability of polyetheretherketone subjected to these treatments. Scanning electron microscopy demonstrated the most effective fibre-matrix bonding to be in the polyetheretherketone.

  19. Dynamic Loading Assessment at the Fifth Metatarsal in Elite Athletes with a history of Jones Fracture (United States)

    Hunt, Kenneth; Goeb, Yannick


    Objectives: Fractures of the proximal metaphysis of the fifth metatarsal (i.e., Jones fractures) are common in the athletic population and frequently require surgical fixation to optimize healing rates and return to sport. Subtle hindfoot varus alignment, which likely results in greater forces at the fifth metatarsal, has been associated with increased risk of Jones fractures due to presumed increase in forces on the lateral foot. The goal of the present study was to dynamically assess plantar pressure loads at the fifth metatarsal in elite athletes with a history of Jones fracture. We hypothesize that athletes who have suffered Jones fractures will apply significantly higher loads at the fifth metatarsal base during athletic activities compared to matched uninjured athletes. Methods: Sixteen elite, competitive athletes were recruited to participate. Eight athletes had a history of Jones fracture and eight age, gender and position-matched athletes without a history of foot injury were recruited as controls. While wearing calibrated, wireless pressure mapping insoles, all athletes performed a standardized series of athletic movements including walking, running and cutting. Tests were repeated with the patient’s standard corrective insole. Peak pressure, mean pressure, maximum force, and force-time integral (i.e., impulse) were recorded for each activity. Comparison between groups was performed using a paired Wilcoxon Sign Rank test. Results: Athletes with a history of Jones fracture showed a significantly increased peak pressure (183 ±23 kPA vs. 138±7 kPA), mean pressure (124±14 kPA vs. 95±4 kPA), and maximum force (15±1.2%BW vs. 12±1.2%BW) at the fifth metatarsal base during walking and running compared to uninjured matched controls (all Pinsole did not significantly reduce peak or mean pressure, maximum force, or impulse at the fifth metatarsal base during running or cutting. Conclusion: Athletes with a history of Jones fracture exert significantly

  20. Analysis of short-time buildup data for finite-conductivity fractures

    Energy Technology Data Exchange (ETDEWEB)

    Rosato, N.D.; Bennett, C.O.; Raghavan, R.; Reynolds, A.C.


    A finite-conductivity vertical fracture intersecting a well is considered. The well is produced at a constant rate or at a constant pressure and then is shut in. The pressure response during the buildup period and the pressure or rate response during the production period are obtained from a numerical model. In this work the authors discuss the analysis of pressure buildup data following a short flow period. The authors present a buildup type curve to analyze pressure buildup data when the pressure (or rate) response is influenced by only the bilinear flow period. This type curve can be used to estimate the fracture flow capacity and a lower limit for the fracture half-length. It will be useful when the equivalent-time or the equivalent-drawdown concepts cannot be used. The authors discuss strengths and limitations of the equivalenttime method proposed in the literature. The theoretical basis for this procedure is provided.

  1. Hip fracture history and risk of nonmelanoma skin cancer: a Danish population-based study

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    Lamberg AL


    Full Text Available Anna Lei Lamberg1,2, Anne Braae Olesen1,2, Annette Østergaard Jensen11Department of Clinical Epidemiology, 2Department of Dermatology, Aarhus University Hospital, DenmarkBackground: Vitamin D deficiency is associated with osteoporotic fractures, such as hip fracture. Sun exposure, the natural source of vitamin D, is the main risk factor for basal cell carcinoma (BCC and squamous cell carcinoma (SCC. In this study, we examined the association between a history of hip fracture and risk of BCC and SCC.Methods: We conducted a population-based case-controlled study using data on BCC and SCC cases registered in the Danish Cancer Registry from 1990–2005. For each case, we selected five population controls matched by age and gender. We used conditional logistic regression to compute odds ratios (OR and 95% confidence intervals (CI, while adjusting for chronic diseases and socioeconomic status.Results: A history of hip fracture was associated with a decreased risk of BCC (OR 0.90, 95% CI 0.85–0.94, which was most pronounced in cases of tumors on the trunk, extremities, or at multiple sites. We found no association for SCC (OR 1.07, 95% CI 0.98–1.17.Conclusion: Our study showed an inverse association between history of hip fracture and risk of BCC, but not of SCC. Sun exposure, resulting in vitamin D synthesis, may explain the link between the two diseases.Keywords: hip fracture, vitamin D, sunlight, basal cell carcinoma, squamous cell carcinoma

  2. History matching of large scale fractures to production data; Calage de la geometrie des reseaux de fractures aux donnees hydrodynamiques de production d'un champ petrolier

    Energy Technology Data Exchange (ETDEWEB)

    Jenni, S.


    Object based models are very helpful to represent complex geological media such as fractured reservoirs. For building realistic fracture networks, these models have to be constrained to both static (seismic, geomechanics, geology) and dynamic data (well tests and production history). In this report we present a procedure for the calibration of large-scale fracture networks to production history. The history matching procedure includes a realistic geological modeling, a parameterization method coherent with the geological model and allowing an efficient optimization. Fluid flow modeling is based on a double medium approach. The calibration procedure was applied to a semi-synthetic case based on a real fractured reservoir. The calibration to water-cut data was performed. (author)

  3. Undue Certainty: Where Howard Zinn's "A People's History" Falls Short (United States)

    Wineburg, Sam


    Howard Zinn's "A People's History" of the United States has few peers among contemporary historical works. With more than 2 million copies in print, "A People's History" is more than a book. It is a cultural icon. While most historians aim to examine the full historical record, Zinn picks and chooses from it. Writing persuasively, he hides the…

  4. A Short History of the International Physics Competition. (United States)

    Kunfalvi, R.


    Provides a brief history of the International Physics Competition (IPC). IPC rules, aims, organization, participants, leaders, finance, language, duration, international jury, problems, evaluation, prizes, and organizers' responsibilities are discussed. Typical problems used and problem solving methods are also discussed. (JN)

  5. A Short History of Polish-Ukrainian Terminography

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    Marek Wojciech Łukasik


    Full Text Available A Short History of Polish-Ukrainian Terminography Specialised dictionaries fulfil a plethora of linguistic and cognitive functions in specialised communication. In particular, such reference works help introduce, harmonise and standardise national terminologies, thus playing an indispensable role in disseminating high quality specialised knowledge. An even more important role may be attributed to bilingual and multilingual specialised dictionaries, whose primary goal is to facilitate the flow of scientific and technical information at an international level. This function has come to the fore in today’s multinational and interconnected professional world. In light of the developing and ever stronger cooperation between Poland and Ukraine, an attempt is being made to evaluate bilingual and multilingual terminographic works containing Polish and Ukrainian which have been published in Poland to date. The aim is to assess the positive developments and to identify the gaps in Polish-Ukrainian terminography. It is hoped that the findings presented in this paper will be applied by terminographers in order to compile terminological dictionaries of higher quality, which satisfy the needs of specific users and follow terminographic principles.   Krótka historia terminografii polsko-ukraińskiej Słowniki specjalistyczne pełnią ważne funkcje lingwistyczne i kognitywne w komunikacji specjalistycznej. W szczególności dzieła terminograficzne umożliwiają rozpowszechnianie, harmonizację i standaryzację terminologii narodowych, stając się niezbędnym narzędziem w transferze wysokiej jakości wiedzy specjalistycznej. Jeszcze ważniejszą rolę można przypisać dwu- i wielojęzycznym słownikom specjalistycznym, których prymarnym celem jest ułatwienie przepływu informacji naukowej i technicznej w wymiarze globalnym, szczególnie w dzisiejszym jednoczącym się, wielonarodowościowym świecie. W świetle rozwijającej się coraz

  6. Numerical Analysis of a Short-Term Tracer Experiment in Fractured Sandstone

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    Tai-Sheng Liou


    Full Text Available A short-term, pulse injection tracer experiment conducted in fractured quartzitic sandstone at Kukuan, Taiwan was analyzed. Tracer transport at the test site was dominated by advection but a specific attenuation mechanism leading to breakthrough curve (BTC tailing also seemed to exist. Matrix diffusion was hypothesized as the transport mechanism that results in the tailing. This hypothesis was proved by comparing the field BTC with numerical simulation results obtained by the general-purpose flow/transport simulator, TOUGH2, based on a single-fracture conceptual model. Due to the lack of accuracy of estimating the interporosity flux by the conventional double porosity model (DPM, TOUGH2 was incorporated with the multiple interacting continua (MINC scheme to simulate the transient characteristics of the interporosity flux. In MINC, rock matrix is discretized as a series of continua according to the perpendicular distance from the fracture that adjoins the matrix. The closer the rock matrix is to the fracture, the finer the rock matrix is discretized. This concept is fundamentally different from DPM in that rock matrix is no longer treated as a single continuum. Simulation results by TOUGH2-MINC have successfully reproduced the observed BTC tailing even under the dominating advection effect. Sensitivity studies showed that TOUGH2-MINC is sensitive to parameters including fracture aperture (2b, matrix porosity (nm and effective molecular diffusion coefficient in matrix (Dm. If 2b, nm , Dm , are respectively 200 _?¿m, 2%, 10-11 m2 s -1, and if hydrodynamic dispersion coefficient (D is 1.69 ¡__n10-6 m2 s -1, TOUGH2-MINC result can well fit the field BTC. Furthermore, the importance of matrix diffusion was verified by fitting the field BTC with analytical solutions that either neglect matrix diffusion or consider the mass exchange between mobile and immobile zones within the fracture as the attenuation transport mechanism. It was found that the BTC

  7. Short time-frame from first to second hip fracture in the Funen County Hip Fracture Study

    DEFF Research Database (Denmark)

    Nymark, T; Lauritsen, Jens; Ovesen, O


    Hip fracture patients represent a frail group of elderly with increased morbidity and mortality. The aim of this study was to evaluate the occurrence and distribution of a second hip fracture in the time interval between the first and the second hip fracture....

  8. Radiological Outcome of Short Segment Posterior Instrumentation and Fusion for Thoracolumbar Burst Fractures (United States)

    Morishita, Yuichiro; Yugue, Itaru; Hayashi, Tetsuo; Maeda, Takeshi; Shiba, Keiichiro


    Study Design Retrospective study. Purpose To evaluate the radiological outcome of the surgical treatment of thoracolumbar burst fractures by using short segment posterior instrumentation (SSPI) and fusion. Overview of Literature The optimal surgical treatment of thoracolumbar burst fractures remains a matter of debate. SSPI is one of a number of possible choices, yet some studies have revealed high rates of poor radiological outcome for this SSPI. Methods Patients treated using the short segment instrumentation and fusion technique at the Spinal Injuries Center (Iizuka, Fukuoka, Japan) from January 1, 2006 to July 31, 2012 were selected for this study. Radiographic parameters such as local sagittal angle, regional sagittal angle, disc angle, anterior or posterior height of the vertebral body at admission, postoperation and final observation were collected for radiological outcome evaluation. Results There were 31 patients who met the inclusion criteria with a mean follow-up duration of 22.7 months (range, 12-48 months). The mean age of this group was 47.9 years (range, 15-77 years). The mean local sagittal angles at the time of admission, post-operation and final observation were 13.1°, 7.8° and 14.8°, respectively. There were 71% good cases and 29% poor cases based on our criteria for the radiological outcome evaluation. The correction loss has a strong correlation with the load sharing classification score (Spearman rho=0.64, p<0.001). Conclusions The loss of kyphotic correction following the surgical treatment of thoracolumbar burst fracture by short segment instrumentation is common and has a close correlation with the degree of comminution of the vertebral body. Patients with high load sharing scores are more susceptible to correction loss and postoperative kyphotic deformity than those with low scores. PMID:26097659

  9. A Short History of Probability Theory and Its Applications (United States)

    Debnath, Lokenath; Basu, Kanadpriya


    This paper deals with a brief history of probability theory and its applications to Jacob Bernoulli's famous law of large numbers and theory of errors in observations or measurements. Included are the major contributions of Jacob Bernoulli and Laplace. It is written to pay the tricentennial tribute to Jacob Bernoulli, since the year 2013…

  10. A Short History of Probability Theory and Its Applications (United States)

    Debnath, Lokenath; Basu, Kanadpriya


    This paper deals with a brief history of probability theory and its applications to Jacob Bernoulli's famous law of large numbers and theory of errors in observations or measurements. Included are the major contributions of Jacob Bernoulli and Laplace. It is written to pay the tricentennial tribute to Jacob Bernoulli, since the year 2013…

  11. Short history of natural product research in the CSIR

    CSIR Research Space (South Africa)

    Walwyn, D


    Full Text Available Natural product research has been a major component of the CSIR's bioscience activities for its entire history, and particularly in the 1960s and 1970s. This type of work is also strongly aligned with one of the objectives of the CSIR, namely...

  12. Provoking Dialogue: A Short History of Outdoor Education in Ontario (United States)

    Borland, James


    History helps educators more clearly describe the role of outdoor education in improving society by fostering awareness of human-nature interconnections. Five branches have shaped outdoor education in Ontario: (1) agricultural education; (2) environmental education; (3) outdoor adventure education; (4) ecological education; and (5) climate change…

  13. A Short History of One Health in the United States. (United States)

    Cowen, Peter; Currier, Russell W; Steele, James H


    Examination of the history of the One Health idea reveals historical periods of prominence as well as periods of displacement. We trace the waxing and waning of the One Health from 18th century United States through the origins of its current renaissance in the 1960s. European One Health advances are only addressed as background for early developments in the United States. The history of One Health is best appreciated and detailed by examination of the work of its most prominent U.S. based advocates including Benjamin Rush, Adoniram B. Judson, James Law, Daniel Elmer Salmon, K.F. Meyer, Richard E. Shope,James Harlan Steele, and Calvin W Schwabe. Examination of these different One Health-based approaches highlight their value and long-term continuity in solving difficult or intractable medical, veterinary, and public health problems that are optimally addressed with a multidisciplinary perspective.

  14. Short-Term Relationship between Hip Fracture and Weather Conditions in Two Spanish Health Areas with Different Climates

    Directory of Open Access Journals (Sweden)

    José María Tenías


    Full Text Available Objective. To evaluate differences in the short-term relationship between weather conditions and the incidence of hip fracture in people aged 65 and over among two regions of Spain. Methods. Hip fracture incidence was calculated for the years 2000–2008 for residents of Health Area 14 in Valencian Community (Mediterranean climate and the “Mancha Centro” Health Area in Castilla-La Mancha (inland climate, Spain. The relationship between hip fracture incidence and weather was analyzed with a case-crossover design and explored in subgroups defined by sex, age, and fracture type. Results. In the inland area, a positive and significant tendency for hip fracture incidence was observed (annual increase: 1.5% whereas in the Mediterranean area a seasonal increase of 9% was noted in autumn and winter with respect to spring. Weather conditions, especially wind, were significantly associated with hip fracture incidence: days with more frequent windy periods and/or a greater wind velocity were associated with an increase in hip fracture incidence of 51% in the Mediterranean area and 44% in the inland area. Conclusions. Hip fracture incidence exhibits seasonal changes that differ between the Mediterranean and inland areas. The short-term relationship with climate, although similar in both areas, may partly explain these seasonal changes.

  15. Plaster of Paris-Short History of Casting and Injured Limb Immobilzation. (United States)

    Szostakowski, B; Smitham, P; Khan, W S


    Various materials have been used since ancient times to help immobilise fractures. In this review, we discuss the history and developments of these materials as well as plaster of Paris. There has been a recent trend away from non-operative management of fractures, and skills in the use of plaster of Paris are declining. For the successful treatment of patients, it is important to appreciate how plaster works, how it should be used, and what can go wrong. In this review, we also discuss principles of applications and complications of plaster of Paris.

  16. Plaster of Paris–Short History of Casting and Injured Limb Immobilzation (United States)

    Szostakowski, B.; Smitham, P.; Khan, W.S.


    Various materials have been used since ancient times to help immobilise fractures. In this review, we discuss the history and developments of these materials as well as plaster of Paris. There has been a recent trend away from non-operative management of fractures, and skills in the use of plaster of Paris are declining. For the successful treatment of patients, it is important to appreciate how plaster works, how it should be used, and what can go wrong. In this review, we also discuss principles of applications and complications of plaster of Paris. PMID:28567158

  17. Two additional augmenting screws with posterior short-segment instrumentation without fusion for unstable thoracolumbar burst fracture – Comparisons with transpedicular grafting techniques

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    Yu-Chih Lin


    Conclusions: Compared with transpedicular grafting techniques, additional two “augmenting screws” in the fracture vertebra with short-segment instrumentation are sufficient for one-level thoracolumbar burst fracture.

  18. Case report of right hamate hook fracture in a patient with previous fracture history of left hamate hook: is it hamate bipartite?

    Directory of Open Access Journals (Sweden)

    Norton Sandra


    Full Text Available Abstract Background Hamate hook fracture is a common fracture in golfers and others who play sports that involve rackets or sticks such as tennis or hockey. This patient had a previous hamate fracture in the opposing wrist along with potential features of hamate bipartite. Case presentation A 19 year old male presented with a complaint of right wrist pain on the ulnar side of the wrist with no apparent mechanism of injury. The pain came on gradually one week before being seen in the office and he reported no prior care for the complaint. His history includes traumatic left hamate hook fracture with surgical excision. Conclusion The patient was found to have marked tenderness over the hamate and with a prior fracture to the other wrist, computed tomography of the wrist was ordered revealing a fracture to the hamate hook in the right wrist. He was referred for surgical evaluation and the hook of the hamate was excised. Post-surgically, the patient was able to return to normal activity within eight weeks. This case is indicative of fracture rather than hamate bipartite. This fracture should be considered in a case of ulnar sided wrist pain where marked tenderness is noted over the hamate, especially after participation in club or racket sports.



    Pujiharto; Sudibyo, .


    This article tries to determine the factors causing the Low Malay short stories became unaccounted, especially those that were collected in Miss Koelit Koetjing (2005), in the constellation of the history of modern Indonesian literature. To answer these problems, this paper explores the criteria applied by the author of the history of Indonesian literature, comparing it with the Low Malay short stories, and relates them to their cultural historical context. The results showed the reason t...

  20. A Short History of Designing for Communication on the Web

    DEFF Research Database (Denmark)

    Heilesen, Simon


    Web design is important for how we communicate on the internet, and it also has an influence on computer interface design in general. Taking a very literal view of the theme of ‘designing for communication’, this chapter examines the development of web design as a prerequisite for understanding...... what it has become today, and it concludes by offering some reflections on the future of web design. In the first part of the chapter, the history of web design is outlined in terms of the complex interplay of various social, cultural, economic, technological and communicative factors. This section...

  1. A Short History of Designing for Communication on the Web

    DEFF Research Database (Denmark)

    Heilesen, Simon


    Web design is important for how we communicate on the internet, and it also has an influence on computer interface design in general. Taking a very literal view of the theme of ‘designing for communication’, this chapter examines the development of web design as a prerequisite for understanding...... what it has become today, and it concludes by offering some reflections on the future of web design. In the first part of the chapter, the history of web design is outlined in terms of the complex interplay of various social, cultural, economic, technological and communicative factors. This section...... concludes with the presentation of a framework for web design that allows for – if not actually reconciles – the many existing approaches to the subject. In the second part of the chapter it is suggested that web design, as it has developed so far, may be facing major changes as the requirements of users...

  2. A short history of medical informatics in bosnia and herzegovina. (United States)

    Masic, Izet


    The health informatics profession in Bosnia and Herzegovina has relatively long history. Thirty five years from the introduction of the first automatic manipulation of data, thirty years from the establishment of Society for Medical Informatics BiH, twenty years from the establishment of the Scientific journal "Acta Informatica Medica (Acta Inform Med", indexed in PubMed, PubMed Central Scopus, Embase, etc.), twenty years on from the establishment of the first Cathedra for Medical Informatics on Biomedical Faculties in Bosnia and Herzegovina, ten years on from the introduction of the method of "Distance learning" in medical curriculum. The author of this article is eager to mark the importance of the above mentioned Anniversaries in the development of Health informatics in Bosnia and Herzegovina and have attempted, very briefly, to present the most significant events and persons with essential roles throughout this period.

  3. Physics a short history from quintessence to quarks

    CERN Document Server

    Heilbron, John L


    How does the physics we know today - a highly professionalised enterprise, inextricably linked to government and industry - link back to its origins as a liberal art in Ancient Greece? What is the path that leads from the old philosophy of nature and its concern with humankind's place in the universe to modern massive international projects that hunt down fundamental particles and industrial laboratories that manufacture marvels? John Heilbron's fascinating history of physics introduces us to Islamic astronomers and mathematicians, calculating the size of the earth whilst their caliphs conquered much of it; to medieval scholar-theologians investigating light; to Galileo, Copernicus, Kepler, and Newton, measuring, and trying to explain, the universe. We visit the 'House of Wisdom' in 9th-century Baghdad; Europe's first universities; the courts of the Renaissance; the Scientific Revolution and the academies of the 18th century; the increasingly specialised world of 20th and 21st century science. Highlighting th...

  4. The Hammerhead Ribozyme: A Long History for a Short RNA. (United States)

    de la Peña, Marcos; García-Robles, Inmaculada; Cervera, Amelia


    Small nucleolytic ribozymes are a family of naturally occurring RNA motifs that catalyse a self-transesterification reaction in a highly sequence-specific manner. The hammerhead ribozyme was the first reported and the most extensively studied member of this family. However, and despite intense biochemical and structural research for three decades since its discovery, the history of this model ribozyme seems to be far from finished. The hammerhead ribozyme has been regarded as a biological oddity typical of small circular RNA pathogens of plants. More recently, numerous and new variations of this ribozyme have been found to inhabit the genomes of organisms from all life kingdoms, although their precise biological functions are not yet well understood.

  5. The Hammerhead Ribozyme: A Long History for a Short RNA

    Directory of Open Access Journals (Sweden)

    Marcos de la Peña


    Full Text Available Small nucleolytic ribozymes are a family of naturally occurring RNA motifs that catalyse a self-transesterification reaction in a highly sequence-specific manner. The hammerhead ribozyme was the first reported and the most extensively studied member of this family. However, and despite intense biochemical and structural research for three decades since its discovery, the history of this model ribozyme seems to be far from finished. The hammerhead ribozyme has been regarded as a biological oddity typical of small circular RNA pathogens of plants. More recently, numerous and new variations of this ribozyme have been found to inhabit the genomes of organisms from all life kingdoms, although their precise biological functions are not yet well understood.

  6. Treatment of Displaced Sacroiliac Fracture Using the Lateral Window for Short Plate Buttress Reduction and Percutaneous Sacroiliac Screw Fixation.

    Directory of Open Access Journals (Sweden)

    Colin Murphy


    Full Text Available Fractures through the sacroiliac joint are very challenging to treat, technically difficult to reduce through closed methods on account of the multiaxial displacement of fractures fragments, frequently occur in very unwell patients, and have poor outcomes if malreduction is present. We describe a technique utilising the lateral window and a short buttress plate to reduce and stabilize the fragments prior to percutaneous fixation with sacroiliac screws.

  7. Mapping the prescriptiome to fractures in men--a national analysis of prescription history and fracture risk

    DEFF Research Database (Denmark)

    Abrahamsen, B; Brixen, K


    . We observed an odds ratio (OR [95% CI] for any fracture) for fracture in users of dopaminergic agents (1.6 [1.3-1.9]) and iron compounds (1.2 [1.1-1.5]). The largest impact on fracture risk at population level was exerted by loop diuretics and analgesics. CONCLUSIONS: An array of drugs is associated...

  8. A Short History of the Bulletin of the History of Archaeology

    Directory of Open Access Journals (Sweden)

    Douglas R. Givens


    Full Text Available As my tenure as Editor of the Bulletin ofthe History of Archaeology (BHA draws to a close (31 December 2002,I think it useful to the readership that I provide a very brief history of the BRA covering its inception, early years, and my aspirations for its future. The BHA was just a passing idea in my mind in 1990 when I organized an Advanced Seminar held at the School of American Search (SAR in Santa Fe,New Mexico (14-18 July 1990, concerning the then current state of writing the history of archaeology for the Society for American Archaeology's Committee on theHistory.of Archaeology. To a great degree the SAR advanced seminar grew out of a seminal gathering (Visitor Scholar's Conference that Andrew Christenson had put together in 1987 at Southern Ilinois University at Carbondaie,Dlinois - a gathering of those working in the history of archaeology.

  9. A short history of waste management at the Hanford Site (United States)

    Gephart, Roy E.

    The world’s first full-scale nuclear reactors and chemical reprocessing plants built at the Hanford Site in the desert of southeastern Washington State produced two-thirds of the plutonium generated in the United States for nuclear weapons. Operating these facilities also created large volumes of radioactive and chemical waste, some of which was released into the environment exposing people who lived downwind and downstream. Hanford now contains the largest accumulation of nuclear waste in the Western Hemisphere. Hanford’s last reactor shut down in 1987 followed by closure of the last reprocessing plant in 1990. Today, Hanford’s only mission is cleanup. Most onsite radioactive waste and nuclear material lingers inside underground tanks or storage facilities. About half of the chemical waste remains in tanks while the rest persists in the soil, groundwater, and burial grounds. Six million dollars each day, or nearly two billion dollars each year, are spent on waste management and cleanup activities. There is significant uncertainty in how long cleanup will take, how much it will cost, and what risks will remain for future generations. This paper summarizes portions of the waste management history of the Hanford Site published in the book “Hanford: A Conversation about Nuclear Waste and Cleanup.” ( Gephart, 2003).

  10. Aspects of Danish Business History since 1970 - a short introduction

    Directory of Open Access Journals (Sweden)

    Mogens Rostgaard Nissen


    Full Text Available In this volume of Erhvervshistorisk Årbog, Danish Yearbook of Business History, some of the results of a large project are presented. This introduction present mainly the historical components of the project, based on studies of contemporarily sources dating back to ca. 1970. The volume consists of four articles that refer to four different industries: The textile industry, the furniture industry, the shipbuilding and marine equipment industry, and finally the shipbuilding industry and the formation of spin-off companies instead. In this project we have chosen to use the simple "smiley"-model of the value-chain. The project, called GONE, has uncovered how these industries have changed value-chain strategies, which in turn has had a major impact on those employed in these industries and for Danish society as a whole. It is indisputable that the number of persons employed in the actual manufacturing jobs has decreased very significantly in Denmark since 1970. Instead more people are working in design, purchasing, sales and branding.

  11. A short history of anti-rheumatic therapy. II. Aspirin

    Directory of Open Access Journals (Sweden)

    P. Marson


    Full Text Available The discovery of aspirin, an antipyretic, anti-inflammatory and analgesic drug, undoubtedly represents a milestone in the history of medical therapy. Since ancient times the derivatives of willow (Salix alba were used to treat a variety of fevers and pain syndromes, although the first report dates back to 1763 when the English Reverend Edward Stone described the effect of an extract of the bark willow in treating malaria. In the XIX century many apothecaries and chemists, including the Italian Raffaele Piria and Cesare Bertagnini, developed the biological processes of extraction and chemical synthesis of salicylates, and then analyzed their therapeutic properties and pharmacokinetic and pharmacodynamic characteristics. In 1899 the Bayer Company, where Felix Hoffmann, Heinrich Dreser and Arthur Eichengrün worked, recorded acetyl-salicylic acid under the name “Aspirin”. In the XX century, besides the definition of the correct applications of aspirin in the anti-rheumatic therapy being defined, Lawrence L. Crawen identified the property of this drug as an anti-platelet agent, thus opening the way for more widespread uses in cardiovascular diseases.

  12. NARRATIVE: A short history of my life in science A short history of my life in science (United States)

    Manson, Joseph R.


    institute directed by Professor Wolfgang Ernst. The story of how this particular collaboration developed is interesting because it illustrates again how important personal contacts and social interactions are in the progress of science. In 2007 I was contacted by Bodil Holst, then of the TU-Graz and now at the Technical University of Bergen in Norway, about the possibility of having one of her very bright graduate students visit Clemson for a few months as a part of his work in analyzing some He atom scattering data that they had taken on silica glass surfaces. A decade earlier Holst had been a postdoctoral research associate at the Toennies laboratory in Göttingen during several of the summers I was also there and, although we never worked directly together at that time, we had many interesting discussions about science and other subjects. The student, Wolfram Steurer, arrived in Clemson in the middle of the fall semester with his belongings in a bag that was smaller than the guitar he carried strapped over his back. He immediately created for himself a place in our department, and by the time he left three months later we had developed some rudimentary ideas of how to analyze the data he had, and we also suspected that this data might reveal some new aspects of the dynamics of glass surfaces that had not been realized before. Wolfram delved into this problem with a vengeance, and shortly afterwards we began a series of papers involving Holst, Ernst and Steurer and the Graz graduate students, Andreas Apfolter and Mattias Koch, as well as Elin Søndergård of the French CNRS laboratory located at the St Gobain Corporation's research facilities in Paris. It was this initial contact with Holst a decade earlier that eventually led to a productive period of research on glass surfaces, something that I would have never predicted beforehand, but a collaboration that shows every sign of continuing into the future to produce new and interesting results. So, this brings the history

  13. A model of short-lived outbursts on the 67P from fractured terrains (United States)

    Skorov, Yu. V.; Rezac, L.; Hartogh, P.; Bazilevsky, A. T.; Keller, H. U.


    Aims: We develop a physical model to explain the potent outbursts that occurred in the fractured terrain of comet 67P near perihelion, and predict its temporal characteristics. Methods: The feasibility of the proposed mechanism is studied using a numerical model accounting for the relevant microscopic/macroscopic processes. We rely on the thermophysical, compositional, and geo-morphological data from the published measurements of respective instruments on board Rosetta. Results: The key idea of this novel mechanism is built around observations of fractures/cracks in the region of interest. It is argued that as the stresses on the nucleus increased during the perihelion approach, a crack deepening event occurred reaching the deeper material containing super-volatile ices in equilibrium with the surrounding. This sudden opening lead to a violent sublimation of the super-volatile ices. The time scales and mass release of this process are modeled and reported. In our modeling we pay attention to the question of the existence of super-volatile ices in the deeper interior for a long time, and the thermal equilibrium in the interior. Conclusions: The deepening of pre-existing cracks (fracture) into the material containing highly volatile ices can explain the observed outburst features. The sudden disequilibration of the steady-state reservoir of highly volatile ices results in a violent release of gas and dust. The proposed mechanism also explains the rapid shut down of this activity in accordance with the observations. The proposed mechanism is independent of solar illumination history of a given region, or the pre-existance of large sealed nucleus cavities.

  14. Environment, population, and biology: a short history of modern epidemiology. (United States)

    Parodi, Alessandra; Neasham, David; Vineis, Paolo


    Since its origin in the 19th century, epidemiology has faced an internal tension between an approach oriented toward biology and the study of mechanisms, and an approach oriented toward populations and their interactions with the environment. Initially, this tension took the form of an opposition between microbiology and statistics. We describe the early roots of the quantitative approach to health and disease and several historical examples of the above tension. The search for the causes of pellagra exemplifies our thesis. In Italy, where pellagra was endemic, contrasting opinions coexisted between the hypothesis of contaminated maize, supported by Cesare Lombroso, and the hypothesis of a prevailing role of poverty and poor nutrition. In the United States, Joseph Goldberger found no evidence for the hypothesis of contaminated maize or for a microbiological agent, but recognized the central role of nutrition. The "cure" Goldberger proposed was land reform, but he continued studying the disease from a mechanistic point of view; shortly after his death, niacin deficiency was identified as the cause of pellagra. The tension between mechanistic and population-based studies is still present within epidemiology and is in fact essential for the success of the discipline.

  15. Measuring dynamic fracture toughness of cement rock using a short rod specimen

    Institute of Scientific and Technical Information of China (English)


    As Daqing Oilfield is developing oil layer with a big potential,the requirement for the quality of well cementation is higher than ever before.Cement rock is a brittle material containing a great number of microcracks and defects.In order to reduce the damage to cement ring and improve sealed cementing property at the interface,it is necessary to conduct research on the modification of the cement rock available.According to the principle of super mixed composite materials,various fillers are added to the ingredients of cement rock.Dynamic fracture toughness of cement rock will be changed under the influence of filler.In this paper,short rod specimens of cement rock are employed in the experiments to investigate the dynamic fracture toughness of cement rocks with different ingredients using split Hopkinson Pressure Bar,and partial experimental results are given.The results indicate that fiber reinforcement is an effective way to improve the impact resistance of cement rock.

  16. Outcome of Radial Head Arthroplasty in Comminuted Radial Head Fractures: Short and Midterm Results

    Directory of Open Access Journals (Sweden)



    had moderate or severe periarticular ossification, and scored substantially worse according to MEPI and Morrey. Four patients required revisional surgery due to loosening of the prosthesis and chronic pain. In addition, one patient required a neurolysis of the ulnaris nerve, one developed a neobursa, and one had extensive swelling and blistering. The time interval between injury and treatment appeared to have an effect on results. Thirty-five patients were treated within the first 5 days after accident and showed better results than the 40 patients who were treated after 5 days. Conclusions Comminuted radial head fractures with elbow instability can be treated well with a modular radial head prosthesis, which restores stability in acute treatment. The modular radial head arthroplasty used in this study showed promising findings in short to midterm results.


    Directory of Open Access Journals (Sweden)



    Full Text Available This article tries to determine the factors causing the Low Malay short stories became unaccounted, especially those that were collected in Miss Koelit Koetjing (2005, in the constellation of the history of modern Indonesian literature. To answer these problems, this paper explores the criteria applied by the author of the history of Indonesian literature, comparing it with the Low Malay short stories, and relates them to their cultural historical context. The results showed the reason that Low Malay short stories collected in Miss Koelit Koetjing were not accounted, are caused by the following factors. First, most of the short stories still retain the traditional genres, such as hikayat (saga and fairy tales, which show the strength of the cultural orientation of the past. Second, the authors of short stories are not natives; the author is not in the sense of the creator, the creator, but a storyteller, just to recount a story that has been there before. Third, short stories were published in newspapers and not in the book form. Fourth, the world of their stories came from diverse cultures and not from the world of the Indonesian archipelago. With a similar reality, it can be concluded that the short stories collected in Miss Koelit Koetjing, in the broad realm of Low Malay literature, is a literary tradition of its own in the constelation history of Indonesian literature.

  18. Implementing ground surface deformation tools to characterize field-scale properties of a fractured aquifer during a short hydraulic test (United States)

    Schuite, Jonathan; Longuevergne, Laurent; Bour, Olivier; Boudin, Frédérick; Durand, Stéphane


    In naturally fractured reservoirs, fluid flow is governed by the structural and hydromechanical properties of fracture networks or conductive fault zones. In order to ensure a sustained exploitation of resources or to assess the safety of underground storage, it is necessary to evaluate these properties. As they generally form highly heterogeneous and anisotropic reservoirs, fractured media may be well characterized by means of several complementary experimental methods or sounding techniques. In this framework, the observation of ground deformation has been proved useful to gain insight of a fractured reservoir's geometry and hydraulic properties. Commonly, large conductive structures like faults can be studied from surface deformation from satellite methods at monthly time scales, whereas meter scale fractures have to be examined under short-term in situ experiments using high accuracy intruments like tiltmeters or extensometers installed in boreholes or at the ground's surface. To the best of our knowledge, the feasability of a field scale (~ 100 m) characterization of a fractured reservoir with geodetic tools in a short term experiment has not yet been addressed. In the present study, we implement two complementary ground surface geodetic tools, namely tiltmetry and optical leveling, to monitor the deformation induced by a hydraulic recovery test at the Ploemeur hydrological observatory (France). Employing a simple purely elastic modeling approach, we show that the joint use of time constraining data (tilt) and spatially constraining data (vertical displacement) makes it possible to evaluate the geometry (dip, root depth and lateral extent) and the storativity of a hydraulically active fault zone, in good agreement with previous studies. Hence we demonstrate that the adequate use of two complementary ground surface deformation methods offer a rich insight of large conductive structure's properties using a single short term hydraulic load. Ground surface

  19. The impact of cognitive impairment at admission on short-term functional outcome of elderly hip fracture patients

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    Dubljanin-Raspopović Emilija


    Full Text Available Introduction The number of patents with dementia increases among hip fracture patients. Cognitive dysfunction is defined as a premorbid state which is potentionally negatively related to short-term functional outcome. Objective To assess the relationship between cognitive status on admission and functional gain during an early rehabilitation period in elderly hip fracture patients. Methods Forty-five elderly patients with surgically treated hip fracture were examined. Cognitive status was assessed by the Mini Mental State Examination (MMSE at admission; functional status was assessed by the motor subscale of Functional Independence Measure (FIM at admission and before discharge, while absolute functional gain was determined by the motor FIM gain (FIM discharge - FIM admission. Absolute functional gain was analyzed in respect to cognitive status. Results Both cognitively impaired and cognitively intact hip fracture patients exhibited overall FIM motor improvements, as well as functional gains in specific FIM motor areas (p<0.01. Absolute functional gain, however, was higher in 1 cognitively intact compared to cognitively impaired patients (p<0.01, and 2 cognitively moderately impaired patients compared to severely cognitively impaired patients (p<0.01. No difference in functional gain was detected between the patients with moderately cognitively impaired compared to the cognitive intact patients (p>0.05. Conclusion The systematic use of MMSE identifies cognitively impaired hip fracture patients, and effectively predicts their short-term functional outcome. A higher admission cognitive status is related to a more favorable short term rehabilitation outcome. In spite of cognitive impairment, elderly patients with hip fracture can benefit from participation in rehabilitation programmes. The systematic identification of cognitively impaired hip fracture patients at admission facilitates optimal treatment and rehabilitation, and thus enables the best

  20. Brittle fracture phase-field modeling of a short-rod specimen

    Energy Technology Data Exchange (ETDEWEB)

    Escobar, Ivana [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Tupek, Michael R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Bishop, Joseph E. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)


    Predictive simulation capabilities for modeling fracture evolution provide further insight into quantities of interest in comparison to experimental testing. Based on the variational approach to fracture, the advent of phase-field modeling achieves the goal to robustly model fracture for brittle materials and captures complex crack topologies in three dimensions.

  1. Redevelopment of the Cardium Formation using fractured horizontal wells : reservoir engineering perspectives and early case histories

    Energy Technology Data Exchange (ETDEWEB)

    Omatsone, E.N.; Bagheri, M.A.; Galas, C.M.F. [Sproule Associates Ltd., Calgary, AB (Canada); Curtis, B. [Bonterra Energy, Calgary, AB (Canada); Frankiw, K. [Midway Energy, Calgary, AB (Canada)


    The Cardium Formation holds approximately 25 percent of Alberta's total discovered conventional oil resource, which totals over 10 billion barrels of oil-in-place. However, the achieved recovery factor is only 17 percent, from a combination of primary, secondary and tertiary recovery schemes with predominantly vertical drilling in different parts of the formation. However, operators have demonstrated that redeveloping the Cardium Formation with multi-stage hydraulically fractured horizontal wells has the possibility to significantly increase production by increasing reservoir contact in the undeveloped and under-developed areas. This paper presented a short review of the historical performance of vertical wells in the low reservoir quality areas of the Cardium and described the impact of placing multi-stage fractured horizontal producers in these areas. The paper dealt with the redevelopment of the Cardium Formation from a primary recovery perspective only. It focused on the fringe areas around the super-giant Pembina field as well as the development of a mainly untapped resource in the A lobe of the Cardium in the Garrington/Caroline areas. The paper discussed the performance of the over 120 multi-stage fractured horizontals that have been placed on production from the perspective of geologic, reservoir engineering, development modeling, and economic analyses. Some proposals for typical Cardium horizontal well performance profiles for reserves assignment purposes were presented and some data-gathering and forward-modeling recommendations for Cardium operators/stakeholders were identified in order to assist them in maximizing the near- and long-term values of their assets. It was concluded that in both the Pembina fringe areas and the Garrington/Caroline area, wells with longer horizontal lengths appeared to consistently outperform those with shorter horizontal lengths. 9 refs., 2 appendices.

  2. A Quantitative Study of History in the English Short-Title Catalogue (ESTC, 1470-1800

    Directory of Open Access Journals (Sweden)

    Leo Lahti


    Full Text Available This article analyses the publication trends of history in early modern Britain and North-America, 1470-1800, based on the English Short-Title Catalogue (ESTC data. Its most important contribution is a demonstration how digitized library catalogues can become a crucial tool for scholarship and part of reproducible research. The article also suggests a novel way how to make a quantitative analysis of a particular trend in book production, namely publishing of history. This study is also our first experiment with the analysis of paper consumption in early modern book production. It demonstrates in practice the importance of open science principles for library and information science. The article studies three main research questions: 1 who wrote history 2 where was history published, and 3 how did publishing of history change over time in early modern Britain and North America. As the main findings, we demonstrate that the average book size for history publications becomes smaller over time and that the octavo-sized book is the rising vehicle of history in the eighteenth century that tells us factually about widening audiences. The article will also compare different aspects of most popular authors on history such as Edmund Burke and David Hume. While focusing on history publishing, these findings may reflect more widespread trends in publication in the early modern era, and this article illustrates how some of the key questions in this field can be assessed by statistical analysis of large-scale bibliographic data collections.

  3. A quantitative study of history in the english short-title catalogue (ESTC), 1470-1800

    NARCIS (Netherlands)

    Lahti, Leo; Ilomäki, Niko; Tolonen, Mikko


    This article analyses publication trends in the field of history in early modern Britain and North America in 1470-1800, based on English Short-Title Catalogue (ESTC) data.2 Its major contribution is to demonstrate the potential of digitized library catalogues as an essential scholasti

  4. A quantitative study of history in the english short-title catalogue (ESTC), 1470-1800

    NARCIS (Netherlands)

    Lahti, Leo; Ilomäki, Niko; Tolonen, Mikko


    This article analyses publication trends in the field of history in early modern Britain and North America in 1470-1800, based on English Short-Title Catalogue (ESTC) data.2 Its major contribution is to demonstrate the potential of digitized library catalogues as an essential scholasti

  5. A quantitative study of history in the english short-title catalogue (ESTC), 1470-1800

    NARCIS (Netherlands)

    Lahti, Leo; Ilomäki, Niko; Tolonen, Mikko


    This article analyses publication trends in the field of history in early modern Britain and North America in 1470-1800, based on English Short-Title Catalogue (ESTC) data.2 Its major contribution is to demonstrate the potential of digitized library catalogues as an essential

  6. Estimating the effect of incident delirium on short-term outcomes in aged hip fracture patients through propensity score analysis. (United States)

    Radinovic, Kristina; Markovic-Denic, Ljiljana; Dubljanin-Raspopovic, Emilija; Marinkovic, Jelena; Milan, Zoka; Bumbasirevic, Vesna


    We aimed to evaluate the factors contributing to delirium after hip fracture and assess the effect of incident delirium on short-term clinical outcomes. A total of 270 non-delirious, consecutive hip fracture patients 60 years and older were included in a prospective cohort study. The patients were assessed with respect to physical status according to the American Society of Anesthesiologists classification, medical comorbidities with the Charlson Comorbidity Index, cognitive function with the Portable Mental Status Questionnaire and depression with the Geriatric Depressive Scale. Incident delirium was evaluated daily. Clinical outcomes and 1-month mortality were recorded. Incident delirium was present in 53.0% of patients. Patients with delirium were older (P = 0.046), had higher American Society of Anesthesiologists and Charlson Comorbidity Index scores (P Scale scores (P risk of reintervention plus death (P propensity score, patients with delirium were at higher risk of reintervention plus death (P < 0.05) and longer length of hospital stay (P < 0.01). Patients who are older, with worse physical status, worse cognitive function and depression are more likely to develop delirium after hip fracture. Incident delirium has negative independent effects on short-term outcomes in elderly patients after hip fracture. © 2014 Japan Geriatrics Society.

  7. Bilateral undisplaced insufficiency neck of femur fractures associated with short-term steroid use: a case report

    Directory of Open Access Journals (Sweden)

    Gurdezi Sabahat


    Full Text Available Abstract Introduction We present an interesting and unusual case of a 61-year-old woman with bilateral, undisplaced, stress neck of femur fractures associated with short-term steroid use. Insufficiency fractures of the neck of femur without preceding trauma have been described in the literature, although bilateral involvement is infrequent. These fractures have been associated with strenuous exercise, seizures, renal osteodystrophy, fluoride treatment, long-term corticosteroid use, amenorrhoea, abnormal anatomy and osteomalacia due to nutritional and/or hormonal factors. Case Presentation The case we present differs from other published reports, in that the patient's symptoms developed acutely after only a short course of steroids and with no associated trauma or strenuous exercise. It is also the only case described where no operative intervention was required. Conclusion Our case reiterates the importance of considering insufficiency or stress fractures in high-risk patients who present with musculoskeletal pain. Institution of bone protection should also be considered in these patients. Morbidity related to delayed treatment has been well documented, so a high level of clinical suspicion is imperative.

  8. [Case-control study on the treatmentof the fifth metatarsal base fractures by cardboard compression pad versus short leg plaster]. (United States)

    Xu, Ying-peng; Xie, Li-min; Xu, Chao; Zhang, Yue; Li, Yu-bin; Qiao, Xin


    To compare the effect,safety,and advantage of flexible fixation with paperboard and pad versus short leg plaster in treating the fifth metatarsal base fracture,and establish the standard of diagnosis and treatment of the fifth metatarsal base fractures in flexible fixation with paperboard and pad. From June 2010 to March 2013,59 patients with the fifth metatarsal base fracture were treated with paperboard and pad fixation or short leg plaster. Patients were enrolled and divided into paperboard and pad treatment group (paperboard group) and short leg plaster treatment group (plaster group) randomly according to the random number table. In paperboard group,there were 29 cases including 9 males and 20 females with an average age of (51.79±11.40) years old; the average course of injury was (11.59±6.58) hours. In plaster group, there were 30 cases including 9 males and 21 females with an average age of (52.13+17.34) years old ;the average course of injury was (11.03±7.06) hours. According to whether the fracture line across the articular surface, in paperboard group there were 14 cases of type A,15 of type B; in plaster group,16 of type A, 14 of type B. According to the degree of dislocation,in paperboard group there were 16 cases of degree I ,13 of degree II ; in plaster group,20 were degree I ,10 were degree II. Fracture was restored according to the type in manual. Patients in paperboard group were treated with paperboard and pad, and patients in plaster group were treated with short leg plaster. Fracture was fixed for 4 to 6 weeks according to fracture healing. On the 2nd, 4th,6th, 8th week and 3rd, 6th month after fixation, patients were followed up, and the foot function score was used to evaluate the function of injured foot. X-ray of injured foot was taken on the 2nd, 4th, 6th and 8th week were used to assess fracture healing. All patients got complete follow-up. The X-ray result showed that all fracture reached at clinical healing on the 8th week after

  9. Catastrophic biaxial proximal sesamoid bone fractures in UK Thoroughbred races (1999-2004): horse characteristics and racing history. (United States)

    Kristoffersen, M; Parkin, T D H; Singer, E R


    Catastrophic biaxial proximal sesamoid bone fractures (PSBF) have not yet been described in detail in the UK racing population. To determine the incidence and relative risk (RR) of PSBF in different types of racing in the UK; and to describe horse-level characteristics and racing histories of horses sustaining these injuries. Distal limbs were collected from all racehorses suffering catastrophic fractures during racing at all 59 racecourses in the UK, in a prospective study from February 1999 to December 2004. Post mortem investigation identified the anatomical location and type of fracture. Horse, racing history, race and racecourse details were obtained. Characteristics of the horses that sustained PSBF were described. The incidence and RR of PSBF in the different types of racing in the UK were calculated. Thirty-one horses suffered PSBF during the study period. The incidence of PSBF in all types of race was 0.63 per 10,000 starts (31/494,744). The incidence was highest in flat races on all weather surfaces (1.63 per 10,000 starts: 12/73,467; RR = 4.4 when compared to turf flat racing). Affected horses had an average age of 5.6 years and had started a mean of 28 races at the time of fracture. There is a strong association between type of racing surface and PSBF. Horses competing in flat races on all weather surfaces have an increased risk of PSBF. These fractures appear to happen in experienced horses with several starts, with few fractures occurring within the first season of racing. Further research should focus on identification of underlying pathology of these fractures. Epidemiological studies aimed at the identification of risk factors for PSBF in the UK racing population would require a large number of cases acquired over many years given the relatively low incidence of PSBF.

  10. Short or long fusion after thoracolumbar burst fractures does not alter selected gait parameters: a preliminary study. (United States)

    Oken, Fuad; Yildirim, Ozgur; Oken, Oznur; Gulcek, Murat; Yavuzer, Gunes; Ucaner, Ahmet


    We evaluated the gait characteristics of patients who had short or long-segment fusion after thoracolumbar burst fractures. The study included 12 patients (5 male, 7 female) who had vertebral fusion after traumatic thoracolumbar region (T12-L2) burst fractures. Patients were divided into two groups based on fixation type (short or long segment). Twelve healthy age and sex-matched subjects (seven male, five female) served as controls. Quantitative gait data, including all time-distance (walking velocity, cadence, step time, step length, double support time), kinematic (joint rotation angles of pelvis, hip, knee, and ankle), and kinetic data (moments of hip in sagittal and coronal plane) were collected. Three patients had a T12, six patients an L1, and three patients had an L2 lesion. Patients in the two groups were similar in terms of age, sex, and time since operation. No significant differences were found in the time-distance, kinematic, and kinetic gait characteristics between the two groups. This preliminary study reveals that the gait characteristics of patients with short and long-segment fusion after thoracolumbar burst fractures were similar to those of healthy subjects and did not differ from each other. However, the present results should be interpreted with caution due to the small sample size. Future studies with larger groups are needed to provide additional data to validate these findings.

  11. Direct Numerical Simulation of Fracture Behaviour for Random Short Wood Fibres Reinforced Composites, Comparison with Digital Image Correlation Experiments (United States)

    Shen, M.; Touchard, F.; Bezine, G.; Brillaud, J.


    The work is to predict fracture behaviour of bio-composites from the tensile properties of its components. In this work, we have realized a direct numerical simulation of fracture behaviour for random short spruce fibers reinforced composites. For calculations, wood fibers have been considered as linear elastic bodies, polypropylene matrix as an elastic-plastic material. Then, numerical results have been compared with experimental results that have been obtained by digital image correlation. This comparison indicates that random fiber FE model of random short spruce fibers reinforced composites can be able to fairly reflect the influence of random fibers microstructure in the composite on its fracture behavior. The calculation of both random fiber and homogeneous FE model and their comparison with experiments show that the average values of J-integral in a region in the front of the crack tip from both numerical FE models are in good agreement with the average J value of DIC experiment in the same region when the numerical and experimental CT specimens of the short spruce fiber reinforced composite are subjected to the same extension at their loading point.

  12. Direct Numerical Simulation of Fracture Behaviour for Random Short Wood Fibres Reinforced Composites, Comparison with Digital Image Correlation Experiments

    Directory of Open Access Journals (Sweden)

    Brillaud J.


    Full Text Available The work is to predict fracture behaviour of bio-composites from the tensile properties of its components. In this work, we have realized a direct numerical simulation of fracture behaviour for random short spruce fibers reinforced composites. For calculations, wood fibers have been considered as linear elastic bodies, polypropylene matrix as an elastic-plastic material. Then, numerical results have been compared with experimental results that have been obtained by digital image correlation. This comparison indicates that random fiber FE model of random short spruce fibers reinforced composites can be able to fairly reflect the influence of random fibers microstructure in the composite on its fracture behavior. The calculation of both random fiber and homogeneous FE model and their comparison with experiments show that the average values of J-integral in a region in the front of the crack tip from both numerical FE models are in good agreement with the average J value of DIC experiment in the same region when the numerical and experimental CT specimens of the short spruce fiber reinforced composite are subjected to the same extension at their loading point.

  13. A Simple Analytical Approach to Simulate Underbalanced- drilling in Naturally Fractured Reservoirs—The Effect of Short Overbalanced Conditions and Time Effect

    Directory of Open Access Journals (Sweden)

    Knut Inge Andersen


    Full Text Available This paper describes an analytical approach to investigate the nature of short overbalanced conditions and time effects during underbalanced drilling (UBD in a naturally fractured reservoir. This study uses an analytical model which is developed for kinetic invasion of mud into the fractures. The model is based on fluid flow between two parallel plates, which is further extended to model the fluid flow in a fractured formation. The effect of short overbalanced pressure and the time effect during UBD as well as the aspects of well productivity and flow efficiency are explained. This model is an Excel-based program and provides a fast and convenient tool for analysis and evaluation of drilling conditions (mud properties, time, and pressure of drilling in a fractured formation. The model can also predict the impact of the fracture and mud properties on the depth of invasion in the fractured formations.

  14. Short- and long-term results following standing fracture repair in 34 horses. (United States)

    Payne, R J; Compston, P C


    Standing fracture repair in the horse is a recently described surgical procedure and currently there are few follow-up data. This case series contains 2 novel aspects in the standing horse: repair of incomplete sagittal fractures of the proximal phalanx and medial condylar repair from a lateral aspect. To describe outcome in a case series of horses that had lower limb fractures repaired under standing sedation at Rossdales Equine Hospital. Case records for all horses that had a fracture surgically repaired, by one surgeon at Rossdales Equine Hospital, under standing sedation and local anaesthesia up until June 2011, were retrieved. Hospital records, owner/trainer telephone questionnaire and the Racing Post website were used to evaluate follow-up. Thirty-four horses satisfied the inclusion criteria. Fracture sites included the proximal phalanx (incomplete sagittal fracture, n = 14); the third metacarpal bone (lateral condyle, n = 12, and medial condyle, n = 7); and the third metatarsal bone (lateral condyle, n = 1). One horse required euthanasia due to caecal rupture 10 days post operatively. Twenty horses (66.7% of those with available follow-up) have returned to racing. Where available, mean time from operation to return to racing was 226 days (range 143-433 days). Standing fracture repair produced similar results to fracture repair under general anaesthesia in terms of both the number of horses that returned to racing and the time between surgery and race. Repair of lower limb fracture in the horse under standing sedation is a procedure that has the potential for tangible benefits, including avoidance of the inherent risks of general anaesthesia. The preliminary findings in this series of horses are encouraging and informative when discussing options available prior to fracture repair. © 2012 EVJ Ltd.

  15. Effects of fibre content on mechanical properties and fracture behaviour of short carbon fibre reinforced geopolymer matrix composites

    Indian Academy of Sciences (India)

    Tiesong Lin; Dechang Jia; Meirong Wang; Peigang He; Defu Liang


    Geopolymer matrix composites reinforced with different volume fractions of short carbon fibres (Cf/geopolymer composites) were prepared and the mechanical properties, fracture behaviour and microstructure of as-prepared composites were studied and correlated with fibre content. The results show that short carbon fibres have a great strengthening and toughening effect at low volume percentages of fibres (3.5 and 4.5 vol.%). With the increase of fibre content, the strengthening and toughening effect of short carbon fibres reduce, possibly due to fibre damage, formation of high shear stresses at intersect between fibres and strong interface cohesion of fibre/matrix under higher forming pressure. The property improvements are primarily based on the network structure of short carbon fibre preform and the predominant strengthening and toughening mechanisms are attributed to the apparent fibre bridging and pulling-out effect.

  16. Short-term follow-up of pertrochanteric fractures treated using the proximal femoral locking plate. (United States)

    Johnson, Benjamin; Stevenson, Jonathan; Chamma, Ramsey; Patel, Amit; Rhee, Shin-Jae; Lever, Caroline; Starks, Ian; Roberts, Phillip J


    The proximal femoral locking compression plate is a fixed angled anatomically contoured stainless steel plate used to treat pertrochanteric fractures of the proximal femur. Recent reports quote a high failure rate associated with this implant. We aimed to identify the common methods of failure and determine the elements of surgical techniques that could be altered to potentially improve outcomes should this implant be used for the treatment of unstable pertrochanteric fractures. Retrospective chart analysis. Three separate centers. Twenty-nine patients with 29 fractures. All patients were treated for pertrochanteric fractures using the proximal femoral locking compression plate. The patient demographics, fracture classification, implant details, and complications. Twelve of 29 fractures (41.4%) suffered a complication associated with the implant, and 83% of these occurred in elderly women. Complications included bending, backing-out, fracture, or cut-out of the proximal screws and plate fracture. Common technical errors included the following: (1) leaving the plate proud proximally, (2) malposition of the proximal screws within the femoral neck/head, (3) inappropriate use of the hook plate, (4) creating too ridged a construct when used as a bridging plate. Our experience with the use of this implant suggests an unacceptably high failure rate (41.4%). A knowledge of the common pitfalls encountered when using this device is critical in an effort to reduce failure rates. Based on our data, we would urge caution when considering this device for unstable pertrochanteric fractures, especially in the elderly female. Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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

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


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

  18. Long-term functional results after short-segment pedicle fixation of thoracolumbar fractures

    DEFF Research Database (Denmark)

    Mølmer, Michael; Gehrchen, Poul Martin; Dahl, Benny


    A retrospective study to assess the health-related quality of life in patients undergoing posterior fixation of thoracolumbar fractures, and to compare the outcome with norm scores and HRQL in patients undergoing surgical treatment for degenerative conditions of the spine.......A retrospective study to assess the health-related quality of life in patients undergoing posterior fixation of thoracolumbar fractures, and to compare the outcome with norm scores and HRQL in patients undergoing surgical treatment for degenerative conditions of the spine....

  19. The Use of Posterior Short Segment Screw Fixation and Balloon Kyphoplasty in the Surgical Treatment of Traumatic Vertebral Fracture: A Case Report

    Directory of Open Access Journals (Sweden)

    Sevim Ondul


    Full Text Available Surgical treatments for the fracture of the spine are frequently used in clinical practice. Posterior spine stabilization with transpedicular screw fixation is one of the surgical treatment methods in the surgical treatment of spinal fractures. A 48-year old male patient was admitted to our hospital with a diagnosis of the L1 compression fracture resulting from traumatic injury. Posterior transpedicular screws were placed at one level above and one level below of the fractured vertebrate. Anterior column of the fractured vertebrate was strengthened with balloon kyphoplasty application. The system was completed with the placement of transverse rods. Fusion with allograft was performed. According to the ASIA neurological grading system, the patient was assessed as Grade E. 10 cm skin and fascia incision was done. Operation time of about 70 minutes and blood loss was less than 100 cc. The patient was mobilized on the first day of surgery and was discharged from the hospital on the third day after the surgery. Short segment transpedicular fixation on the one level above and one level below of the fractured vertebrate together with balloon kyphoplasty on the corpus of the fractured vertebrate may be used as a minimally invasive surgical treatment in such kind of injuries. The advantages are short duration of hospital stay, less blood loss, providing early mobilization, and a reliable method for fixation and stabilization. In this article, a case with traumatic fracture that fixed and stabilized with short segment transpedicular screw placement and balloon kyphoplasty application was presented.

  20. Before the Tiger Stripes: A History of Fracturing in the South Polar Terrain of Enceladus (United States)

    Patthoff, D. A.; Kattenhorn, S. A.


    Extending for over 120 km, four fairly linear fractures (dubbed tiger stripes) stand out against the background of much shorter, but more numerous, fractures in the tectonically diverse south-polar region of Enceladus. The tiger stripes, and the plumes generated along them, have been the focus of numerous studies, leaving many of the smaller features largely ignored. Using the most recently available Cassini spacecraft images, we have created detailed maps revealing three additional relict, tiger stripe-like fracture sets among the smaller fractures. These old tiger stripe-like features have similar characteristics, but different orientations, to the present-day tiger stripes. The younger fractures have cut and deformed the older fractures, making them much less prominent than the named tiger stripes. However, the older fracture sets do retain some long, over 40 km, linear features. We believe these longer features once looked similar to the present day tiger stripes, before they were rotated away from the primary stress field in which they formed and were overprinted by younger features. By using crosscutting relationships, we were able to establish relative ages of the three old systematic fracture sets and the tiger stripes to determine the sequence of fracturing in the south polar terrain (SPT). The fracture sets show a counterclockwise progression in orientation through time which implies the causal SPT stress field created distinct fracture sets at different points in time, gradually rotating approximately 153° counterclockwise relative to the present day surface and culminating in the stress field that produced the tiger stripes. Older fracture sets clearly influenced the development of younger sets. For example, the tiger stripe Alexandria Sulcus inherited a portion of an older fracture along part of its length, creating a distinct jog along the otherwise nearly linear feature. Similar geometries occur at other locations where younger tiger stripes

  1. Short-term mortality in hip fracture patients admitted during weekends and holidays

    DEFF Research Database (Denmark)

    Foss, N B; Kehlet, H


    Acute surgical admission during weekends, with reduced staffing levels, has been associated with increased risk of mortality, but the effect of longer vacation/holiday periods has not been studied. We therefore examined early postoperative mortality in hip fracture patients admitted during weekends...

  2. Pace bowlers in cricket with history of lumbar stress fracture have increased risk of lower limb muscle strains, particularly calf strains

    Directory of Open Access Journals (Sweden)

    John Orchard


    Full Text Available John Orchard1, Patrick Farhart2, Alex Kountouris3, Trefor James3, Marc Portus31School of Public Health, University of Sydney, Australia; 2Punjab Kings XI team, Indian Premier League, India; 3Cricket Australia, Melbourne, AustraliaObjective: To assess whether a history of lumbar stress fracture in pace bowlers in cricket is a risk factor for lower limb muscle strains.Methods: This was a prospective cohort risk factor study, conducted using injury data from contracted first class pace bowlers in Australia during seasons 1998–1999 to 2008–2009 inclusive. There were 205 pace bowlers, 33 of whom suffered a lumbar stress fracture when playing first class cricket. Risk ratios ([RR] with 95% confidence intervals[CI] were calculated to compare the seasonal incidence of various injuries between bowlers with a prior history of lumbar stress fracture and those with no history of lumbar stress fracture.Results: Risk of calf strain was strongly associated with prior lumbar stress fracture injury history (RR = 4.1; 95% CI: 2.4–7.1. Risks of both hamstring strain (RR = 1.5; 95% CI: 1.03–2.1 and quadriceps strain (RR = 2.0; 95% CI: 1.1–3.5 were somewhat associated with history of lumbar stress fracture. Risk of groin strain was not associated with history of lumbar stress fracture (RR = 0.7; 95% CI: 0.4–1.1. Other injuries showed little association with prior lumbar stress fracture, although knee cartilage injuries were more likely in the non-stress fracture group.Conclusion: Bony hypertrophy associated with lumbar stress fracture healing may lead to subsequent lumbar nerve root impingement, making lower limb muscle strains more likely to occur. Confounders may be responsible for some of the findings. In particular, bowling speed is likely to be independently correlated with risk of lumbar stress fracture and risk of muscle strain. However, as the relationship between lumbar stress fracture history and calf strain was very strong, and that there is a

  3. Sex effects on short-term complications after hip fracture: a prospective cohort study

    Directory of Open Access Journals (Sweden)

    Ekström W


    Full Text Available Wilhelmina Ekström,1 Bodil Samuelsson,2 Sari Ponzer,3 Tommy Cederholm,4,5 Karl-Göran Thorngren,6 Margareta Hedström7 1Department of Molecular Medicine and Surgery, Section of Orthopaedics and Sports Medicine, Karolinska Institutet, Karolinska University Hospital, Solna, 2Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, 3Department of Clinical Science and Education, Section of Orthopaedics, Karolinska Institutet, Södersjukhuset, Stockholm, 4Department of Public Health and Caring Sciences, 5Department of Geriatrics, Uppsala University, Uppsala University Hospital, Uppsala, 6Department of Clinical Sciences, Lund, Orthopaedics, Lund University, Lund, 7Department of Orthopaedics, Institute of Clinical Science, Intervention and Technology (CLINTEC, Karolinska University Hospital, Huddinge, Stockholm, Sweden Objectives: To evaluate potential sex differences and other factors associated with complications within 4 months after a hip fracture.Methods: A total of 1,915 patients ≥65 years (480 men with hip fracture were consecutively included in a prospective multicenter cohort study. A review of medical records and patient interviews according to a study protocol based on the Standardized Audit of Hip Fractures in Europe (SAHFE, RIKSHÖFT was performed. Sex differences in comorbidity according to the American Society of Anesthesiologists score and complications 4 months after a hip fracture were registered. Multivariate logistic regression analysis was performed to identify factors related to complications.Results: Male sex was associated with worse general health according to the American Society of Anesthesiologists classification (P=0.005 and with more comorbidities (P<0.001. Male sex emerged as a risk factor for developing pneumonia (P<0.001, and additionally, 18% of the men suffered from cardiac complications compared with 13% of the females (P=0.018. Female sex was predisposed for urinary tract infections, 30% vs 23

  4. Short review: Potential impact of delamination cracks on fracture toughness of structural materials

    Directory of Open Access Journals (Sweden)

    X.C. Arnoult


    Full Text Available The current energy policy envisages extended lifetime for the current nuclear power plants (GEN II NPP. This policy imposes a large research effort to understand the ageing of power plant components. In this goal, it is necessary to improve knowledge about safety, reliability and components’ integrity for more than forty years of operation. In Central and Eastern Europe, the majority of NPPs are VVER types, where some of the components are produced from austenitic steel 08Ch18N10T. Irradiated 08Ch18N10T may exhibit brittle behavior, namely delamination cracks are found in some cases on the fracture surface of irradiated 08Ch18N10T with elongated δ-ferrite. Delamination cracks have also been observed on the fracture surface of high-strength steels or aluminum-lithium alloys. This article presents a state-of-the art review to provide a detailed analysis of the influence of delamination cracks on the toughness of metal alloys. In general, the delamination cracks are present in metal alloys having a high texture and microstructure anisotropy. Three types of delamination cracks have been observed and are classified as crack arrester delamination, crack divider delamination and crack splitting delamination. The microscopy characterization, 3D fracture theories and computational studies explaining possible causes and effects of delamination cracks on the mechanical properties of metal alloys are presented.

  5. Leak of a fractured miter, a contributing factor to a refinery fire in Kuwait: a case history

    Energy Technology Data Exchange (ETDEWEB)

    Alawi, H.; Akbar, A.; Al-Ameeri, R.; Akasha, S.


    Fatigue cracks in the welds of a fabricated and tested miter (specification, ASA B 31.3-1962 Code) were concluded to be the source of the leak which fueled a spark at the initial fire site in the Shuaiba Industrial Area of the State of Kuwait on 20 August 1981, which caused one death, some injuries and initial losses close to (100 million dollars. The stress history of the fractured miter is presented. Stress corrosion fatigue cracking was concluded to be the mechanism of the failure. (author).

  6. A Concise History of Asperger Syndrome: The Short Reign of a Troublesome Diagnosis. (United States)

    Barahona-Corrêa, J B; Filipe, Carlos N


    First described in 1944 by Hans Asperger (1944), it was not before 1994 that Asperger Syndrome (AS) was included in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders, only to disappear in the Manual's fifth edition in 2013. During its brief existence as a diagnostic entity, AS aroused immense interest and controversy. Similar to patients with autism, AS patients show deficits in social interaction, inappropriate communication skills, and interest restriction, but also display a rich variety of subtle clinical characteristics that for many distinguish AS from autism. However, difficulties operationalising diagnostic criteria and differentiating AS from autism ultimately led to its merging into the unifying category of Autistic Spectrum Disorders. Here we briefly review the short history of this fascinating condition.

  7. A Concise History of Asperger Syndrome: the short reign of a troublesome diagnosis

    Directory of Open Access Journals (Sweden)

    Bernardo eBarahona-Correa


    Full Text Available First described in 1944 by Hans Asperger, it was not before 1994 that Asperger Syndrome (AS was included in the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders, only to disappear in the Manual’s 5th edition in 2013. During its brief existence as a diagnostic entity, AS aroused immense interest and controversy. Similar to patients with autism, AS patients show deficits in social interaction, inappropriate communication skills, and interest restriction, but also display a rich variety of subtle clinical characteristics that for many distinguish AS from autism. However, difficulties operationalising diagnostic criteria and differentiating AS from autism ultimately led to its merging into the unifying category of Autistic Spectrum Disorders. Here we briefly review the short history of this fascinating condition.

  8. A review on the young history of the wind power short-term prediction

    DEFF Research Database (Denmark)

    Costa, A.; Crespo, A.; Navarro, J.


    This paper makes a brief review on 30 years of history of the wind power short-term prediction, since the first ideas and sketches on the theme to the actual state of the art oil models and tools, giving emphasis to the most significant proposals and developments. The two principal lines of thought...... the same in order to compare two models (this fact makes it almost impossible to carry out a quantitative comparison between a huge number of models and methods). In place of a quantitative description, a qualitative approach is preferred for this review, remarking the contribution (and innovative aspect......) of each model. On the basis of the review, some topics for future research are pointed out....

  9. Dust environment and dynamical history of a sample of short period comets

    CERN Document Server

    Pozuelos, F J; Aceituno, F; Casanova, V; Sota, A; López-Moreno, J J; Castellano, J; Reina, E; Diepvens, A; Betoret, A; Häusler, B; González, C; Rodríguez, D; Bryssinck, E; Cortés, E; García, F; García, F; Limón, F; Grau, F; Fratev, F; Baldrís, F; Rodriguez, F A; Montalbán, F; Soldán, F; Muler, G; Almendros, I; Temprano, J; Bel, J; Sánchez, J; Lopesino, J; Báez, J; Hernández, J F; Martín, J L; Ruiz, J M; Vidal, J R; Gaitán, J; Salto, J L; Aymamí, J M; Bosch, J M; Henríquez, J A; Martín, J J; Lacruz, J; Tremosa, L; Lahuerta, L; Reszelsky, M; Rodríguez, M; Camarasa, M; Campas, M; Canales, O; Dekelver, P J; Moreno, Q; Benavides, R; Naves, R; Dymoc, R; García, R; Lahuerta, S; Climent, T


    Aims. In this work, we present an extended study of the dust environment of a sample of short period comets and their dynamical history. With this aim, we characterized the dust tails when the comets are active, and we made a statistical study to determine their dynamical evolution. The targets selected were 22P/Kopff, 30P/Reinmuth 1, 78P/Gehrels 2, 115P/Maury, 118P/Shoemaker-Levy 4, 123P/West-Hartley, 157P/Tritton, 185/Petriew, and P/2011 W2 (Rinner). Methods. We use two different observational data: a set of images taken at the Observatorio de Sierra Nevada and the Afrho curves provided by the amateur astronomical association Cometas-Obs. To model these observations, we use our Monte Carlo dust tail code. From this analysis, we derive the dust parameters, which best describe the dust environment: dust loss rates, ejection velocities, and size distribution of particles. On the other hand, we use a numerical integrator to study the dynamical history of the comets, which allows us to determine with a 90% of co...

  10. A review on the young history of the wind power short-term prediction

    Energy Technology Data Exchange (ETDEWEB)

    Costa, Alexandre; Navarro, Jorge [Wind Energy, Division of Renewable Energies, Department of Energy, CIEMAT, Av. Complutense, 22, Ed. 42, 28044 Madrid (Spain); Crespo, Antonio [Laboratorio de Mecanica de Fluidos, Departmento de Ingenieria Energetica y Fluidomecanica, ETSII, Universidad Politecnica de Madrid, C/Jose Gutierrez Abascal, 2-28006 Madrid (Spain); Lizcano, Gil [Oxford University Centre for the Environment, University of Oxford, South Parks Road, Oxford OX1 3QY (United Kingdom); Madsen, Henrik [Informatics and Mathematical Modelling - IMM, Technical University of Denmark, Richard Petersens Plads, Building 321, Office 019, 2800 Kgs. Lyngby (Denmark); Feitosa, Everaldo [Brazilian Wind Energy Centre - CBEE, Centro de Tecnologia e Geociencias, UFPE-50.740-530 Recife, PE (Brazil)


    This paper makes a brief review on 30 years of history of the wind power short-term prediction, since the first ideas and sketches on the theme to the actual state of the art on models and tools, giving emphasis to the most significant proposals and developments. The two principal lines of thought on short-term prediction (mathematical and physical) are indistinctly treated here and comparisons between models and tools are avoided, mainly because, on the one hand, a standard for a measure of performance is still not adopted and, on the other hand, it is very important that the data are exactly the same in order to compare two models (this fact makes it almost impossible to carry out a quantitative comparison between a huge number of models and methods). In place of a quantitative description, a qualitative approach is preferred for this review, remarking the contribution (and innovative aspect) of each model. On the basis of the review, some topics for future research are pointed out. (author)

  11. Concomitant upper limb fractures and short-term functional recovery in hip fracture patients: does the site of upper limb injury matter? (United States)

    Di Monaco, Marco; Castiglioni, Carlotta; Vallero, Fulvia; Di Monaco, Roberto; Tappero, Rosa


    The aim of this study was to evaluate functional recovery in a subgroup of hip fracture patients who sustained a simultaneous fracture at the upper limb, taking into account the site of upper limb injury. Of 760 patients admitted consecutively to the authors' rehabilitation hospital because of a fall-related hip fracture, 700 were retrospectively investigated. Functional outcome was assessed using Barthel Index scores. In 49 of the 700 patients, a single fall resulted in both a hip fracture and a fracture of either wrist (n = 34) or proximal humerus (n = 15). The patients with concomitant shoulder fractures had lower median Barthel Index scores after rehabilitation (70 vs. 90, P = 0.003), lower median Barthel Index effectiveness (57.1 vs. 76.9, P = 0.018), and prolonged median length of stay (42 vs. 36 days, P = 0.011) than did the patients with isolated hip fractures. Significant differences persisted after adjustment for six potential confounders. The adjusted odds ratio for achieving a Barthel Index score lower than 85 was 6.71 (95% confidence interval, 1.68-26.81; P = 0.007) for the patients with concomitant shoulder fractures. Conversely, no prognostic disadvantages were associated with concomitant wrist fractures. Data show a worse functional recovery and a prolonged length of stay in the subgroup of hip fracture patients who sustained a concomitant fracture at the proximal humerus, but not at the wrist.

  12. Effect of a Home Bleaching Agent on the Fracture Toughness of Resin Composites: using short rod design

    Directory of Open Access Journals (Sweden)

    Bagheri R.


    Full Text Available Statement of Problem: Resin composites are brittle materials and their major shortcomings are manifested in their sensitivity to flaws and defects. Although various mechanical properties of resin composites have been described, few studies are available on assessing the effect of bleaching agents on resin composites using the short rod design. Materials and Method: Specimens were prepared from three resin composites; Rok (SDI, Esthet (Dentsply, and Estelite (Tokuyama. For each material, a total of 24 disc-shaped specimens were prepared using a custom-made mould. Specimens were randomly divided into 3 groups of 8 and conditioned in 37°C distilled water for either 24 hours, or 21 days. 21 day specimens were tested both with and without applying bleaching agent; Polanight (SDI. Study group specimens were bleached for 21 days, 2 hours a day. The specimens were loaded using a universal testing machine with a crosshead speed of 0.5 mm per minute. The maximum load at specimen failure was recorded and the KIc (MPa. M 0.5 was calculated. Results: Statistical analysis using two-way ANOVA showed a significant relationship between material and time (p< 0.05. Tukey’s test showed that after 24 h of immersion in distilled water, Rok revealed the highest KIc followed by Esthet and Estelite. The bleaching agent significantly improved the fracture toughness values of Esthet while it decreased that of Estelite. Conclusion: The fracture toughness of the resin composites was affected by the bleaching agent and distilled water. In comparison with Rok and Estelite, fracture toughness of Esthet was increased due to aging and application of bleaching agent.

  13. «Short Course in History of Ukraine» in the Context of Soviet Scientific History of late 1940s

    Directory of Open Access Journals (Sweden)

    Lubov A. Sidorova


    Full Text Available The contribution considers one of the events of ideological campaign, struggling for cosmopolitism, bourgeois objectivism and nationalism in Soviet historical science of the late 1940s. Special attention is attached to the consideration of the model “Short Course in History of Ukraine” as the instrument of political and ideological verification.

  14. [Analysis of reason and strategy for the failure of posterior pedicle screw short-segment internal fixation on thoracolumbar fractures]. (United States)

    Xing, Jin-Ming; Peng, Wen-Ming; Shi, Chu-Yun; Xu, Lei; Pan, Qi-Huao


    To analyze the reason and strategy for failure of posterior pedicle screw short-segment internal fixation on thoracolumbar fractures. From March 2008 to December 2010,the clinical data of 18 patients with thoracolumbar fracture failed in posterior pedicle screw short-segment internal fixation were retrospectively analyzed. There were 11 males and 7 females with an average age of 37.2 years (ranged, 19 to 63). The time from the first operation to complication occurrence was from 6 to 44 months with an average of 14.3 months. Of them,fusion failure was in 7 cases (combined with screw breakage in 4 cases), the progressive neuro-dysfunction was in 5 cases,the progressive lumbodorsal pain was in 6 cases. All 18 patients with kyphosis were treated with anterior internal fixation remaining posterior fixation (9 cases) and anterior internal fixation after posterior fixation removal (9 cases). All the patients were followed up from 18 to 50 months with an average of 30.5 months. No intetnal fixation loosening and breakage were found, moreover, X-ray and lamellar CT showed bone healing well. Preoperative, postoperative at 3 months and at final follow-up, ODI score was respectively 31.6+/-5.1, 8.6+/-5.7, 8.3+/-3.2; VAS score was respectively 7.2+/-2.3, 2.3+/-0.7, 2.1+/-1.1; kyphosis angle was respectively (-21.2/-+7.8 degreeso, (-5.3+/-6.8 degrees ), (-5.8+/-7.8 )degrees. Compared with preoperative data ,above-listed items had obviously ameliorated(Pinternal fixation may result in the complications such as bone nonunion ,internal fixation breakage and progressive kyphosis. Anterior reconstruction may be a good strategy for the failure of posterior operation.

  15. A Short History of International Business in Italy: What We Know and How We Know It

    Directory of Open Access Journals (Sweden)

    Veronica Binda


    Full Text Available This article is a voyage through the history of international business in Italy, one which takes contemporary studies and, in particular, studies conducted over time by business historians from the Italian Unification until the present day, into account. After a brief introduction, the first part of the article is devoted to an analysis of the literature, especially focusing on the early studies conducted on foreign capital until World War Two, on the investigations done in the second part of the twentieth century, and on the most recent trends and contributions in research. The second part of the article deals, in a stylised way, with a very short summary of the principal information that we have attained on foreign direct investments in the country, with a special focus on international business in Italy before the Great War, in the inter-war years, until the 1980s, and in the most recent decades. Finally, the conclusions indicate the possible main directions for future research in this field.

  16. Short (

    NARCIS (Netherlands)

    Telleman, Gerdien; den Hartog, Laurens


    Aim: This systematic review assessed the implant survival rate of short (<10 mm) dental implants installed in partially edentulous patients. A case report of a short implant in the posterior region have been added. Materials and methods: A search was conducted in the electronic databases of MEDLINE

  17. Short (

    NARCIS (Netherlands)

    Telleman, Gerdien; den Hartog, Laurens


    Aim: This systematic review assessed the implant survival rate of short (<10 mm) dental implants installed in partially edentulous patients. A case report of a short implant in the posterior region have been added. Materials and methods: A search was conducted in the electronic databases of MEDLINE

  18. Short-term Natural History of High-Risk Human Papillomavirus Infection in Mid-Adult Women Sampled Monthly (Short title: Short-term HPV Natural History in Mid-Adult Women) (United States)

    Fu, Tsung-chieh (Jane); Xi, Long Fu; Hulbert, Ayaka; Hughes, James P.; Feng, Qinghua; Schwartz, Stephen M.; Hawes, Stephen E.; Koutsky, Laura A.; Winer, Rachel L.


    Characterizing short-term HPV detection patterns and viral load may inform HPV natural history in mid-adult women. From 2011–2012, we recruited women aged 30–50 years. Women submitted monthly self-collected vaginal samples for high-risk HPV DNA testing for 6 months. Positive samples were tested for type-specific HPV DNA load by real-time PCR. HPV type-adjusted linear and Poisson regression assessed factors associated with 1) viral load at initial HPV detection and 2) repeat type-specific HPV detection. One-hundred thirty-nine women (36% of 387 women with ≥4 samples) contributed 243 type-specific HR HPV infections during the study; 54% of infections were prevalent and 46% were incident. Incident (versus prevalent) detection and past pregnancy were associated with lower viral load, whereas current smoking was associated with higher viral load. In multivariate analysis, current smoking was associated with a 40% (95%CI:5%–87%) increase in the proportion of samples that were repeatedly positive for the same HPV type, whereas incident (versus prevalent) detection status and past pregnancy were each associated with a reduction in the proportion of samples repeatedly positive (55%,95%CI:38%–67% and 26%,95%CI:10%–39%, respectively). In a separate multivariate model, each log10 increase in viral load was associated with a 10% (95%CI:4%–16%) increase in the proportion of samples repeatedly positive. Factors associated with repeat HPV detection were similar to those observed in longer-term studies, suggesting that short-term repeat detection may relate to long-term persistence. The negative associations between incident HPV detection and both viral load and repeat detection suggest that reactivation or intermittent persistence was more common than new acquisition. PMID:25976733

  19. Inulin and erythritol as sucrose replacers in short-dough cookies: sensory, fracture, and acoustic properties. (United States)

    Laguna, Laura; Primo-Martín, Cristina; Salvador, Ana; Sanz, Teresa


    The effect of sucrose replacement by erythritol and inulin was studied in short-dough cookies using instrumental and sensory analysis. Two levels of replacement were used (25% and 50% of total sucrose content). Descriptive sensory analysis showed that the sucrose replacement affects visual and texture cookies characteristics, being the differences perceived by mouth greater than by hand. In general, sucrose substitutes produced a less crispy cookie and lower consumer acceptability, with the exception of 25% sucrose replacement by inulin. Matrix aeration attributes such as open and crumbly obtained by trained panel were important properties, and correlated positively with consumer acceptance and negatively with maximum force at break (hardness). Inulin cookies sensory properties were more similar to the control than the erythritol cookies. Also, consumer overall acceptance decreased significantly with sucrose replacement by erythritol. The analysis of texture and sound revealed that inulin cookies were softer whereas erythritol cookies were harder in comparison with control cookies; despite this difference, inulin cookies had similar sound characteristics to erythritol cookies.

  20. The Retrospective Analysis of Posterior Short-Segment Pedicle Instrumentation without Fusion for Thoracolumbar Burst Fracture with Neurological Deficit

    Directory of Open Access Journals (Sweden)

    Zhouming Deng


    Full Text Available This study aims to investigate the efficacy of posterior short-segment pedicle instrumentation without fusion in curing thoracolumbar burst fracture. All of the 53 patients were treated with short-segment pedicle instrumentation and laminectomy without fusion, and the restoration of retropulsed bone fragments was conducted by a novel custom-designed repositor (RRBF. The mean operation time and blood loss during surgery were analyzed; the radiological index and neurological status were compared before and after the operation. The mean operation time was 93 min (range: 62–110 min and the mean intraoperative blood loss was 452 mL in all cases. The average canal encroachment was 50.04% and 10.92% prior to the surgery and at last followup, respectively (P<0.01. The preoperative kyphotic angle was 17.2 degree (±6.87 degrees, whereas it decreased to 8.42 degree (±4.99 degrees at last followup (P<0.01. Besides, the mean vertebral body height increased from 40.15% (±9.40% before surgery to 72.34% (±12.32% at last followup (P<0.01. 45 patients showed 1-2 grades improvement in Frankel’s scale at last followup. This technique allows for satisfactory canal clearance and restoration of vertebral body height and kyphotic angle, and it may promote the recovery of neurological function. However, further research is still necessary to confirm the efficacy of this treatment.

  1. 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 ve

  2. Combined anterior and posterior decompression and short segment fixation for unstable burst fractures in the dorso lumbar region.

    Directory of Open Access Journals (Sweden)

    Ramani P


    Full Text Available The dorso lumbar segment of spine (D10 to L2 is an unstable zone between fixed dorsal and mobile lumbar spine. A combined anterior and posterior approach with short segment stabilization was found most appropriate. Thirty cases were treated over a period of 4 years and 6 months. There were 26 male and 4 female patients with mean age of 32.6 years. L1 vertebra was fractured in 17 cases, D1 in 8 cases, D11 in 4 cases and D10 in one case. 14 cases had total neurological deficit, 9 cases had partial and 7 had no neurological deficit. We have used three column classification of Denis to assess the cases. Seven patients returned to regular physical work, 5 had restricted physical work, 5 remained in full time light job and 9 patients were unable to return to original job but did some work. Most had flaccid paraplegia but 4 patients were completely disabled due to spastic paraplegia. Neurological recovery occurred in all the patients with partial paralysis, and appeared to be dependent on initial kyphosis. The overall recovery rate varied from 50% to 90%. There is no correlation between canal compromise and severity of injury. Neurological injury occured at the time of trauma, rather than as a result of pressure of fragment in the canal. No strong conclusion could be drawn to say that the results of surgery were superior to non-operative treatment.

  3. Case-control study of high-speed exercise history of Thoroughbred and Quarter Horse racehorses that died related to a complete scapular fracture. (United States)

    Vallance, S A; Entwistle, R C; Hitchens, P L; Gardner, I A; Stover, S M


    Identification of exercise history patterns that are related to catastrophic scapular fracture will facilitate prevention of racehorse fatalities. To determine if exercise patterns are associated with scapular fracture in Thoroughbred (TB) and Quarter Horse (QH) racehorses. High-speed exercise histories for 65 TB and 26 QH racehorses that had a complete scapular fracture (cases) and 2 matched control racehorses were retrospectively studied. Exercise variables were created from lifetime race and official timed workout reports. Associations between exercise variables and scapular fracture were investigated using conditional logistic regression. Thoroughbreds with a scapular fracture had a greater number of workouts, events (combined works and races), and mean event distances than QHs with a scapular fracture. Quarter Horses worked less frequently and accumulated distance at a lower rate than TBs. Breed differences were not found for career race number or length, time between races or lay-up variables for horses with ≥1 lay-up. For both breeds, cases had fewer events, lower recent accumulated distance and fewer active days in training than controls; however, a subset of TB cases with >10 events since lay-up had a longer active career than controls. For QHs that had a lay-up, total and mean lay-up times were greater for cases than controls. Multivariable models revealed that odds ratios (OR) of scapular fracture were greater for TBs that had not yet raced (OR = 23.19; 95% confidence interval (CI) 3.03-177.38) and lower for QHs with more events (OR = 0.71; 95% CI 0.54-0.94). Racehorses that are in early high-speed training but behind that of their training cohort should be examined for signs of scapular stress remodelling. Quarter Horses that had a prolonged lay-up and TBs that have endured high-speed training for a longer duration than that of their training cohort also were at greater risk. © 2012 EVJ Ltd.

  4. New Bathymetry Reveals Detailed History of Transform Fault Segmentation at the Clarion Fracture Zone (United States)

    Morrow, T. A.; Kim, S. S.; Mittelstaedt, E. L.; Olive, J. A. L.; Howell, S. M.


    Between 150°W and 135°W, the Clarion Fracture Zone (FZ) coalesces from six discrete FZ traces to a single FZ over a period of 30 million years, coinciding with a change in plate motion that placed the associated transform fault (TF) in compression. Although FZ observations suggest segmented TFs may unify to a single TF as a response to tectonic compression, little is known about the timing of this process, as well as how it may alter lithosphere structure. Using new bathymetry and gravity data from the Clarion FZ, we investigate this process through interpreted structural maps of the seafloor, numerical simulations of a segmented FZ, and modeling of gravitational anomalies. From 3154 mapped volcanic ridges and faults, we observe temporally correlated changes in intra-transform spreading center (ITSC) fabrics and plate motions that suggest that ITSC fabrics further from the center of the FZ responded to compressional changes in plate motion sooner (up to 5 million years) than ITSC fabrics located near the center of the FZ. Using the 2D finite-difference, visco-elastic-plastic code SiStER, we simulate the tectonic evolution of a differentially cooling lithosphere broken by several FZs and subject to compression or extension. We vary parameters such as the number of initial ITSC segments (0-4) and the rate of compression or extension (0-4.5 mm/year). In some model cases, we also vary the strength of the initial FZ offset by introducing small, low-viscosity weaknesses in the modeled lithosphere at the FZ. Gravity anomalies are calculated from the simulated lithospheric structure by using Talwani's 2D polygon algorithm. We then compare model predicted and existing satellite-derived gravity anomalies over the segmented Clarion FZ to constrain the relative timing of compressional changes along individual transform segment traces and structural changes within the FZ. Our observations suggest that compression and extension are not uniformly distributed across a segmented

  5. Treatment of acute thoracolumbar burst fractures with kyphoplasty and short pedicle screw fixation: Transpedicular intracorporeal grafting with calcium phosphate: A prospective study

    Directory of Open Access Journals (Sweden)

    Korovessis Panagiotis


    Full Text Available Background: In the surgical treatment of thoracolumbar fractures, the major problem after posterior correction and transpedicular instrumentation is failure to support the anterior spinal column, leading to loss of correction and instrumentation failure with associated complaints. We conducted this prospective study to evaluate the outcome of the treatment of acute thoracolumbar burst fractures by transpedicular balloon kyphoplasty, grafting with calcium phosphate cement and short pedicle screw fixation plus fusion. Materials and Methods : Twenty-three consecutive patients of thoracolumbar (T 9 to L 4 burst fracture with or without neurologic deficit with an average age of 43 years, were included in this prospective study. Twenty-one from the 23 patients had single burst fracture while the remaining two patients had a burst fracture and additionally an adjacent A1-type fracture. On admission six (26% out of 23 patients had neurological deficit (five incomplete, one complete. Bilateral transpedicular balloon kyphoplasty with liquid calcium phosphate to reduce segmental kyphosis and restore vertebral body height and short (three vertebrae pedicle screw instrumentation with posterolateral fusion was performed. Gardner kyphosis angle, anterior and posterior vertebral body height ratio and spinal canal encroachment were calculated pre- to postoperatively. Results : All 23 patients were operated within two days after admission and were followed for at least 12 months after index surgery. Operating time and blood loss averaged 45 min and 60 cc respectively. The five patients with incomplete neurological lesions improved by at least one ASIA grade, while no neurological deterioration was observed in any case. The VAS and SF-36 (Role physical and Bodily pain domains were significantly improved postoperatively. Overall sagittal alignment was improved from an average preoperative 16° to one degree kyphosis at final follow-up observation. The anterior

  6. A Short Cultural-Astronomical History on Asteroids, Comets and Meteors in Romania (United States)

    Grigore, V.; Gheorghe, A. D.


    The poster presents significant moments in astronomy history and culture of meteors, comets and asteroids in Romania and the modern role of the Romanian Society for Meteors and Astronomy (SARM) in research, education, and culture in these fields.

  7. Historie

    DEFF Research Database (Denmark)

    Poulsen, Jens Aage

    Historie i serien handler om læreplaner og læremidler og deres brug i skolefaget historie. Bogen indeholder nyttige redskaber til at analysere og vurdere læremidler......Historie i serien handler om læreplaner og læremidler og deres brug i skolefaget historie. Bogen indeholder nyttige redskaber til at analysere og vurdere læremidler...

  8. Efficacy of a short multidisciplinary falls prevention program for elderly persons with osteoporosis and a fall history: a randomized controlled trial.

    NARCIS (Netherlands)

    Smulders, E.; Weerdesteijn, V.G.M.; Groen, B.E.; Duysens, J.E.J.; Eijsbouts, A.; Laan, R.F.J.M.; Lankveld, W.G.J.M. van


    OBJECTIVE: To evaluate the efficacy of the Nijmegen Falls Prevention Program (NFPP) for persons with osteoporosis and a fall history in a randomized controlled trial. Persons with osteoporosis are at risk for fall-related fractures because of decreased bone strength. A decrease in the number of fall


    Directory of Open Access Journals (Sweden)



    Full Text Available INTRODUCTION Neglected, untreated and delayed neck femur fractures are commonly encountered fractures and the treatment dilemma arises specially when the patient is physiologically young and osteosynthesis is the preferred option. Past literature creates confusion as the various head salvage surgeries like valgus subtrochanteric osteotomy, non-vascularised fibular bone grafting, muscle pedicle bone grafting (Tensor fascia lata (TFL and Quadratus femoris graft and vascularised bone grafting do not have clear lines of indications. We present a series of fracture neck femur cases, each with delayed presentation beyond the vascular emergency period, which were treated with osteosynthesis with MPBG using tensor fascia lata muscle pedicle graft.

  10. Consequences of extreme life history traits on population persistence: do short-lived gobies face demographic bottlenecks? (United States)

    Lefèvre, Carine D.; Nash, Kirsty L.; González-Cabello, Alonso; Bellwood, David R.


    The majority of coral reef goby species are short-lived, with some highly abundant species living less than 100 d. To understand the role and consequences of this extreme life history in shaping coral reef fish populations, we quantitatively documented the structure of small reef fish populations over a 26-month period (>14 short-lived fish generations) at an inshore reef on the Great Barrier Reef, Australia. Most species with life spans >1 yr, such as pomacentrids, exhibited a peak in recruitment during the austral summer, driving seasonal changes in the small fish community composition. In contrast, there were no clear changes in goby community composition, despite the abundance of short-lived, high turnover species. Species of Eviota, the most abundant gobiid genus observed, showed remarkably similar demographic profiles year-round, with consistent densities of adults as well as recently recruited juveniles. Our results demonstrate ongoing recruitment of these small cryptic fishes, which appears to compensate for an exceptionally short life span on the reef. Our results suggest that gobiid populations are able to overcome demographic limitations, and by maintaining reproduction, larval survival and recruitment throughout the year, they may avoid population bottlenecks. These findings also underline the potential trophodynamic importance of these small species; because of this constant turnover, Eviota species and other short-lived fishes may be particularly valuable contributors to the flow of energy on coral reefs, underpinning the year-round trophic structure.

  11. History of medical informatics in europe - a short review by different approach. (United States)

    Mihalas, George; Zvarova, Jana; Kulikowski, Casimir; Ball, Marion; van Bemmel, Jan; Hasman, Arie; Masic, Izet; Whitehouse, Diane; Barber, Barry


    The panel intended to collect data, opinions and views for a systematic and multiaxial approach for a comprehensive presentation of "History of Medical Informatics", treating both general (global) characteristics, but emphasizing the particular features for Europe. The topic was not only a subject of large interest but also of great importance in preparing a detailed material for celebration of forty years of medical informatics in Europe. The panel comprised a list of topics, trying to cover all major aspects to be discussed. Proposals of staging the major periods of medical informatics history were also discussed.

  12. Short report: Influence of culture and trauma history on autobiographical memory specificity. (United States)

    Humphries, Clare; Jobson, Laura


    This study investigated the influence of culture and trauma history on autobiographical memory specificity. Chinese international and British undergraduate university students (N=64) completed the autobiographical memory test, Hopkins symptom checklist-25, twenty statements test, trauma history questionnaire, and impact of events scale-revised. The results indicated that the British group provided significantly more specific memories than the Chinese group. The high trauma exposure group provided significantly fewer specific autobiographical memories than the low trauma exposure group. The interaction was not significant. The findings suggest that even in cultures where specificity is not as evident in autobiographical remembering style, trauma exposure appears to exert similar influence on autobiographical memory specificity.

  13. Pace bowlers in cricket with history of lumbar stress fracture have increased risk of lower limb muscle strains, particularly calf strains


    John Orchard; Patrick Farhart; Alex Kountouris; et al.


    John Orchard1, Patrick Farhart2, Alex Kountouris3, Trefor James3, Marc Portus31School of Public Health, University of Sydney, Australia; 2Punjab Kings XI team, Indian Premier League, India; 3Cricket Australia, Melbourne, AustraliaObjective: To assess whether a history of lumbar stress fracture in pace bowlers in cricket is a risk factor for lower limb muscle strains.Methods: This was a prospective cohort risk factor study, conducted using injury data from contracted first class pace bowlers i...



    A. S. Zolotov; S. A. Dubovyy


    The article is devoted to the history of one of the methods of conservative treatment humeral transcondylar extensor fractures in children - a method «collar and cuff». The second and very common name of this method is connected with the name of the american orthopaedist Walter Blount. «The method of Blount» is mentioned in many domestic and foreign sources. Nevertheless the analysis of publications on the history of the discussed method of treatment indicates the priority in this matter othe...

  15. The short-tailed Albatross, Diomedea albatrus, its status, distribution and natural history (United States)

    Hasegawa, H.; DeGange, A.R.


    The Short-tailed Albatross (Diomedea albatrus) is presently an Endangered Species that was formerly abundant in the North Pacific. Owing to the activities of feather hunters operating on the albatross's nesting grounds for a 50-year period in the late 19th and early 20th centuries, the species was almost reduced to extinction. The Short-tailed Albatross is the largest of the three species of Diomedea that breed in the North Pacific (Table 1) and when mature is the only albatross in the North Pacific with a white back.

  16. Home Economics as an Academic Discipline: A Short History. Topical Paper No. 15. (United States)

    Carver, Marie Negri

    The history of the home economics curriculum is traced from the late nineteenth century. The importance of the ideas of Sir Francis Bacon and Count Rumford in providing the philosophical justification for the application of science to everyday living is emphasized. The establishment of land grant colleges and women's colleges in the nineteenth…

  17. The "M" in SMEC: A Short History of the Mathematics Education Presence (United States)

    Malone, John A.


    In this paper I examine the history of the integration of mathematics education into the Science Education Centre, which had been established by physicist, John de Laeter, within the School of Science and Engineering at Curtin University in Perth, Australia. De Laeter's vision for science education was that teachers should have access to…

  18. A Short History of the Fibonacci and Golden Numbers with Their Applications (United States)

    Debnath, Lokenath


    This article deals with a brief history of Fibonacci's life and career. It includes Fibonacci's major mathematical discoveries to establish that he was undoubtedly one of the most brilliant mathematicians of the Medieval Period. Special attention is given to the Fibonacci numbers, the golden number and the Lucas numbers and their fundamental…

  19. History of medical informatics in Europe-a short review by different approach

    NARCIS (Netherlands)

    G. Mihalas (George); J. Zvárová (Jana); C. Kulikowski; M. Ball (Marion); J.H. van Bemmel (Jan); A.P.M. Hasman (Arie); I. Masic (Izet); D. Whitehouse (Diane); B. Barber (Barry)


    textabstractThe panel intended to collect data, opinions and views for a systematic and multiaxial approach for a comprehensive presentation of "History of Medical Informatics", treating both general (global) characteristics, but emphasizing the particular features for Europe. The topic was not only

  20. The Bratsk Organization of the Union of Architects of Russia: A Short Excursion to the History

    Directory of Open Access Journals (Sweden)

    Victoria Astrakhantseva


    Full Text Available The article presents the history of the Bratsk Organization of the Union of Architects of Russia, from formation of the Bratsk Branch of the Union of Architects of the USSR in 1974 and its transformation into an independent organization in 1992, until the present time.

  1. Home Economics as an Academic Discipline: A Short History. Topical Paper No. 15. (United States)

    Carver, Marie Negri

    The history of the home economics curriculum is traced from the late nineteenth century. The importance of the ideas of Sir Francis Bacon and Count Rumford in providing the philosophical justification for the application of science to everyday living is emphasized. The establishment of land grant colleges and women's colleges in the nineteenth…


    NARCIS (Netherlands)


    The crustose tetrasporophyte of the red alga Acrosymphyton purpuriferum is a qualitative short-day plant in the formation of its tetrasporangia. The critical daylength for the response was determined in plants precultured in various long-day regimes [20:4, 18:6, 16:8 and 14:10 (L:D, h)]. There was a

  3. Interaction Histories and Short Term Memory: Enactive Development of Turn-taking Behaviors in a Childlike Humanoid Robot

    CERN Document Server

    Broz, Frank; Kose-Bagci, Hatice; Dautenhahn, Kerstin


    In this article, an enactive architecture is described that allows a humanoid robot to learn to compose simple actions into turn-taking behaviors while playing interaction games with a human partner. The robot's action choices are reinforced by social feedback from the human in the form of visual attention and measures of behavioral synchronization. We demonstrate that the system can acquire and switch between behaviors learned through interaction based on social feedback from the human partner. The role of reinforcement based on a short term memory of the interaction is experimentally investigated. Results indicate that feedback based only on the immediate state is insufficient to learn certain turn-taking behaviors. Therefore some history of the interaction must be considered in the acquisition of turn-taking, which can be efficiently handled through the use of short term memory.

  4. A short history of stochastic integration and mathematical finance: the early years, 1880–1970


    Jarrow, Robert; Protter, Philip


    We present a history of the development of the theory of Stochastic Integration, starting from its roots with Brownian motion, up to the introduction of semimartingales and the independence of the theory from an underlying Markov process framework. We show how the development has influenced and in turn been influenced by the development of Mathematical Finance Theory. The calendar period is from 1880 to 1970.

  5. XtalView, protein structure solution and protein graphics, a short history. (United States)

    McRee, Duncan E; Israel, Mark


    From a user's point-of-view we are in the Golden Age of protein crystallographic software. In the past few decades, solving protein structures has gone from a task requiring man-months of effort to a process requiring minutes on an ordinary laptop with no human intervention required. The birth of XtalView coincided with the mainstream use of synchrotron radiation, seleno-Met phasing and it continues to be used in this age of robotic crystallization, Fed-Ex data collection and fully automated structure solution "pipelines". This article is a retrospective history of protein crystallographic computing and a discussion of the current state of the art.

  6. A short history of anti-rheumatic therapy - VII. Biological agents

    Directory of Open Access Journals (Sweden)

    B. Gatto


    Full Text Available The introduction of biological agents has been a major turning-point in the treatment of rheumatic diseases, particularly in rheumatoid arthritis. This review describes the principle milestones that have led, through the knowledge of the structure and functions of nucleic acids, to the development of production techniques of the three major families of biological agents: proteins, monoclonal antibodies and fusion proteins. A brief history has also been traced of the cytokines most involved in the pathogenesis of inflammatory rheumatic diseases (IL-1 and TNF and the steps which have led to the use of the main biological drugs in rheumatology: anakinra, infliximab, adalimumab, etanercept and rituximab.

  7. Assessment of fracture risk

    Energy Technology Data Exchange (ETDEWEB)

    Kanis, John A. [WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX (United Kingdom)], E-mail:; Johansson, Helena; Oden, Anders [WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX (United Kingdom); McCloskey, Eugene V. [WHO Collaborating Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield S10 2RX (United Kingdom); Osteoporosis Centre, Northern General Hospital, Sheffield (United Kingdom)


    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.

  8. Enlightening symbols a short history of mathematical notation and its hidden powers

    CERN Document Server

    Mazur, Joseph


    While all of us regularly use basic math symbols such as those for plus, minus, and equals, few of us know that many of these symbols weren't available before the sixteenth century. What did mathematicians rely on for their work before then? And how did mathematical notations evolve into what we know today? In Enlightening Symbols, popular math writer Joseph Mazur explains the fascinating history behind the development of our mathematical notation system. He shows how symbols were used initially, how one symbol replaced another over time, and how written math was conveyed before and after symbols became widely adopted. Traversing mathematical history and the foundations of numerals in different cultures, Mazur looks at how historians have disagreed over the origins of the numerical system for the past two centuries. He follows the transfigurations of algebra from a rhetorical style to a symbolic one, demonstrating that most algebra before the sixteenth century was written in prose or in verse employing the wr...

  9. [A short history of thrombosis: concepts and therapies from ancient to modern times]. (United States)

    Karenberg, A


    Historians of thrombosis usually cover a period from mid-19th to late 20th century, thus highlighting the era of scientific progress. The present study, however, follows history farther back to its earlier stages which harbour crucial elements for understanding later epochs and the present-day state of the art. Relevant primary sources and secondary material as well as selected illustrations were identified and interpreted in their historical context. Early concepts drew upon the doctrine passed on by the Greeks that thrombosis originated form "metastases" formed by phlegm and black bile. Whereas scholars of the Middle Ages concerned themselves with haematoscopy as a "prototype" of diagnostic investigation, those of early modern times focused on mechanistic and morphological factors when formulating aetiological concepts of thrombosis and embolism. With Rudolf Virchow and his consolidated findings the modern age of positivist research began. During the following era of technological progress, new and scientifically tested treatments as well as prophylactic interventions replaced empirically based cures. The history of thrombosis is characterized by a multitude of different paradigms. Time will tell if innovative therapeutic strategies developed during the last two decades will lead to the next important paradigm change. © Georg Thieme Verlag KG Stuttgart · New York.

  10. The `M' in SMEC: a short history of the mathematics education presence (United States)

    Malone, John A.


    In this paper I examine the history of the integration of mathematics education into the Science Education Centre, which had been established by physicist, John de Laeter, within the School of Science and Engineering at Curtin University in Perth, Australia. De Laeter's vision for science education was that teachers should have access to professional education that allowed them to extend their discipline and pedagogical knowledge using strategies that brought together theory and practice in ways that were meaningful for teachers. This model was expanded when mathematics education was also included, paving the way also for technology education. I present the history of this integration laying out the themes that are important for the continued educational effectiveness of the Science and Mathematics Education Centre (SMEC) and the role that mathematics education has played in this process. As the title suggests, this article focuses on the activities of the group of mathematics educators who have worked within the Science and Mathematics Education Centre of Curtin University since it was established 30 or so years ago and who have contributed to its reputation. The two streams operated then and now more-or-less independently in matters of student thesis topic choice but offered students opportunities for interaction that might not have been available if the "M" had not been incorporated into the Science Education Centre (SEC). This article's focus is on the mathematics educators who contributed to the Centre's success and reputation, highlighting the synergistic relationship between mathematics and science that helped to make SMEC a leading center for mathematics and science education.

  11. A short history of evolutionary theory Uma breve história da teoria evolutiva

    Directory of Open Access Journals (Sweden)

    Edson Perreira da Silva


    Full Text Available The history of the Theory of Evolution has been told a number of times by historians, philosophers, professors, writers, scientists and so on. However, many of these versions differ from or even contradict one another. In this article, the history of the Theory of Evolution is retold according to a dialectical-materialistic perspective. It analyzes the historical contradictions between Darwinian evolution theory and Mendel's model, the background that led to the synthetic theory of evolution, the debate carried out by classic schools and the result of synthesis, as well as the still current debate between Neutralism and Selectionism. Finally, it also discusses the interpretative model used ("an idiosyncratic dialectic materialism", mainly in relation with Popper's and Kuhn's models.A história da teoria evolutiva tem sito contada inúmeras vezes por historiadores, filósofos, professores, escritores, cientistas etc. Contudo, muitas destas versões diferem entre si ou mesmo se contradizem. Neste trabalho, a história da teoria evolutiva é recontada a partir de uma perspectiva materialista dialética. São analisadas as contradições históricas entre a teoria evolutiva darwiniana e o modelo mendeliano, o caminho para a teoria sintética da evolução, o debate entre as escolas clássica e do balanco que sucedeu a síntese, bem como o debate, ainda atual, entre neutralismo e selecionismo. Ao final, o modelo interpretativo utilizado ("um materialismo dialético idiossincrático" é discutido, principalmente, em relação aos modelos popperiano e kuhniano.

  12. Arthroplasty versus Internal Fixation for Displaced Intracapsular Femoral Neck Fracture in the Elderly: Systematic Review and Meta-analysis of Short- and Long-term Effectiveness

    Institute of Scientific and Technical Information of China (English)

    Chen-Yi Ye; An Liu; Ming-Yuan Xu; Nwofor Samuel Nonso; Rong-Xin He


    Background:There is conflicting evidence as to whether the femoral head should be preserved or replaced in elderly patients with displaced intracapsular femoral neck fractures.In this article,we performed a systematic review and meta-analysis to compare the short-and long-term effectiveness of arthroplasty (AR) and internal fixation (IF).Methods:PubMed,Embase,and the Cochrane Library were searched systematically up to January 2016.All randomized controlled trials directly comparing the effectiveness of AR and IF for displaced intracapsular fracture were retrieved with no limitation on language or publication year.Results:In total,eight prospective randomized studies involving 2206 patients were included.The results of our study showed that patients in the AR group reported significantly lower complication (risk ratio:0.56,95% confidence interval [CI] =0.38-0.80),re-operation (risk ratio:0.17,95% CI =0.13-0.22),revision rates (risk ratio:0.11,95% CI:0.08-0.16),and better function compared with their IF counterparts,and they were less likely to suffer postoperative pain.No statistically significant differences for the rates of mortality,infection,and/or deep vein thrombosis between AR and IF were found.Conclusions:Based on our analysis,we recommend that AR should be used as the primary treatment for displaced intracapsular femoral neck fractures in the elderly.However,IF may be appropriate for those who are very frail.

  13. The contribution of intellectuals to the history of traumatology during the Renaissance: treatment of femoral fracture through François Rabelais' glossocomion. (United States)

    Manzini, Francesco; Manzini, Claudio; Cesana, Giancarlo; Riva, Michele Augusto


    During the Middle Ages and the Renaissance, intellectuals often included clinical cases and medical descriptions in their literary works. These authors appeared to be more interested in internal and infectious diseases rather than in musculoskeletal disorders and orthopaedics. François Rabelais (1490-1553) was one of the most renowned humanists and philologists of the sixteenth century. He was also a physician with an interest in translating ancient texts of medical authors. Rabelais rediscovered a device for treating femoral fracture originally described by the Roman physician Galen and named as glossocomion. Since the original apparatus had some imperfections, Rabelais redesigned and modified it. This new, improved version became a model for new devices for treating femoral fracture, as also reported by the great French surgeon Ambroise Paré. For this contribution, Rabelais deserves major consideration in the history of orthopaedics and traumatology.

  14. Health-related Quality of Life in Accordance with Fracture History and Comorbidities in Korean Patients with Osteoporosis (United States)

    Kwon, Hye-Young; Ha, Yong-Chan


    Background The purpose of this study was to explore health-related quality of life (HRQOL) among Korean patients with osteoporosis and to measure the impact of fractures and comorbidity on their quality of life (QOL) using the Korean National Health and Nutrition Examination Survey (KNHANES) data with a nationwide representativeness. Methods This study was based on 4-year-data obtained from the KNHANES 2008 to 2011. Osteoporosis was diagnosed in 2,078 survey participants according to their bone mineral density measurements using dual energy X-ray absorptiometry. According to the World Health Organization study group, T-scores at or above -1.0 are considered normal, those between -1.0 and -2.5 as osteopenia, and those at or below -2.5 as osteoporosis The EuroQol five-dimensional questionnaire (EQ-5D) index score was used to assess the QOL. Results Of 2,078 patients diagnosed with osteoporosis, fractures were found to occur at 11.02%. Wrist fracture was the most frequent, affecting 4.52% of the patients, with a significantly different prevalence among men and women (Prelated diseases. Conclusions We found that low health utility was associated with previous spine fracture and comorbidities in patients with osteoporosis. In particular, the number of fracture experiences greatly deteriorated the HRQOL in patients with osteoporosis. Thus, prevention of secondary fractures and chronic care model for comorbidities should be a priority for osteoporosis management in order to improve HRQOL. PMID:27965941

  15. Interactions of grazing history, cattle removal and time since rain drive divergent short-term responses by desert biota.

    Directory of Open Access Journals (Sweden)

    Anke S K Frank

    Full Text Available Arid grasslands are used worldwide for grazing by domestic livestock, generating debate about how this pastoral enterprise may influence native desert biota. One approach to resolving this question is to experimentally reduce livestock numbers and measure the effects. However, a key challenge in doing this is that historical grazing impacts are likely to be cumulative and may therefore confound comparisons of the short-term responses of desert biota to changes in stocking levels. Arid areas are also subject to infrequent flooding rainfalls that drive productivity and dramatically alter abundances of flora and fauna. We took advantage of an opportunity to study the recent effects of a property-scale cattle removal on two properties with similarly varied grazing histories in central Australia. Following the removal of cattle in 2006 and before and after a significant rainfall event at the beginning of 2007, we sampled vegetation and small vertebrates on eight occasions until October 2008. Our results revealed significant interactions of time of survey with both grazing history and grazing removal for vascular plants, small mammals and reptiles. The mammals exhibited a three-way interaction of time, grazing history and grazing removal, thus highlighting the importance of careful sampling designs and timing for future monitoring. The strongest response to the cessation of grazing after two years was depressed reproductive output of plants in areas where cattle continued to graze. Our results confirm that neither vegetation nor small vertebrates necessarily respond immediately to the removal of livestock, but that rainfall events and cumulative grazing history are key determinants of floral and faunal performance in grassland landscapes with low and variable rainfall. We suggest that improved assessments could be made of the health of arid grazing environments if long-term monitoring were implemented to track the complex interactions that influence

  16. A short history of nomograms and tables used for thermal radiation calculations (United States)

    Stewart, Seán. M.; Johnson, R. Barry


    The theoretical concept of a perfect thermal radiator, the blackbody, was first introduced by the German physicist Gustav Robert Kirchhoff in 1860. By the latter half of the nineteenth century it had become the object of intense theoretical and experimental investigation. While an attempt at trying to theoretically understand the behavior of radiation emitted from a blackbody was undertaken by many eminent physicists of the day, its solution was not found until 1900 when Max Planck put forward his now famous law for thermal radiation. Today, of course, understanding blackbody behavior is vitally important to many fields including infrared systems, illumination, pyrometry, spectroscopy, astronomy, thermal engineering, cryogenics, and meteorology. Mathematically, the form Planck's law takes is rather cumbersome meaning calculations made with it before the advent of modern computers were rather tedious, dramatically slowing the process of computation. Fortunately, during those early days of the twentieth century researchers quickly realized Planck's equation, and the various functions closely related to it, readily lend themselves to being given a graphical, mechanical, or numerically tabulated form for their evaluation. The first of these computational aids to appear were tables. These arose shortly after Planck introduced his equation, were produced in the greatest number, and remained unsurpassed in their level of accuracy compared to all other aids made. It was also not long before nomograms designed to aid thermal radiation calculations appeared. Essentially a printed chart and requiring nothing more than a straightedge to use, nomograms were cheap and extremely easy to use. Facilitating instant answers to a range of quantities relating to thermal radiation, a number were produced and the inventiveness displayed in some was quite remarkable. In this paper we consider the historical development of many of the nomograms and tables developed and used by generations

  17. Keeping track of hidden dangers - The short history of the Sabiá virus

    Directory of Open Access Journals (Sweden)

    Joel Henrique Ellwanger

    Full Text Available Abstract Emerging infectious diseases are a global threat. In countries like Brazil, where biodiversity is high and public health conditions in terms of infrastructure and medical care are often precarious, emerging diseases are particularly worrisome. The lack of monitoring strategies to identify pathogens with the potential to cause outbreaks or epidemics is another problem in Brazil and other developing countries. In this article, we present the history of the Sabiá virus (SABV, a pathogen that was described in the 1990s in Brazil. Several aspects of the biology and ecology of the SABV remain unknown. The SABV has the potential to cause hemorrhagic fever in humans. To date, four cases of human infections have been reported worldwide; two were naturally acquired (both in Brazil, whereas the other two were linked to occupational exposure in the laboratory environment (one in Brazil and one in the USA. In this review, we summarize the basic biological and ecological characteristics of the SABV. This is the first work to gather all available data on the historical aspects involving the cases of SABV infection along with an update on its characteristic features.

  18. [Comparison between the short program and the long program of post-operative rehabilitation of hip fracture for making the critical path]. (United States)

    Abe, T; Tsuchida, N; Ishibashi, H; Yamamoto, S


    Patients receiving operative treatment for fracture are good candidate for critical path management. Recently, we have developed a Short Program (SP) for post-operative rehabilitation of hip fractures. The purpose of this study was to evaluate the effectiveness, the safety and the cost efficiency of this SP, by comparing it with the former Long Program (LP) in terms of choosing the better program for the critical path. The enrolled patients were over 65 years old, had been able to walk by themselves with or without canes, were free from neurological diseases like hemiplegia and Parkinson's disease, and without pathological fractures. We enrolled 101 patients (mean age: 83.1) for the LP and 143 patients (mean age: 82.8) for the SP. The operative procedure for these patients was internal fixation with a sliding hip screw or prosthetic replacement for a femoral head. Length of hospitalization, the rate of recovering walking ability, medical expenses during hospitalization, and the types and incidence of complications were investigated to determine differences between the SP and the LP. Length of hospitalization was significantly shorter in SP patients (p fever complications than the LP group (p < 0.05). As a result, the SP was superior to the LP in terms of effectiveness, safety and cost efficiency, thus it was considered to be suitable for critical path management of hip fracture cases. However, because recovery of walking ability was harder for patients over 85 years old with the SP than with the LP, a modified program is necessary for such older patients.

  19. From separations to reconstitution - a short history of Plutonium in the U.S. and Russia

    Energy Technology Data Exchange (ETDEWEB)

    Gray, L W


    During the cold war plutonium was produced in reactors in both the US and Russia. It was then separated from the residual uranium and fission products by a variety of precipitation processes, such as Bismuth Phosphate, Redox, Butex, Purex, etc. in the US and uranium acetate and Purex in Russia. After a period of time in the field, plutonium weapons were recycled and the plutonium re-purified and returned to weapons. purification was accomplished by a variety of aqueous and molten salt processes, such as nitric-hydrofluoric acid dissolution followed by anion exchange, Purex modifications, molten salt extraction, electrorefining, etc. in the US and nitric acid dissolution or sodium hydroxide fusion followed by anion exchange in Russia. At the end of the Cold War, plutonium production of weapons-grade plutonium was cut off in the US and is expected to be cut off in Russia shortly after the turn of the century. Now both countries are looking at methods to reconstitute plutonium with fission products to render it no longer useful for nuclear weapons. These methods include immobilization in a ceramic matrix and then encasement in fission product laden glass, irradiation of MOX fuel, and disposal as waste in WIPP in the US and irradiation of MOX fuel in Russia. This paper details the contrast between the treatment of plutonium during the cold war and after the cold war was over.

  20. Short rotation plantations policy history in Europe: lessons from the past and recommendations for the future. (United States)

    Lindegaard, Kevin N; Adams, Paul W R; Holley, Martin; Lamley, Annette; Henriksson, Annika; Larsson, Stig; von Engelbrechten, Hans-Georg; Esteban Lopez, Gonzalo; Pisarek, Marcin


    Short rotation plantations (SRPs) are fast-growing trees (such as willow (Salix spp.), poplar (Populus spp.) and Eucalyptus) grown closely together and harvested in periods of 2-20 years. There are around 50,000 hectares of SRPs in Europe, a relatively small area considering that there have been supportive policy measures in many countries for 30 years. This paper looks at the effect that the policy measures used in different EU countries have had, and how other external factors have impacted on the development of the industry. Rokwood was a 3-year European funded project which attempted to understand the obstacles and barriers facing the woody energy crops sector using well established methods of SWOT and PESTLE analysis. Stakeholder groups were formed in six different European regions to analyze the market drivers and barriers for SRP and propose ways that the industry could make progress through targeted research and development and an improved policy framework. Based upon the outcomes of the SWOT and PESTLE analysis, each region produced a series of recommendations for policymakers, public authorities, and government agencies to support the development, production, and use of SRP-derived wood fuel in each of the partner countries. This study provides details of the SRP policy analysis and reveals that each region shared a number of similarities with broad themes emerging. There is a need to educate farmers and policymakers about the multifunctional benefits of SRPs. Greater financial support from regional and/or national government is required in order to grow the SRP market. Introducing targeted subsidies as an incentive for growers could address lack of local supply chains. Long-term policy initiatives should be developed while increasing clarity within Government departments. Research funding should enable closer working between universities and industry with positive research findings developed into supportive policy measures.

  1. Prevalence of sarcopenia in acute hip fracture patients and its influence on short-term clinical outcome. (United States)

    González-Montalvo, Juan I; Alarcón, Teresa; Gotor, Pilar; Queipo, Rocío; Velasco, Rocío; Hoyos, Rubén; Pardo, Armando; Otero, Angel


    Current international criteria provide standardized procedures to diagnose sarcopenia in older people. However, to date few data exist on patients with acute disease. The present study was carried out to determine the frequency of sarcopenia in acute hip fracture patients, and its association with their baseline characteristics and prognosis during hospitalization. Data were collected from 509 consecutive patients hospitalized for hip fracture. The European Working Group on Sarcopenia in Older People Criteria for sarcopenia were applied in the first 72 h. Muscle mass was measured by electrical bioimpedance and grip strength by hydraulic dynamometer. Clinical, functional and cognitive characteristics were assessed at baseline and hospital discharge, and their association with the presence of sarcopenia was studied. A total of 479 patients (94%) met the inclusion criteria. The mean age was 85.3 (SD 6.8 years). The frequency of sarcopenia was 17.1% (12.4% in men, 18.3% in women). Sarcopenia was associated with residence in nursing homes (30.5% vs 19.6%, P = 0.030), older age (86.8, SD 6.2 vs 85.1, SD 6.9 years, P = 0.038), and lower body mass index (23.1, SD 3.6 vs 25.6, SD 4.23, P sarcopenia (OR 0.85, 95% CI 0.80-0.91). Sarcopenia was associated with worse functional prognosis at discharge in the crude analysis (OR 1.88, 95% CI 1.15-3.07), but not in the multivariate analysis (OR 1.68, 95% CI 0.99-2.84). Sarcopenia was detected in almost one of five acute hip fracture patients and was associated with lower body mass index, but an association with worse prognosis at discharge could not be confirmed. Geriatr Gerontol Int 2016; 16: 1021-1027. © 2015 Japan Geriatrics Society.

  2. Fractures in Individuals With and Without a History of Infantile Autism. A Danish Register Study Based on Hospital Discharge Diagnoses

    DEFF Research Database (Denmark)

    Mouridsen, Svend-Erik; Rich, Bente; Isager, Torben


    We compared the prevalence and types of fractures in a clinical sample of 118 individuals diagnosed as children with infantile autism (IA) with 336 matched controls from the general population. All participants were screened through the nationwide Danish National Hospital Register. The average...... observation time was 30.3 years (range 27.3-30.4 years), and mean age at follow-up was 42.7 years (range 27.3-57.3 years). Of the 118 individuals with IA, 14 (11.9%) were registered with at least one fracture diagnosis against 83 (24.7%) in the comparison group (p = 0.004; OR = 0.41; 95%CI 0.......22-0.76), but the nature of their fractures seems somewhat different. Epilepsy was a risk factor, but only in the comparison group. Our results lend no support to the notion that fracture is a common comorbid condition in a population of people diagnosed with IA as children....

  3. Influence of ``short`` cracks on fracture mechanics material characteristics - methods of determination and their effects; Einfluss ``kurzer`` Risse auf die bruchmechanischen Werkstoffkennwerte - Bestimmungsmethoden und ihre Auswirkungen

    Energy Technology Data Exchange (ETDEWEB)

    Roos, E.; Silcher, H.; Eisele, U. [Stuttgart Univ. (Germany). Staatliche Materialpruefungsanstalt


    The methods applicable to determining fracture mechanics characteristics of the threshold toughness, published in various recommendations and draft standards, are compared and evaluated. The methods are put to the test and comparatively analysed using compact tensile specimens (CT), standardized three-point bending specimens (TPB), and TPB specimens with short cracks. It is shown that only the physical crack initiation value J{sub i} yields results that can be applied for comparative evaluations. (orig./CB) [Deutsch] Die fuer das Uebergangsgebiet der Zaehigkeit in verschiedenen Pruefempfehlungen und Normvorschlaegen veroeffentlichten Verfahren zur Bestimmung bruchmechanischer Kennwerte werden gegenuebergestellt und bewertet. Anhand von Kompaktzugproben (CT), Standard Drei-Punkt-Biegeproben (TPB) und TPB-Proben mit kurzen Rissen werden diese Verfahren angewandt und die Ergebnisse verglichen. Es zeigt sich, dass nur der physikalische Risseinleitungswert J{sub i} fuer alle untersuchten Probenformen vergleichbare und uebertragbare Ergebnisse liefert. (orig.)

  4. Transition of historial tube flaps to free flap for 2-stage total knee arthroplasty in a patient with a history of Gustilo grade IIIB tibia fracture. (United States)

    Spence, Sean A; Doren, Erin L; Dayicioglu, Deniz; Bernasek, Thomas


    We report the case of a 56-year-old patient who had posttraumatic bilateral knee arthritis and underwent sequential bilateral total knee arthroplasty (TKA). The left knee joint required 2-stage reconstruction: a free flap for enhanced soft-tissue coverage and then left knee TKA. Uniquely, at age 16 years this patient sustained a left tibia grade IIIB high-energy crush injury in a car crash and underwent reconstruction with multiple pedicle tube flaps and transfer of soft tissues. Most of that reconstruction was done between the ages of 16 and 19. At age 56 years, staged TKA was performed. To our knowledge, this is the first report of a knee reconstructed with pedicle tube flaps for a grade IIIB tibial fracture, followed years later by free-flap coverage before TKA. This report offers insights and treatment recommendations through long-term follow-up of a unique case and a historical perspective on how reconstructive options have evolved.

  5. Timing and risk factors for clinical fractures among postmenopausal women: a 5-year prospective study

    Directory of Open Access Journals (Sweden)

    Rinkens Paula ELM


    Full Text Available Abstract Background Many risk factors for fractures have been documented, including low bone-mineral density (BMD and a history of fractures. However, little is known about the short-term absolute risk (AR of fractures and the timing of clinical fractures. Therefore, we assessed the risk and timing of incident clinical fractures, expressed as 5-year AR, in postmenopausal women. Methods In total, 10 general practice centres participated in this population-based prospective study. Five years after a baseline assessment, which included clinical risk factor evaluation and BMD measurement, 759 postmenopausal women aged between 50 and 80 years, were re-examined, including undergoing an evaluation of clinical fractures after menopause. Risk factors for incident fractures at baseline that were significant in univariate analyses were included in a multivariate Cox survival regression analysis. The significant determinants were used to construct algorithms. Results In the total group, 12.5% (95% confidence interval (CI 10.1–14.9 of the women experienced a new clinical fracture. A previous clinical fracture after menopause and a low BMD (T-score Conclusion In postmenopausal women, clinical fractures cluster in time. One in two women with a recent clinical fracture had a new clinical fracture within 5 years, regardless of BMD. The 5-year AR for a first clinical fracture was much lower and depended on BMD.

  6. Short-term CT findings after osteosynthesis of fractures of the vertebral spine; Kurzfristige Veraenderungen in der Computertomographie nach osteosynthetischer Versorgung von Wirbelsaeulenfrakturen

    Energy Technology Data Exchange (ETDEWEB)

    Schroeder, R.J.; Noor, J.; Herzog, H.; Roettgen, R.; Hidajat, N.; Felix, R. [Klinik fuer Strahlenheilkunde, Charite, Campus Virchow-Klinikum, Humboldt-Univ. zu Berlin (Germany); Klinik fuer Unfall- und Wiederherstellungschirurgie, Charite, Campus Virchow-Klinikum, Humboldt-Univ. zu Berlin (Germany); Pflugmacher, R.; Maeurer, J. [Radiologie am Prinzregentenplatz, Muenchen (Germany)


    Purpose: evaluation of a correlation between surgical stabilization of fractures of the vertebral spine and postoperative short-term CT findings with special attention to degenerative changes. Materials and methods: The pre- and post-operative CT of 55 patients (43male, 12 female, age: 7 - 73 years, mean = 37.7 years) with traumatic fractures of the vertebral spine who underwent surgical stabilization using an internal fixator were analyzed retrospectively. The interval between surgical intervention and first postoperative CT control did not exceed one week. The interval to the second short-term follow-up CT ranged from 6 up to 24 months (mean: 10.3 {+-} 2.7 months). The consensus reading of the short-term CT by two experienced radiologists was compared to the pre- and immediately postoperative CT examinations and with the neurologic findings. Statistical analysis was done using the chi-square- or the Fisher's exact-test. Results: no statistically significant correlation (p > 0.05) was found between the patient's age and the postoperative incidence of osteoporosis, spondylarthrosis, scoliosis, spondylolisthesis or disc protrusion after posttraumatic surgical stabilization using an internal fixator. Also, there was no significant correlation between the fracture's type or location, presence of polytraumatization, the technique of surgical intervention, and the incidence of postoperative degenerative changes in the neighboring segments. The thesis has not been verified (p > 0.05) that polysegment stabilization or prior surgical interventions at the vertebral spine with scar induction are responsible for a higher rate of degeneration. The only risk factor observed for postoperative scoliosis was the burst rotation fracture type C1.3 (AO-classification). (orig.) [German] Ziel: Ziel dieser Studies war, einen Zusammenhang zwischen der operativen Stabilisierung von Wirbelsaeulenfrakturen und kurzfristigen postoperativen, computertomographisch fassbaren


    Energy Technology Data Exchange (ETDEWEB)

    HOLDEN, N.E.


    A short history of CSISRS, pronounced ''scissors'' and standing for the Cross Section Information Storage and Retrieval System, is given. The relationship of CSISRS to CINDA, to the neutron nuclear data four-centers, to EXFOR and to ENDF, the evaluated neutron nuclear data file, is briefly explained.

  8. Flow of fluids from matrix to fractures in rock

    Energy Technology Data Exchange (ETDEWEB)

    Lupo, M.J.


    The flow of a single-phase compressible fluid from the rock matrix to fractures was modeled using the pressure diffusion equation. Pressure histories are presented for homogeneous isotropic blocks bounded by planar fractures. The case of an infinite slab bounded by planes of constant pore pressure was studied. The slab was divided by a planar fracture perpendicular to the planes. Lateral flow was found to cease once equilibrium is reached between the fracture and the matrix. Disequilibrium is found to be short-lived for laboratory-sized specimens of typical reservoir rock. The most-important parameter in cross-flow is the distance l between the two planes of constan pore pressure. When a second fracture was added, parallel to the first, the cross-flow behavior was nearly identical to the one fracture case if the spacing of the fractures is greater than l. The pressure history of the blocks of the continuum model of naturally fractured reservoirs was examined with a discrete mathematical model. An analytical solution to the pressure diffusion equation with time dependent boundary conditions is presented for blocks in both a finite and infinite reservoir.

  9. Management of Odontoid Fracture in Elderly

    Directory of Open Access Journals (Sweden)

    Muhammad Nadeem


    Full Text Available Odontoid type II fractures are associated with high mortality in the elderly. Their management can be done either conservatively or surgically, however, surgical treatment is technically demanding and relatively new. We report a case of 75 years old man who presented to our clinical setting, following a history of fall. The CT scan and MRI showed odontoid type II fracture. With time, the neurological deficit got marked and he underwent transoral odontoidectomy and occipitocervical fixation using rods and screws via posterior approach. Patient’s neurological condition improved dramatically and on the short term follow up, he had no motor deficit. Our experience suggests that occipitocervical fixation via posterior approach is a viable option for the management of odontoid type II fracture in the geriatric population.

  10. 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:; Hojreh, Azadeh [Department of Radiology, Medical University of Vienna, Vienna General Hospital, Waehringerstr. 18-20, 1090 Vienna (Austria)


    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.

  11. Atraumatic First Rib Fracture

    Directory of Open Access Journals (Sweden)

    Koray Aydogdu


    Full Text Available Rib fractures are usually seen after a trauma, while atraumatic spontaneous rib fractures are quite rare. A first rib fracture identified in our 17 years old female patient who had not a history of trauma except lifting a heavy weight was examined in details in terms of the potential complications and followed-up for a long time. We presented our experience on this case with atraumatic first rib fracture that has different views for the etiology in light of the literature.

  12. Stress history and fracture pattern in fault-related folds based on limit analysis: application to the Sub-Andean thrust belt of Bolivia (United States)

    Barbe, Charlotte; Leroy, Yves; Ben Miloud, Camille


    A methodology is proposed to construct the stress history of a complex fault-related fold in which the deformation mechanisms are essentially frictional. To illustrate the approach, fours steps of the deformation of an initially horizontally layered sand/silicone laboratory experiment (Driehaus et al., J. of Struc. Geol., 65, 2014) are analysed with the kinematic approach of limit analysis (LA). The stress, conjugate to the virtual velocity gradient in the sense of mechanicam power, is a proxy for the true statically admmissible stress field which prevailed over the structure. The material properties, friction angles and cohesion, including their time evolution are selected such that the deformation pattern predicted by the LA is consistent with the two main thrusting events, the first forward and the second backward once the layers have sufficiently rotated. The fractures associated to the stress field determined at each step are convected on today configuration to define the complete pattern which should be observed. The end results are presented along virtual vertical wells and could be used within the oil industry at an early phase of exploration to prepare drealing operations.


    Directory of Open Access Journals (Sweden)

    Nikolay I. Sobolev


    Full Text Available Th e article is dedicated to one of the major problems of literature that is scientifi c description, introduction into scientifi c use and comprehension of handwritten materials of  writer’s creative heritage. At the heart of the research there is a draft novel of I. S. Shmelev “Crossroads” [“Rosstani”] kept in the Research Department of Manuscripts of the Russian State Library. Th e  article presents codicological description and textual analysis of the draft that brought to light two versions and two editions of the short novel, revealed their genealogy, the process of formation and development of the narration. Philological analysis of discrepancies in the editions allows us to comprehend genesis of the plot, reveal the author’s objectives in the poetics of the short novel. In the course of the comparative analysis of diff erent editions in the poetics of the short novel there were found out literary devices inherent to a Neo-Realist literary work, such as the abundance of out-of-plot elements that produce eff ect of a discrete narrative; repeating common details, the images of Russian nature, the motives of memory and leave that form a symbolic level of the short novel.

  14. From convenience to hazard: a short history of the emergence of the menstrual activism movement, 1971-1992. (United States)

    Bobel, Chris


    In this article, I explore the early history of contemporary menstrual activism in the United States by looking through the lens of the first seven editions of the feminist women's health classic, Our Bodies, Ourselves (OBOS). This analysis illustrates the development of a critical menstrual consciousness as three key phases of the emerging movement, offers a representation of the dynamic nature of feminist health consciousness, and highlights the importance of linking current activism to its past.

  15. Theory of the dependence of population levels on environmental history for semelparous species with short reproductive seasons. (United States)

    Coleman, B D; Hsieh, Y H


    A population that is strongly self-regulating through density-dependent effects is expected to be such that, if many generations have elapsed since its establishment, its present size should not be sensitive to its initial size but should instead be determined by the history of the variables that describe the influence of the environment on fecundity, mortality, and dispersal. Here we discuss the dependence of abundance on environmental history for a semelparous population in which reproduction is synchronous. It is assumed that at each instant t: (i) the rate of loss of members of age a by mortality and dispersal is given by a function rho of t, a, and the present number x = x(a,t) of such members; and (ii) the number x(0,t) of members born in the population is given by a function F of t and the number of x(a(f),t) at a specified age a(f) of fecundity. It is further assumed that the functions rho and F have the forms rho(x,a,t) = pi(1)(a,t)x + pi(2)(a,t)x(2) and F(x(a(f),t),t) = nu(t)x(a(f),t). For such a population, a change in the environment is significant only if it results in a change in nu(t) pi(1)(a,t), or pi(2)(a,t), and, hence, the history of the environment up to time t is described by giving nu(tau), pi(1)(a,tau), and pi(2)(a,tau) for each tau history of the environment can be calculated explicitly and has certain properties of "fading memory"; i.e., environmental events that occurred in the remote past have less effect upon the present abundance than comparable events in the recent past.

  16. A careful evaluation of scout CT lateral radiograph may prevent unreported vertebral fractures

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    Bazzocchi, Alberto; Spinnato, Paolo [Imaging Division, Clinical Department of Radiological and Histocytopathological Sciences, University of Bologna, Sant’Orsola – Malpighi Hospital, Via Massarenti 9, 40138 Bologna (Italy); Albisinni, Ugo [Department of Radiology, Rizzoli Orthopaedic Institute, Via Pupilli 1, 40136 Bologna (Italy); Battista, Giuseppe [Imaging Division, Clinical Department of Radiological and Histocytopathological Sciences, University of Bologna, Sant’Orsola – Malpighi Hospital, Via Massarenti 9, 40138 Bologna (Italy); Rossi, Cristina [Section of Radiological Sciences, Department of Clinic Sciences, University of Parma, Via Gramsci 14, 43100 Parma (Italy); Guglielmi, Giuseppe, E-mail: [Department of Radiology, University of Foggia, Viale Luigi Pinto 1, 71100 Foggia (Italy); Department of Radiology, Scientific Institute “Casa Sollievo della Sofferenza” Hospital, Viale Cappuccini 1, 71013 San Giovanni Rotondo, Foggia (Italy)


    Objectives: Our purpose was to review scout CT lateral radiographs to reveal osteoporotic vertebral fractures unreported by radiologists and to explore scout CT as a potential diagnostic tool in the detection of vertebral fractures. Methods: We considered 500 patients (303 males, 197 females, age 64.6 ± 13.5 year-old). Our investigation was firstly focused on scout CT lateral images to detect vertebral fractures with a combined semiquantitative and quantitative diagnostic approach. Findings addressed to vertebral fracture were subsequently confirmed by multiplanar sagittal CT reconstructions. Whenever a vertebral fracture was discovered the radiologist report was read and a collection of patient anamnesis followed to understand whether fractures were already known. Results: In 44/500 patients (8.8%) the evaluation on scout CT was incomplete or limited for patient/technical-based conditions, and 15 were excluded from the analysis. In 67/485 patients (13.8%) 99 vertebral fractures were detected. Among 67 fractured patients only 18 (26.9%) were previously diagnosed by radiologists. However, in the clinical history of 32 patients vertebral fractures were already known. Conclusions: The perception and sensibility to vertebral fractures among radiologists are still poor when the assessment of the spine is not the aim of the examination. Short time spent for the evaluation of scout CT lateral radiographs could improve our accuracy.


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    Mahendra Bendale


    Full Text Available BACKGROUND Femoral neck fractures are common in postmenopausal elderly females as a result of osteoporosis due to trivial trauma or in the young due to high energy trauma. The goal of the surgeon is to return the patient to his/her prefracture functional status. Femoral neck fracture could be impacted and undisplaced or displaced. Femoral neck fractures are also considered “fractures of necessity”, best treated surgically irrespective of displacement. Surgery permits early patient mobilisation and minimises the complications of prolonged recumbence. The bipolar prosthesis has advantage over the unipolar in having two bearings for the movements to occur. This study intends to compare the functional outcome of unipolar Moore’s hemi-replacement and fixed bipolar replacement in elderly patients with fracture neck of femur. In this scenario, the null hypothesis would be that there is no significant difference in the results between the patients treated with Moore’s prosthesis and those treated with bipolar prosthesis. The aim of the study is to compare the results of unipolar and bipolar hemi-arthroplasty for fracture neck of femur in the elderly patients. MATERIALS AND METHODS 30 elderly postmenopausal women with fracture neck femur were included in the study. They were divided into 2 groups and were operated upon by using unipolar and bipolar implants respectively after thorough investigation. The functional outcome was assessed using the Harris Hip Score (HHS. RESULTS Femoral neck fractures belonged to 53.3% with type III fracture and 46.7 had type IV fractures. Fifteen patients had replacement with Austin Moore prosthesis and fifteen patients with bipolar prosthesis. The average HHS at 6 weeks for unipolar and bipolar groups was 65.2 and 66.0, respectively. The average HHS at 12 months for unipolar and bipolar group was 81.0 and 83.6, respectively. 19 (65.5% patients had good HHS at the end of one year. Corrected chi-square value is 2

  18. A short history of the Catalan campaign to win the .cat Internet domain, with implications for other minority languages

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    Peter Gerrand


    Full Text Available On 15 September 2005 ICANN approved the first top-level Internet domain to be devoted to a particular human language and culture: .cat. This paper describes the history of the Catalan campaign to win the .cat domain against political opposition from the former conservative Spanish government and the reluctance of some decision-makers within ICANN circles. While .cat creates a precedent for greater use on the Internet of 'minority languages', there are significant hurdles for other candidates for language-based top-level domains. The paper discusses the concomitant factors needed to support the greater use of any minority language on the Internet.

  19. Short-term Results of Muscle-Pedicle Bone Grafting with Tensor Fascia Lata for Delayed Femoral Neck Fractures; Case Series and Literature Review

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    Kuldip Salgotra


    Full Text Available Neglected, untreated and delayed femur neck fractures are commonly encountered and the treatment dilemma arises especially when the patient is physiologically young and osteosynthesis is the preferred option. Controversy exists in the current literature as the various head salvage surgeries like valgus subtrochanteric osteotomy, non-vascularized fibular bone grafting, muscle pedicle bone grafting (Tensor fascia lata and Quadratus femoris graft and vascularized bone grafting do not have clear lines of indications. The current study is a case series of 7 patients with femur neck fractures with delayed presentation beyond the vascular emergency period who were treated with osteosynthesis with muscle pedicle bone graft (MPBG using tensor fascia lata muscle pedicle graft. Patients were followed clinical and radiologically at 6 weeks, 3 and 6 months, 1 year and 3 years and patients were regularly followed. The mean age of the patients was 47 ± 1.1 ranging from 38 to 55 years. There were 6 (85.7% men and 1 (14.3% women among the patients. Overall 5 (71.5% patients had transcervical and 2 (28.5% had subcapital fractures. At the end of 6 months, 6 (85.7% patients were pain free and on plain radiographs fracture union was noted. One (14.3% patient developed collapse and persistent nonunion. Younger group less than 50 years presenting with neglected fracture neck femur should always be give an option of head salvage surgery in selected cases. Muscle pedicle bone grafting has been proven although inconsistently as a valid option for fracture neck femur. We encourage osteosynthesis with the use of tensor fascia lata muscle pedicle grafting along with cancellous cannulated screws as a first option in selected cases of neglected femur neck fractures.

  20. Analysis of trace elements in the shells of short-necked clam Ruditapes philippinarum (Mollusca: Bivalvia) with respect to reconstruction of individual life history

    Energy Technology Data Exchange (ETDEWEB)

    Arakawa, Jumpei; Sakamoto, Wataru [Division of Applied Biosciences, Graduate School of Agriculture, Kyoto Univ., Kyoto (Japan)


    Strontium (Sr) concentration in the shells of short-necked clams collected at different locations (Shirahama, warm area and Maizuru, cold area, Japan) was analyzed by two methods, PIXE and EPMA. The Sr concentration of external surface of shell umbo, which was made during short term at early benthic phase, was analyzed by PIXE, and was ranged from 1000 to 3500 ppm for individuals. The Sr concentration of clams collected at Shirahama showed positive correlation with shell length (SL) in individuals with SL < 31 mm, whereas clams collected at Maizuru did not show significant correlation. This result may be caused from the difference of the spawning seasons between two areas. The Sr concentration of cross section of shell umbo, which develops thicker continuously during their life to form faint stratum structure, was analyzed by EPMA along the line across the stratum structure. Some surges and long term waving patterns of the Sr concentration were observed. These results suggest that the life histories of individual clams could be recorded in the shell umbo cross sections as variations of trace elements and analyses of trace elements could clarify the histories of individual clams. (author)

  1. Autoimmune Pancreatitis Presenting a Short Narrowing of Main Pancreatic Duct with Subsequent Progression to Diffuse Pancreatic Enlargement over 24 Months; Natural History of Autoimmune Pancreatitis

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    Shuichiro Umemura


    Full Text Available Context Initial pancreatogram and natural history of autoimmune pancreatitis (AIP have not been clarified, and there were few recent studies concerning the association between AIP and intraductal papillary mucinous neoplasm (IPMN. Case report We report an 81-yearold man with AIP associated with IPMN. Although the initial pancreatogram was normal, a short narrowing of the main pancreatic duct (MPD appeared during a follow-up for IPMN after 6 months, which was highly suggestive of pancreatic cancer. A narrowing of the MPD extended after 15 months, and this progressed to diffuse narrowing of the MPD with an elevation in the serum IgG4 levels after 24 months. Finally, the patient was diagnosed with diffuse-type AIP, according to the Japanese diagnostic criteria 2011 and the International Consensus Diagnostic Criteria. Considering the natural history of AIP, this marked change of the MPD is indicative of this condition. Conclusion Wereport a case of AIP presenting with a short narrowing of the MPD with subsequent progression to diffuse pancreatic enlargement during a follow-up for IPMN.

  2. 中青年胸腰椎骨折经皮椎弓根钉棒系统短节段内固定术后螺钉断裂浅析%Analysis on Percutaneous Pedicle Screw Rod System With Short Segment Fixation After Screw Fracture in Young Thoracolumbar Fractures

    Institute of Scientific and Technical Information of China (English)

    高飞; 阿日奔吉日嘎啦; 姜富祥; 王兴; 张弘来; 王高强


    Objective TTo explore the causes of percutaneous pedicle screw rod system with short segment ifxation after screw fracture in young thoracolumbar fractures.Methods54 cases of thoracolumbar vertebral fracture percutaneous pedicle nail stick system short segment internal fixation in young patients, 4 cases of postoperative screw fracture, the clinical data were retrospectively analyzed.Results in this group of patients appear screw breakage was 7.40%. The main cause of the fracture of the screw for pedicle screw insertion angle deviation, connecting rod camber is too large.Conclusion The mechanical stability and gravity load of the percutaneous pedicle screw rod system are important reasons for the screw breakage.%目的:探讨中青年胸腰椎骨折经皮椎弓根钉棒系统短节段内固定术后螺钉断裂的原因。方法54例行胸腰段椎体骨折经皮椎弓根钉棒系统短节段内固定术的中青年患者中,4例术后发生螺钉断裂,将其临床资料进行回顾性分析。结果本组病例出现螺钉断裂为7.40%,原因为椎弓根钉置入角度不适,连接棒弯度过大。对比剩余50例螺钉未出现断裂病例(P<0.05)。结论经皮椎弓根钉棒系统自身的力学稳定性和重力负荷是导致螺钉断裂的重要原因。

  3. [(Impending) pathological fracture]. (United States)

    Sutter, P M; Regazzoni, P


    Pathological fractures will be encountered in increasing frequency due to more patients with cancer, surviving a longer period. The skeleton is the third most frequent localization for metastases. Breast cancer is still the most common primary tumor, but bone metastases from lung cancer seem to be diagnosed more and more. Despite of finding metastases most often in the spinal column, fractures are seen mostly at the femoral site. A pathological fracture and, in almost all cases, an impending fracture are absolute indication for operation. An exact definition of an "impending fracture" is still lacking; it is widely accepted, that 50 per cent of bone mass must be destroyed before visualization in X-ray is possible, thus defining an impending fracture. The score system by Mirels estimates the fracture risk by means of four parameters (localization, per cent of destructed bone mass, type of metastasis, pain). Improving quality of life, relieving pain, preferably with a single operation and a short length of stay are the goals of (operative) treatment. For fractures of the proximal femur, prosthetic replacement, for fractures of the subtrochanteric region or the shaft, intramedullary nails are recommended. Postoperative radiation therapy possibly avoids tumor progression. In patient with a good long term prognosis, tumor should be removed locally aggressive.

  4. Hip Fracture (United States)

    Diseases and Conditions Hip fracture By Mayo Clinic Staff A hip fracture is a serious injury, with complications that can be life-threatening. The risk of hip fracture rises with age. Older people are at a ...

  5. [A short history of infectious diseases since the fifties of the last century and the importance of vaccination]. (United States)

    Marešová, Vilma


    Vaccination in the Czech lands has a long history; it begun during the Austro-Hungarian Empire in 1803 by vaccination against smallpox, and in the late 19th century by vaccination against rabies. In the second half of the 20th century, the basic vaccination included also other vaccines. Thanks to paediatricians, vaccination coverage of children was so high that in addition to the immunity of individuals the collective immunity was also significant. The incidence of infectious diseases has dropped significantly. Today the population, both medical and lay, almost does not know the classic childrens infectious diseases or their risk of complications. This creates a feeling in recent years that vaccination is unnecessary and that it is a source of complication and, therefore, better not to vaccinate. However, diseases, except for smallpox, have not disappeared, and for the susceptible unvaccinated individuals they represent a great risk. There are now occurring at atypical age groups where their diagnosis is even not considered. Therefore, it is important to return to the course of disease as well as to the potentially serious complications in unvaccinated people.

  6. Coral Bleaching Susceptibility Is Decreased following Short-Term (1–3 Year Prior Temperature Exposure and Evolutionary History

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    Joshua A. Haslun


    Full Text Available Coral exposed to short periods of temperature stress (≥1.0°C above mean monthly maximum and/or increased frequencies of high temperatures may bolster resilience to global warming associated with climate change. We compared Montastraea cavernosa (Linnaeus, 1767; Cnidaria, Scleractinia, Faviidae from the Florida Keys National Marine Sanctuary (FKNMS and the Flower Garden Banks National Marine Sanctuary (FGBNMS. Thermal stress has been reported frequently within the FKNMS; however, corals in the FGBNMS experience nominal exposures to similar stressors. Corals were exposed to three temperatures (27°C, 31°C, and 35°C for 72 h. Colonies from the FKNMS lost significantly fewer viable and necrotic zooxanthellae under conditions of acute stress (35°C than the FGBNMS colonies. This indicates that the FKNMS corals are less temperature-sensitive than those in the FGBNMS. The observed differences point to greater prior temperature exposure and adaptation in the former versus the latter site when correlated to previous years of thermal exposure.

  7. Interferon: ten stories in one. A short review of some of the highlights in the history of an almost quinquagenarian. (United States)

    De Clercq, E


    This short review article on some pertinent observations in the unfolding story of interferon is dedicated to Professor Ilona Béládi on the occasion of her 80th birthday. This by no means covers the whole story on interferon. It just highlights some of the more striking findings made with interferon (or its inducers) over a time span of almost 50 years since its original discovery (in 1957) by Isaacs and Lindenmann. These observations concern (i) the induction of interferon by synthetic polyanions such as polyacrylic acid and polymethacrylic acid; (ii) the prolonged antiviral activity shown by polyacrylic acid in vivo; (iii) the interferon-inducing ability of double-stranded RNAs such as poly(I) x poly(C) and (iv) mismatched derivatives thereof (i.e. ampligen); (v) the cloning and expression of interferon-beta, and (vi) its usefulness in the treatment of multiple sclerosis; (vii) the potential of (pegylated) interferon-alpha in the treatment of hepatitis C and (viii) the therapy/prophylaxis of SARS; (ix) the efficacy of interferon (inducers) in the experimental treatment of flavivirus encephalitis and enterovirus myocarditis; and, finally, (x) the role of interferon in the activity shown by S-adenosylhomocysteine inhibitors such as 3-deazaneplanocin A against experimental Ebola virus infections in mice.

  8. History and person in short stories of Alexis Remizov The cycle «Poor fortune» Rational-irrational aspect of the writer’s fictional world

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    Sergeev O.V.


    Full Text Available This article devoted to short stories, written by A.M. Remizov. Selected stories are united thematically. All of them depicted terror of history. Victim of that terror is an ordinary men. Famous historic persons represented as symptoms of tragic fate of Russia. This issue contains comparison of two different editions of his book of dreams «Bedovaja dolja» («Bad fate» and «Martyn Zadeka» on the background of different art’ periods, Silver age of Russian literature and émigré literature. As Russian artist Remizov used to feel his personal fate as a part of common fate of his main land, Rus-Russia. Because of it paradoxical forms of perceptions represented as different types of understanding complicated moments of individual life and existentional moments of human beings.

  9. Reliability and validity of the medical outcomes study, a 36-item short-form health survey, (MOS SF-36 after one-year hospital discharge of hip fracture patient in a public hospital

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    Anan Udombhornprabha


    Full Text Available Introduction: There is scarce of data in terms of health-related quality of life for hip fracture patients in Thailand due to the following: (i lack of epidemiological aspects of hip fracture (eg. the relative incidence of osteoporosis, falls fractures and repeat fractures in particular subgroups, (ii lack of health status and quality of life aspects of both illness itself and the availability of different treatment options especially for elderly people. (iii a substantial variation in terms of outcomes of care for patients and service for hip fractures. Objective: Hip fracture is a major healthcare burden in Thailand. This study explores quality of life for hip fracture patients from perspective of (i Reliability of patient-reported outcomes (ii Some clinical and demographic characteristics related to patient-reported outcomes Method: Pre-hospital discharge 201 hip fracture patients were screened and follow-up over one year. Mail survey by a self-rated Medical Outcomes Study, a 36-item Short-Form Health Survey (Thai dispatched for follow-up, other clinical and demographic characteristics were collected through direct interviews from patients or caregivers during recruitment with simultaneous crosschecking from medical records. A descriptive cross-sectional analysis was performed.Result: Mails responder represented by 59.2% (N=119, with 36.1% (N=43 and 63.8% (N=76 for patient and caregiver rated outcomes. Mean(SD, [95% CI] score for physical, mental and global health of patient and care-giver rated outcomes of 36.2(10.6[32.9-39.4], 54.5(10.0[51.4-57.5],43.9(9.3[41.0-46.7], and 34.6(12.3[31.7-37.4], 52.5(12.3[49.6-55.3],42.7(11.1[40.1-45.2] were not statistically difference with p-value at 0.630,0.330 and 0.788 respectively. Respecting Cronbach’s alpha reliability coefficient by patients versus caregivers rated of the MOS SF-36 were 0.90 vs 0.91, 0.78 vs 0.84 and 0.90 vs 0.92. The presence of comorbidity significantly explains differences for

  10. Fracture resistance of endodontically treated teeth restored with short fiber composite used as a core material-An in vitro study. (United States)

    Garlapati, Tejesh Gupta; Krithikadatta, Jogikalmat; Natanasabapathy, Velmurugan


    This in-vitro study tested the fracture resistance of endodontically treated molars with Mesial-Occluso-Distal (MOD) cavities restored with fibre reinforced composite material everX posterior in comparision with hybrid composite and ribbond fiber composite. Fifty intact freshly extracted human mandibular first molars were collected and were randomly divided into five groups (n=10). Group 1: positive control (PC) intact teeth without any endodontic preparation. In groups 2 through 6 after endodontic procedure standard MOD cavities were prepared and restored with their respective core materials as follows: group 2, negative control (NC) left unrestored or temporary flling was applied. Group 3, Hybrid composite (HC) as a core material (Te-Econom Plus Ivoclar Vivadent Asia) group 4, Ribbond (Ribbond; Seattle, WA, USA)+conventional composite resin (RCR) group 5, everX posterior (everX Posterior GC EUROPE)+conventional composite resin (EXP) after thermocycling fracture resistance for the samples were tested using universal testing machine. The results were analysed using ANOVA and Tukey's HSD post hoc tests. Mean fracture resistance (in Newton, N) was group 1: 1568.4±221.71N, group 2: 891.0±50.107N, group 3: 1418.3±168.71N, group 4:1716.7±199.51N and group 5: 1994.8±254.195N. Among the materials tested, endodontically treated teeth restored with everX posterior fiber reinforced composite showed superior fracture resistance. Copyright © 2017 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

  11. Species Selection Favors Dispersive Life Histories in Sea Slugs, but Higher Per-Offspring Investment Drives Shifts to Short-Lived Larvae. (United States)

    Krug, Patrick J; Vendetti, Jann E; Ellingson, Ryan A; Trowbridge, Cynthia D; Hirano, Yayoi M; Trathen, Danielle Y; Rodriguez, Albert K; Swennen, Cornelis; Wilson, Nerida G; Valdés, Ángel A


    For 40 years, paleontological studies of marine gastropods have suggested that species selection favors lineages with short-lived (lecithotrophic) larvae, which are less dispersive than long-lived (planktotrophic) larvae. Although lecithotrophs appeared to speciate more often and accumulate over time in some groups, lecithotrophy also increased extinction rates, and tests for state-dependent diversification were never performed. Molecular phylogenies of diverse groups instead suggested lecithotrophs accumulate without diversifying due to frequent, unidirectional character change. Although lecithotrophy has repeatedly originated in most phyla, no adult trait has been correlated with shifts in larval type. Thus, both the evolutionary origins of lecithotrophy and its consequences for patterns of species richness remain poorly understood. Here, we test hypothesized links between development mode and evolutionary rates using likelihood-based methods and a phylogeny of 202 species of gastropod molluscs in Sacoglossa, a clade of herbivorous sea slugs. Evolutionary quantitative genetics modeling and stochastic character mapping supported 27 origins of lecithotrophy. Tests for correlated evolution revealed lecithotrophy evolved more often in lineages investing in extra-embryonic yolk, the first adult trait associated with shifts in development mode across a group. However, contrary to predictions from paleontological studies, species selection actually favored planktotrophy; most extant lecithotrophs originated through recent character change, and did not subsequently diversify. Increased offspring provisioning in planktotrophs thus favored shifts to short-lived larvae, which led to short-lived lineages over macroevolutionary time scales. These findings challenge long-standing assumptions about the effects of alternative life histories in the sea. Species selection can explain the long-term persistence of planktotrophy, the ancestral state in most clades, despite frequent

  12. [Kidney and bone update : the 5-year history and future of CKD-MBD. Disorders of musculoskeletal system in CKD ; bone fracture and periarticular calcification]. (United States)

    Yamada, Shunsuke; Taniguchi, Masatomo


    Chronic kidney disease-mineral and bone disorder (CKD-MBD) affects life expectancy through vascular calcification, and impairs patient's activity of daily living (ADL) and quality of life (QOL) through bone fracture and periarticular calcification. In CKD patients, vitamin D deficiency and secondary hyperparathyroidism impairs bone strength, and muscle dysfunction related to vitamin D deficiency also causes easy fall, leading to the high risk of bone fracture. Bone fracture not only aggravates ADL and QOL but increases the risk of mortality. Periarticular calcification such as tumoral calcinosis in relation to CKD-MBD causes restricted range of articular motion, leading to the deterioration of patient's ADL and QOL. Because bone fragility and tumoral calcinosis occurs in relation to CKD-MBD, the appropriate management of CKD-MBD is madatory.

  13. Odanacatib for the treatment of postmenopausal osteoporosis: development history and design and participant characteristics of LOFT, the Long-Term Odanacatib Fracture Trial. (United States)

    Bone, H G; Dempster, D W; Eisman, J A; Greenspan, S L; McClung, M R; Nakamura, T; Papapoulos, S; Shih, W J; Rybak-Feiglin, A; Santora, A C; Verbruggen, N; Leung, A T; Lombardi, A


    Odanacatib is a cathepsin K inhibitor investigated for the treatment of postmenopausal osteoporosis. Phase 2 data indicate that 50 mg once weekly inhibits bone resorption and increases bone mineral density, with only a transient decrease in bone formation. We describe the background, design and participant characteristics for the phase 3 registration trial. Odanacatib (ODN) is a selective cathepsin K inhibitor being evaluated for the treatment of osteoporosis. In a phase 2 trial, ODN 50 mg once weekly reduced bone resorption while preserving bone formation and progressively increased BMD over 5 years. We describe the phase III Long-Term ODN Fracture Trial (LOFT), an event-driven, randomized, blinded placebo-controlled trial, with preplanned interim analyses to permit early termination if significant fracture risk reduction was demonstrated. An extension was planned, with participants remaining on their randomized treatment for up to 5 years, then transitioning to open-label ODN. The three primary outcomes were radiologically determined vertebral, hip, and clinical non-vertebral fractures. Secondary end points included clinical vertebral fractures, BMD, bone turnover markers, and safety and tolerability, including bone histology. Participants were women, 65 years or older, with a BMD T-score≤-2.5 at the total hip (TH) or femoral neck (FN) or with a prior radiographic vertebral fracture and a T-score≤-1.5 at the TH or FN. They were randomized to ODN or placebo tablets. All received weekly vitamin D3 (5600 international units (IU)) and daily calcium supplements as needed to ensure a daily intake of approximately 1200 mg. Altogether, 16,713 participants were randomized at 387 centers. After a planned interim analysis, an independent data monitoring committee recommended that the study be stopped early due to robust efficacy and a favorable benefit/risk profile. Following the base study closeout, 8256 participants entered the study extension. This report details the

  14. Surgical treatment of thoracolumbar fractures by using the posterior short segment pedicle screw fixation%后路短节段固定联合伤椎置钉治疗胸腰椎骨折

    Institute of Scientific and Technical Information of China (English)

    胡力丰; 张志成; 王晓凯; 孙天胜


    Objective To evaluate the efficacy,indications and clinical outcomes of the treatment of thoracolumbar fractures by short segmental pedicle screws fixation at the level of the fracture.Methods Thirtytwo patients with thoracolumbar fracture,who underwent surgical procedure of short segmental pedicle screws fixation at the level of the fracture from 2007 to 2010,were followed up.X rays were performed preoperatively and postoperatively to locate the injured vertebral segment height and fractured kyphosis vertebral (Cobb angle).Frankel standard was used to assess the spinal cord function.Results All patients were followed up for 12 to 20 months and were in satisfying condition in the reduction of fracture.After surgery,the height of fractured vertebral body leading edge recovered from preoperative (32.4% ~69.3%,averaged (51.6 ± 17.8)% ) to (85.6% ~99.2%,averaged (92.8 ±6.2)% ) after two weeks and (90.6% ~97.8%,averaged (93.8 ±3.6)% ) at the last follow-up.Fractured vertebral Cobb angle was recovered from the preoperative ( 12.8 ° ~ 30.5 °,averaged [20.8±9.1] °) to (0° ~7.8 °,averaged [4.9 ±3.2] °) two weeks later and (2.0° ~ 12.0°,averaged [ 6.2 ± 4.6 ] o at the last follow-up.Cobb angle of the injured vertebral segment and the extend of vertebral compression were significantly improved after the angle was corrected ( P <0.01 ).Conclusion Using reduction and short segment pedicle screw fixation at the fracture level would be helpful to correct kyphotic vertebral compression and restore the height of injured vertebrate,which was also of benefit to increase the stability of short-segment posterior fixation system and reduce the loss of correction in a long run.%目的 观察经伤椎椎弓根置钉复位固定治疗胸腰椎骨折的可行性、适应证及临床疗效.方法 我院2007年1月至2010年1月收治的胸腰椎骨折采用经伤椎椎弓根置钉复位固定治疗,共随访32例,对患者术前及术后伤椎

  15. [Atlas fractures]. (United States)

    Schären, S; Jeanneret, B


    Fractures of the atlas account for 1-2% of all vertebral fractures. We divide atlas fractures into 5 groups: isolated fractures of the anterior arch of the atlas, isolated fractures of the posterior arch, combined fractures of the anterior and posterior arch (so-called Jefferson fractures), isolated fractures of the lateral mass and fractures of the transverse process. Isolated fractures of the anterior or posterior arch are benign and are treated conservatively with a soft collar until the neck pain has disappeared. Jefferson fractures are divided into stable and unstable fracture depending on the integrity of the transverse ligament. Stable Jefferson fractures are treated conservatively with good outcome while unstable Jefferson fractures are probably best treated operatively with a posterior atlanto-axial or occipito-axial stabilization and fusion. The authors preferred treatment modality is the immediate open reduction of the dislocated lateral masses combined with a stabilization in the reduced position using a transarticular screw fixation C1/C2 according to Magerl. This has the advantage of saving the atlanto-occipital joints and offering an immediate stability which makes immobilization in an halo or Minerva cast superfluous. In late instabilities C1/2 with incongruency of the lateral masses occurring after primary conservative treatment, an occipito-cervical fusion is indicated. Isolated fractures of the lateral masses are very rare and may, if the lateral mass is totally destroyed, be a reason for an occipito-cervical fusion. Fractures of the transverse processes may be the cause for a thrombosis of the vertebral artery. No treatment is necessary for the fracture itself.

  16. A Short History of Hanford

    Energy Technology Data Exchange (ETDEWEB)

    Gephart, Roy E.


    Nine nuclear reactors and four reprocessing plants at Hanford produced nearly two-thirds of the plutonium used in the United States for government purposes . These site operations also created large volumes of radioactive and chemical waste. Some contaminants were released into the environment, exposing people who lived downwind and downstream. Other contaminants were stored. The last reactor was shut down in 1987, and the last reprocessing plant closed in 1990. Most of the human-made radioactivity and about half of the chemicals remaining onsite are kept in underground tanks and surface facilities. The rest exists in the soil, groundwater, and burial grounds. Hanford contains about 40% of all the radioactivity that exists across the nuclear weapons complex. Today, environmental restoration activities are under way.

  17. The short history of gastroenterology. (United States)

    Sródka, A


    In this paper research on the stomach and bowel physiology is presented in a historical perspective. The author tries to show how digestive processes were interpreted by the ancients and how they tried to adjust them to the dominating humoral theory of disease. It is pointed out that the breakthrough which created a new way of understanding of the function of the digestive system was made by Andreas Vesalius and his modern model of anatomy. The meaning of acceptance of chemical processes in digestion by iatrochemics representatives in XVII century is shown. Physiological research in XIX century, which decided about a rapid development of physiology, especially the physiology of the gastrointestinal tract, is discussed. Experiments were performed by all main representatives of this discipline: Claude Bernard, Jan Ewangelista Purkyne, Rudolph Heidenhain and especially Ivan Pavlov, who, thanks to the discoveries in the secretion physiology, explained basic functions of the central nervous system. The XX century was dominated by the research showing the important role of the endocrine system and biological agents in the regulation of secretion and motility of the digestive system. The following discoveries are discussed: Ernest Sterling (secretin), John Edkins (gastrin) and André Latarjet and Lester Dragstedt (acetylcholine). It is underlined that Polish scientists play an important role in the development of the gastroenterological science--among others, Walery Jaworski, who made a historical suggestion about the role of the spiral bacteria in etiopathogenesis of the peptic ulcer, Leon Popielski, who stated the stimulating influence of histamine on the stomach acid secretion, Julian Walawski, who discovered enterogastrons--hormones decreasing secretion. As a supplement, there is the list of achievements in the field of the physiology and pathology of the gastrointestinal tract awarded with Nobel Prize and the list of most important Polish papers in this field.

  18. A Short History of Spin

    CERN Document Server

    Milner, Richard G


    The paper outlines the historical development of spin in physics from about 1920 to the present day. It aims to provide the student with an accurate chronology of important developments, both scientific and technical.

  19. Root fractures

    DEFF Research Database (Denmark)

    Andreasen, Jens Ove; Christensen, Søren Steno Ahrensburg; Tsilingaridis, Georgios


    The purpose of this study was to analyze tooth loss after root fractures and to assess the influence of the type of healing and the location of the root fracture. Furthermore, the actual cause of tooth loss was analyzed.......The purpose of this study was to analyze tooth loss after root fractures and to assess the influence of the type of healing and the location of the root fracture. Furthermore, the actual cause of tooth loss was analyzed....

  20. Stress Fractures (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 ...

  1. Joint Inversion of Fracture Model Properties for CO2 Storage Monitoring or Oil Recovery History Matching Inversion conjointe des propriétés d’un modèle de fractures pour le monitoring d’un stockage de CO2 ou le calage d’un historique de production

    Directory of Open Access Journals (Sweden)

    Verscheure M.


    Full Text Available For oil recovery or CO2 storage, “reservoirs” are commonly used to designate geological structures where oil can be found or CO2 can be stored. All reservoirs present a heterogeneity in terms of rock type and properties (such as porosity and permeability. In addition, some of these reservoirs present fractures and faults. Fractured reservoirs are an important part of the oil reserves in the world (Middle East, Gulf of Mexico, etc. and some of them are important reservoirs in terms of oil volume and productivity in spite of the fractures. In addition, studies of reservoirs for geologic storage of CO2 have shown the existence of diffuse fractures and faults and their strong impacts on flow. A key point in fractured reservoirs is to understand the geometry and hydraulic conductivity of the network formed by the fractures. This requires the construction of a reservoir model that integrates all available conceptual knowledge and quantitative data. The topic of the present paper deals with a new methodology able to perform the history matching of a fractured reservoir model by adapting the sub-seismic fault properties and positions. The main difficulty of this work is to generate a sub-seismic fault network whose fault positions can be easily modified while respecting the statistical fault model. The sub-seismic fault model we have chosen allows us to obtain a sub-seismic fault network that is consistent with the seismic fault network and that succeeds in capturing the specific spatial organization of the faults. In a first step, the geometry of the seismic fault network is characterized using fractal methods. Sub-seismic faults are then generated according to a stochastic algorithm. Finally, the geometry of this discrete fracture network is optimized in order to match the hydrodynamic data about the reservoir. The optimization algorithm modifies the sub-seismic fault positions, leading to the history matching of the reservoir model. Fractal

  2. Economic evaluation of osteoporosis liaison service for secondary fracture prevention in postmenopausal osteoporosis patients with previous hip fracture in Japan. (United States)

    Moriwaki, K; Noto, S


    A model-based cost-effectiveness analysis was performed to evaluate the cost-effectiveness of secondary fracture prevention by osteoporosis liaison service (OLS) relative to no therapy in patients with osteoporosis and a history of hip fracture. Secondary fracture prevention by OLS is cost-effective in Japanese women with osteoporosis who have suffered a hip fracture.

  3. Fracture Networks in Sea Ice

    Directory of Open Access Journals (Sweden)

    Jonas Nesland Vevatne


    Full Text Available Fracturing and refreezing of sea ice in the Kara sea are investigated using complex networkanalysis. By going to the dual network, where the fractures are nodes and their intersectionslinks, we gain access to topological features which are easy to measure and hence comparewith modeled networks. Resulting network reveal statistical properties of the fracturing process.The dual networks have a broad degree distribution, with a scale-free tail, high clusteringand efficiency. The degree-degree correlation profile shows disassortative behavior, indicatingpreferential growth. This implies that long, dominating fractures appear earlier than shorterfractures, and that the short fractures which are created later tend to connect to the longfractures.The knowledge of the fracturing process is used to construct growing fracture network (GFNmodel which provides insight into the generation of fracture networks. The GFN model isprimarily based on the observation that fractures in sea ice are likely to end when hitting existingfractures. Based on an investigation of which fractures survive over time, a simple model forrefreezing is also added to the GFN model, and the model is analyzed and compared to the realnetworks.

  4. Spall measurements in shock-loaded hemispherical shells from free-surface velocity histories. [Dynamic fracture of hemishells of copper and tantalum

    Energy Technology Data Exchange (ETDEWEB)

    Cagliostro, D.J.; Warnes, R.H.; Johnson, N.L.; Fujita, R.K.


    Copper and tantalum hemishells are externally loaded by a hemishell of PBX 9501 detonated at its pole. Free-surface velocity histories of the metal hemishells are measured at the pole and at 50 from the pole with a Fabry-Perot interferometer. These histories are used to determine spall strengths and depths by simple wave-interaction analyses and are compared with hydro-code (CAVEAT) predictions using simple and void-growth spall models. 8 refs., 4 figs., 1 tab.

  5. Analysis of damage processes in short glass fibre reinforced polyamide under mechanical loading by X-ray refractometry, fracture mechanics and fractography; Analyse der Schaedigungsprozesse in einem kurzglasfaserverstaerkten Polyamid unter mechanischer Belastung mittels Roentgenrefraktometrie, Bruchmechanik und Fraktografie

    Energy Technology Data Exchange (ETDEWEB)

    Guenzel, Stephan


    This thesis presents an analysis of the damage behaviour in a short glass fibre reinforced polyamide. The micro cracking is investigated by X-ray refraction technique under various, mechanical in-service loadings. In this context, potentials and limits of X-ray refraction analysis for short glass fibre reinforced polyamides are compiled. In particular the influence of fibre orientation and the influence of damage mechanisms are examined according to the X-ray refraction analysis and its interpretation. The method offers a quantitative and phenomenological based characterisation of micro crack damage. For the investigated material micro crack damage emerges as fibre matrix debonding and matrix micro cracking. The state of damage correlates with a nonlinear strain portion in a linear manner and depends on the kind of loading. Absorption of moisture in the material may influence significantly the micro crack damage behaviour. Damage of micro cracking appears preferentially under tension. The macro damage due to propagation of a single crack is characterised in an automated test setup, considering the fibre orientation and content of moisture. Based on the findings an empirical assessment approach is developed. The investigations of the micro and macro damage behaviour are accompanied by fractography, in order to support the model assumptions according to damage and fracture mechanisms.

  6. Prophylactic bilateral intramedullary femoral nails for bisphosphonate-associated signs of impending subtrochanteric hip fracture. (United States)

    Yoon, Richard S; Beebe, Kathleen S; Benevenia, Joseph


    In the short and midterm, bisphosphonates have proven highly efficacious in the prevention of low-energy fractures, but long-term results and adverse effects have yet to be definitively identified. Of particular concern are emerging reports of long-term bisphosphonate users presenting with unusual low-energy subtrochanteric femur fractures. Perhaps associated with hyperactive bone remodeling leading to an eventually weakened bony architecture, the efficacy of longer-term bisphosphonate use has come into question, especially in those with >5 years of therapy.This article describes a case of a 65-year-old woman with a 10-year history of bisphosphonate use who presented with prodromal thigh pain and characteristic radiographic findings indicative of potential impending subtrochanteric insufficiency fracture. Supported by reports in the literature, unique characteristics of a certain clinical picture warn of potential bisphosphonate-associated subtrochanteric hip fracture; to our knowledge, we present the first reported prophylactic bilateral femoral intramedullary nailing to prevent fragility fracture. A deeper look into the biochemistry behind associated bony weakness caused by long-term incorporation of bisphosphonates is needed, especially if an endpoint to the therapy is to be determined. However, with mounting clinical evidence supporting the risk of bisphosphonate-associated fragility fracture, a characteristic radiographic appearance and clinical presentation cannot be ignored. In the interim, elective surgery may be an efficacious alternative in the treatment of an expected, readily preventable fracture.

  7. Case History: Merging the Tools of DC Resistivity and Fracture Trace Analysis for Locating High Yield Domestic Water Wells in Karst Terrain, Shenandoah Valley, Virginia, USA (United States)

    Frangos, W.; Eaton, L. S.


    The karstic eastern margin of Virginia's Shenandoah Valley hosts large volumes of high quality ground water in discrete zones or pockets. Industrial and culinary exploitation poses a challenging exploration problem. Recent work by the authors using geophysical and aerial photogrammetric techniques resulted in the successful location of three high- yield water wells. This indirect methodology increases the probability of locating valuable wells by locating geologic features that may harbor water-bearing zones. The eastern Shenandoah Valley is geologically complex. The underlying bedrock is dominantly limestones, dolomites, and shales of Cambrian age that have been extensively folded, fractured, and faulted. Geomorphologic features such as solution cavities, caves, disappearing streams, and sinkholes are common. Extensive alluvial fan and river terrace deposits, comprised dominantly of quartzite gravel and sand, cover much of the land surface, and fill surface depressions. The combination of sand and gravel filtering and large storage capacity in the voids makes this region ideal for producing a large quantity of high quality groundwater. Two sites were investigated for karst aquifers near the town of Stuarts Draft. Interbedded limestones and dolomites underlie Barth Farm, situated on the north bank of the South River. The owners attempted to installed a water well to service an active vineyard. The drilling located a previously unknown, water-filled cavern ~5 m below the surface; subsequent high pumping rates in finishing the well resulted in a surface collapse and the creation of a sinkhole. A second effort, offset by ~30 meters, resulted in a catastrophic collapse, and seriously endangered the lives of the drillers. A subsequent dipole-dipole DC resistivity survey delineated a conductive zone coincident with the two sinkholes. Fracture trace analysis of pre-drilling aerial photographs indicates the presence of lineaments that pass through this drilling site

  8. [Acetabular fractures]. (United States)

    Gänsslen, A; Oestern, H J


    Treatment of acetabular fractures requires extensive knowledge of the bony anatomy, the amount of possible exposure of the bone with the selected approaches and fracture type-dependent indications of operative treatment. Classification of the fracture with detailed analysis of the fracture morphology is the basis for decision making and planning. The primary treatment aim is the anatomic reconstruction of the acetabulum which results in optimal long-term results.The basis of this overview is the presentation of standard treatment concepts in acetabular fracture surgery. Beside characteristics of the acetabular bony anatomy, biomechanical and pathomechanical principles and the relevant radiological anatomy, the treatment options, both conservative and operative and basic principles of the indications for standard surgical approaches will be discussed.The special fracture type is discussed in detail regarding incidence, injury mechanism, concomitant injuries, options for conservative and operative treatment, quality of operative reduction and long-term results.Furthermore, epidemiological data on typical postoperative complications are evaluated.

  9. [Hip Fracture--Epidemiology, Management and Liaison Service. Risk factor for hip fracture]. (United States)

    Fujiwara, Saeko


    Many risk factors have been identified for hip fracture, including female, advanced age, osteoporosis, previous fractures, low body weight or low body mass index, alcohol drinking, smoking, family history of fractures, use of glucocorticoid, factors related to falls, and bone strength. The factors related to falls are number of fall, frail, post stroke, paralysis, muscle weakness, anti-anxiety drugs, anti-depression drugs, and sedatives. Dementia and respiratory disease and others have been reported to be risk factors for secondary hip fracture.

  10. Sports fractures.


    DeCoster, T. A.; Stevens, M. A.; Albright, J. P.


    Fractures occur in athletes and dramatically influence performance during competitive and recreational activities. Fractures occur in athletes as the result of repetitive stress, acute sports-related trauma and trauma outside of athletics. The literature provides general guidelines for treatment as well as a variety of statistics on the epidemiology of fractures by sport and level of participation. Athletes are healthy and motivated patients, and have high expectations regarding their level o...

  11. Hamate fractures. (United States)

    Sarabia Condés, J M; Ibañez Martínez, L; Sánchez Carrasco, M A; Carrillo Julia, F J; Salmerón Martínez, E L


    The purpose of this paper is to present our experience in the treatment of the fractures of the hamate and to make a review of the literature on this topic. We retrospectively reviewed 10 patients treated in our clinic between 2005-2012 suffering from fractures of the hamate. Six cases were fractures of the body and four were fractures of the hamate. Five cases were of associated injuries. Diagnostic delay ranged from 30 days to 2 years. Patient follow-up ranged from 1 to 10 years. Patient satisfaction was evaluated using the DASH questionnaire. Five patients with a fracture of the body underwent surgery, and one was treated conservatively. Two patients with fracture of the hook of the hamate were treated with immobilization, and two more patients had the fragment removed. The grip strength and the digital clip were reduced in 2 cases. Flexion and extension of the wrist was limited in 3 cases. The mobility of the fingers was normal in all the cases, except in one. The results obtained from the DASH questionnaire were normal in all the cases, except in one case of fracture of the hamate, and in two cases of fracture of the body. The surgical treatment should reduce the dislocation and stabilize the injuries with osteosynthesis. The fractures of the hamate are usually diagnosed late, and the most recommended treatment is removal of the fragment, although it cannot be deduced from this study. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  12. Colles Fracture


    Sánchez León, Belisario; Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú


    Our expertise is the study of more than 2,000 cases of Colles' fractures. Colles name should in this case to synthesize the type of fractures of the lower end of the radius. There have been various proposed classifications according to the different fracture lines can be demonstrated radiologically in the region of the wrist. We believe that these ratings should only be retained if the concept of the articular fracture or not in the classical sense, since it has great value in the functional ...

  13. Acute hip pain in the nonambulatory infant: Salter-Harris type I fracture in the capital femoral epiphysis without a traumatic history. (United States)

    Gross, Shari L; Orndorff, Douglas G; Romness, Mark; Poelstra, Kornelis A


    An otherwise healthy 11-month-old girl was brought to the hospital after her parents noted the acute onset of right hip pain and refusal to bear weight. No abnormalities were seen in the initial radiographs, laboratory values were within reference range, and noninvasive workup was negative for septic arthritis. The parents reported a recent minor fall from a standing position, but stated that the child seemed to return to normal without pain after a few minutes of crying. A hemarthrosis without purulence was found upon joint aspiration, and the patient improved significantly after administration of anti-inflammatory medication. Follow-up radiographs 13 days after initial presentation showed an extremely rare Salter-Harris type I proximal physeal fracture well into the healing process.

  14. Pathogenesis of osteoporotic hip fractures. (United States)

    McClung, Michael R


    Osteoporosis is characterized late in the course of the disease by an increased risk of fracture, particularly in the elderly. It occurs in both sexes, affecting approximately 8 million women and 2 million men aged > or = 50 years (1). While low bone density is a predictor of fractures, it is not the only determinant of fracture risk. Other factors include advanced age, altered bone quality, a personal or family history of falls, frailty, poor eyesight, debilitating diseases, and high bone turnover. A diet with sufficient calcium and vitamin D is important to minimize bone loss and, along with regular exercise, to maintain muscle strength. Bisphosphonates have been shown to reduce the risk of hip fracture. For elderly patients, the use of hip protectors may be used as a treatment of last resort. Regardless of the age of the patient, individual patient risk factors must be considered to target appropriate treatment and prevent fracture.

  15. Growth Kinematics of Opening-Mode Fractures (United States)

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


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

  16. Fracture Mechanics

    CERN Document Server

    Zehnder, Alan T


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

  17. Low-trauma fractures indicate increased risk of hip fracture in frail older people. (United States)

    Chen, Jian Sheng; Cameron, Ian D; Simpson, Judy M; Seibel, Markus J; March, Lyn M; Cumming, Robert G; Lord, Stephen R; Sambrook, Philip N


    This study aims to investigate the risk of subsequent fractures after low-trauma fracture in frail older people. A total of 1412 elderly residents (mean age 86.2 years, SD 7.0 years, female 77%) were recruited from aged care facilities in Australia. Residents were assessed and then followed for any fracture for 2 years and hip fractures for at least 5 years. Residents with and without a newly acquired fracture in the first 2 years were compared for risk of subsequent hip fracture. Residents with a nonhip fracture in the first 2 years had an increased risk of subsequent hip fracture for about 2.5 years, whereas those with a hip fracture had a similar risk over the whole period compared with those with no fracture. During these 2.5 years, 60, 28, and 6 subsequent hip fractures occurred in the nonfracture group (n = 953), the nonhip fracture group (n = 194), and the hip fracture group (n = 101), respectively, resulting in the probability of subsequent hip fracture of 8.0%, 19.9%, and 10.4%, respectively. Compared with the nonfracture group, the hazard ratio (HR) was 2.82 [95% confidence interval (CI) 1.73-4.59; p < .001] for the nonhip fracture group and 1.48 (95% CI 0.63-3.49, p = .37) for the hip fracture group after adjusting for age, sex, residence type, calcaneal broadband ultrasound attenuation, fracture history, weight, lower leg length, immobility, cognitive function, and medications. Frail institutionalized older people with newly acquired fractures are at increased risk of subsequent hip fracture for the next few years. Accordingly, despite their advanced age, they are a high-priority target group to investigate interventions that might reduce the risk of hip fracture.

  18. Low incidence of flexion-type supracondylar humerus fractures but high rate of complications. (United States)

    Kuoppala, Eira; Parviainen, Roope; Pokka, Tytti; Sirviö, Minna; Serlo, Willy; Sinikumpu, Juha-Jaakko


    Background and purpose - Supracondylar humerus fractures are the most common type of elbow fracture in children. A small proportion of them are flexion-type fractures. We analyzed their current incidence, injury history, clinical and radiographic findings, treatment, and outcomes. Patients and methods - We performed a population-based study, including all children <16 years of age. Radiographs were re-analyzed to include only flexion-type supracondylar fractures. Medical records were reviewed and outcomes were evaluated at a mean of 9 years after the injury. In addition, we performed a systematic literature review of all papers published on the topic since 1990 and compared the results with the findings of the current study. Results - During the study period, the rate of flexion-type fractures was 1.2% (7 out of 606 supracondylar humeral fractures). The mean annual incidence was 0.8 per 105. 4 fractures were multidirectionally unstable, according to the Gartland-Wilkins classification. All but 1 were operatively treated. Reduced range of motion, changed carrying angle, and ulnar nerve irritation were the most frequent short-term complications. Finally, in the long-term follow-up, mean carrying angle was 50% more in injured elbows (21°) than in uninjured elbows (14°). 4 patients of the 7 achieved a satisfactory long-term outcome according to Flynn's criteria. Interpretation - Supracondylar humeral flexion-type fractures are rare. They are usually severe injuries, often resulting in short-term and long-term complications regardless of the original surgical fixation used.

  19. A clinical comparative analysis of the treatment between open short-segment pedicle screw fixation and percutaneous short-segment pedicle screw fixation for thoracolumbar fractures%伤椎置钉和经皮短节段固定治疗胸腰段椎体骨折的疗效比较

    Institute of Scientific and Technical Information of China (English)

    杨晓明; 徐宏光; 刘平; 王弘


    目的:对比开放伤椎置钉和经皮微创短节段固定治疗胸腰段椎体骨折的近期临床疗效。方法回顾性分析35例胸腰段椎体骨折患者,分为开放伤椎置钉短节段固定组(A 组)和经皮微创短节段固定组(B 组),测量手术前后骨折椎体压缩程度,椎体后凸畸形角度,疼痛视觉模拟评分(VAS)以及术后腰椎功能障碍指数(ODI),统计两组患者住院时间,手术失血和手术时间,并对以上参数进行对比分析。结果两组患者一般资料,术前骨折椎体压缩程度和 VAS 评分差异无统计学意义(P >0.05)。两组患者术后骨折椎体高度均有效恢复(P <0.05),且良好维持,术后 VAS 和 ODI 评分均较术前改善(P <0.05),且 B 组术后 ODI 评分优于 A 组。B 组在手术时间,失血量和住院时间上较 A 组缩短。结论两种手术方式均能有效恢复骨折椎体高度,改善术后功能,但经皮微创短节段固定在手术时间,失血量,住院时间和功能上要优于伤椎置钉短节段固定组。%Objective To comparatively analyze the clinical efficacies of the treatment between open short-segment pedicle screw fixa-tion including the fractured vertebra and percutaneous short-segment pedicle screw fixation for thoracolumbar fractures.Methods A retrospective analysis was made of 35 cases of thoracolumbar fractures which were assigned into open short-segment pedicle screw fixa-tion including the fractured vertebra(group A)and minimally invasive percutaneous short-segment pedicle screw fixation group(group B).The compression percentage of the fractured vertebra,vertebral kyphosis angle,visual analogue scale(VAS)of back pain and Oswe-stry Disability Index(ODI)were measured before and after surgery.Hospitalized time,blood loss and surgical time were also compara-tively analyzed between the two groups.Results The demographic data,compression percentage of vertebral

  20. Unusual presentation of a radial neck fracture in a child

    Directory of Open Access Journals (Sweden)

    Murali Poduval


    Full Text Available Fracture of the radial neck are uncommon injuries. In children, they may present as radial neck fractures, a components of forearm fracture dislocations, or as isolated fracture dislocations. Here, we present an unusual and previously undescribed variant of radial neck fracture with dislocation of the radial head to the medial side and ulnar nerve injury. The fracture dislocation was openly reduced and fixed with a small fragment plate. The fracture healed with some loss of rotational movements. At short followup of 6 months patient had useful elbow function but ulnar nerve did not recover.

  1. Effects of Short-Term Experimental Insulin Resistance and Family History of Diabetes on Pancreatic β-Cell Function in Nondiabetic Individuals

    National Research Council Canada - National Science Library

    Rasouli, Neda; Hale, Terri; Kahn, Steven E; Spencer, Horace J; Elbein, Steven C


    ...: Glucose tolerance, insulin sensitivity (SI), and insulin response to iv glucose (AIRG) were compared in nondiabetic individuals with and without a family history of diabetes before and after nicotinic acid (NA) treatment. Setting...

  2. The prognostic importance of a history of hypertension in patients with symptomatic heart failure is substantially worsened by a short mitral inflow deceleration time

    DEFF Research Database (Denmark)

    Andersson, Charlotte; Gislason, Gunnar H; Weeke, Peter;


    Hypertension is a common comorbidity in patients with heart failure and may contribute to development and course of disease, but the importance of a history of hypertension in patients with prevalent heart failure remains uncertain.......Hypertension is a common comorbidity in patients with heart failure and may contribute to development and course of disease, but the importance of a history of hypertension in patients with prevalent heart failure remains uncertain....


    Directory of Open Access Journals (Sweden)

    Gde Rastu Adi Mahartha


    Full Text Available Fracture is a loss of continuity of bone, either total or partial, is usually caused by trauma. Overall incidence of fractures was 11.3 in 1,000 per year, in males was 11.67 in 1000 per year, whereas in 10.65 in 1,000 women per year. The classic symptom is a history of trauma fracture, pain and swelling in the broken bones, deformity, musculoskeletal dysfunction, breaking the continuity of the bone, and neurovascular disorders. Principles of fracture treatment is to restore the position of the fracture to its original position (reposition and held that position during the healing of fractures (immobilization. Special in open fractures, must be considered the danger of infection, either general or local infection.

  4. Fracture mechanics

    CERN Document Server

    Perez, Nestor


    The second edition of this textbook includes a refined presentation of concepts in each chapter, additional examples; new problems and sections, such as conformal mapping and mechanical behavior of wood; while retaining all the features of the original book. The material included in this book is based upon the development of analytical and numerical procedures pertinent to particular fields of linear elastic fracture mechanics (LEFM) and plastic fracture mechanics (PFM), including mixed-mode-loading interaction. The mathematical approach undertaken herein is coupled with a brief review of several fracture theories available in cited references, along with many color images and figures. Dynamic fracture mechanics is included through the field of fatigue and Charpy impact testing. Explains computational and engineering approaches for solving crack-related problems using straightforward mathematics that facilitate comprehension of the physical meaning of crack growth processes; Expands computational understandin...

  5. Fracture mechanics (United States)

    Shannon, John L., Jr.


    The application of fracture mechanics to the design of ceramic structures will require the precise measurement of crack growth and fracture resistance of these materials over their entire range of anticipated service temperatures and standardized test methods for making such measurements. The development of a standard test for measuring the plane strain fracture toughness is sought. Stress intensity factor coefficients were determined for three varieties of chevron-notch specimens, and fracture toughness measurements were made on silicon nitrides, silicon carbides, and aluminum oxides to assess the performance of each specimen variety. It was determined that silicon nitride and silicon carbides have flat crack growth resistance curves, but aluminum oxide does not. Additionally, batch-to-batch differences were noticed for the aluminum oxide. Experiments are continuing to explain the rising crack growth resistance and batch-to-batch variations for the aluminum oxide.

  6. Gravity-Driven Hydraulic Fractures (United States)

    Germanovich, L. N.; Garagash, D.; Murdoch, L. C.; Robinowitz, M.


    This study is motived by a new method for disposing of nuclear waste by injecting it as a dense slurry into a hydraulic fracture that grows downward to great enough depth to permanently isolate the waste. Disposing of nuclear waste using gravity-driven hydraulic fractures is mechanically similar to the upward growth of dikes filled with low density magma. A fundamental question in both applications is how the injected fluid controls the propagation dynamics and fracture geometry (depth and breadth) in three dimensions. Analog experiments in gelatin [e.g., Heimpel and Olson, 1994; Taisne and Tait, 2009] show that fracture breadth (the short horizontal dimension) remains nearly stationary when the process in the fracture "head" (where breadth is controlled) is dominated by solid toughness, whereas viscous fluid dissipation is dominant in the fracture tail. We model propagation of the resulting gravity-driven (buoyant or sinking), finger-like fracture of stationary breadth with slowly varying opening along the crack length. The elastic response to fluid loading in a horizontal cross-section is local and can be treated similar to the classical Perkins-Kern-Nordgren (PKN) model of hydraulic fracturing. The propagation condition for a finger-like crack is based on balancing the global energy release rate due to a unit crack extension with the rock fracture toughness. It allows us to relate the net fluid pressure at the tip to the fracture breadth and rock toughness. Unlike the PKN fracture, where breadth is known a priori, the final breadth of a finger-like fracture is a result of processes in the fracture head. Because the head is much more open than the tail, viscous pressure drop in the head can be neglected leading to a 3D analog of Weertman's hydrostatic pulse. This requires relaxing the local elasticity assumption of the PKN model in the fracture head. As a result, we resolve the breadth, and then match the viscosity-dominated tail with the 3-D, toughness

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

    Nielson, Carrie M; Orwoll, Eric; Bauer, Douglas C; Cauley, Jane A


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

  8. 股骨颈骨折内固定手术简史%A brief history of internal fixation of femoral neck fracture

    Institute of Scientific and Technical Information of China (English)



    1858年,德国外科医师VonLangenbeck采用镀银螺钉完成了世界第1例股骨颈骨折内固定手术.1875年,德国医生Franz K(o)nig在消毒后,成功利用金属螺钉实施股骨颈内固定术.1883年,美国外科医生Nicholass Senn提出了股骨颈骨折都应手术治疗的观点,但未能得到广泛认可.1931年,美国医生Smith-Petersen和他的同事发表了股骨颈骨折切开复位三翼钉内固定的治疗结果.随后,瑞典医生Sven Johansson、美国医生H.Heyward Wescott分别于1932年和1934年为闭合三翼钉内固定手术设计了相应的手术辅助器械.1941年,AAOS建议对股骨颈骨折使用三翼钉内固定.1976年,The British Medical Research Council指出,三翼钉不适用于有移位的股骨颈骨折.1980年,Asnis空心螺钉开始使用,并沿用至今.20世纪40年代,孟继懋和叶衍庆相继开展三翼钉内固定术治疗股骨颈骨折.1989年,危杰首先在中国就用AO空心钉治疗股骨颈骨折.此后,空心加压螺钉治疗股骨颈骨折在全国范围内得到了广泛的推广.%In 1858,a German surgeon named Von Langenbeck did the first internal fixation of femoral neck fracture (FNF) with metal silver screw.In 1875,a German doctor Franz K? nig did the same operation successfully with metal screws under antiseptic condition.In 1883,an American surgeon,Nicholass Senn suggested that all of the FNF should be treated by operation,but the proposition was not accepted extensively.In 1931,Smith-Petersen from the USA and his colleagues first published the report on the result of open reduction and internal fixation of FNF by the use of trifin nail.Due to the help of auxiliary appliance designed separately by the Swedish Sven Johansson (1932) and American H.Heyward Wescott (1934).In 1941,the American Academy of Orthopaedic Surgeons (AAOS) advocated the technique of trifin nail for its internal fixation.However,in 1976,the British Medical Research Council pointed out that the trifin nail was not

  9. Direct and socially-mediated effects of food availability late in life on life-history variation in a short-lived lizard. (United States)

    Mugabo, Marianne; Marquis, Olivier; Perret, Samuel; Le Galliard, Jean-François


    Food availability is a major environmental factor that can influence life history within and across generations through direct effects on individual quality and indirect effects on the intensity of intra- and intercohort competition. Here, we investigated in yearling and adult common lizards (Zootoca vivipara) the immediate and delayed life-history effects of a prolonged food deprivation in the laboratory. We generated groups of fully fed or food-deprived yearlings and adults at the end of one breeding season. These lizards were released in 16 outdoor enclosures together with yearlings and adults from the same food treatment and with food-deprived or fully fed juveniles, creating four types of experimental populations. Experimental populations were then monitored during 2 years, which revealed complex effects of food on life-history trajectories. Food availability had immediate direct effects on morphology and delayed direct effects on immunocompetence and female body condition at winter emergence. Also, male annual survival rate and female growth rate and body size were affected by an interaction between direct effects of food availability and indirect effects on asymmetric competition with juveniles. Reproductive outputs were insensitive to past food availability, suggesting that female common lizards do not solely rely on stored energy to fuel reproduction. Finally, food conditions had socially-mediated intergenerational effects on early growth and survival of offspring through their effects on the intensity of competition. This study highlights the importance of social interactions among cohorts for life-history trajectories and population dynamics in stage-structured populations.

  10. Galeazzi fracture. (United States)

    Atesok, Kivanc I; Jupiter, Jesse B; Weiss, Arnold-Peter C


    Galeazzi fracture is a fracture of the radial diaphysis with disruption at the distal radioulnar joint (DRUJ). Typically, the mechanism of injury is forceful axial loading and torsion of the forearm. Diagnosis is established on radiographic evaluation. Underdiagnosis is common because disruption of the ligamentous restraints of the DRUJ may be overlooked. Nonsurgical management with anatomic reduction and immobilization in a long-arm cast has been successful in children. In adults, nonsurgical treatment typically fails because of deforming forces acting on the distal radius and DRUJ. Open reduction and internal fixation is the preferred surgical option. Anatomic reduction and rigid fixation should be followed by intraoperative assessment of the DRUJ. Further intraoperative interventions are based on the reducibility and postreduction stability of the DRUJ. Misdiagnosis or inadequate management of Galeazzi fracture may result in disabling complications, such as DRUJ instability, malunion, limited forearm range of motion, chronic wrist pain, and osteoarthritis.

  11. Validity of parental recall of children’s fracture: implications for investigation of childhood osteoporosis (United States)

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


    Purpose The diagnosis of osteoporosis in children requires either a vertebral compression fracture, or a significant fracture history (defined as ≥2 long bone fractures <10 years or ≥3 long bone fractures <19 years, excluding high impact fractures) and low bone mineral density. As children with frequent fractures might benefit from further evaluation, we determined whether parental reports of lifetime fracture were accurate compared to radiological reports, and if they appropriately selected children for further consideration of osteoporosis. Methods Parents of children (<18 years) with a musculoskeletal injury completed a questionnaire on their child’s fracture history, including age, site and mechanism of previous fracture(s). Radiological reports were reviewed to confirm the fracture. Results 660 parents completed the questionnaire, and reported 276 previous fractures in 207 children. An injury treated at our hospital was recorded in 214 of the 276 parentally reported fractures. 34 of 214 (16%) had not resulted in a confirmed fracture. An injury was recorded for all parentally reported fractures in 150 children, but for 21% children there were inaccurate details (no evidence of fracture, incorrect site or forgotten fractures) on parent report. 18/150 children had a significant fracture history on parental report alone, but following review of radiology reports, 2 of 18 (11%) did not have clinically significant fracture histories. Conclusions Approximately 1 in 6 fractures reported by parents to have occurred in their child’s lifetime had not resulted in a fracture. 1 in 9 children with a significant fracture history could have been investigated unnecessarily. PMID:26286627

  12. Fracture Blisters

    Directory of Open Access Journals (Sweden)

    Uebbing, Claire M


    Full Text Available Fracture blisters are a relatively uncommon complication of fractures in locations of the body, such as the ankle, wrist elbow and foot, where skin adheres tightly to bone with little subcutaneous fat cushioning. The blister that results resembles that of a second degree burn.These blisters significantly alter treatment, making it difficult to splint or cast and often overlying ideal surgical incision sites. Review of the literature reveals no consensus on management; however, most authors agree on early treatment prior to blister formation or delay until blister resolution before attempting surgical correction or stabilization. [West J Emerg Med. 2011;12(1;131-133.

  13. Osteoporotic fracture in an elite male Kenyan athlete. (United States)

    Pollock, N; Hamilton, B


    An elite Kenyan runner presented with a tibial fracture sustained during an international cross-country race. There was no clear history of symptoms suggestive of preceding overload and no radiological features of stress fracture. He was found to have sustained an osteoporotic, insufficiency fracture. There are no previous case reports of an osteoporotic fracture in a male athlete. Possible aetiologies and directions for future investigation are presented.

  14. Ischial apophyseal fracture in an abused infant

    Energy Technology Data Exchange (ETDEWEB)

    Bixby, Sarah D.; Kleinman, Paul K. [Boston Children' s Hospital, Department of Radiology, Boston, MA (United States); Wilson, Celeste R. [Boston Children' s Hospital, Child Protection Program, Department of Pediatrics, Boston, MA (United States); Barber, Ignasi [Hospital Vall d' Hebron, Department of Pediatric Radiology, Barcelona (Spain)


    We report a previously healthy 4-month-old who presented to the hospital with leg pain and swelling and no history of trauma. Radiographs demonstrated a comminuted left femur fracture. Given the concern for child abuse, skeletal survey was performed and revealed four vertebral compression deformities. Although abuse was suspected, the possibility of a lytic lesion associated with the femur fracture and multiple spinal abnormalities raised the possibility of an underlying process such as Langerhans cell histiocytosis. Subsequently 18F-NaF positron emission tomographic (PET) scintigraphy revealed increased tracer activity in the ischium, and MRI confirmed an ischial apophyseal fracture. Pelvic fractures, particularly ischial fractures, are extremely rare in the setting of child abuse. This case report describes the multimodality imaging findings of an ischial fracture in an abused infant. (orig.)

  15. Risk of falling in patients with a recent fracture

    Directory of Open Access Journals (Sweden)

    Willems Gittie


    Full Text Available Abstract Background Patients with a history of a fracture have an increased risk for future fractures, even in short term. The aim of this study was to assess the number of patients with falls and to identify fall risk factors that predict the risk of falling in the first three months after a clinical fracture. Methods Prospective observational study with 3 months of follow-up in a large European academic and regional hospital. In 277 consenting women and men aged ≥ 50 years and with no dementia and not receiving treatment for osteoporosis who presented to hospital with a clinical fracture, fall risk factors were assessed according to the guidelines on fall prevention in the Netherlands. Follow-up information on falls and fractures was collected by monthly telephone interview. Incidence of falls and odds ratio's (OR, with 95% confidence intervals were calculated. Results 512 consecutive patients with a fracture were regarded for analysis, 87 were not eligible for inclusion and 137 patients were excluded. No follow-up data were available for 11 patients. Therefore full analysis was possible in 277 patients. A new fall incident was reported by 42 patients (15%, of whom five had a fracture. Of the 42 fallers, 32 had one new fall and 10 had two or more. Multivariate analysis in the total group with sex, age, ADL difficulties, urine incontinence and polypharmacy showed that sex and ADL were significant fall risk factors. Women had an OR of 3.02 (95% CI 1.13–8.06 and patients with ADL-difficulties had an OR of 2.50 (95% CI 1.27–4.93. Multivariate analysis in the female group with age, ADL difficulties, polypharmacy and presence of orthostatic hypotension indicated that polypharmacy was the predominant risk factor (OR 2.51; 95% CI: 1.19 – 5.28. The incidence of falls was 35% in women with low ADL score and polypharmacy compared to 15% in women without these risk factors (OR 3.56: CI 1.47 – 8.67. Conclusion 15% of patients reported a new fall

  16. Hand Fractures (United States)

    ... Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is ... serve as a framework. This framework supports the muscles that make the wrist ... When one of these hand bones is broken (fractured), it can prevent you ...

  17. Fracture source

    Directory of Open Access Journals (Sweden)


    Full Text Available The fracture properties of many different types of fibers are covered in a timely new book that will prove to be a tremendous source of information and references for researchers in the wide and diverse field of fibers and composites, says Bill Clegg.

  18. Rib Fractures (United States)

    ... Commentary Recent News Scientists Working on Solar-Powered Prosthetic Limbs Exercise a Great Prescription to Help Older Hearts Bavencio Approved for Rare Skin Cancer Older Mothers May Raise Better-Behaved Kids, Study ... or a collapsed lung (pneumothorax—see Traumatic Pneumothorax ). An injury that fractures the lower ribs sometimes also damages the liver (see Liver ...

  19. [Thoracolumbar fractures]. (United States)

    Freslon, M; Bouaka, D; Coipeau, P; Defossez, G; Leclercq, N; Nebout, J; Marteau, E; Poilbout, N; Prebet, R


    Thoracolumbar fractures are frequent and the functional outcomes are sometimes severe. This multicentric study, including five medical centers, was performed to evaluate the long-term outcomes of the patients. One hundred and thirty six patients with thoracolumbar fracture (T11 to L2) was evaluated with a minimal follow-up of two years. Every one had a clinical exam with a score of Oswestry and an X-Ray study (before and after treatment and at revision). Most of them presented compression fractures, the most often at L1 level. On X-rays, a gain was noted on the vertebral kyphosis immediately after surgery, but there is a loss of correction over time whatever the treatment. The clinical outcomes for the patients were great, with an Oswestry average score of 6,4. A correlation was noted between this functional score and vertebral kyphosis. So, an anterior column strengthening (isolated or performed during the surgery) could improve these functional outcomes. Moreover, the Thoraco Lumbar Injury Severity Score (TLISS) seems to be a simple organigram to determine the most appropriate treatment of these fractures, with particular attention to the distraction mechanism or posterior ligamentous complex lesions. However, RMI before surgery is necessary to evaluate these lesions.

  20. Influence of fracture heterogeneity and wing length on the response of vertically fractured wells

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, C.O.; Raghavan, R.; Reynolds, A.C.; Rosato, N.D.


    A finite-conductivity vertical fracture intersecting a well produced at a constant rate or at a constant pressure is considered. The pressure (or rate) response is obtained from a numerical model. Two aspects of this problem are considered: variable fracture conductivity and unequal fracture wing lengths. The first part of this paper examines the influence of fracture conductivity on the well response. In practice, the fracture conductivity is a decreasing function of distance from the wellbore. If the fracture conductivity decreases monotonically with distance from the wellbore, then at late times the variable fracture conductivity solutions behave like a constant-conductivity fracture, with conductivity equal to the arithmetic average of the conductivity. At early times the response is identical to that of a constant-conductivity fracture, corresponding to the highest conductivity of the fracture. For the variable fracture conductivity case, the bilinear flow period characterized by a one-quarter slope line may be obscured. Thus, analysis of short-time data can be difficult. The authors also consider situations where the fracture conductivity does not decrease monotonically with distance. The response for these cases is discussed in detail. The second part of the paper examines the effect of unequal wing lengths on the pressure response.

  1. Influence of fracture heterogeneity and wing length on the response of vertically fractured wells

    Energy Technology Data Exchange (ETDEWEB)

    Bennett, C.O.; Raghavan, R.; Reynolds, A.C.; Rosato, N.D.


    A finite-conductivity vertical fracture intersecting a well produced at a constant rate or at a constant pressure is considered. The pressure (or rate) response is obtained from a numerical model. Two aspects of this problem are considered: variable fracture conductivity and unequal fracture wing lengths. The first part of this paper examines the influence of fracture conductivity on the well response. In practice, the fracture conductivity is a decreasing function of distance from the wellbore. If the fracture conductivity decreases monotonically with distance from the wellbore, then at late times the variable fracture conductivity solutions behave like a constant-conductivity fracture, with conductivity equal to the arithmetic average of the conductivity. At early times the response is identical to that of a constant-conductivity fracture, corresponding to the highest conductivity of the fracture. For the variable fracture conductivity case, the bilinear flow period characterized by a one-quarter slope line may be obscured. Thus, analysis of short-time data can be difficult. The authors also consider situations where the fracture conductivity does not decrease monotonically with distance. The response for these cases is discussed in detail. The second part of the paper examines the effect of unequal wing lengths on the pressure response. The authors delineate conditions under which the effect of wing length on the response will become dominant. They discuss the influence of wing length on both early- and long-time data.

  2. A short history of neutrinos, what we have learned about them, what we have learned using them, up to neutrino oscillations.”

    CERN Document Server

    CERN. Geneva


    This, the opening talk of the Kyoto conference, Neutrino 2012, attempts a brief review of the history of the neutrinos, up to neutrino oscillations, beginning with the discovery of the continuous β spectrum in 1914, to the demonstration of the tau neutrino in 2001, the contributions of the study of neutrino interactions to the evolution of the electroweak and the QCD theories, in particular the discovery of neutral currents, the demonstrations that the partons of nuclear structure are quarks, and the first quantitative confirmation of QCD in the scaling violations of deep inelastic scattering, and the structure functions of the nucleon.

  3. Numerical simulation of the environmental impact of hydraulic fracturing of tight/shale gas reservoirs on near-surface ground water: background, base cases, shallow reservoirs, short-term gas and water transport (United States)

    Researchers examined gas and water transport between a deep tight shale gas reservoir and a shallow overlying aquifer in the two years following hydraulic fracturing, assuming a pre-existing connecting pathway.

  4. A short history of two nineteenth century German instruments at the Bologna Observatory: The 16-cm Steinheil refractor and the Ertel & Sohn meridian circle (United States)

    Poppi, Francesco; Bònoli, Fabrizio; Gualandi, Andrea


    Recent work to restore and set up the materials exhibited at the Museo della Specola of the University of Bologna provided an opportunity to review the history of two important German instruments from the mid-nineteenth century, an Ertel & Sohn meridian circle and a Steinheil refractor. Purchased by the directors of the Bologna Observatory to revitalise local astronomical research, which had gradually declined over the years, both instruments have intriguing histories because, despite the fact that they were essentially underused, they also contributed to two important research projects. Lorenzo Respighi used one of them - the Ertel & Sohn meridian circle - for an experiment in physical optics related to the debate on whether light was undulatory or corpuscular, and it was essentially a forerunner of ‘water-filled telescopes’. The other, a Steinheil refractor to which a Tauber spectroscope was attached, was the largest and most important instrument used by the Italian expedition to India, organised by Pietro Tacchini to observe the transit of Venus across the Sun in 1874.

  5. History of adaptation determines short-term shifts in performance and community structure of hydrogen-producing microbial communities degrading wheat straw. (United States)

    Valdez-Vazquez, Idania; Morales, Ana L; Escalante, Ana E


    This study addresses the question of ecological interest for the determination of structure and diversity of microbial communities that degrade lignocellulosic biomasses to produce biofuels. Two microbial consortia with different history, native of wheat straw (NWS) and from a methanogenic digester (MD) fed with cow manure, were contrasted in terms of hydrogen performance, substrate disintegration and microbial diversity. NWS outperformed the hydrogen production rate of MD. Microscopic images revealed that NWS acted on the cuticle and epidermis, generating cellulose strands with high crystallinity, while MD degraded deeper layers, equally affecting all polysaccharides. The bacterial composition markedly differed according to the inocula origin. NWS almost solely comprised hydrogen producers of the phyla Firmicutes and Proteobacteria, with 38% members of Enterococcus. After hydrogen fermentation, NWS comprised 8% Syntrophococcus, an acetogen that cleaves aryl ethers of constituent groups on the aromatic components of lignin. Conversely, MD comprised thirteen phyla, primarily including Firmicutes with H2 -producing members, and Bacteroidetes with non-H2 -producing members, which reduced the hydrogen performance. Overall, the results of this study provide clear evidence that the history of adaptation of NWS enhanced the hydrogen performance from untreated wheat straw. Further, native wheat straw communities have the potential to refine cellulose fibers and produce biofuels simultaneously. © 2017 The Authors. Microbial Biotechnology published by John Wiley & Sons Ltd and Society for Applied Microbiology.

  6. Fluid driven fracture mechanics in highly anisotropic shale: a laboratory study with application to hydraulic fracturing (United States)

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


    The finding of considerable volumes of hydrocarbon resources within tight sedimentary rock formations in the UK led to focused attention on the fundamental fracture properties of low permeability rock types and hydraulic fracturing. Despite much research in these fields, there remains a scarcity of available experimental data concerning the fracture mechanics of fluid driven fracturing and the fracture properties of anisotropic, low permeability rock types. In this study, hydraulic fracturing is simulated in a controlled laboratory environment to track fracture nucleation (location) and propagation (velocity) in space and time and assess how environmental factors and rock properties influence the fracture process and the developing fracture network. Here we report data on employing fluid overpressure to generate a permeable network of micro tensile fractures in a highly anisotropic shale ( 50% P-wave velocity anisotropy). Experiments are carried out in a triaxial deformation apparatus using cylindrical samples. The bedding planes are orientated either parallel or normal to the major principal stress direction (σ1). A newly developed technique, using a steel guide arrangement to direct pressurised fluid into a sealed section of an axially drilled conduit, allows the pore fluid to contact the rock directly and to initiate tensile fractures from the pre-defined zone inside the sample. Acoustic Emission location is used to record and map the nucleation and development of the micro-fracture network. Indirect tensile strength measurements at atmospheric pressure show a high tensile strength anisotropy ( 60%) of the shale. Depending on the relative bedding orientation within the stress field, we find that fluid induced fractures in the sample propagate in two of the three principal fracture orientations: Divider and Short-Transverse. The fracture progresses parallel to the bedding plane (Short-Transverse orientation) if the bedding plane is aligned (parallel) with the

  7. Current concepts in pediatric femur fracture treatment. (United States)

    Kanlic, Enes; Cruz, Miguel


    Femoral neck fractures require urgent evacuation of intracapsular hematoma, anatomic reduction, and secure fixation with screws and cast immobilization. Extracapsular trochanteric and subtrochanteric fractures are best treated by fixed angle devices (locked plates or dynamic screw and side plate). "Length stable" low energy shaft fractures with minimal displacement or fractures are treated operatively. Transverse or short oblique shaft fractures in patients fractures. Children > 12 years have less risk of vascular disturbance to the proximal physis, and should have lateral transtrochanateric entry locked rigid nails. Fractures with severe soft tissue injuries could be temporized with external fixation. Distal physis and epiphyseal injuries require anatomical reduction and smooth wires and/or screw fixation (placed in such a way as to minimize further damage to the physis) and need to be augmented with a brace. Leg-length discrepancy is not a significant clinical problem in operatively treated patients. We recommend hardware removal after complete fracture healing, usually in 6 to 12 months. Implants left in the growing child could become buried deep inside of the bone, or cause "periprosthetic" fractures and/or eventually impede adult reconstruction. Minimal risks are reported for hardware removal in healthy patients with healed fractures (4 cortices bridged).

  8. Physiological and Psychological Predictors of Short-Term Disability in Workers with a History of Low Back Pain: A Longitudinal Study (United States)

    Dubois, Jean-Daniel; Cantin, Vincent; Piché, Mathieu; Descarreaux, Martin


    Despite an elusive pathophysiology, common characteristics are often observed in individuals with chronic low back pain (LBP). These include psychological symptoms, altered pain perception, altered pain modulation and altered muscle activation. These factors have been explored as possible determinants of disability, either separately or in cross-sectional studies, but were never assessed in a single longitudinal study. Therefore, the objective was to determine the relative contribution of psychological and neurophysiological factors to future disability in individuals with past LBP. The study included two experimental sessions (baseline and six months later) to assess cutaneous heat pain and pain tolerance thresholds, pain inhibition, as well as trunk muscle activation. Both sessions included the completion of validated questionnaires to determine clinical pain, disability, pain catastrophizing, fear-avoidance beliefs and pain vigilance. One hundred workers with a history of LBP and 19 healthy individuals took part in the first experimental session. The second experimental session was exclusively conducted on workers with a history of LBP (77/100). Correlation analyses between initial measures and disability at six months were conducted, and measures significantly associated with disability were used in multiple regression analyses. A first regression analysis showed that psychological symptoms contributed unique variance to future disability (R2 = 0.093, p = .009). To control for the fluctuating nature of LBP, a hierarchical regression was conducted while controlling for clinical pain at six months (R2 = 0.213, p < .001) where pain inhibition contributed unique variance in the second step of the regression (R2 change = 0.094, p = .005). These results indicate that pain inhibition processes may constitute potential targets for treatment to alleviate future disability in individuals with past or present LBP. Then again, the link between psychological symptoms and

  9. Short-term Results of Muscle-Pedicle Bone Grafting with Tensor Fascia Lata for Delayed Femoral Neck Fractures; Case Series and Literature Review (United States)

    Salgotra, Kuldip; Kohli, Sarabjeet; Vishwakarma, Nilesh


    Neglected, untreated and delayed femur neck fractures are commonly encountered and the treatment dilemma arises especially when the patient is physiologically young and osteosynthesis is the preferred option. Controversy exists in the current literature as the various head salvage surgeries like valgus subtrochanteric osteotomy, non-vascularized fibular bone grafting, muscle pedicle bone grafting (Tensor fascia lata and Quadratus femoris graft) and vascularized bone grafting do not have clear lines of indications. The current study is a case series of 7 patients with femur neck fractures with delayed presentation beyond the vascular emergency period who were treated with osteosynthesis with muscle pedicle bone graft (MPBG) using tensor fascia lata muscle pedicle graft. Patients were followed clinical and radiologically at 6 weeks, 3 and 6 months, 1 year and 3 years and patients were regularly followed. The mean age of the patients was 47 ± 1.1 ranging from 38 to 55 years. There were 6 (85.7%) men and 1 (14.3%) women among the patients. Overall 5 (71.5%) patients had transcervical and 2 (28.5%) had subcapital fractures. At the end of 6 months, 6 (85.7%) patients were pain free and on plain radiographs fracture union was noted. One (14.3%) patient developed collapse and persistent nonunion. Younger group less than 50 years presenting with neglected fracture neck femur should always be give an option of head salvage surgery in selected cases. Muscle pedicle bone grafting has been proven although inconsistently as a valid option for fracture neck femur. We encourage osteosynthesis with the use of tensor fascia lata muscle pedicle grafting along with cancellous cannulated screws as a first option in selected cases of neglected femur neck fractures. PMID:27331067

  10. Diagenesis in porosity evolution of opening-mode fractures, Middle Triassic to Lower Jurassic La Boca Formation, NE Mexico (United States)

    Laubach, Stephen E.; Ward, Meghan E.


    Opening-mode fractures (joints) in Middle Triassic to Lower Jurassic La Boca Formation sandstones, northeastern Mexico, have patterns of fracture porosity, mineral-fill structures, and size distributions not previously described from outcrop. Patterns match those found in cores from many basins. We used aperture measurements along lines of observation (scanlines), fracture-trace maps, petrography, high-resolution scanning-electron-microscope-(SEM)-based cathodoluminescence, and fluid inclusions to characterize fracture populations. Open fractures are lined by quartz that precipitated while fractures were opening, whereas sealed fractures additionally contain calcite deposited after fractures ceased opening. Large fractures and arrays of contemporaneous microfractures have consistent power-law aperture-size scaling over approximately three orders of magnitude. Our results imply that open fractures and fracture sizes depend on diagenetic state. The interplay of fracture mechanics and diagenetic history is a determinant on effective porosity within fractures and, thus, open fracture persistence, connectivity, and fluid flow.

  11. Multiple Sclerosis Increases Fracture Risk: A Meta-Analysis

    Directory of Open Access Journals (Sweden)

    Guixian Dong


    Full Text Available Purpose. The association between multiple sclerosis (MS and fracture risk has been reported, but results of previous studies remain controversial and ambiguous. To assess the association between MS and fracture risk, a meta-analysis was performed. Method. Based on comprehensive searches of the PubMed, Embase, and Web of Science, we identified outcome data from all articles estimating the association between MS and fracture risk. The pooled risk ratios (RRs with 95% confidence intervals (CIs were calculated. Results. A significant association between MS and fracture risk was found. This result remained statistically significant when the adjusted RRs were combined. Subgroup analysis stratified by the site of fracture suggested significant associations between MS and tibia fracture risk, femur fracture risk, hip fracture risk, pelvis fracture risk, vertebrae fracture risk, and humerus fracture risk. In the subgroup analysis by gender, female MS patients had increased fracture risk. When stratified by history of drug use, use of antidepressants, hypnotics/anxiolytics, anticonvulsants, and glucocorticoids increased the risk of fracture risk in MS patients. Conclusions. This meta-analysis demonstrated that MS was significantly associated with fracture risk.

  12. Viral load and short-term natural history of type-specific oncogenic human papillomavirus infections in a high-risk cohort of midadult women. (United States)

    Winer, Rachel L; Xi, Long Fu; Shen, Zhenping; Stern, Joshua E; Newman, Laura; Feng, Qinghua; Hughes, James P; Koutsky, Laura A


    Oncogenic human papillomavirus (HPV) viral load may inform the origin of newly detected infections and characterize oncogenic HPV natural history in midadult women. From 2007 to 2011, we enrolled 521 25-65-year-old-female online daters and followed them triannually with mailed health and sexual behavior questionnaires and kits for self-sampling for PCR-based HPV DNA testing. Samples from oncogenic HPV positive women were selected for type-specific DNA load testing by real-time PCR with adjustment for cellularity. Linear or logistic regression models were used to evaluate relationships between viral levels, health and sexual behavior, and longitudinal oncogenic HPV detection. Type-specific viral levels were borderline significantly higher in oncogenic HPV infections that were prevalent versus newly detected (p = 0.092), but levels in newly detected infections were higher than in infections redetected after intercurrent negativity (p infections detected intermittently, the likelihood of persistent (OR = 4.31, 95% CI: 2.20-8.45) or single-time (OR = 1.32, 95% CI: 1.03-1.71) detection increased per 1-unit increase in baseline log10 viral load. Viral load differences between redetected and newly detected infections suggest a portion of new detections were due to new acquisition, although report of recent new sex partners (a potential marker of new infection) was not predictive of viral load; oncogenic HPV infections in midadult women with new partners likely represent a mix of new acquisition and reactivation or intermittent detection of previous infection. Intermittent detection was characterized by low viral levels, suggesting that intermittent detection of persisting oncogenic HPV infection may be of limited clinical significance. © 2013 UICC.

  13. How the “People’s game“ conquered the world: A short socio-economic history of football in Europe and Serbia

    Directory of Open Access Journals (Sweden)

    Đorđević Ivan


    Full Text Available Contemporary football represents a highly commodified spectacle, a segment of the entertainment industry where huge amounts of money change hands, and the popularity of football competitions - whether national or international - is a global phenomenon, which billions of people take part in. Only thirty years ago, however, the situation was very different. In Western Europe, and especially Great Britain, football was mostly associated with hooliganism, and the audiences at the run-down stadiums were dwindling in numbers. On the other hand, in Eastern Europe before the fall of the Berlin wall football was at its peak, only to fall from grace and onto the European periphery in the 90’s, where it is, by and large, still situated. This dramatic transformation which turned football into “entertainment for rich people” did not occur by accident, it has deep roots in the history of the sport, but also in the wider socio-economic transformations within the context of which this segment of pop culture exists. In this paper I will offer a look at the social and economic conditions in which football developed with the aim of establishing a framework for understanding the changes which occurred within the sport and within the society, with a special focus on the connection between football and the rise of nationalism in the former Yugoslavia, but also wider social processes linked to the descent of Serbia into the so-called process of “transition”, or the acceptance of parliamentary democracy and capitalism as bases of social order. It is my intention to, through the analysis of sociohistorical elements which influenced the development and transformation of the game of football, indicate the wider frame of possibilities for the analysis of contemporary events through the prism of this segment of pop-culture.[Projekat Ministarstva nauke Republike Srbije, br. 177026

  14. Patients with rett syndrome sustain low-energy fractures

    DEFF Research Database (Denmark)

    Roende, Gitte; Ravn, Kirstine; Fuglsang, Kathrine


    We present the first case-control study addressing both fracture occurrence and fracture mechanisms in Rett syndrome (RTT). Two previous studies have shown increased fracture risk in RTT. This was also our hypothesis regarding the Danish RTT population. Therefore, we investigated risk factors...... and x-ray evaluations. National register search on fracture diagnoses was done to obtain complete fracture histories. Our results showed that patients with RTT sustained significantly more low-energy fractures from early age compared with controls, even though overall fracture occurrence apparently...... was not increased. Low-energy fractures were significantly associated with less mobility and lack of ambulation. Associations with MECP2 mutations or epilepsy were not demonstrated, contrary to previous findings. Blood biochemistry indicated a possible need for D vitamin supplementation in RTT. Our study casts...

  15. Weber B Distal Fibular Fracture Diagnosed by Point of Care Ultrasound in the Emergency Department


    Makinen, James


    We report the case of a 45 year-old woman who presented to the Emergency Department (ED) after an acute ankle inversion injury. After history and physical exam suggested a potential fracture, point of care (POC) ultrasound demonstrated a cortical defect of the distal fibula, consistent with fracture. Plain radiography failed to demonstrate a fracture. Later, the fracture was identified as a Weber B distal fibular fracture by stress-view radiography. This case reviews the evaluation of acute a...

  16. Growth Plate Fractures (United States)

    ... the most widely used by doctors is the Salter-Harris system, described below. Type I Fractures These ... incidence of growth plate fractures peaks in adolescence. Salter-Harris classification of growth plate fractures. AAOS does ...

  17. A different trauma, a different fracture

    Directory of Open Access Journals (Sweden)

    Ü. Kaldırım


    Discussion and conclusion: The epiphyses and the apophyses are the weakest part of all the skeletal system. In these regions, avulsion fractures may occur with sudden and severe spasm of the muscles. Avulsion fractures of SIAS are mostly treated conservatively unless there is more than 2 cm fragment separated and non-union case in which case surgery is recommended. This type of injuries can be easily overlooked or misdiagnosed due to history of trauma free. It may also effects

  18. Pneumatic fracturing of low permeability media

    Energy Technology Data Exchange (ETDEWEB)

    Schuring, J.R. [New Jersey Institute of Technology, Newark, NJ (United States)


    Pneumatic fracturing of soils to enhance the removal and treatment of dense nonaqueous phase liquids is described. The process involves gas injection at a pressure exceeding the natural stresses and at a flow rate exceeding the permeability of the formation. The paper outlines geologic considerations, advantages and disadvantages, general technology considerations, low permeability media considerations, commercial availability, efficiency, and costs. Five case histories of remediation using pneumatic fracturing are briefly summarized. 11 refs., 2 figs., 1 tab.

  19. Chopart fractures. (United States)

    Klaue, Kaj


    The Chopart articular space was described by François Chopart (1743-1795) as a practical space for amputations in cases of distal foot necrosis. It corresponds to the limit between the anatomical hind-foot and the mid-foot. The bones involved are the talus and the calcaneus proximally, and the navicular and the cuboid distally. This space thus holds two functionally distinct entities, the anterior part of the coxa pedis (an essential functional joint) and the calcaneo-cuboidal joint,which can be considered to be an "adaptive joint" within a normal foot. Trauma to this region may cause fractures and/or dislocations and, in high energy trauma,compartment syndromes. Principles of treatment are immediate reduction of dislocations and realignment of the medial and lateral column of the foot in length and orientation. Open reduction and internal fixation of talus and navicular fractures are often indicated to restore the "coxa pedis". Open reconstruction or fusion in correct length of the calcaneo-cuboidal joint is occasionally indicated. Salvage procedures in malunions include navicular osteotomies and calcaneo-cuboidal bone block fusions. Treatment of joint destructions, especially involving the talo-navicular joint, include triple arthrodesis.

  20. Fracture of maternal sternum during spontaneous delivery. (United States)

    Stubert, J; Gerber, B


    We report of a maternal sternal fracture during a spontaneous delivery in a 31-year-old primipara without a suitable trauma. The putative mechanism of fracture was strong hyperflexion of the thoracic spine and additional cervical flexion with pushing the chin to the thorax due to active management of labour. The history of the healthy woman was free of related risk factors. A possible promoting factor might be pregnancy-induced bone loss. Although there were clear symptoms, the diagnosis of the fracture was delayed by a week because nobody took account of such a possibility.

  1. Fractures of the distal radius (Colles' fracture)

    National Research Council Canada - National Science Library

    João Carlos Belloti; João Baptista Gomes dos Santos; Álvaro Nagib Atallah; Walter Manna Albertoni; Flavio Faloppa


    CONTEXT AND OBJECTIVE: Although Colles' fracture is a common clinical situation for the orthopedist, we did not find any information in the literature that would allow safe decision-making on the best treatment for each fracture type...

  2. The Effects of Acute Restraint Stress on Plasma Levels of Prolactin and Corticosterone across Life-History Stages in a Short-Lived Bird: Gambel's White-Crowned Sparrow (Zonotrichia leucophrys gambelii). (United States)

    Krause, Jesse S; Meddle, Simone L; Wingfield, John C


    The general reproductive effort model attempts to predict the resources that will be allocated to a current reproductive bout or to future survival by aborting the current reproductive attempt. Life-history theory predicts that short-lived species should devote more resources toward a reproductive event because brood value is far greater compared with that of long-lived species that have multiple breeding opportunities. Previous bird studies have used patterns of hormone secretion to understand the regulation of parental investment in response to environmental challenges, such as stress. The two key hormones investigated have been prolactin, which promotes parental investment, and corticosterone, which can reduce parental investment. Research on long-lived seabirds showed that prolactin levels decrease in response to a stressor, but the magnitude of the decline was positively correlated with future reproductive potential. However, little is known about the role of prolactin in short-lived species. Here we present prolactin and corticosterone data from a short-lived Arctic breeding, migratory songbird-the white-crowned sparrow, Zonotrichia leucophrys gambelii-at multiple stages of the breeding and nonbreeding seasons following standardized acute restraint stress. These data show that both prolactin and corticosterone are modulated seasonally. Corticosterone levels increased significantly in response to acute restraint stress during the breeding season in both sexes, but prolactin levels did not change in response to acute restraint stress at any stage of the annual cycle. We found no relationship between corticosterone or prolactin at either baseline or peak induced levels during any stage of breeding.

  3. Pediatric Hip Fractures in California: Results from a Community-Based Hip Fracture Registry. (United States)

    Prentice, Heather A; Paxton, Elizabeth W; Hunt, Jessica J; Grimsrud, Christopher D; Weiss, Jennifer M


    Hip fracture registries offer an opportunity to identify and to monitor patients with rare conditions and outcomes, including hip fractures in pediatric patients. To report patient demographics and surgical outcomes of pediatric patients treated surgically for hip fractures in a large integrated health care system. Pediatric patients (fracture) with hip fractures were identified between 2009 and 2012 using our health care system's hip fracture registry. Patient characteristics, type of fracture, surgical treatment, and short-term complications. Among 39 patients identified, 31 (79.5%) were male, and the median age was 15 years old (interquartile range: 11-17 years). Most patients were Hispanic (n = 17, 43.6%) or white (n = 14, 35.9%). There were 8 patients (20.5%) with 15 comorbidities. Delbet Type IV (intertrochanteric) fractures were the most common fracture type (n = 22, 56.4%), and fixation method was equally distributed between intramedullary, screw and sideplate, and screws (n = 12, 30.8% for each). Most surgeries were performed by medium-volume surgeons (n = 22, 56.4%) at medium- and high-volume hospitals (n = 37, 94.9%). Three 90-day readmissions (7.7%), 1 infection (2.6%), 1 malunion (2.6%), and 1 revision (2.6%) were observed in this cohort during the study period. In our series using registry data, hip fractures younger than age 21 years were more common in boys and Hispanic patients. Intertrochanteric fractures (Delbet Type IV) were the most frequently observed type in our community-based hip fracture registry. Short-term complications were infrequent.

  4. Biomechanical analysis of short-segment pins Index-level screw fixation for low lumbar burst fractures%Index-level螺钉短节段固定治疗下腰椎爆裂压缩骨折的生物力学研究

    Institute of Scientific and Technical Information of China (English)

    王涛; 马剑雄; 王玉龙; 马信龙; 张晓林; 徐宝山; 杨强


    目的 通过对L4椎体爆裂骨折模型以及应用不同方法固定后的生物力学测试,探讨Index-level螺钉短节段固定方法在治疗下腰椎爆裂骨折中的意义.方法 选取10具新鲜尸体腰骶椎标本,通过截骨、切断部分韧带的方法制作L4椎体爆裂骨折模型,然后依序进行长节段固定、短节段固定以及短节段+ Index-level螺钉固定并进行生物力学测试,比较不同固定方法腰椎活动度(range of motion,ROM)的差异.结果 与短节段固定比较,短节段+Index-level螺钉固定在前屈、轴向旋转和侧屈时ROM降低,差异有统计学意义(P<0.05).在后伸位时短节段+Index-level固定稳定性提高,ROM降低32.7%,但差异无统计学意义.结论 Index-level螺钉短节段固定较单纯短节段内固定平均提高32.5%的即刻稳定性,而且比长节段固定保留更大范围ROM.%Objective To establish L4 vertebrae burst fractures and take a biomechanical test of different internal fixations so as to discuss the significance of internal fixation using short-segment plus Index-level screws in treatment of low lumbar burst fractures.Methods Ten fresh human lumbosacral vertebrae specimens were used to establish models of L4 vertebrae burst fractures by corpectomy and partial removal of ligament.Thereafter,the biomechanical test was performed in order as below:longsegment fixation,short-segment fixation and short-segment construction plus Index-level screw fixation.Differences of range of motion (ROM) of the lumbar after three different internal fixations were compared.Results Compared with short-segment fixation,short-segment plus Index-level screw fixation showed that ROM of the lumbar was decreased in front flexion,axial rotation and lateral bending (P < 0.05),but stability was improved and ROM of lumbar was decreased by 32.7% in back extension (P > 0.05).Conclusions Compared with short-segment fixation,the short-segment plus Index-level screw fixation can

  5. 髋臼横断骨折后柱长/短钢板内固定的有限元建模及分析%FEM Modeling and Analysis of Transverse Fractured Acetabulum with Fixations of Posterior Column Long Plate and Short Plate

    Institute of Scientific and Technical Information of China (English)

    吴淑琴; 潘宏侠; 裴葆青


    目的 建立有效的髋臼横断骨折有限元模型,完成两种内固定方式的比较.方法 利用Mimics 10.0中建立髋臼骨骨折的三维模型,在逆向工程Geomagic中进行相应处理后,在ANSYS Workbench中生成短/长钢板固定模型,并进行加载分析.结果 相同加载方式下,短钢板模型的最大位移、模型整体及髋臼窝处的最大应力和最大应变,均大于长钢板模型.另外,短钢板模型更容易错位失效.结论 本文有限元模型能有效地反映骨盆应力分布,分析结果表明后壁钢板固定时,将钢板长度延伸至坐骨结节处能提供更大的稳定性.%Objective To establish a valid finite element model of the transverse fractured acetabulum and finish the analysis of inner fixation ways. Methods The three-dimensional image of the pelvis was reconstructed with the software Mimics 10. 0 and was modified with the software Geomagic. Then the 3D model of fractured pelvis was imported into ansys workbench and was established after some operations. After that the integrated 3D finite element models of transverse fractured acetabulums were established, which were fixed with posterior column long and short plates respectively. Finally the vertical load pressure was exerted on the upper terminal plate of the pelvis with some constrainer, and the distribution of stress was analyzed. Results With same loads , the maximum total deformation , von-mises stress and von-mises strain of short plate were bigger than them of long plate. In addition, the model with short plate was easier to lapse. Conclusion It was indicated that the proposed model was stable and valid to contribute the stress of pelvis. For the fixation of transverse fractured acetabulum with a posterior plate, extending the plate to hucklebone tuber was considered more stable.

  6. Hidden penile fracture: An unusual presentation and review of literature. (United States)

    Sabharwal, Sagar; George, Arun Jacob Philip; Singh, J Chandra


    Penile fractures, a not so uncommon urological emergency, mostly present with a characteristic history and physical examination. Here, we present an atypical case where even in the absence of physical findings, a characteristic history led us to penile exploration and timely repair, highlighting the importance of careful history-taking in these cases.

  7. Sauve-Kapandji手术治疗陈旧性伴桡骨短缩的桡骨远端骨折的疗效观察%lnvestigate the clinical effect of the Sauve-Kapandji therapy for the old distal radius fracture with short radius

    Institute of Scientific and Technical Information of China (English)

    李利军; 魏杰; 宋洁富; 常峰; 常保国; 赵金善


    Objective: To investigate the clinical effect of the Sauve-Kapandji therapy for the old distal radius fracture with short raius.Methods:From May 2000,12 cases of the old distal radius fracture were treated using Sauve-Kapandji method.The postoperative follow-up ranged from 6to 24 months. Results: The mobility of wrist improved,the rotation movement of forearm improved from (98.45 ±13.12)to (134.94 ±13.45) and gripping strength improved from (17.56 ±1.13)to (35.12 ±2.87).Conclusion:Sauve-Kapandji method is a good way for the old distal radius fracture with short radius.%目的:应用Sauve-Kapandji手术治疗陈旧性伴桡骨短缩的桡骨远端骨折的临床疗效探讨。方法:对2000年5月以来应用该手术治疗12例患者,术后随访6~24个月。以最后恢复的功能情况进行评估。结果:12例患者腕关节伸屈活动明显改善,前臂旋转活动范围由(98.45±13.12)恢复至(134.94±13.45),手握力由(17.56±1.13)恢复至(35.12±2.87)。结论: Sauve-Kapandji手术是治疗陈旧性伴桡骨短缩的桡骨远端骨折的一种安全而有效的方法。

  8. Numerical Investigation of Fracture Propagation in Geomaterials (United States)

    Newell, P.; Borowski, E.; Major, J. R.; Eichhubl, P.


    Fracture in geomaterials is a critical behavior that affects the long-term structural response of geosystems. The processes involving fracture initiation and growth in rocks often span broad time scales and size scales, contributing to the complexity of these problems. To better understand fracture behavior, the authors propose an initial investigation comparing the fracture testing techniques of notched three-point bending (N3PB), short rod (SR), and double torsion (DT) on geomaterials using computational analysis. Linear softening cohesive fracture modeling (LCFM) was applied using ABAQUS to computationally simulate the three experimental set-ups. By applying material properties obtained experimentally, these simulations are intended to predict single-trace fracture growth. The advantages and limitations of the three testing techniques were considered for application to subcritical fracture propagation taking into account the accuracy of constraints, load applications, and modes of fracture. This work is supported as part of the Geomechanics of CO2 Reservoir Seals, a DOE-NETL funded under Award Number DE-FOA-0001037. Sandia National Laboratories is a multi-program laboratory managed and operated by Sandia Corporation, a wholly owned subsidiary of Lockheed Martin Corporation, for the U.S. Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000.

  9. Effect of Natural Fractures on Hydraulic Fracturing (United States)

    Ben, Y.; Wang, Y.; Shi, G.


    Hydraulic Fracturing has been used successfully in the oil and gas industry to enhance oil and gas production in the past few decades. Recent years have seen the great development of tight gas, coal bed methane and shale gas. Natural fractures are believed to play an important role in the hydraulic fracturing of such formations. Whether natural fractures can benefit the fracture propagation and enhance final production needs to be studied. Various methods have been used to study the effect of natural fractures on hydraulic fracturing. Discontinuous Deformation Analysis (DDA) is a numerical method which belongs to the family of discrete element methods. In this paper, DDA is coupled with a fluid pipe network model to simulate the pressure response in the formation during hydraulic fracturing. The focus is to study the effect of natural fractures on hydraulic fracturing. In particular, the effect of rock joint properties, joint orientations and rock properties on fracture initiation and propagation will be analyzed. The result shows that DDA is a promising tool to study such complex behavior of rocks. Finally, the advantages of disadvantages of our current model and future research directions will be discussed.

  10. Subchondral insufficiency fracture of the femoral head in younger adults

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Takuaki; Nakashima, Yasuharu; Shuto, Toshihide; Jingushi, Seiya; Iwamoto, Yukihide [Graduate School of Medical Sciences, Kyushu University, Department of Orthopaedic Surgery, Fukuoka (Japan)


    We report two cases of subchondral insufficiency fracture of the femoral head observed in younger adults without any history of overexertion. In both cases, MRI revealed an irregular, discontinuous low-intensity band on the T1-weighted images. Both patients were treated operatively, and histological examination confirmed the diagnosis of subchondral fracture. A diagnosis of subchondral insufficiency fracture needs to be put in as one of the diagnoses in younger patients with a hip pain. (orig.)

  11. Fracture channel waves (United States)

    Nihei, Kurt T.; Yi, Weidong; Myer, Larry R.; Cook, Neville G. W.; Schoenberg, Michael


    The properties of guided waves which propagate between two parallel fractures are examined. Plane wave analysis is used to obtain a dispersion equation for the velocities of fracture channel waves. Analysis of this equation demonstrates that parallel fractures form an elastic waveguide that supports two symmetric and two antisymmetric dispersive Rayleigh channel waves, each with particle motions and velocities that are sensitive to the normal and tangential stiffnesses of the fractures. These fracture channel waves degenerate to shear waves when the fracture stiffnesses are large, to Rayleigh waves and Rayleigh-Lamb plate waves when the fracture stiffnesses are low, and to fracture interface waves when the fractures are either very closely spaced or widely separated. For intermediate fracture stiffnesses typical of fractured rock masses, fracture channel waves are dispersive and exhibit moderate to strong localization of guided wave energy between the fractures. The existence of these waves is examined using laboratory acoustic measurements on a fractured marble plate. This experiment confirms the distinct particle motion of the fundamental antisymmetric fracture channel wave (A0 mode) and demonstrates the ease with which a fracture channel wave can be generated and detected.

  12. Traumatic thoracolumbar spine fractures

    NARCIS (Netherlands)

    J. Siebenga (Jan)


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


    Directory of Open Access Journals (Sweden)

    Z Moinfar


    Full Text Available Short rib polydactyly syndrome (SRPS is a very rare congenital anomaly that is classified into four subtypes. It is an autosomal recessive inherited disease. We report a case of this syndrome without a previous family history of congenital defects.

  14. Risk factors for hip fracture in European women: the MEDOS Study. Mediterranean Osteoporosis Study. (United States)

    Johnell, O; Gullberg, B; Kanis, J A; Allander, E; Elffors, L; Dequeker, J; Dilsen, G; Gennari, C; Lopes Vaz, A; Lyritis, G


    The aims of this study were to determine common international risk factors for hip fracture in women aged 50 years or more. We studied women aged 50 years or more who sustained a hip fracture in 14 centers from Portugal, Spain, France, Italy, Greece, and Turkey over a 1-year period. Women aged 50 years or more selected from the neighborhood or population registers served as controls. Cases and controls were interviewed using a structured questionnaire on work, physical activity, exposure to sunlight, reproductive, history and gynecologic status, height, weight, mental score, and consumption of tobacco, alcohol, calcium, coffee, and tea. Significant risk factors identified by univariate analysis included low body mass index (BMI), short fertile period, low physical activity. lack of sunlight exposure, low milk consumption, no consumption of tea, and a poor mental score. No significant adverse effects of coffee or smoking were observed. Moderate intake of spirits was a protective factor in young adulthood, but otherwise no significant effect of alcohol intake was observed. For some risks, a threshold effect was observed. A low BMI and milk consumption were significant risks only in the lowest 50% and 10% of the population, respectively. A late menarche, poor mental score, low BMI and physical activity, low exposure to sunlight, and a low consumption of calcium and tea remained independent risk factors after multivariate analysis, accounting for 70% of hip fractures. Excluding mental score and age at menarche (not potentially reversible), the attributable risk was 56%. Thus, about half of the hip fractures could be explained on the basis of the potentially reversible risk factors sought. In contrast, the use of risk factors to "predict" hip fractures had moderate sensitivity and specificity. We conclude that variations in lifestyle factors are associated with significant differences in the risk of hip fracture, account for a large component of the total risk, and may

  15. Meteorite Fractures and Scaling for Atmospheric Entry (United States)

    Bryson, Kathryn L.; Ostrowski, Daniel R.


    We are attempting to understand the behavior of asteroids entering the atmosphere in order to help quantify the impact hazard. The strength of meteorites plays a critical role in determining the outcome of their impact events. Our objective is to scale fracture parameters in meteorites to their parent body.In this study over a thousand meteorite fragments in the Natural History Museums of Vienna and London (mostly hand-sized, some 40 or 50 cm across) were examined and fracture patterns in selected fragments were imaged. We identified six kinds of fracturing behavior. The density and length of the observed fractures were measured in hand specimens and thin sections. We assume that fracturing follows the Weibull distribution, where fractures are assumed to be randomly distributed through the target and the likelihood of encountering a fracture increases with distance. The images collected of the six fracture behaviors provide a two-dimensional view of the fractures. A relationship exists between the distributions of measured trace length and actual fracture size, where the slope of a log-log plot of trace length vs fracture density is proportional to α, the shape parameter. The value for α is unclear and a large range in α has been determined from light curve data. α can be used to scale strengths from the meteorite to the larger parent body.The majority of the meteorite fractures imaged displayed no particular sensitivity to meteorite texture. A value of α of 0.185 has been determined for a chondrite with a fracture pattern that shows no sensitivity to meteorite texture and has no point of origin. This study will continue to examine additional meteorites with similar fracture patterns along with the other 5 patterns to see if there is a correlation between fracture pattern and α. This may explain the variations in α determined from fireball data. Values of α will be used in models created by the Asteroid Threat Assessment Project to try to determine the

  16. Management of Bilateral Femoral Fractures in Pregnancy: A Case ...

    African Journals Online (AJOL)

    Management of Bilateral Femoral Fractures in Pregnancy: A Case Report. ... There was no history of loss of consciousness, abdominal pains or vaginal bleeding. ... and manage the pregnancy to the point where the baby is safe for delivery.

  17. [Periprosthetic Acetabulum Fractures]. (United States)

    Schreiner, A J; Stuby, F; de Zwart, P M; Ochs, B G


    In contrast to periprosthetic fractures of the femur, periprosthetic fractures of the acetabulum are rare complications - both primary fractures and fractures in revision surgery. This topic is largely under-reported in the literature; there are a few case reports and no long term results. Due to an increase in life expectancy, the level of patients' activity and the number of primary joint replacements, one has to expect a rise in periprosthetic complications in general and periprosthetic acetabular fractures in particular. This kind of fracture can be intra-, peri- or postoperative. Intraoperative fractures are especially associated with insertion of cementless press-fit acetabular components or revision surgery. Postoperative periprosthetic fractures of the acetabulum are usually related to osteolysis, for example, due to polyethylene wear. There are also traumatic fractures and fractures missed intraoperatively that lead to some kind of insufficiency fracture. Periprosthetic fractures of the acetabulum are treated conservatively if the implant is stable and the fracture is not dislocated. If surgery is needed, there are many possible different surgical techniques and challenging approaches. That is why periprosthetic fractures of the acetabulum should be treated by experts in pelvic surgery as well as revision arthroplasty and the features specific to the patient, fracture and prosthetic must always be considered. Georg Thieme Verlag KG Stuttgart · New York.

  18. Short history of PACS. Part I: USA

    Energy Technology Data Exchange (ETDEWEB)

    Huang, H.K., E-mail: [Departments of Radiology and Biomedical Engineering, University of Southern California (United States); Hong Kong Polytechnic University (Hong Kong); Shanghai Institute of Technical Physics, Chinese Academy of Sciences (China)


    This historical review covers the PACS development in the USA during the past 28 years from 1982 to 2010. General historical remarks of PACS and international scene in three stages from infancy, puberty to adolescence are presented. Early PACS development was mostly financed by the federal government including the National Institutes of Health (NIH) and the U.S. Army Medical Research and Materiel Command. PACS evolution went through several stages. The earliest stages included the definition of large-scale PACS, establishment of the DICOM and other standards, the development of some early key PACS related technologies, and PACS implementation strategies. The later stages were in the concept of enterprise PACS, IHE (Integrating the Healthcare Enterprise) workflow profiles, and ePR with image distribution. The current most excited accomplishment is in the development of the new field in medical imaging informatics. This review goes through these stages and events in the USA during these 28 years, whenever an event involved participants from other countries, the contributors are cited.

  19. Heterotrimeric G-proteins: a short history. (United States)

    Milligan, Graeme; Kostenis, Evi


    Some 865 genes in man encode G-protein-coupled receptors (GPCRs). The heterotrimeric guanine nucleotide-binding proteins (G-proteins) function to transduce signals from this vast panoply of receptors to effector systems including ion channels and enzymes that alter the rate of production, release or degradation of intracellular second messengers. However, it was not until the 1970s that the existence of such transducing proteins was even seriously suggested. Combinations of bacterial toxins that mediate their effects via covalent modification of the alpha-subunit of certain G-proteins and mutant cell lines that fail to generate cyclic AMP in response to agonists because they either fail to express or express a malfunctional G-protein allowed their identification and purification. Subsequent to initial cloning efforts, cloning by homology has defined the human G-proteins to derive from 35 genes, 16 encoding alpha-subunits, five beta and 14 gamma. All function as guanine nucleotide exchange on-off switches and are mechanistically similar to other proteins that are enzymic GTPases. Although not readily accepted initially, it is now well established that beta/gamma complexes mediate as least as many functions as the alpha-subunits. The generation of chimeras between different alpha-subunits defined the role of different sections of the primary/secondary sequence and crystal structures and cocrystals with interacting proteins have given detailed understanding of their molecular structure and basis of function. Finally, further modifications of such chimeras have generated a range of G-protein alpha-subunits with greater promiscuity to interact across GPCR classes and initiated the use of such modified G-proteins in drug discovery programmes.

  20. A Short History of Posterior Dynamic Stabilization

    Directory of Open Access Journals (Sweden)

    Cengiz Gomleksiz


    Full Text Available Interspinous spacers were developed to treat local deformities such as degenerative spondylolisthesis. To treat patients with chronic instability, posterior pedicle fixation and rod-based dynamic stabilization systems were developed as alternatives to fusion surgeries. Dynamic stabilization is the future of spinal surgery, and in the near future, we will be able to see the development of new devices and surgical techniques to stabilize the spine. It is important to follow the development of these technologies and to gain experience using them. In this paper, we review the literature and discuss the dynamic systems, both past and present, used in the market to treat lumbar degeneration.

  1. A Short History of Hindu Astronomy & Ephemeris


    P Rudra


    We have summarized here the astronomical knowledge of the ancient Hindu astronomers. This knowledge was accumulated from before 1500 B.C. up to around 1200 A.D. In Section \\ref{equiv} we have correlated terms used by the Hindu astronomers and their equivalents in modern astronomy. In Section \\ref{coord} we have defined the different astronomical coordinate systems and their transformation relations. In Sections \\ref{seasons} and \\ref{cycles} we have collected the main features of solar and lu...

  2. A Short History of Deinstitutionalisation in Slovenia

    Directory of Open Access Journals (Sweden)

    Vito Flaker


    Full Text Available The definition of deinstitutionalisation needs to be broader than just resettlement of the people from closed institutions into the community; it also presents a fundamental shift in the power relations of users and professionals as well as an epistemological rupture away from aprioristic and esoteric knowledge of control towards wisdom of everyday live. The process in Slovenia began in the sixties with the experiment in Logatec demonstrating that an institution can be transformed, introducing new methods of working with people based on democratic relationships, action research and experiment. An incubation period ensued in the seventies in various action research projects, most legendary being the kids summer camp in Rakitna and Črni mrav (Black Ant scouts camps, providing holidays and including children and youth with various labels in the community leisure organisations. These projects featured anti-authoritarianism, inclusion of the stigmatised, democratisation of the community by the community and group work. The goals of deinstitutionalisation – closure of the institutions and alternative provision of community services – was clearly articulated in the eighties in youth work camps in the long-stay institution of Hrastovec and in the activities of the Committee for Social Protection of Madness. First, community services – group homes, day centres and clubs, self-help and users and carers associations, but also individual planning and direct funding were introduced in the nineties in the nongovernmental sector. The real deinstitutionalisation process commenced in the first decade of this century by resettlement of the long stay inmates in Hrastovec, followed also by other long stay institutions. When deinstitutionalisation had to become a principle guiding the whole system, the process came to a halt, partly because of the lack of political will and partly because of the segmentation of the sectors and professions. Deinstitutionalisation has to be understood as a process of liberation and emancipation, as a movement that transcends the divisions between professionals and people – as an opportunity to work differently – for the good of the people.

  3. A short history of laser development. (United States)

    Hecht, Jeff


    Half a century has passed since Theodore Maiman's small ruby rod crossed the threshold of laser emission. The breakthrough demonstration earned headlines, but in the early years the laser was called "a solution looking for a problem," and there was a germ of truth in the joke. Years of development since then have vastly improved laser performance,and tremendously increased their variety, earning lasers important roles in scientific research, consumer products, telecommunications,engineering, medicine, materials working, and a host of other applications. This article reviews the highlights of those developments and puts them into context, showing how laser technology has evolved to meet application requirements.

  4. A short history of bad acoustics. (United States)

    Wright, M C M


    Every branch of science attracts its share of cranks and pseudoscientists, and acoustics has been no exception. A brief survey of those who touched on acoustics is given with quotations from the more interesting or egregious examples. A contrast is drawn between the nineteenth century contrarian's quarrel with particular theories and the modern new age wholesale rejection of theory. This world-view is traced back to the later scientific writings of Goethe. Examples of pseudoscience applied to biomedical acoustics, architectural acoustics, and audio reproduction are given.

  5. A short term analysis on of therapeutic effects of locking proximal humerus plate for the treatment of comminuted fractures of proximal humerus%肱骨近端锁定钢板治疗肱骨近端粉碎性骨折的短期随访研究

    Institute of Scientific and Technical Information of China (English)

    李昌坤; 张斌; 杨先武


    目的 探讨肱骨近端锁定钢板治疗肱骨近端粉碎性骨折的短期疗效,为临床应用提供依据.方法 总结2008年8月~2009年12月20例使用LPHP治疗的肱骨近端粉碎性骨折患者资料,使用Consta-nt-Murley(C-M)肩关节评分标准进行疗效评定.结果 术后所有患者切口Ⅰ期愈合,所有患者定期随访,分别在术后3、6和12个月,随访时间12 ~26个月,平均13.15个月.18例于术后5~8个月获得骨性愈合.术后3、6与12个月C-M肩关节评分比较,差异无统计学意义,其中优7例,良6例,一般5例,差2例.结论 LPHP治疗肱骨近端粉碎性骨折,短期疗效显著.%Objective To investigate the short-term curative effects of locking proximal humerus plate for the treatment of comminuted fractures of proximal humerus, and provide evidences for the clinical practice. Methods From August 2008 and December 2009,20 patients with comm inuted fractures of proximal humerus were treated with locking plates, Outcomes were assessed with radio graphy and the Constant-Murley(C-M) shoulder evalution. Results All the patients got primary healing of incisions. Twenty patients were followed up,and the duration ranged from 12 to 26 months,with an average of 13. 15 months. Eighteen patients had fracture healing during 5 to 8months after operation. There was no significant differences among 3,6 and 12 months after operation in C-M scoring. There were 7 cases got an excellent result, 6 good, 5 fair, and 2 poor. Conclusion The short-term curative effect of the locking proximal humerus plate in the treatment of proximal humeral fractures is significant.

  6. The effects of long (C20/22) and short (C18) chain omega-3 fatty acids on keel bone fractures, bone biomechanics, behavior, and egg production in free-range laying hens. (United States)

    Toscano, M J; Booth, F; Wilkins, L J; Avery, N C; Brown, S B; Richards, G; Tarlton, J F


    Keel fractures in the laying hen are the most critical animal welfare issue facing the egg production industry, particularly with the increased use of extensive systems in response to the 2012 EU directive banning conventional battery cages. The current study is aimed at assessing the effects of 2 omega-3 (n3) enhanced diets on bone health, production endpoints, and behavior in free-range laying hens. Data was collected from 2 experiments over 2 laying cycles, each of which compared a (n3) supplemented diet with a control diet. Experiment 1 employed a diet supplemented with a 60:40 fish oil-linseed mixture (n3:n6 to 1.35) compared with a control diet (n3:n6 to 0.11), whereas the n3 diet in Experiment 2 was supplemented with a 40:60 fish oil-linseed (n3:n6 to 0.77) compared to the control diet (n3:n6 to 0.11). The n3 enhanced diet of Experiment 1 had a higher n3:n6 ratio, and a greater proportion of n3 in the long chain (C20/22) form (0.41 LC:SC) than that of Experiment 2 (0.12 LC:SC). Although dietary treatment was successful in reducing the frequency of fractures by approximately 27% in Experiment 2, data from Experiment 1 indicated the diet actually induced a greater likelihood of fracture (odds ratio: 1.2) and had substantial production detriment. Reduced keel breakage during Experiment 2 could be related to changes in bone health as n3-supplemented birds demonstrated greater load at failure of the keel, and tibiae and humeri that were more flexible. These results support previous findings that n3-supplemented diets can reduce fracture likely by increasing bone strength, and that this can be achieved without detriment to production. However, our findings suggest diets with excessive quantities of n3, or very high levels of C20/22, may experience health and production detriments. Further research is needed to optimize the quantity and type of n3 in terms of bone health and production variables and investigate the potential associated mechanisms. © 2015

  7. Radiation induced fracture of the scapula

    Energy Technology Data Exchange (ETDEWEB)

    Riggs, J.H. III; Schultz, G.D.; Hanes, S.A. (Los Angeles College of Chiropractic, Whittier, CA (USA))


    A case of radiation induced osteonecrosis resulting in a fracture of the scapula in a 76-yr-old female patient with a history of breast carcinoma is presented. Diagnostic imaging, laboratory recommendations and clinical findings are discussed along with an algorithm for the safe management of patients with a history of cancer and musculoskeletal complaints. This case demonstrates the necessity of a thorough investigation of musculoskeletal complaints in patients with previous bone-seeking carcinomas.

  8. Espelho da alma: teoria social e subjetivação em um conto de Machado de Assis Mirror of the soul: subjectivity and social theory in a short history by Machado de Assis

    Directory of Open Access Journals (Sweden)

    César Sabino


    Full Text Available O objetivo deste trabalho é delinear de forma breve as interseções teóricas existentes no conto "O espelho. Um esboço de uma nova teoria da alma humana", de Machado de Assis, e parte da tradição da teoria social que sugere uma síntese sociológica entre ação e estrutura relacionada ao aspecto da construção da identidade e subjetivação, reprodução e mudança social.This paper aims to present a brief outline of the theoretical intersections in the short history "The looking glass. Rough draft of a new theory of the human soul", by Machado de Assis. It departs from the tradiction of social theory that suggests a sociological syntheses between action and strutcture that is closely linked to the issue of one's construction of identity and subjectivaction, their reproduction and social transformation.

  9. Imaging of vertebral fractures

    Directory of Open Access Journals (Sweden)

    Ananya Panda


    Full Text Available Vertebral fracture is a common clinical problem. Osteoporosis is the leading cause of non-traumatic vertebral fracture. Often, vertebral fractures are not clinically suspected due to nonspecific presentation and are overlooked during routine interpretation of radiologic investigations. Moreover, once detected, many a times the radiologist fails to convey to the clinician in a meaningful way. Hence, vertebral fractures are a constant cause of morbidity and mortality. Presence of vertebral fracture increases the chance of fracture in another vertebra and also increases the risk of subsequent hip fracture. Early detection can lead to immediate therapeutic intervention improving further the quality of life. So, in this review, we wish to present a comprehensive overview of vertebral fracture imaging along with an algorithm of evaluation of vertebral fractures.



    Novotny, Julius J.


    This case study involves a patient who presented at a chiropractic clinic with an acute torticollis. Although preceding trauma was sincerely denied by the patient, a thorough case history with appropriate radiological investigation revealed a Jefferson fracture with an associated rupture of the osseous attachment of the transverse ligament.

  11. Fragility Fractures in Patients with Psoriatic Arthritis. (United States)

    Del Puente, Antonio; Esposito, Antonella; Costa, Luisa; Benigno, Carla; Del Puente, Aurora; Foglia, Francesca; Oriente, Alfonso; Bottiglieri, Paolo; Caso, Francesco; Scarpa, Raffaele


    Psoriatic arthritis (PsA) can have peculiar effects on bone, including mechanisms of bone loss such as erosions, but also of bone formation, such as ankylosis or periostitis. The aim of the present study was to describe the prevalence of fractures in patients with PsA as compared to healthy controls and to investigate determinants of fractures among cases. For both cases and controls, radiographs were read to identify vertebral fractures (VF), and the presence of femoral neck or other nonvertebral fractures was obtained from patients' medical history. The prevalence of fragility fractures on radiographic readings did not differ between cases and controls. The number of subjects showing a VF was 33 (36%) among PsA patients and 36 (36%) among controls, with a prevalence of severe VF of 8% among cases and 4% among controls. Controlling for covariates in a logistic model, the only variables showing a significant correlation with the presence of nonvertebral fractures (NVF) were disease duration (p=0.02), age (p=0.03), and bone mineral density at femoral neck (inverse correlation, p=0.04). Fractures should be carefully considered when evaluating the global picture of the patient with PsA for their contribution to the "fragility" profile.

  12. Estudo biomecânico da fixação pedicular curta na fratura-explosão toracolombar Estudio biomecánico de fijación pedicular corta en la fracturaexplosión toracolumbar Biomechanical evaluation of short-segment fixation for thoracolumbar burst-fractures

    Directory of Open Access Journals (Sweden)

    Marcos André Sonagli


    controlada. Los parámetros de carga (N y desplazamiento (mm eran generados en un gráfico instantáneo y la rigidez (N/mm fue determinada. El test era interrumpido cuando ocurría una caída súbita en la curva en el gráfico señalando la falla de la muestra. RESULTADOS: La rigidez de las columnas fracturadas fue 53% menor que la rigidez de las columnas intactas, siendo esta diferencia estadísticamente significativa (pOBJECTIVE: Compare the biomechanical stiffness between the intact spine, the spine with burst fracture and the short-segment pedicle fixation on porcine thoracolumbar burst fracture. METHODS: 30 samples of thoracolumbar spine (T11-L3 of porcine were divided into three groups with 10 samples each. Group 1 represented the intact spine, Group 2 the spine with burst fracture and Group 3 the burst fracture associated with short-segment pedicle fixation. The burst fracture injury was created with a "V" shape cut of the third middle of the vertebral body compromising the L1 anterior and medial columns simulating the burst fracture. Group 3 was stabilized with Schanz pedicle screws. The groups were subjected to biomechanical testing in a controlled axial compression. The parameters of load (N and displacement (mm were generated in a graphic snapshot and stiffness (N/mm was determined. The test was stopped when there was a sudden drop in the curve on the chart indicating failure of the sample. RESULTS: The stiffness of the fractured spines was 53% lower than the stiffness of the intact spine and this difference was statistically significant (p < 0.05. The stiffness of the short-segment pedicle fixation was 50% higher than the fractured spine. This difference was statistically significant (p < 0.05. The stiffness of the short-segment pedicle fixation was 30% lower than the intact spine. These differences were statistically significant (p < 0.05. CONCLUSION: The short-segment pedicle fixation does not provide sufficient stability to restore the stiffness of the intact

  13. Fracture Criterion for Fracture Mechanics of Magnets

    Institute of Scientific and Technical Information of China (English)

    潘灏; 杨文涛


    The applicability and limitation of some fracture criteria in the fracture mechanics of magnets are studied.It is shown that the magnetic field intensity factor can be used as a fracture criterion when the crack in a magnet is only affected by a magnetic field. For some magnetostrictive materials in which the components of magnetostriction strain do not satisfy the compatibility equation of deformation, the stress intensity factor can no longer be effectively applicable as a fracture criterion when the crack in a magnet is affected by a magnetic field and mechanical loads simultaneously.

  14. A biological approach to crown fracture: Fracture reattachment: A report of two cases. (United States)

    Vijayaprabha, K; Marwah, Nikhil; Dutta, Samir


    The development of adhesive dentistry has allowed dentists to use the patient's own fragment to restore the fractured tooth, which is considered to be the most conservative method of treatment of crown fracture allowing restoration of original dental anatomy, thus rehabilitating function and esthetics in a short time by preserving dental tissues. The tooth fragment reattachment is preferred over full coverage crowns or composite resin restoration because it conserves sound tooth structure, and is more esthetic, maintaining the original anatomy and translucency, and the rate of incisal wear also matches that of original tooth structure. Presented here is a report of two cases of crown fracture managed by reattachment procedures.

  15. A biological approach to crown fracture: Fracture reattachment: A report of two cases (United States)

    Vijayaprabha, K.; Marwah, Nikhil; Dutta, Samir


    The development of adhesive dentistry has allowed dentists to use the patient's own fragment to restore the fractured tooth, which is considered to be the most conservative method of treatment of crown fracture allowing restoration of original dental anatomy, thus rehabilitating function and esthetics in a short time by preserving dental tissues. The tooth fragment reattachment is preferred over full coverage crowns or composite resin restoration because it conserves sound tooth structure, and is more esthetic, maintaining the original anatomy and translucency, and the rate of incisal wear also matches that of original tooth structure. Presented here is a report of two cases of crown fracture managed by reattachment procedures. PMID:23230362

  16. Primary total hip arthroplasty for acetabular fracture

    Institute of Scientific and Technical Information of China (English)

    WANG Zi-ming; SUN Hong-zhen; WANG Ai-min; DU Quan-yin; WU Siyu; ZHAO Yu-feng; TANG Ying


    Objective: To explore the operative indications and operative methods of primary total hip arthroplasty for acetabular fracture and to observe the clinical curative effect.Methods: We retrospectively summarized and analyzed the traumatic conditions, fracture types, complications,operative time, operative techniques, and short-term curative effect of 11 patients( 10 males and 1 female, with a mean age of 42. 4 years ) with acetabular fracture who underwent primary total hip arthroplasty.Results: The patients were followed up for 6-45 months ( mean = 28 months). Their average Harris score of postoperative hip joint was 78.Conclusion: Under strict mastery of indications,patients with acetabular fracture may undergo primary total hip arthroplasty, but stable acetabular components should be made.

  17. Challenges in Continuum Modelling of Intergranular Fracture

    DEFF Research Database (Denmark)

    Coffman, Valerie; Sethna, James P.; Ingraffea, A. R.;


    Intergranular fracture in polycrystals is often simulated by finite elements coupled to a cohesive zone model for the interfaces, requiring cohesive laws for grain boundaries as a function of their geometry. We discuss three challenges in understanding intergranular fracture in polycrystals. First......, 3D grain boundary geometries comprise a five-dimensional space. Second, the energy and peak stress of grain boundaries have singularities for all commensurate grain boundaries, especially those with short repeat distances. Thirdly, fracture nucleation and growth depend not only upon the properties...... properties. To address the last challenge, we demonstrate a method for atomistically extracting the fracture properties of geometrically complex local regions on the fly from within a finite element simulation....

  18. Fracture Blisters After Primary Total Knee Arthroplasty. (United States)

    Halawi, Mohamad J


    Fracture blisters are tense vesicles that arise on markedly swollen skin overlying traumatized soft tissue. While this relatively uncommon complication has been well described in the trauma literature, this article reports for the first time a case of fracture blisters after primary total knee arthroplasty. The fracture blisters developed within 36 hours of surgery and were associated with profound swelling and erythema. There was no evidence of vascular injury, compartment syndrome, iatrogenic fracture, or deep venous thrombosis. The patient was treated with leg elevation, loosely applied nonadhesive dressings, and a short course of oral antibiotics after skin desquamation. Blood-filled blisters required longer time to reepithelialization than fluid-filled blisters. Knee stiffness developed because of pain and fear of participation with physical therapy, but the patient was able to resume intensive rehabilitation after resolution of the blisters. Patient factors, surgical factors, and review of the literature are discussed.

  19. Disentangling the Emerging Evidence around Atypical Fractures

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Clark, Emma M


    Atypical femur fractures are rare but a growing concern, as they are more common in patients who use bisphosphonates. The best radiology-based studies have had access to only short-term exposure data, while the studies using prescription databases with substantial long-term data did not have access...... to radiology reports. The interests of the patients are probably best served by reserving long-term bisphosphonate treatment for patients who are at the highest risk of osteoporotic fractures and considering drug holidays after 5 years in patients at low risk. Recent studies have further strengthened the case...... for active medical or surgical therapy in patients with incomplete fractures, but patient numbers are small, and randomized controlled trials may not be forthcoming in the immediate future. The recommendations made to establish an international database for such fractures have not yet been followed, and more...

  20. Rib fractures in infants due to cardiopulmonary resuscitation efforts. (United States)

    Dolinak, David


    Although it is widely known that adults may sustain fractures of the anterior and/or lateral aspects of the ribs due to cardiopulmonary resuscitation (CPR) efforts, relatively little is written about the generation of CPR-related rib fractures in the infant age range. In a series of 70 consecutive autopsies in infants ranging in age from 2 weeks to 8 months, with no history or indications of injury, the parietal pleura of the thoracic cage was stripped and the ribs carefully examined for fracture. Subtle fractures of the anterolateral aspects of the ribs were discovered in 8 (11%) of the 70 cases. In 7 of the 8 cases, multiple ribs were fractured (ranging up to 10 rib fractures), and in 5 of these cases, the rib fractures were bilateral. All of the rib fractures were subtle, had little if any associated blood extravasation, and would have been easily missed had the parietal pleura not been stripped. These anterolateral rib fractures in infants are the likely correlate of anterolateral rib fractures that are not uncommonly seen in the adult population, resulting from resuscitation efforts. The rib fractures are subtle and may not be identified unless the parietal pleura is stripped.

  1. Bilateral impacted femoral neck fracture in a renal disease patient

    Directory of Open Access Journals (Sweden)

    Pramod Devkota


    Full Text Available Spontaneous bilateral femoral neck facture in a renal disease patient is not common. We report a case of 47-year-old female patient with chronic renal failure and on regular hemodialysis for the past 5 years who sustained bilateral impacted femoral neck fracture without history of trauma and injury and refused any surgical intervention. The patient was mobilised on wheel chair one year after the fractures. The cause of the fracture and the literature review of the bilateral femoral neck fracture in renal disease are discussed.

  2. Fractal modeling of natural fracture networks. Final report, June 1994--June 1995

    Energy Technology Data Exchange (ETDEWEB)

    Ferer, M.V.; Dean, B.H.; Mick, C.


    Recovery from naturally fractured, tight-gas reservoirs is controlled by the fracture network. Reliable characterization of the actual fracture network in the reservoir is severely limited. The location and orientation of fractures intersecting the borehole can be determined, but the length of these fractures cannot be unambiguously determined. Fracture networks can be determined for outcrops, but there is little reason to believe that the network in the reservoir should be identical because of the differences in stresses and history. Because of the lack of detailed information about the actual fracture network, modeling methods must represent the porosity and permeability associated with the fracture network, as accurately as possible with very little apriori information. Three rather different types of approaches have been used: (1) dual porosity simulations; (2) `stochastic` modeling of fracture networks, and (3) fractal modeling of fracture networks. Stochastic models which assume a variety of probability distributions of fracture characteristics have been used with some success in modeling fracture networks. The advantage of these stochastic models over the dual porosity simulations is that real fracture heterogeneities are included in the modeling process. In the sections provided in this paper the authors will present fractal analysis of the MWX site, using the box-counting procedure; (2) review evidence testing the fractal nature of fracture distributions and discuss the advantages of using their fractal analysis over a stochastic analysis; (3) present an efficient algorithm for producing a self-similar fracture networks which mimic the real MWX outcrop fracture network.


    Institute of Scientific and Technical Information of China (English)

    郭大立; 刘慈群; 赵金洲


    In order to devoid the hard work and factitious error in selecting charts while analyzing and interpreting hydraulic fracturing fracture parameters, on the basis of the nonDarcy flow factor, this paper put out the non-Darcy flow mathematical model of real gas in the formation and fracture, established the production history automatic matching model to identify fracture parameters, and offered the numerical solutions of those models, which took the variation of fracture conductivity in production process. These results offered a precise and reliable method to understand formation, analyze and evaluate the fracturing treatment quality of gas well.

  4. Tibia (Shinbone) Shaft Fractures (United States)

    ... energy collisions, such as an automobile or motorcycle crash, are common causes of tibial sha fractures. In cases like these, the bone can be broken into several pieces (comminuted fracture). Sports injuries, such as a fall while skiing or running ...

  5. Fractures in anisotropic media (United States)

    Shao, Siyi

    Rocks may be composed of layers and contain fracture sets that cause the hydraulic, mechanical and seismic properties of a rock to be anisotropic. Coexisting fractures and layers in rock give rise to competing mechanisms of anisotropy. For example: (1) at low fracture stiffness, apparent shear-wave anisotropy induced by matrix layering can be masked or enhanced by the presence of a fracture, depending on the fracture orientation with respect to layering, and (2) compressional-wave guided modes generated by parallel fractures can also mask the presence of matrix layerings for particular fracture orientations and fracture specific stiffness. This report focuses on two anisotropic sources that are widely encountered in rock engineering: fractures (mechanical discontinuity) and matrix layering (impedance discontinuity), by investigating: (1) matrix property characterization, i.e., to determine elastic constants in anisotropic solids, (2) interface wave behavior in single-fractured anisotropic media, (3) compressional wave guided modes in parallel-fractured anisotropic media (single fracture orientation) and (4) the elastic response of orthogonal fracture networks. Elastic constants of a medium are required to understand and quantify wave propagation in anisotropic media but are affected by fractures and matrix properties. Experimental observations and analytical analysis demonstrate that behaviors of both fracture interface waves and compressional-wave guided modes for fractures in anisotropic media, are affected by fracture specific stiffness (controlled by external stresses), signal frequency and relative orientation between layerings in the matrix and fractures. A fractured layered medium exhibits: (1) fracture-dominated anisotropy when the fractures are weakly coupled; (2) isotropic behavior when fractures delay waves that are usually fast in a layered medium; and (3) matrix-dominated anisotropy when the fractures are closed and no longer delay the signal. The

  6. Sprains, Strains and Fractures (United States)

    ... Young Physicians Annual Scientific Meeting Webinars Careers in Podiatry APMA 2040 Student Profiles CPME REdRC Manage Your ... and fractures. Many fractures and sprains occur during sports. Football players are particularly vulnerable to foot and ...

  7. Hip fracture - discharge (United States)

    ... this page: // Hip fracture - discharge To use the sharing features on this page, please enable JavaScript. Hip fracture surgery is done to repair a break in ...

  8. Hip fracture surgery (United States)

    ... neck fracture repair; Trochanteric fracture repair; Hip pinning surgery; Osteoarthritis - hip ... You may receive general anesthesia for this surgery. This means you ... spinal anesthesia . With this kind of anesthesia, medicine is ...

  9. Metatarsal stress fractures - aftercare (United States)

    ... page: // Metatarsal stress fractures - aftercare To use the sharing features on ... that connect your ankle to your toes. A stress fracture is a break in the bone that ...

  10. Periprosthetic acetabular fractures. (United States)

    Benazzo, Francesco; Formagnana, Mario; Bargagliotti, Marco; Perticarini, Loris


    The aim of this article is to propose a diagnostic and therapeutic algorithm for the acetabular periprosthetic fractures. This article explores the current literature on the epidemiology, causes and classification of periprosthetic acetabular fractures. Integrating data with the experience of the authors, it offers a guide to diagnosis and possible therapeutic strategies. Intra-operative fractures can occur during rasping, reaming or implant impaction, and they must be treated immediately if the component(s) is (are) unstable. Post-operative fractures can be due to major trauma (acute fractures) or minor forces in bone osteolysis; it is possible to plan reconstruction and fixation according to fracture characteristics. Treatment choice depends upon fracture site and implant stability. Periprosthetic acetabular fractures are uncommon complications that can occur intra-operatively or post-operatively, and a reconstructive surgeon must be able to manage the procedure. Accurate planning and reconstruction implant are necessary to achieve good cup stability.

  11. Sacral fatigue fractures in children with sacral spina bifida occulta (United States)

    Hama, Shingo; Sakai, Toshinori; Higashino, Kosaku; Abe, Mitsunobu; Nagamachi, Akihiro; Sairyo, Koichi


    In this report, we present two cases of 9-year-old children with spina bifida occulta (SBO) of the sacrum, who were diagnosed with sacral fatigue fractures. In both patients, MRI showed a linear signal void and high signal in sacral ala on the short tau inversion recovery sequence. Sacral SBO at the same level of the sacral fracture was observed in each patient on computed tomography images. These lesions healed with rest. This is the first literature reporting cases with sacral stress fractures who had SBO at the same level of fracture. PMID:26196371

  12. Identifying osteoporotic vertebral fracture


    Griffith, James F.


    Osteoporosis per se is not a harmful disease. It is the sequela of osteoporosis and most particularly the occurrence of osteoporotic fracture that makes osteoporosis a serious medical condition. All of the preventative measures, investigations, treatment and research into osteoporosis have one primary goal and that is to prevent the occurrence of osteoporotic fracture. Vertebral fracture is by far and away the most prevalent osteoporotic fracture. The significance and diagnosis of vertebral f...

  13. Idiopathic short stature

    Directory of Open Access Journals (Sweden)

    Vlaški Jovan


    Full Text Available Growth is a complex process and the basic characteristic of child- hood growth monitoring provides insight into the physiological and pathological events in the body. Statistically, the short stature means departure from the values of height for age and sex (in a particular environment, which is below -2 standard deviation score, or less than -2 standard deviation, i.e. below the third percentile. Advances in molecular genetics have contributed to the improvement of diagnostics in endocrinology. Analysis of patients’ genotypes should not be performed before taking a classical history, detailed clinical examination and appropriate tests. In patients with idiopathic short stature specific causes are excluded, such as growth hormone deficiency, Turner syndrome, short stature due to low birth weight, intrauterine growth retardation, small for gestational age, dysmorphology syndromes and chronic childhood diseases. The exclusion of abovementioned conditions leaves a large number of children with short stature whose etiology includes patients with genetic short stature or familial short stature and those who are low in relation to genetic potential, and who could also have some unrecognized endocrine defect. Idiopathic short stature represents a short stature of unknown cause of heterogeneous etiology, and is characterized by a normal response of growth hormone during stimulation tests (>10 ng/ml or 20 mJ/l, without other disorders, of normal body mass and length at birth. In idiopathic short stature standard deviation score rates <-2.25 (-2 to -3 or <1.2 percentile. These are also criteria for the initiation of growth hormone therapy. In children with short stature there is also the presence of psychological and social suffering. Goals of treatment with growth hormone involve achieving normal height and normal growth rate during childhood.

  14. Fracture prevention in men

    NARCIS (Netherlands)

    Geusens, PP; Sambrook, P.N.; Lems, W.F.


    The lifetime risk of experiencing a fracture in 50-year-old men is lower (20%) than the risk in women (50%). Consequently, much less research has been carried out on osteoporosis and fracture risk in men. Differences in the risk and incidence of fractures between men and women are related to differe

  15. Characterizing Fractures Across the Astronaut Corps: Preliminary Findings from Population-Level Analysis (United States)

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


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

  16. 老年人股骨颈骨折股骨头置换术中短柄假体的有限元分析%Finite element analysis of the short-stem prothesis in femoral head replacement among the elderly femoral neck fractures

    Institute of Scientific and Technical Information of China (English)

    吕大伟; 苏琴; 姚咏明; 赵晓东


    目的:针对老年人股骨颈骨折后假体置换术,使用有限元分析的方法对股骨短柄假体与常规股骨假体的生物力学特性进行对比。方法利用薄层CT资料建立股骨三维有限元模型,利用我院股骨中空多孔股骨假体相关参数建立两种髋关节股骨假体三维有限元模型;应用Ansys 5.7有限元分析软件考察两种假体植入后的应力分布,并进行比较。结果短柄假体所受最大mises应力较常规股骨假体明显减小;力学传导模式仍为远端应力集中,最大mises应力仍出现在张力侧。结论老年人股骨颈骨折关节置换术中短柄假体力学特性优越。%Objective To compare biomechanical properties of the short-stem prosthesis with conventional prosthesis with the finite element analysis method for the elderly femoral neck fracture after femoral head replace -ment.Methods Three-dimensional finite element models of the upper femur and prosthesis were established .The stress distribution difference between the short-stem prosthesis and conventional prosthesis was compared by using fi-nite element analysis software Ansys 5.7.Results The maximum mises stress of the short-stem prosthesis de-creased significantly,while stress distribution model remained the same .Conclusion The short-stem prosthesis presents superior mechanical properties in femoral head replacement among the elderly femoral neck fractures .

  17. Hand fractures and their management: an international view. (United States)

    Bernstein, Michael L; Chung, Kevin C


    Fractures of the bones of the hand are among the commonest fractures in humans, but their management varies widely in the different regions of the world. This variability is due to many reasons, including availability of resources, social factors, geographic constraints, surgeon preference and experience, and local practice patterns. Developing countries are more likely to apply less expensive methods of managing hand fractures. The treatment of these injuries will fall somewhere along a continuum that parallels the historical development of hand fracture management. This paper will review the history of phalangeal and metacarpal fracture management to infer global differences in the treatment of hand fractures. An overview of how different health care systems are likely to manage these injuries will assist health care providers in choosing the most appropriate treatment method.

  18. Double level Chance-type fractures of spine in ankylosing spondylitis

    Directory of Open Access Journals (Sweden)

    Vargaonkar Shantaram


    Full Text Available Chance fractures are usually associated with seat belt injuries. Mechanism is always related to flexion-distraction at vertebral level. Double level Chance-type fractures have rarely been reported in published literature. We presented such a fracture at D10 and L3 level in a 38-year-old patient with ankylosing spondylitis. Management was done with posterior decompression and short segment fi xation separately. Key words: Chance fractures; Ankylosing spondylitis; Spine

  19. 短节段椎弓根内固定并伤椎重建术治疗胸腰椎骨折%Short-segment pedicle fixation and reconstruction for treatment of thoracolumbar fractures

    Institute of Scientific and Technical Information of China (English)

    赵斌; 罗华云; 赵轶波; 田江华; 马迅


    目的 评价经后路矫形固定结合椎体撬拨植骨术治疗胸腰椎骨折的临床疗效.方法 采用经后路椎弓根螺钉矫形固定,同时经椎弓根对骨折椎体进行撬拨,恢复椎体前、中柱高度,并行椎体内植骨治疗30例(34椎)胸腰椎骨折.男23例,女7例;年龄24~77岁,平均40.8岁.所有患者均为外伤性骨折,其中6例合并骨质疏松.植骨材料分别采用Cem-Ostetic人工骨浆(3例)、自体骨(17例)和同种异体骨(10例).随访观察患者疼痛视觉模拟评分(visual analogue scale,VAS)及影像学改变情况.结果所有患者术后均获12~24个月随访,平均18个月.术前、术后1周及末次随访,椎体前高分别平均为(15.5±3.8)mm、(23.3±5.7)mm和(22.5±5.1)mm;椎体后高分别平均为(25.8±3.4)mm、(28.6±2.0)mm和(28.3±2.2)mm;后凸角度平均分别为23.5±7.6°、14.3°±7.1°和15.7°±7.5°;VAS分别平均为7.57±1.45、2.57±0.65和2.07±0.62.各项指标均较术前有显著改善,差异有统计学意义(P0.05).随访期间内固定无松动、断裂等.骨折椎体密度等同或高于上、下邻椎体,部分行后外侧植骨融合病例亦达到临床融合标准.结论 经后路矫形固定结合椎体撬拨植骨治疗胸腰椎骨折,可有效恢复和维持椎体高度,提高骨折椎体密度,增强脊柱前、中柱的稳定性.%Objective To evaluate the clinical effects of posterior instrumentation fixation combined with the vertebral lifted bone grafting to treat thoracolumbar fractures. Methods Thirty patients (34 verte-brae) with thoracolumbar fractures were treated with posterior instrumentation fixation, restoring the anterior and middle column height of vertebral body and inserting the bone graft through the pedicle. There were 23 males and 7 females with an average age of 40.8 years (range, 24-77 years). All patients were traumatic frac-tures (6 patients with osteoporosis). The bone grafting included Cem-Ostetic 3 cases, autograft 17 cases and

  20. Short tunnels.

    NARCIS (Netherlands)

    Schreuder, D.A.


    Before dealing with the question of lighting short tunnels, it is necessary define what is meant by a tunnel and when it should be called 'short'. Confined to motorized road traffic the following is the most apt definition of a tunnel: every form of roofing-over a road section, irrespective of it le

  1. Proximal humerus fractures. (United States)

    Price, Matthew C; Horn, Pamela L; Latshaw, James C


    Proximal humerus fractures are among the most common fractures associated with osteoporosis. With an aging population, incidence of these fractures will only increase. The proximal humerus not only forms the lateral portion of the shoulder articulation but also has significant associations with musculoskeletal and neurovascular structures. As a result, fractures of the proximal humerus can significantly impact not only the function of the shoulder joint, but the health and function of the entire upper extremity as well. Understanding of these fractures, the management options, and associated nursing care, can help reduce morbidity rate and improve functional outcomes.

  2. Stress fractures in runners. (United States)

    McCormick, Frank; Nwachukwu, Benedict U; Provencher, Matthew T


    Stress fractures are a relatively common entity in athletes, in particular, runners. Physicians and health care providers should maintain a high index of suspicion for stress fractures in runners presenting with insidious onset of focal bone tenderness associated with recent changes in training intensity or regimen. It is particularly important to recognize “high-risk” fractures, as these are associated with an increased risk of complication. A patient with confirmed radiographic evidence of a high-risk stress fracture should be evaluated by an orthopedic surgeon. Runners may benefit from orthotics, cushioned sneakers, interval training, and vitamin/calcium supplementation as a means of stress fracture prevention.

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

    Energy Technology Data Exchange (ETDEWEB)

    Nachtrab, O. [Department of Radiology, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry Shropshire SY10 7AG (United Kingdom); Cassar-Pullicino, V.N., E-mail: [Department of Radiology, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry Shropshire SY10 7AG (United Kingdom); Lalam, R.; Tins, B.; Tyrrell, P.N.M.; Singh, J. [Department of Radiology, The Robert Jones and Agnes Hunt Orthopaedic Hospital, Gobowen, Oswestry Shropshire SY10 7AG (United Kingdom)


    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.

  4. Fractures in multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, E; Jensen, K


    In a cross-sectional study of 299 MS patients 22 have had fractures and of these 17 after onset of MS. The fractures most frequently involved the femoral neck and trochanter (41%). Three patients had had more than one fracture. Only 1 patient had osteoporosis. The percentage of fractures increased...... with increasing age and disease duration. Among 34 deceased MS patients 4 had had fractures. These findings are discussed in relation to physical and cognitive impairment in MS. A case-control study is recommended....

  5. Prediction of postoperative morbidity, mortality and rehabilitation in hip fracture patients

    DEFF Research Database (Denmark)

    Foss, Nicolai B; Kristensen, Morten T; Kehlet, Henrik


    To validate the cumulated ambulation score as an early postoperative predictor of short-term outcome in hip fracture patients.......To validate the cumulated ambulation score as an early postoperative predictor of short-term outcome in hip fracture patients....

  6. Total Hip Arthroplasty after Treatment of an Atypical Subtrochanteric Femoral Fracture in a Patient with Pycnodysostosis



    The authors describe the case of a 51-year-old woman with an osteonecrosis of her right femoral head after treatment of an atypical subtrochanteric fracture caused by pycnodysostosis. She had this fracture after a low-trauma fall. She was of short stature with typical facial features, short stubby hands, and radiological features including open cranial sutures, obtuse mandible, and generalized skeletal sclerosis. The majority of cases of atypical subtrochanteric fractures are associated wi...

  7. Cardiovascular Risk Factor Analysis in Patients with a Recent Clinical Fracture at the Fracture Liaison Service

    Directory of Open Access Journals (Sweden)

    Caroline E. Wyers


    Full Text Available Patients with a low bone mineral density have an increased risk of cardiovascular diseases (CVD and venous thromboembolic events (VTE. The aim of our retrospective chart review was to investigate the prevalence of CVD, VTE, hypertension (HT, and diabetes mellitus type 2 (DM2 in patients with a recent clinical fracture visiting the Fracture Liaison Service (FLS. Out of 3057 patients aged 50–90 years, 1359 consecutive patients, who agreed and were able to visit the FLS for fracture risk evaluation, were included (71.7% women; mean age 65.2 yrs. Based on medical history, 29.9% had a history of CVD (13.7%, VTE (1.7%, HT (14.9%, and DM2 (7.1% or a combination. Their prevalence increased with age (21% in patients aged 50–59 years to 48% in patients aged >80 years and was higher in men than in women (36% versus 27%, but independent of bone mineral density and fracture type. Careful evaluation of medical history with respect to these risk factors should be performed in patients with a recent clinical fracture before starting treatment with medications that increase the risk of VTE or cardiovascular events, such as raloxifene, strontium ranelate, or NSAIDs.

  8. [Fractures of carpal bones]. (United States)

    Lögters, T; Windolf, J


    Fractures of the carpal bones are uncommon. On standard radiographs fractures are often not recognized and a computed tomography (CT) scan is the diagnostic method of choice. The aim of treatment is to restore pain-free and full functioning of the hand. A distinction is made between stable and unstable carpal fractures. Stable non-displaced fractures can be treated conservatively. Unstable and displaced fractures have an increased risk of arthritis and non-union and should be stabilized by screws or k‑wires. If treated adequately, fractures of the carpal bones have a good prognosis. Unstable and dislocated fractures have an increased risk for non-union. The subsequent development of carpal collapse with arthrosis is a severe consequence of non-union, which has a heterogeneous prognosis.

  9. Orbital fractures: a review

    Directory of Open Access Journals (Sweden)

    Jeffrey M Joseph


    Full Text Available Jeffrey M Joseph, Ioannis P GlavasDivision of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, School of Medicine, New York University, New York, NY, USA; Manhattan Eye, Ear, and Throat Hospital, New York, NY, USAAbstract: This review of orbital fractures has three goals: 1 to understand the clinically relevant orbital anatomy with regard to periorbital trauma and orbital fractures, 2 to explain how to assess and examine a patient after periorbital trauma, and 3 to understand the medical and surgical management of orbital fractures. The article aims to summarize the evaluation and management of commonly encountered orbital fractures from the ophthalmologic perspective and to provide an overview for all practicing ophthalmologists and ophthalmologists in training.Keywords: orbit, trauma, fracture, orbital floor, medial wall, zygomatic, zygomatic complex, zmc fracture, zygomaticomaxillary complex fractures 

  10. Oblique Axis Body Fracture

    DEFF Research Database (Denmark)

    Takai, Hirokazu; Konstantinidis, Lukas; Schmal, Hagen


    Purpose. Anderson type III odontoid fractures have traditionally been considered stable and treated conservatively. However, unstable cases with unfavorable results following conservative treatment have been reported. Methods. We present the cases of two patients who sustained minimally displaced...... Anderson type III fractures with a characteristic fracture pattern that we refer to as "oblique type axis body fracture." Results. The female patients aged 90 and 72 years, respectively, were both diagnosed with minimally displaced Anderson type III fractures. Both fractures had a characteristic "oblique...... type" fracture pattern. The first patient was treated conservatively with cervical spine immobilization in a semirigid collar. However, gross displacement was noted at the 6-week follow-up visit. The second patient was therefore treated operatively by C1-C3/4 posterior fusion and the course...

  11. Epidemiology of fractures in people with severe and profound developmental disabilities (United States)

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


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

  12. Short stature (United States)

    ... condition. Bone or skeletal disorders, such as: Rickets Achondroplasia Chronic diseases, such as: Asthma Celiac disease Congenital ... growth seems slow or your child seems small. TREATMENT Your child's short stature may affect her self- ...

  13. Short communication

    African Journals Online (AJOL)

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    ABSTRACT: Nutrients, metabolizable energy (ME), anti-nutritional factors, digestible organic ... for animals are in short supply and expensive, ... peels from hotels (Hawassa); sisal waste from ..... chain omega-3 fatty acids in livestock meat and.

  14. [Fracture endoprosthesis of distal humerus fractures]. (United States)

    Müller, L P; Wegmann, K; Burkhart, K J


    The treatment of choice for fractures of the distal humerus is double plate osteosynthesis. Due to anatomical preshaped angle stable plates the primary stability and management of soft tissues has been improved. However, osteoporotic comminuted fractures in the elderly are often not amenable to stable osteosynthesis and total elbow arthroplasty has been established as an alternative therapy. Although complication rates have been reduced, complications of total elbow arthroplasty are still much more frequent than in total hip replacement. Furthermore, patients are advised not to exceed a weight bearing of 5 kg. Therefore, the indications for elbow arthroplasty must be evaluated very strictly and should be reserved for comminuted distal humeral fractures in the elderly with poor bone quality that are not amenable to stable osteosynthesis or for simple fractures in cases of preexisting symptomatic osteoarthritis. This article introduces and discusses modern concepts of elbow arthroplasty, such as modular convertible prosthesis systems, hemiarthroplasty and radial head replacement in total elbow arthroplasty.

  15. An Epidemiological Study on Pattern and Incidence of Mandibular Fractures

    Directory of Open Access Journals (Sweden)

    Subodh S. Natu


    Full Text Available Mandible is the second most common facial fracture. There has been a significant increase in the number of cases in recent years with the advent of fast moving automobiles. Mandibular fractures constitute a substantial proportion of maxillofacial trauma cases in Lucknow. This study was undertaken to study mandibular fractures clinicoradiologically with an aim to calculate incidence and study pattern and the commonest site of fractures in population in and around Lucknow. Patient presenting with history of trauma at various centers of maxillofacial surgery in and around Lucknow were included in this study. Detailed case history was recorded followed by thorough clinical examination, and radiological interpretation was done for establishing the diagnosis and the data obtained was analyzed statistically. Out of 66 patients with mandibular fractures, highest percentage was found in 21–30 years of age with male predominance. Road traffic accidents were the most common cause of fracture with parasymphysis being commonest site. Commonest combination was parasymphysis with subcondyle. There was no gender bias in etiology with number of fracture sites. The incidence and causes of mandibular fracture reflect trauma patterns within the community and can provide a guide to the design of programs geared toward prevention and treatment.

  16. Factors contributing to the surgical retreatment of mandibular fractures

    Directory of Open Access Journals (Sweden)

    João Gualberto de Cerqueira Luz


    Full Text Available The purpose of this retrospective study was to evaluate contributing factors in patients requiring surgical retreatment of mandibular fractures. Of all the patients with mandibular fractures who were treated using internal fixation at a trauma hospital over a seven-year period, 20 patients (4.7% required a second surgery and thus composed the “reoperated” group. The control group comprised 42 consecutive patients with mandibular fractures who were treated at the same clinic and who healed without complications. Medical charts were reviewed for gender, age, substance abuse history, dental condition, etiology, location of fracture, degree of fragmentation, fracture exposure, teeth in the fracture line, associated facial fractures, polytrauma, time elapsed between trauma and initial treatment, surgical approach and fixation system. Statistical analyses were performed using the Statistical Package for Social Sciences (SPSS version 20.0; descriptive statistics and the chi-squared test were used to determine differences between groups. Significant differences in substance abuse (p = 0.006, dental condition (p < 0.001, location of fracture (p = 0.010, degree of fragmentation (p = 0.003 and fracture exposure (p < 0.001 were found. With regard to age and time elapsed between trauma and initial treatment, older patients (31.4 years, SD = 11.1 and a delay in fracture repair (19.1 days, SD = 18.7 were more likely to be associated with reoperation. It was concluded that substance abuse, age, dental condition, location of fracture, degree of fragmentation, fracture exposure and the time between trauma and initial treatment should be considered contributing factors to the occurrence of complications that require surgical retreatment of mandibular fractures.

  17. Fracture risk following bariatric surgery: a population-based study. (United States)

    Nakamura, K M; Haglind, E G C; Clowes, J A; Achenbach, S J; Atkinson, E J; Melton, L J; Kennel, K A


    The effects of bariatric surgery on skeletal health are poorly understood. We found that bariatric surgery patients are more prone to fracture when compared to the general population. While further studies of fracture risk in this population are needed, bone health should be discussed in bariatric surgery clinics. Bariatric surgery is an increasingly common treatment for medically complicated obesity. Adverse skeletal changes after bariatric surgery have been reported, but their clinical importance remains unknown. We hypothesized that bariatric surgery patients are at increased risk of fracture. We conducted a historical cohort study of fracture incidence among 258 Olmsted County, Minnesota, residents who underwent a first bariatric surgery in 1985-2004. Relative fracture risk was expressed as standardized incidence ratios (SIRs), while potential risk factors were evaluated by hazard ratios (HR) obtained from a time-to-fracture regression model. The mean (±SD) body mass index at bariatric surgery was 49.0 ± 8.4 kg/m(2), with an average age of 44 ± 10 years and 82% (212) females. Gastric bypass surgery was performed in 94% of cases. Median follow-up was 7.7 years (range, 6 days to 25 years), during which 79 subjects experienced 132 fractures. Relative risk for any fracture was increased 2.3-fold (95% confidence interval (CI), 1.8-2.8) and was elevated for a first fracture at the hip, spine, wrist, or humerus (SIR, 1.9; 95% CI, 1.1-2.9), as well as for a first fracture at any other site (SIR, 2.5; 95% CI, 2.0-3.2). Better preoperative activity status was associated with a lower age-adjusted risk (HR, 0.4; 95% CI, 0.2-0.8) while prior fracture history was not associated with postoperative fracture risk. Bariatric surgery, which is accompanied by substantial biochemical, hormonal, and mechanical changes, is associated with an increased risk of fracture.

  18. Correlation of transmissive fractures in pilot holes ONK-PH8 - PH12 and fracture traces mapped in ONKALO

    Energy Technology Data Exchange (ETDEWEB)

    Palmen, J.; Nummela, J.; Ahokas, H. [Poeyry Finland Oy, Vantaa (Finland)


    fractures from the pilot holes ONK-PH8 - ONK-PH12 were imported as circle polygon objects to a 3D AutoCAD model. The mapped and verified 13 247 ONKALO fracture traces were divided to 3 subsets according to their length: (6 fracture traces in FDB (Fracture Database) were lacking the length attribute) 433 long fractures (length equal or greater than 10 m), 1 288 medium length fractures (length less than 10 m but equal or greater than 3.5 m) and 11 520 short fracture traces (length less than 3.5 m) and then imported to 3D model to be linked to hydraulically conductive fractures of pilot holes. The combining was carried out by investigating the location and orientation of each suspected pair of a polygon (PFL fracture) and a polyline in the 3D AutoCAD model. Additionally leakage attribute of each ONKALO fracture trace was considered as an conductivity indicator and the fracture traces bearing leakage classification were combined with the PFL fractures. (orig.)

  19. Community History. (United States)

    Lewis, Helen M.


    Recounts the experience of researching community history in Ivanhoe, Virginia, between 1987 and 1990. The Ivanhoe History Project involved community members in collecting photographs, memorabilia, and oral histories of their town. Subsequent published volumes won the W. D. Weatherford Award and inspired a quilt exhibit and a theatrical production.…

  20. Dietary and training predictors of stress fractures in female runners. (United States)

    Wentz, Laurel; Liu, Pei-Yang; Ilich, Jasminka Z; Haymes, Emily M


    To compare female runners with and without a history of stress fractures to determine possible predictors of such fractures. 27 female runners (age 18-40 yr) who had had at least 1 stress fracture were matched to a control sample of 32 female runners without a history of stress fractures. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (iDXA). Subjects answered questionnaires on stress-fracture history, training, menstrual status, and diet. No significant differences were found in menstrual characteristics, diet and dairy intake, or bone measurements. Weekly servings of milk during middle school significantly predicted BMD at the femur (p = .010), femoral neck (p = .002), Ward's triangle (p = .014), and femoral shaft (p = .005). Number of menstrual cycles in the previous year predicted femoral-neck BMD (p = .004). Caffeine intake was negatively associated with BMD of the femur (p = .010), femoral neck (p = .003), trochanter (p = .038), and femoral shaft (p = .035). Weekly hours of training were negatively associated with total-body BMD (p = .021), total-body bone mineral content (p = .028), and lumbar-spine BMD (p = .011). Predictors for stress fractures included the number of years running, predominantly running on hard ground, irregular menstrual history, low total-body BMD, and low current dietary calcium intake when controlling for body-mass index (Nagelkerke R2 = .364). Servings of milk during middle-school years were positively correlated with hip BMD, although current calcium intake, low BMD, irregular menstrual history, hard training surface, and long history of training duration were the most important predictors of stress fractures.

  1. Jaw fractures in children. (United States)

    Kotilainen, R; Kärjä, J; Kullaa-Mikkonen, A


    From a total of 350 jaw fractures treated in 1980-1984 at Kuopio University Central Hospital, 20% were in children. These injuries were evaluated retrospectively regarding age, sex, incidence and etiology. Forty-five of the patients were boys and 25 girls. The frequency of maxillary and mandibular fractures in 70 young patients was 28.6%. The most common type of bone fractures was fracture of the alveolar process, which was prevalent in persons with mixed dentition. Before the age of 7 years, falls from height were the common causes of jaw fractures. The major cause of the jaw fractures in children from 7 to 15 years old was road accidents (47.1%), especially in boys. Most of these were cycling accidents, only a few patients were victims of automobile accidents. In addition, about one third (25.7%) of the patients were treated in the hospital because of multiple injuries to other organs.

  2. Growing skull fracture

    Directory of Open Access Journals (Sweden)

    Mihajlović Miljan H.


    Full Text Available Background. Growing skull fracture or craniocerebral erosion is a rare complication of linear skull fracture in childhood. It is characterized by progressive diastatic enlargement of the fracture line, which leads to a cranial defect, dural cleft, and cerebral herniation. It is presented as a soft pulsabile scalp swelling above the fracture, with a clear cranial defect. Case report. In this paper we presented a patient, an 8-month-old boy with the growing skull fracture revealed four weeks after the injury. After the surgical treatment, the boy was in a good general condition without the presence of neurologic impairment. Conclusion. Early recognition of craniocerebral erosion is very important. Timely detection prevents further progression of the disease and the evolution of neurological impairment. Surgery is the method of choice for treating a growing skull fracture .

  3. Pelvic fractures and mortality.


    K.H. Chong; DeCoster, T.; Osler, T.; Robinson, B.


    A retrospective study of all patients (N = 343) with pelvic fractures admitted to our trauma service was conducted to evaluate the impact of pelvic fractures on mortality. All patients sustained additional injuries with an average Injury Severity Score (ISS) of twenty. Thirty-six patients died. This group had more severe pelvic fractures as graded by the Tile classification as well as a greater number and severity of associated injuries. Six patients died as a direct result of pelvic hemorrha...

  4. Oblique Axis Body Fracture

    DEFF Research Database (Denmark)

    Takai, Hirokazu; Konstantinidis, Lukas; Schmal, Hagen;


    was uneventful. Conclusions. Oblique type axis body fractures resemble a highly unstable subtype of Anderson type III fractures with the potential of severe secondary deformity following conservative treatment, irrespective of initial grade of displacement. The authors therefore warrant a high index of suspicion......Purpose. Anderson type III odontoid fractures have traditionally been considered stable and treated conservatively. However, unstable cases with unfavorable results following conservative treatment have been reported. Methods. We present the cases of two patients who sustained minimally displaced...

  5. Independent predictors of all osteoporosis-related fractures in healthy postmenopausal women: the OFELY study. (United States)

    Albrand, G; Munoz, F; Sornay-Rendu, E; DuBoeuf, F; Delmas, P D


    Several epidemiological studies have identified clinical factors that predict the risk of hip fractures in elderly women independently of the level of bone mineral density (BMD), such as low body weight, history of fractures, and clinical risk factors for falls. Their relevance in predicting all fragility fractures in all postmenopausal women, including younger ones, is unknown. The objective of this study was to identify independent predictors of all osteoporosis-related fractures in healthy postmenopausal women. We prospectively followed for 5.3 +/- 1.1 years a cohort of 672 healthy postmenopausal women (mean age 59.1 +/- 9.8 years). Information on social and professional conditions, demographic data, current and past medical history, fracture history, medication use, alcohol consumption, caffeine consumption, daily calcium intake, cigarette smoking, family history of fracture, and past and recent physical activity was obtained. Anthropometric and total hip bone mineral density measurements were made. Incident falls and fractures were ascertained every year. We observed 81 osteoporotic fractures (annual incidence, 21 per 1000 women/year). The final model consisted of seven independent predictors of incident osteoporotic fractures: age > or = 65 years, odds ratio estimate (OR), 1.90 [95% confidence interval (CI) 1.04-3.46], past falls, OR, 1.76 (CI 1.00-3.09), total hip bone mineral density (BMD) < or = 0.736 g/cm(2), OR, 3.15 (CI 1.75-5.66), left grip strength < or = 0.60 bar, OR, 2.05 (CI 1.15-3.64), maternal history of fracture, OR, 1.77 (CI 1.01-3.09), low physical activity, OR, 2.08 (CI 1.17-3.69), and personal history of fragility fracture, OR, 3.33 (CI 1.75-5.66). In contrast, body weight, weight loss, height loss, smoking, neuromuscular coordination assessed by three tests, and hormone replacement therapy were not independent predictors of all fragility fractures after adjustment for all variables. We found that some--but not all--previously reported

  6. Atypical periprosthetic acetabular fracture in long-term alendronate therapy. (United States)

    Marongiu, Giuseppe; Capone, Antonio


    Bisphosphonates have been commonly used in the treatment of osteoporosis, demonstrating its efficacy in fracture risk reduction. However, even if are generally safe and well tolerated, concerns have emerged about atypical fractures related to its prolonged use. Although atypical femoral fracture are more common, case reports demonstrated that even other skeletal areas can be involved by unusual pattern of fracture. We report a atypical acetabular periprosthetic fracture in a 83-year-old female patient after prolonged alendronate treatment for osteoporosis and isolated acetabular revision surgery. The patient underwent to clinical, bioumoral and radiological evaluation and all the history cases were fully reported. We believe this periprosthetic fracture, according to the available data, may have similar underlying pathology to atypical femoral fractures. Awareness of symptoms, in addition to a regular radiographic survey may facilitate early diagnosis and possible prevention of spontaneous periprosthetic fractures, in patients receiving bisphosphonate therapy beyond 5 years. The treatment of this atypical periprosthetic fracture should include both surgical than pharmacological therapy to obtained bone healing.

  7. Atypical periprosthetic acetabular fracture in long-term alendronate therapy (United States)

    Marongiu, Giuseppe; Capone, Antonio


    Summary Bisphosphonates have been commonly used in the treatment of osteoporosis, demonstrating its efficacy in fracture risk reduction. However, even if are generally safe and well tolerated, concerns have emerged about atypical fractures related to its prolonged use. Although atypical femoral fracture are more common, case reports demonstrated that even other skeletal areas can be involved by unusual pattern of fracture. We report a atypical acetabular periprosthetic fracture in a 83-year-old female patient after prolonged alendronate treatment for osteoporosis and isolated acetabular revision surgery. The patient underwent to clinical, bioumoral and radiological evaluation and all the history cases were fully reported. We believe this periprosthetic fracture, according to the available data, may have similar underlying pathology to atypical femoral fractures. Awareness of symptoms, in addition to a regular radiographic survey may facilitate early diagnosis and possible prevention of spontaneous periprosthetic fractures, in patients receiving bisphosphonate therapy beyond 5 years. The treatment of this atypical periprosthetic fracture should include both surgical than pharmacological therapy to obtained bone healing. PMID:28228784

  8. Fracture mechanics safety approaches

    Energy Technology Data Exchange (ETDEWEB)

    Roos, E.; Schuler, X.; Eisele, U. [Materials Testing Inst. (MPA), Univ. of Stuttgart (Germany)


    Component integrity assessments require the knowledge of reliable fracture toughness parameters characterising the initiation of the failure process in the whole relevant temperature range. From a large number of fracture mechanics tests a statistically based procedure was derived allowing to quantify the initiation of fracture toughness as a function of temperature as a closed function as well as the temperature dependence of the cleavage instability parameters. Alternatively to the direct experimental determination one also can use a correlation between fracture toughness and notch impact energy. (orig.)

  9. Scaphoid fractures in children

    Directory of Open Access Journals (Sweden)

    Gajdobranski Đorđe


    Full Text Available Introduction. Scaphoid fractures are rare in childhood. Diagnosis is very difficult to establish because carpal bones are not fully ossified. In suspected cases comparative or delayed radiography is used, as well as computerized tomography, magnetic resonance imaging, ultrasound and bone scintigraphy. Majority of scaphoid fractures are treated conservatively with good results. In case of delayed fracture healing various types of treatment are available. Objective. To determine the mechanism of injury, clinical healing process, types and outcome of treatment of scaphoid fractures in children. Methods. We retrospectively analyzed patients with traumatic closed fracture of the scaphoid bone over a ten-year period (2002-2011. The outcome of the treatment of “acute” scaphoid fracture was evaluated using the Mayo Wrist Score. Results. There were in total 34 patients, of mean age 13.8 years, with traumatic closed fracture of the scaphoid bone, whose bone growth was not finished yet. Most common injury mechanism was fall on outstretched arm - 76% of patients. During the examined period 31 children with “acute” fracture underwent conservative treatment, with average immobilization period of 51 days. Six patients were lost to follow-up. In the remaining 25 patients, after completed rehabilitation, functional results determined by the Mayo Wrist Score were excellent. Conclusion. Conservative therapy of “acute” scaphoid fractures is an acceptable treatment option for pediatric patients with excellent functional results.

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

    Directory of Open Access Journals (Sweden)

    K N Dubey


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

  11. In vivo shell-like fractures of veneered-ZrO2 fixed dental prostheses

    Directory of Open Access Journals (Sweden)

    Renan Belli


    Full Text Available Fractographic analyses are performed in two fixed dental prosthetic reconstructions made of ZrO2 frameworks covered by a veneering ceramic that fractured during function in the mouth. Processing histories, material properties, recovered broken parts and replicas of the fracture surface were used, along with fractographic markings to determine fracture origins and cause of failure. A shell-like fracture pattern was found common for both cases, although different factors were identified to be involved in each fracture event. Internal thermal residual stresses and occlusal surface defects from localized contact overloading were found to precipitate the fracture in Case 1, whereas extreme occlusal surface damage from sliding chewing contact was determinant in the fracture of Case 2. The interface between the veneering ceramic and the ZrO2 framework was unaffected by the fractures.

  12. Sequential Proximal Tibial Stress Fractures associated with Prolonged usage of Methotrexate and Corticosteroids: A Case Report

    Directory of Open Access Journals (Sweden)

    Tan TJL


    Full Text Available Stress fractures of the proximal tibia metaphysis are rare in the elderly. We present a case of a 65-year old male who developed sequential proximal tibia stress fractures associated with prolonged usage of methotrexate and prednisolone within a span of 18 months. Magnetic Resonance Imaging revealed an incomplete stress fracture involving the medial proximal tibial region. The patient was treated with stemmed total knee arthroplasty (TKA bilaterally. Stress fractures should be considered in patients with atypical knee pain who have a history of methotrexate and prednisolone usage. TKA is an effective treatment in stress fractures of the proximal tibia.

  13. Pregnancy-related osteoporosis and spinal fractures (United States)

    Yun, Ka Yeong; Han, Si Eun; Kim, Seung Chul; Lee, Kyu Sup


    Pregnancy-related osteoporosis is a very rare condition characterized by the occurrence of fracture during pregnancy or the puerperium. Despite its relative rarity, it can be a dangerous condition that causes severe back pain, height loss and disability. Normal physiologic changes during pregnancy, genetic or racial difference, obstetrical history and obstetrical disease, such as preterm labor or pregnancy-induced hypertension, are presumed risk factors of pregnancy-related osteooporosis. However, exact etiology and pathogenesis are uncertain. The management and natural history are still poorly defined. Traditional medications for osteoporosis are calcium/vitamin D and bisphosphonate. Concerns with bisphosphonate include accumulation in bone and fetal exposure in subsequent pregnancies. The newly developed medication, teriparatide, has shown good results. We report six cases of pregnancy-related osteoporosis and spinal fracture with literature review. PMID:28217686

  14. Hip Fractures among Older Adults (United States)

    ... online training for health care providers. Learn More Hip Fractures Among Older Adults Recommend on Facebook Tweet Share ... get older. What You Can Do to Prevent Hip Fractures You can prevent hip fractures by taking steps ...

  15. Pneumothorax complicating isolated clavicle fracture. (United States)

    Hani, Redouane; Ennaciri, Badr; Jeddi, Idriss; El Bardouni, Ahmed; Mahfoud, Mustapha; Berrada, Mohamed Saleh


    Isolated clavicle fractures are among the commonest of traumatic fractures in the emergency department. Complications of isolated clavicle fractures are rare. Pneumothorax has been described as a complication of a fractured clavicle only rarely in English literature. In all the reported cases, the pneumothorax was treated by a thoracostomy and the clavicle fracture was treated conservatively. In our case, the pneumothorax required a chest drain insertion and the clavicle fracture was treated surgically with good result.

  16. Predicting fractures in an international cohort using risk factor algorithms without BMD. (United States)

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


    Clinical risk factors are associated with increased probability of fracture in postmenopausal women. We sought to compare prediction models using self-reported clinical risk factors, excluding BMD, to predict incident fracture among postmenopausal women. The GLOW study enrolled women aged 55 years or older from 723 primary-care practices in 10 countries. The population comprised 19,586 women aged 60 years or older who were not receiving antiosteoporosis medication and were followed annually for 2 years. Self-administered questionnaires were used to collect data on characteristics, fracture risk factors, previous fractures, and health status. The main outcome measure compares the C index for models using the WHO Fracture Risk (FRAX), the Garvan Fracture Risk Calculator (FRC), and a simple model using age and prior fracture. Over 2 years, 880 women reported incident fractures including 69 hip fractures, 468 "major fractures" (as defined by FRAX), and 583 "osteoporotic fractures" (as defined by FRC). Using baseline clinical risk factors, both FRAX and FRC showed a moderate ability to correctly order hip fracture times (C index for hip fracture 0.78 and 0.76, respectively). C indices for "major" and "osteoporotic" fractures showed lower values, at 0.61 and 0.64. Neither algorithm was better than the model based on age + fracture history alone (C index for hip fracture 0.78). In conclusion, estimation of fracture risk in an international primary-care population of postmenopausal women can be made using clinical risk factors alone without BMD. However, more sophisticated models incorporating multiple clinical risk factors including falls were not superior to more parsimonious models in predicting future fracture in this population.

  17. Research and practice of the impulse sand fracturing technology

    Directory of Open Access Journals (Sweden)

    Bin Qian


    Full Text Available With the deep development of tight sand gas reservoirs, problems such as short stable production period and quick production decline of gas wells after fracturing have become increasingly prominent. Consequently, there is an increasing demand for the effective penetration and conductivity of artificial fractures. Impulse sand fracturing technology introduces a concept of discrete multilayer sanding inside fractures; joint application of pulse blender which can be switched at high frequency, intensive multi-cluster perforation and special fibrous material made it possible to ensure the flow stability of proppant slug, and placement of nonuniformly-laid sand pinnacles and grooves, which markedly upgraded the capacity of the fracture conductivity to several orders of magnitude more than the conventional method. Laboratory engineering simulation evaluation and field test show that pre-fracturing reservoir evaluation, pulse time design and the optimization of degradable fiber and support equipment are the keys to the success of impulse sand fracturing. Compared with the conventional fracturing, this technique can effectively increase well production, decrease the volume of fracturing proppant, and lower sand plugging risks. An independent sand fracturing pilot test has been conducted in 6 layers of 3 wells for the first time in Block Tao 7 of the Sulige Gasfield, Ordos Basin, as a result, the average volume of fracturing proppant dropped by 28.3%, the average sand intensity dropped by 21.88%, and the post-fracturing average daily gas output increased by 26.8%. This technology provides an efficient and environmentally friendly reservoir stimulation option for tight sand gas reservoirs in China.

  18. Vertebral Fracture Prediction

    DEFF Research Database (Denmark)


    Vertebral Fracture Prediction A method of processing data derived from an image of at least part of a spine is provided for estimating the risk of a future fracture in vertebraeof the spine. Position data relating to at least four neighbouring vertebrae of the spine is processed. The curvature...

  19. Radial head fracture - aftercare (United States)

    ... Philadelphia, PA: Elsevier Saunders; 2015:chap 6. Prawer A. Radius and ulna fractures. In: Eiff M, Hatch R, eds. Fracture Management for Primary Care . 3rd ed. Philadelphia, PA: Elsevier Saunders; 2012:chap ... PhD, and the A.D.A.M. Editorial team. Related MedlinePlus Health ...

  20. Displaced patella fractures. (United States)

    Della Rocca, Gregory J


    Displaced patella fractures often result in disruption of the extensor mechanism of the knee. An intact extensor mechanism is a requirement for unassisted gait. Therefore, operative treatment of the displaced patella fracture is generally recommended. The evaluation of the patella fracture patient includes examination of extensor mechanism integrity. Operative management of patella fractures normally includes open reduction with internal fixation, although partial patellectomy is occasionally performed, with advancement of quadriceps tendon or patellar ligament to the fracture bed. Open reduction with internal fixation has historically been performed utilizing anterior tension band wiring, although comminution of the fracture occasionally makes this fixation construct inadequate. Supplementation or replacement of the tension band wire construct with interfragmentary screws, cerclage wire or suture, and/or plate-and-screw constructs may add to the stability of the fixation construct. Arthrosis of the patellofemoral joint is very common after healing of patella fractures, and substantial functional deficits may persist long after fracture healing has occurred. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.


    Institute of Scientific and Technical Information of China (English)



    Objective. To investigate the unique characteristics and treatment of thoracic spine fractures.Methods. Severty-seven patients with thoracic spine fractures were retrospectively reviewed. Of these, therewere 37 compressior fractures, 34 fracture-dislocations, 3 burst fractures and 3 burst-dislocations. Twenty-six pa-tients had a complete lesion of the spinal cord, 14 sustained a neurologically incomplete injury, and 37 wereneurologically intact. Fifty-three patients were treated nonoperatively and 24 treated operatively.Results. All patients were followed up for 2 ~ 15 years. None of the 26 patients with a complete lesion recov-ered any significant function. Of 37 neurologically intact patients, 13 had local pain although all of them re-mained normal function. Two of 14 patients with incomplete paraplegia returned to normal, 7 recovered some func-tion and 5 did not recovered.Conclusions. E ecause of the unique anatomy and biomechanics of the thoracic spine, the classification common-ly applied to thoracolumbar fractures is not suitable for thoracic fractures. Fusion and instrumentation are indicat-ed when the fractures are unstable, while patients with incomplete lesion of the spinal cord may be the candidatesfor supplemented decompression.

  2. Endodontic-orthodontic management of fractured anterior teeth. (United States)

    Delivanis, P; Delivanis, H; Kuftinec, M M


    A case history is presented of a 10-year-old patient, who accidentally injured her maxillary central incisor. The fracture of the crown extended 2 mm below the crest of the alveolar bone. After a pulpotomy was done as a temporary measure, orthodontic appliances were placed by bonding brackets on the maxillary anterior teeth and fitting a sectional arch wire to extrude the fractured tooth. After successful extrusion, the fracture line was brought above the level of alveolar bone where successful restoration of the tooth by the acid-etch method could be accomplished.

  3. Dynamic Fracture in Thin Shells Using Meshfree Method

    Directory of Open Access Journals (Sweden)

    Y. Shie


    Full Text Available We present a meshfree approach to model dynamic fracture in thin structures. Material failure is modeled based on a stress-based criterion and viscoplastic is used to describe the material behavior in the bulk material. Material fracture is simply modeled by breaking bonds between neighboring particles. The method is applied to fracture of cylindrical thin structures under explosive loading. The loading is modelled by a pressure-time history. Comparisons between the computational results and experimental data illustrate the validity and robustness of the proposed method.

  4. Bilateral First Rib Stress Fractures in a Basketball Player

    Directory of Open Access Journals (Sweden)

    Abidin (Radyoloji Kilincer


    Full Text Available I read the article published by Aydogdu et al with a great interest. I congratulate them for this successfully written case report. Additionally, I want to focus an important point about the case they presented is that the diagnosis in that case is likely stress fracture. It is understood from the text and title that they avoided to make a diagnosis of stress fracture in the case, despite of history of lifting heavy weights for three days. And also I decided to mention through this article to an example of our case with bilateral first rib old fractures.

  5. Isolated rib fractures in geriatric patients

    Directory of Open Access Journals (Sweden)

    Elmistekawy Elsayed


    Full Text Available Introduction: The goal of this study was to investigate the short-term outcomes in patients older than 60 years with isolated rib fractures and admitted to emergency hospital. Materials and Methods: This study included patients who were 60 years old or more and sustained blunt chest injury and had isolated rib fractures. The following data were obtained from the medical records: age, gender, number of fracture ribs, side of fracture ribs, mechanism and nature of injury, preexisting medical conditions, complications, admission to intensive care unit (ICU, need for mechanical ventilation, length of ICU and hospital stay and mortality. Results: For the study, 39 patients who were 60 years old or more and admitted to the hospital because of isolated rib fractures were enrolled. There were 28 males (71.7% and 11 females (28.3% with mean age of (66.84 ± 4.7 years. No correlation was found between comorbidities and hospital outcomes except in those who were diabetic (P-value = 0.005 and those with chronic lung disease (P-value = 0.006. Pulmonary complications were the most frequent complications encountered in those patients. Pulmonary complications were: lung contusion in 8 patients (20.5% and pulmonary infection in 6 patients (15.8%. Conclusion: Elderly patients sustaining blunt chest trauma had significant morbidity and potential for mortality.

  6. Hyponatremia and Fractures: Findings from the Osteoporotic Fractures in Men Study (United States)

    Jamal, Sophie A; Arampatzis, Spyridon; Harrison, Stephanie Litwack; Bucur, Roxana C; Ensrud, Kristine; Orwoll, Eric S; Bauer, Douglas C


    Hyponatremia may be a risk factor for fracture. To determine the relationship between hyponatremia and fracture we conducted cross-sectional and longitudinal analyses using data from the Osteoporotic Fractures in Men Study (MrOS). The MrOS study enrolled 5122 community dwelling men aged ≥ 65 years from six centers across the United States. We excluded men taking bisphosphonates, those with unknown medication history, those without serum sodium measures, or those with out of range assays for serum sodium. Serum sodium was measured at study entry. Subjects were followed for fractures (nonspine (including hip), hip, and incident and prevalent morphometric) for up to 9 years. We used cox proportional hazards models to analyze the association between serum sodium levels (<135mmol/L versus ≥135mmol/L) and risk of nonspine and hip fractures, with results presented as hazard ratios (HR) and 95% confidence intervals (CI). We examined the association between morphometric vertebral fractures and serum sodium using logistic regression models, presented as odds ratios (OR) and 95% CI. Hyponatremia was observed in 64 men (1.2% of the cohort). After adjusting for age, BMI, study center, and other covariates, we found that, compared to men with serum sodium ≥ 135mmol/L, those with serum sodium <135mmol/L, had an increased risk hip fracture (HR=3.04; 95% CI: 1.37 to 6.75), prevalent (OR=2.46; 95% CI: 1.22 to 4.95) and incident (OR=3.53; 95% CI: 1.35 to 9.19) morphometric spine fractures but not nonspine fractures (OR=1.44; 95% CI: 0.85 to 2.44). Adjusting for bone mineral density did not change our findings. Our data demonstrate that hyponatremia is associated with up to a doubling in the risk of hip and morphometric spine fractures, independent of BMD. Further studies, to determine how hyponatremia causes fractures and if correction of hyponatremia decreases fractures, are needed. PMID:25294595

  7. Entangled histories (United States)

    Cotler, Jordan; Wilczek, Frank


    We introduce quantum history states and their mathematical framework, thereby reinterpreting and extending the consistent histories approach to quantum theory. Through thought experiments, we demonstrate that our formalism allows us to analyze a quantum version of history in which we reconstruct the past by observations. In particular, we can pass from measurements to inferences about ‘what happened’ in a way that is sensible and free of paradox. Our framework allows for a richer understanding of the temporal structure of quantum theory, and we construct history states that embody peculiar, non-classical correlations in time.

  8. Transphyseal Distal Humerus Fracture. (United States)

    Abzug, Joshua; Ho, Christine Ann; Ritzman, Todd F; Brighton, Brian


    Transphyseal distal humerus fractures typically occur in children younger than 3 years secondary to birth trauma, nonaccidental trauma, or a fall from a small height. Prompt and accurate diagnosis of a transphyseal distal humerus fracture is crucial for a successful outcome. Recognizing that the forearm is not aligned with the humerus on plain radiographs may aid in the diagnosis of a transphyseal distal humerus fracture. Surgical management is most commonly performed with the aid of an arthrogram. Closed reduction and percutaneous pinning techniques similar to those used for supracondylar humerus fractures are employed. Cubitus varus caused by a malunion, osteonecrosis of the medial condyle, or growth arrest is the most common complication encountered in the treatment of transphyseal distal humerus fractures. A corrective lateral closing wedge osteotomy can be performed to restore a nearly normal carrying angle.

  9. Galeazzi fracture-dislocations. (United States)

    Mikić, Z D


    Among 125 patients with the Galeazzi-type fracture-dislocation of the forearm, there were fourteen children and eighty-six adults with the classic Galeazzi lesion, and twenty-five patients with a special type -- fracture of both bones and dislocation of the distal radio-ulnar joint. Conservative management was successful only in children. In adults this method resulted in failure in 80 per cent of cases. The results of operative treatment were much better. The fracture fragments of the radius and the dislocation of the radio-ulnar joint in this complex injury are very unstable, especially in the lesion with fractures of the radius and ulna, and it appears that rigid internal fixation is necessary for the dislocation as well as the fracture. With combined fixation over half of the results were excellent.

  10. Dynamic fracture mechanics (United States)

    Kobayashi, A. S.; Ramulu, M.


    Dynamic fracture and crack propagation concepts for ductile materials are reviewed. The equations for calculating dynamic stress integrity and the dynamic energy release rate in order to study dynamic crack propagation are provided. The stress intensity factor versus crack velocity relation is investigated. The uses of optical experimental techniques and finite element methods for fracture analyses are described. The fracture criteria for a rapidly propagating crack under mixed mode conditions are discussed; crack extension and fracture criteria under combined tension and shear loading are based on maximum circumferential stress or energy criteria such as strain energy density. The development and use of a Dugdale model and finite element models to represent crack and fracture dynamics are examined.

  11. Tibial Plateau Fractures

    DEFF Research Database (Denmark)

    Elsøe, Rasmus

    This PhD thesis reported an incidence of tibial plateau fractures of 10.3/100,000/year in a complete Danish regional population. The results reported that patients treated for a lateral tibial plateau fracture with bone tamp reduction and percutaneous screw fixation achieved a satisfactory level...... with only the subgroup Sport significantly below the age matched reference population. The thesis reports a level of health related quality of life (Eq5d) and disability (KOOS) significantly below established reference populations for patients with bicondylar tibial plateau fracture treated with a ring...... fixator, both during treatment and at 19 months following injury. In general, the thesis demonstrates that the treatment of tibial plateau fractures are challenging and that some disabilities following these fractures must be expected. Moreover, the need for further research in the area, both with regard...

  12. Dating fractures in infants

    Energy Technology Data Exchange (ETDEWEB)

    Halliday, K.E., E-mail: [Department of Radiology, Nottingham University Hospitals, Queen' s Medical Centre, Nottingham (United Kingdom); Broderick, N.J.; Somers, J.M. [Department of Radiology, Nottingham University Hospitals, Queen' s Medical Centre, Nottingham (United Kingdom); Hawkes, R. [Department of Radiology, Paul O' Gorman Building, Bristol (United Kingdom)


    Aim: To document the timing of the appearance of the radiological features of fracture healing in a group of infants in which the date of injury was known and to assess the degree of interobserver agreement. Materials and methods: Three paediatric radiologists independently assessed 161 images of 37 long bone fractures in 31 patients aged 0-44 months. The following features were assessed: soft-tissue swelling, subperiosteal new bone formation (SPNBF), definition of fracture line, presence or absence of callus, whether callus was well or ill defined, and the presence of endosteal callus. Results: Agreement between observers was only moderate for all discriminators except SPNBF. SPNBF was invariably seen after 11 days but was uncommon before this time even in the very young. In one case SPNBF was seen at 4 days. Conclusion: With the exception of SPNBF, the criteria relied on to date fractures are either not reproducible or are poor discriminators of fracture age.

  13. Location of fractures and the characteristics of patients with atypical femoral fractures: analyses of 38 Japanese cases. (United States)

    Hyodo, Kojiro; Nishino, Tomofumi; Kamada, Hiroshi; Nozawa, Daisuke; Mishima, Hajime; Yamazaki, Masashi


    The purpose of this study was to determine fracture location and the characteristics of patients with atypical femoral fractures (AFFs). We studied 38 AFFs in 34 patients admitted to our institution between November 2007 and July 2013. The diagnostic criteria for the AFFs were based on 2014 American Society of Bone and Mineral Research guidelines. We classified the fracture location as proximal, middle, or distal to trisect the femoral diaphysis from just distal to the lesser trochanter to just proximal to the supracondylar flare. Bowing was defined as a line through the inside of the tip of the great trochanter and a condylar center that was outside the medullary cavity. We investigated the fracture's location, existence of coronal bowing, and bisphosphonates (BPs), glucocorticoids (GCs), and proton pump inhibitors therapy. We analyzed associations between fracture location and demographic and clinical factors. Twelve fractures were proximal, 25 were middle, and one was distal. Nineteen limbs showed femoral bowing. Thirty-one patients received BP treatment-20 patients received alendronic acid, eight risedronic acid, and three minodronic acid. Fourteen patients received a GC, and 16 received a proton pump inhibitor. There was a significant association between coronal bowing and middle fracture locations, GC therapy and proximal fracture locations, and older age and middle fracture locations. Tall height and heavy weight had an association with proximal fracture location, and short height and light weight had an association with middle fracture location. In conclusion, we provide evidence supporting a causal relationship between BP-related severely suppressed bone turnover and AFFs. We also provide evidence supporting additional influences from altered distribution of mechanical stress with femoral bowing and various factors, such as GC therapy, age, body weight, and height, which might negatively affect bone intensity and quality and result in fracture.

  14. Comparative assessment of short term outcome of cementless prosthesis versus cemented femoral stem prosthesis in hip arthroplasty for elderly intertrochanteric fracture%生物型与骨水泥型人工髋关节置换治疗高龄转子间骨折早期疗效的比较

    Institute of Scientific and Technical Information of China (English)

    闫文龙; 杨小中; 张华; 张健


    Objective To compare the short-term clinical effect of the distal fixed prosthesis ( cementless prosthesis ) with cemented femoral stem prosthesis in hip arthroplasty for elderly intertrochanteric fracture .Methods Fifty-nine cases(54 cases followed-up) of unilateral intertrochanteric fracture in senile patients from Aug .2010 to Apr.2012 were retrospectively analyzed and randomly divided into 2 groups.In them,21 cases underwent hip ar-throplasty using the distal fixed prosthesis ( cementless group ) ,and the other 33 were treated with cemented hip ar-throplasty (cement group).The difference was compared in time of hospitalization , time of operation,blood loss, adverse effect,Harris scoring and radiological results .Results The average operation time were (42.3 ±7.2) mi-nutes in cementless group and (51.5 ±8.3) minutes in cement group,with significant difference (P0.05).Conclu-sion Hip arthroplasty using cementless prosthesis for treatment of elder patients with intertrochanteric fracture can a -chieve good short-term clinical effect alike cemented prosthesis .It helps reduce operative time ,blood loss and bone cement implantation syndrome during the operation .The medium and long term effect still needs further research . And preoperative evaluation on the shape and size of medullary cavity and the severity of osteoporosis is needed .%目的:比较远端固定生物型股骨假体与骨水泥型股骨假体行人工髋关节置换治疗高龄股骨转子间骨折的早期临床疗效。方法回顾性分析2010年8月~2012年4月在我院骨科行人工髋关节置换治疗的59例单侧股骨转子间骨折高龄患者的临床资料,实际随访54例。随机分成两组:生物固定组21例,骨水泥组33例。比较两组住院时间、手术时间、术中出血量、术后3d总失血量、术后并发症、Harris评分以及放射学效果。结果生物固定组手术时间、术中出血均明显少于骨水泥组;生物固定组术中、

  15. Short Review

    DEFF Research Database (Denmark)

    Lynnerup, Niels; Rühli, Frank


    modality in ancient mummy research. The aim of this short review is to address the advantages and pitfalls of this particular technique for such unique samples. We recommend that when results of X-ray examination of mummies are presented, the specific recording data should be listed, and any given finds......, for example, of Paleopathology, should be cross-checked against other sources, for example, CT-scanning, direct inspection (also by endoscopy), and so forth....

  16. Computed tomograms of blowout fracture

    Energy Technology Data Exchange (ETDEWEB)

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


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

  17. Intellectual History

    DEFF Research Database (Denmark)

    In the 5 Questions book series, this volume presents a range of leading scholars in Intellectual History and the History of Ideas through their answers to a brief questionnaire. Respondents include Michael Friedman, Jacques le Goff, Hans Ulrich Gumbrecht, Jonathan Israel, Phiip Pettit, John Pocock...

  18. Intellectual History

    DEFF Research Database (Denmark)

    In the 5 Questions book series, this volume presents a range of leading scholars in Intellectual History and the History of Ideas through their answers to a brief questionnaire. Respondents include Michael Friedman, Jacques le Goff, Hans Ulrich Gumbrecht, Jonathan Israel, Phiip Pettit, John Pocock...

  19. Romerrigets historie

    DEFF Research Database (Denmark)

    Christiansen, Erik

    Romerrigets historie fra Roms legendariske grundlæggelse i 753 f.v.t. til Heraklios' tronbestigelse i 610 e.v.t.......Romerrigets historie fra Roms legendariske grundlæggelse i 753 f.v.t. til Heraklios' tronbestigelse i 610 e.v.t....

  20. Quantum Histories

    CERN Document Server

    Kent, A


    There are good motivations for considering some type of quantum histories formalism. Several possible formalisms are known, defined by different definitions of event and by different selection criteria for sets of histories. These formalisms have a natural interpretation, according to which nature somehow chooses one set of histories from among those allowed, and then randomly chooses to realise one history from that set; other interpretations are possible, but their scientific implications are essentially the same. The selection criteria proposed to date are reasonably natural, and certainly raise new questions. For example, the validity of ordering inferences which we normally take for granted --- such as that a particle in one region is necessarily in a larger region containing it --- depends on whether or not our history respects the criterion of ordered consistency, or merely consistency. However, the known selection criteria, including consistency and medium decoherence, are very weak. It is not possibl...


    Directory of Open Access Journals (Sweden)

    Shiva Naik


    Full Text Available : INTRODUCTION: Subtrochanteric fractures account for approximately 10-30% of all hip fractures, and they affect persons of all ages. Most frequently, these fractures are seen in 2 patient populations, namely older osteopenic patients after a low-energy fall and younger patients involved in high-energy trauma. A newer population of patients experience subtrochanteric fractures after bisphosphonate use. CASE PRESENTATION: A 45year old Indian woman presented at our orthopaedic outpatients department with 4 months history of pain in left hip and a 1 month history of inability to walk. She had pelvic irradiation for carcinoma of cervix 1 year earlier. Pelvic radiograph confirmed sub trochanteric fracture of left femur. CONCLUSION: Patients with hip pain who have been treated with pelvic irradiation should be thoroughly investigated for hip fractures.

  2. A risk assessment tool for contaminated sites in low-permeability fractured media

    DEFF Research Database (Denmark)

    Chambon, Julie Claire Claudia; Binning, Philip John; Jørgensen, Peter R.


    and history (including secondary sources) and can be applied to a wide range of compounds. The tool successfully simulates published data from short duration column and field experiments. The use for risk assessment is illustrated by three typical risk assessment case studies, involving pesticides......, chlorinated solvents, benzene and MTBE. The model is compared with field data and with results from a simpler approach based on an Equivalent Porous Media (EPM). Risk assessment conclusions of the DF and EPM approaches are very different due to the early breakthrough, long term tailing, and lower attenuation...... due to degradation associated with fractured media. While the DF tool simulates the field data, it is difficult to conclude that the DF model is superior to an EPM model because of a lack of long term monitoring data. However, better agreement with existing field data by the DF model using observed...

  3. Radiographically occult femoral and pelvic fractures are not mutually exclusive: a review of fractures detected by MRI following low-energy trauma

    Energy Technology Data Exchange (ETDEWEB)

    Szewczyk-Bieda, Magdalena; Thomas, Naveena; Oliver, Thomas Barry [Ninewells Hospital and Medical School, Department of Clinical Radiology, Dundee, Scotland (United Kingdom)


    The purpose of this study was to review the MRI examinations of a large group of low-energy trauma patients in whom pelvic MRI had detected radiographically occult fractures, in order to characterize prevailing fracture patterns and determine how often co-existing proximal femoral and pelvic fractures were observed. All patients having pelvic MRI over 5 years were identified. Word-search software selected 269 MRI reports containing the term 'fracture'. Further scrutiny identified 168 with diagnosis of fracture. MRI request and imaging record review identified 102 low-energy trauma cases that had MRI for clinical suspicion of fracture despite normal radiographs. Sixty-six cases were excluded for the following reasons: no expressed clinical suspicion of occult fracture; history suggesting high-energy trauma; skeletal co-morbidity hindering acute fracture identification; interval more than 2 weeks between radiographs and MRI. The 102 study MRI examinations, which employed a limited two-sequence protocol, were reviewed. Any fracture that had not been appreciated on radiographs was recorded and characterized as femoral, pelvic, or co-existing femoral and pelvic fractures. The 102 study cases had a median age of 82 years. The median interval between pelvic radiographs and MRI was 3 days. MRI showed undiagnosed femoral fracture in 48/102 cases (47.1%), sacral fracture in 41/102 (40.2%), and pubic fracture in 55/102 (53.9%). In 11/102 cases (10.8%), MRI showed undiagnosed fractures of both proximal femur and pelvic ring (seven sacral, six pubic bone, two other site fractures). In 10/11 cases with co-existing femoral and pelvic fractures, the femoral fracture was incomplete. Limited pelvic MRI found a high prevalence of radiographically occult femoral and pelvic fractures in low-energy trauma patients, with clinical suspicion of fracture despite normal radiographs. Co-existing occult femoral and pelvic ring fractures were commonly observed, and in such cases, the

  4. Prevalence of dementia in elderly patients with hip fracture. (United States)

    Yiannopoulou, Konstantina G; Anastasiou, Ioannis P; Ganetsos, Theodore K; Efthimiopoulos, Petros; Papageorgiou, Sokratis G


    Hip fractures occur commonly and are a cause of disability for older adults and lead to increased dependence and requirements for social support. Dementia is one of the possible risk factors for falling and hip fracture, a potential source for complications during surgery and during the postoperative period, difficulties in rehabilitation and a risk factor for hip fracture reccurence. However, in previous studies of hip fracture patients, cognitive status has not been formally assessed during the inpatient stay and diagnosis was based only on previous history. Additionally, no previous studies have compared prevalence of dementia between elderly patients with hip fracture and patients with other surgical pathology. Our aim was to define whether dementia was more prevalent in older subjects with hip fracture than in other elderly patients undergoing surgery. In this study, we prospectively assessed all patients aged 68 and older admitted to our hospital for hip fracture surgery during a one year period and compared them with age and gender matched patients attending other surgical departments. 80 hip fracture patients and 80 controls were assessed for dementia. Dementia was common in both groups, presumably reflecting the advanced mean age of both groups and cognitive deterioration due to hospitalization-status. Dementia was significantly higher in the hip fracture group (85%) compared to the control group (61.5%; p=0.002). Dementia is very common in older patients admitted for surgery to a general hospital and extremely common in those with hip fracture. It seems that dementia is under diagnosed in elderly hospitalised patients. Our data confirm that dementia is a major risk factor for hip fracture in the elderly.

  5. Surgical menopause and nonvertebral fracture risk among older US women. (United States)

    Vesco, Kimberly K; Marshall, Lynn M; Nelson, Heidi D; Humphrey, Linda; Rizzo, Joanne; Pedula, Kathryn L; Cauley, Jane A; Ensrud, Kristine E; Hochberg, Marc C; Antoniucci, Diana; Hillier, Teresa A


    The aim of this study was to determine whether older postmenopausal women with a history of bilateral oophorectomy before natural menopause (surgical menopause) have a higher risk of nonvertebral postmenopausal fracture than women with natural menopause. We used 21 years of prospectively collected incident fracture data from the ongoing Study of Osteoporotic Fractures, a cohort study of community-dwelling women without previous bilateral hip fracture who were 65 years or older at enrollment, to determine the risk of hip, wrist, and any nonvertebral fracture. χ(2) and t tests were used to compare the two groups on important characteristics. Multivariable Cox proportional hazards regression models stratified by baseline oral estrogen use status were used to estimate the risk of fracture. Baseline characteristics differed significantly among the 6,616 women within the Study of Osteoporotic Fractures who underwent either surgical (1,157) or natural (5,459) menopause, including mean age at menopause (44.3 ± 7.4 vs 48.9 ± 4.9 y, P menopause, even among women who had never used oral estrogen (hip fracture: hazard ratio [HR], 0.87; 95% CI, 0.63-1.21; wrist fracture: HR, 1.10; 95% CI, 0.78-1.57; any nonvertebral fracture: HR, 1.11; 95% CI, 0.93-1.32). These data provide some reassurance that the long-term risk of nonvertebral fracture is not substantially increased for postmenopausal women who experienced premenopausal bilateral oophorectomy, compared with postmenopausal women with intact ovaries, even in the absence of postmenopausal estrogen therapy.

  6. Spontaneous rib fractures. (United States)

    Katrancioglu, Ozgur; Akkas, Yucel; Arslan, Sulhattin; Sahin, Ekber


    Other than trauma, rib fracture can occur spontaneously due to a severe cough or sneeze. In this study, patients with spontaneous rib fractures were analyzed according to age, sex, underlying pathology, treatment, and complications. Twelve patients who presented between February 2009 and February 2011 with spontaneous rib fracture were reviewed retrospectively. The patients' data were evaluated according to anamnesis, physical examination, and chest radiographs. The ages of the patients ranged from 34 to 77 years (mean 55.91 ± 12.20 years), and 7 (58.4%) were male. All patients had severe cough and chest pain. The fractures were most frequently between 4th and 9th ribs; multiple rib fractures were detected in 5 (41.7%) patients. Eight (66.7%) patients had chronic obstructive pulmonary disease, 2 (16.7%) had bronchial asthma, and 2 (16.7%) had osteoporosis. Bone densitometry revealed a high risk of bone fracture in all patients. Patients with chronic obstructive pulmonary disease or bronchial asthma had been treated with high-dose steroids for over a year. Spontaneous rib fracture due to severe cough may occur in patients with osteoporosis, chronic obstructive pulmonary disease, or bronchial asthma, receiving long-term steroid therapy. If these patients have severe chest pain, chest radiography should be performed to check for bone lesions. © The Author(s) 2015.

  7. Short esophagus. (United States)

    Kunio, Nicholas R; Dolan, James P; Hunter, John G


    In the presence of long-standing and severe gastroesophageal reflux disease, patients can develop various complications, including a shortened esophagus. Standard preoperative testing in these patients should include endoscopy, esophagography, and manometry, whereas the objective diagnosis of a short esophagus must be made intraoperatively following adequate mediastinal mobilization. If left untreated, it is a contributing factor to the high recurrence rate following fundoplications or repair of large hiatal hernias. A laparoscopic Collis gastroplasty combined with an antireflux procedure offers safe and effective therapy.

  8. Prevalence of Sarcopenia and Its Relationship with Sites of Fragility Fractures in Elderly Chinese Men and Women.

    Directory of Open Access Journals (Sweden)

    Wei Hong

    Full Text Available Sarcopenia might be associated with bone fragility in elderly individuals. This study aimed to investigate the prevalence of sarcopenia and its association with fragility fracture sites in elderly Chinese patients.Patients (322 men and 435 women aged 65-94 years and with a history of fragility fractures in the ankle, wrist, vertebrae or hip, and healthy men (n = 1263 and women (n = 1057 aged 65-92 years without a history of fractures were enrolled. Whole-body dual energy X-ray absorptiometry was used to analyze skeletal muscle mass index (SMI, fat mass and bone mineral density. Sarcopenia was defined as SMI less than two standard deviations below the mean of a young reference group.Sarcopenia occurrence varied with fracture location. Sarcopenia was more common in females with vertebral and hip fractures and in men with hip and ankle fractures than in the non-fracture group. Sarcopenia was significantly more prevalent in men with wrist, hip and ankle fractures than in women. SMI was correlated with BMD in different fracture groups. Logistic regression analyses revealed that lower SMI was associated with an increased risk of hip fracture both in men and women and ankle fracture in men.Sarcopenia may be an independent risk factor for hip and ankle fractures in men, and for hip fractures in women.

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

    Directory of Open Access Journals (Sweden)

    Egemen Kucuk


    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.

  10. Geriatric hip fracture management: keys to providing a successful program. (United States)

    Basu, N; Natour, M; Mounasamy, V; Kates, S L


    Hip fractures are a common event in older adults and are associated with significant morbidity, mortality and costs. This review examines the necessary elements required to implement a successful geriatric fracture program and identifies some of the barriers faced when implementing a successful program. The Geriatric Fracture Center (GFC) is a treatment model that standardizes the approach to the geriatric fracture patient. It is based on five principles: surgical fracture management; early operative intervention; medical co-management with geriatricians; patient-centered, standard order sets to employ best practices; and early discharge planning with a focus on early functional rehabilitation. Implementing a geriatric fracture program begins with an assessment of the hospital's data on hip fractures and standard care metrics such as length of stay, complications, time to surgery, readmission rates and costs. Business planning is essential along with the medical planning process. To successfully develop and implement such a program, strong physician leadership is necessary to articulate both a short- and long-term plan for implementation. Good communication is essential-those organizing a geriatric fracture program must be able to implement standardized plans of care working with all members of the healthcare team and must also be able to foster relationships both within the hospital and with other institutions in the community. Finally, a program of continual quality improvement must be undertaken to ensure that performance outcomes are improving patient care.

  11. Multidisciplinary Management of Complicated Crown-Root Fracture of an Anterior Tooth Undergoing Apexification


    Merve Mese; Merve Akcay; Bilal Yasa; Huseyin Akcay


    The purpose of this case report was to present the multidisciplinary management of a subgingival crown-root fracture of a patient undergoing apexification treatment. A 12-year-old male patient was referred to the pediatric dentistry clinic with an extensive tooth fracture of the right permanent maxillary lateral incisor. Clinical and radiographic examinations revealed the presence of a complicated crown-root fracture, which had elongated to the buccal subgingival area. The dental history disc...

  12. Posterior rib fractures in a young infant who received chiropractic care. (United States)

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


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

  13. Periprosthetic fractures in the resurfaced hip--A case report and review of the literature.

    LENUS (Irish Health Repository)

    Brennan, Stephen A


    Traumatic periprosthetic fractures adjacent a hip resurfacing prosthesis are rare. When proximal fractures are encountered the obvious surgical solution is to revise to a large head stemmed femoral component. A previously well functioning implant may however be retained as various non-operative and operative treatment options exist. This paper reports the case history of a traumatic periprosthetic fracture successfully treated with cannulated screw fixation and reviews the current literature.


    Directory of Open Access Journals (Sweden)

    Sanda Dubravcic-Simunjak


    skaters reported major changes in their training routine shortly before the occurrence of the stress fracture. In most cases an excessive number of repetitions of jumps and throw jumps, during each training session (up to 30 repetition of each jump, was reported. Galilee-Belfer and Guskiewicz, 2000 also reported that muscular fatigue and sudden changes in training intensity or duration may contribute to stress fracture incidence. In our survey we found that junior skaters, who participate both in junior and senior events, are exposed to greater stress and impacts than juniors who only skate either in junior or senior competitions. Of all senior skaters with stress fractures 5.9% females and 10% males attributed the occurrence to the greater number of competitions and shows, while 20.8% of all female juniors and 33.3% of all male skaters felt that the large number of competitions and shows during one skating season contributed to the occurrence of stress fractures. This is a novel and relevant finding which may have to be taken into account for developing the competition schedule. In conclusion the data suggest that the cumulative risk of stress fractures is high in figure skating, especially among single figure skaters and female pair skaters. In the light of increasing physiological demands from rigorous training and competitive schedules throughout the skating season, prevention deserves more emphasis. Proper education to athletes and coaches about training regimes, together with early recognition of stress fracture symptoms may help to decrease the stress fracture risks. Because of the large number of competitions and shows in a short period of time, it is recommended to critically review the competitive schedule. In addition, rule changes concerning the ages and skaters possibilities to compete in both senior and junior events may have to be considered

  15. Hydraulic Fracture Containment in Sand

    NARCIS (Netherlands)

    Dong, Y.


    The mechanism of hydraulic fracturing in soft, high permeability material is considered fundamentally different from that in hard, low permeability rock, where a tensile fracture is created and conventional linear elastic fracture mechanics (LEFM) applies. The fracturing and associated modeling work

  16. Paediatric talus fracture.

    LENUS (Irish Health Repository)

    Byrne, Ann-Maria


    Paediatric talus fractures are rare injuries resulting from axial loading of the talus against the anterior tibia with the foot in dorsiflexion. Skeletally immature bone is less brittle, with higher elastic resistance than adult bone, thus the paediatric talus can sustain higher forces before fractures occur. However, displaced paediatric talus fractures and those associated with high-energy trauma have been associated with complications including avascular necrosis, arthrosis, delayed union, neurapraxia and the need for revision surgery. The authors present the rare case of a talar neck fracture in a skeletally immature young girl, initially missed on radiological review. However, clinical suspicion on the part of the emergency physician, repeat examination and further radiographic imaging revealed this rare paediatric injury.

  17. Geothermal Ultrasonic Fracture Imager

    Energy Technology Data Exchange (ETDEWEB)

    Patterson, Doug [Baker-Hughes Oilfield Operation Inc., Houston, TX (United States); Leggett, Jim [Baker-Hughes Oilfield Operation Inc., Houston, TX (United States)


    The Geothermal Ultrasonic Fracture Imager project has a goal to develop a wireline ultrasonic imager that is capable of operating in temperatures up to 300°C (572°F) and depths up to 10 km (32,808 ft). This will address one of the critical needs in any EGS development of understanding the hydraulic flow paths in the reservoir. The ultrasonic imaging is well known in the oil and gas industry as one of the best methods for fracture evaluation; providing both high resolution and complete azimuthal coverage of the borehole. This enables fracture detection and characterization, both natural and induced, providing information as to their location, dip direction and dip magnitude. All of these factors are critical to fully understand the fracture system to enable the optimization of the thermal drainage through injectors and producers in a geothermal resource.

  18. Clavicle Fracture (Broken Collarbone) (United States)

    ... Bahk MS, Kuhn JE, Galatz LM, Connor PM, Williams GR: Acromioclavicular and sternoclavicular injuries and cla- vicular, ... Orthopaedic Surgeons. .org Clavicle Fracture cont. Rehabilitation Specific exercises will help restore movement and strengthen your shoulder. ...

  19. Proximal femoral fractures

    DEFF Research Database (Denmark)

    Palm, Henrik; Teixidor, Jordi


    BACKGROUND: In hip fracture surgery, the exact choice of implant often remains somewhat unclear for the individual surgeon, but the growing literature consensus has enabled publication of evidence-based surgical treatment pathways. The aim of this article was to review author pathways and national...... guidelines for hip fracture surgery and discuss a method for future pathway/guideline implementation and evaluation. METHODS: By a PubMed search in March 2015 six studies of surgical treatment pathways covering all types of proximal femoral fractures with publication after 1995 were identified. Also we...... searched the homepages of the national heath authorities and national orthopedic societies in West Europe and found 11 national or regional (in case of no national) guidelines including any type of proximal femoral fracture surgery. RESULTS: Pathway consensus is outspread (internal fixation for un...

  20. A biological approach to crown fracture: Fracture reattachment - A report of two cases

    Directory of Open Access Journals (Sweden)

    K Vijayaprabha


    Full Text Available The development of adhesive dentistry has allowed dentists to use the patient′s own fragment to restore the fractured tooth, which is considered to be the most conservative method of treatment of crown fracture allowing restoration of original dental anatomy, thus rehabilitating function and esthetics in a short time by preserving dental tissues. The tooth fragment reattachment is preferred over full coverage crowns or composite resin restoration because it conserves sound tooth structure, and is more esthetic, maintaining the original anatomy and translucency, and the rate of incisal wear also matches that of original tooth structure. Presented here is a report of two cases of crown fracture managed by reattachment procedures.

  1. Family History (United States)

    Your family history includes health information about you and your close relatives. Families have many factors in common, including their genes, ... as heart disease, stroke, and cancer. Having a family member with a disease raises your risk, but ...

  2. Risk Factors for Hip Fracture in Older Men: The Osteoporotic Fractures in Men Study (MrOS). (United States)

    Cauley, Jane A; Cawthon, Peggy M; Peters, Katherine E; Cummings, Steven R; Ensrud, Kristine E; Bauer, Douglas C; Taylor, Brent C; Shikany, James M; Hoffman, Andrew R; Lane, Nancy E; Kado, Deborah M; Stefanick, Marcia L; Orwoll, Eric S


    Almost 30% of hip fractures occur in men; the mortality, morbidity, and loss of independence after hip fractures are greater in men than in women. To comprehensively evaluate risk factors for hip fracture in older men, we performed a prospective study of 5994 men, primarily white, age 65+ years recruited at six US clinical centers. During a mean of 8.6 years of 97% complete follow-up, 178 men experienced incident hip fractures. Information on risk factors including femoral neck bone mineral density (FNBMD) was obtained at the baseline visit. Cox proportional hazards models were used to calculate the hazard ratio (HR) with 95% confidence intervals; Fine and Gray models adjusted for competing mortality risk. Older age (≥75 years), low FNBMD, currently smoking, greater height and height loss since age 25 years, history of fracture, use of tricyclic antidepressants, history of myocardial infarction or angina, hyperthyroidism or Parkinson's disease, lower protein intake, and lower executive function were all associated with an increased hip fracture risk. Further adjustment for competing mortality attenuated HR for smoking, hyperthyroidism, and Parkinson's disease. The incidence rate of hip fracture per 1000 person-years (PY) was greatest in men with FNBMD T-scores hip fracture at rates of 14.52 versus 0.88 per 1000 PY in men age hip fracture. Many of these assessments can easily be incorporated into routine clinical practice and may lead to improved risk stratification. © 2016 American Society for Bone and Mineral Research. © 2016 American Society for Bone and Mineral Research.

  3. Fracture Behavior under Impact. (United States)


    discussed for the different loading rates ob- tai ned . 1. Introduction In static fracture mechanics crack tip stress intensity factors can easi- - ly...deviation to the left or to the right hand side of the original crack path was observed. Herrmann [151 speculated that this behavior results from stress...Materials’ Draft 2c, American Society for Testing and Materials, Philadelphia, .. ,-- 1980. 15. Herrmann , G., "Dynamic Fracture of Beams in Bending

  4. Relative permeability through fractures

    Energy Technology Data Exchange (ETDEWEB)

    Diomampo, Gracel, P.


    The mechanism of two-phase flow through fractures is of importance in understanding many geologic processes. Currently, two-phase flow through fractures is still poorly understood. In this study, nitrogen-water experiments were done on both smooth and rough parallel plates to determine the governing flow mechanism for fractures and the appropriate methodology for data analysis. The experiments were done using a glass plate to allow visualization of flow. Digital video recording allowed instantaneous measurement of pressure, flow rate and saturation. Saturation was computed using image analysis techniques. The experiments showed that gas and liquid phases flow through fractures in nonuniform separate channels. The localized channels change with time as each phase path undergoes continues breaking and reforming due to invasion of the other phase. The stability of the phase paths is dependent on liquid and gas flow rate ratio. This mechanism holds true for over a range of saturation for both smooth and rough fractures. In imbibition for rough-walled fractures, another mechanism similar to wave-like flow in pipes was also observed. The data from the experiments were analyzed using Darcy's law and using the concept of friction factor and equivalent Reynold's number for two-phase flow. For both smooth- and rough-walled fractures a clear relationship between relative permeability and saturation was seen. The calculated relative permeability curves follow Corey-type behavior and can be modeled using Honarpour expressions. The sum of the relative permeabilities is not equal one, indicating phase interference. The equivalent homogeneous single-phase approach did not give satisfactory representation of flow through fractures. The graphs of experimentally derived friction factor with the modified Reynolds number do not reveal a distinctive linear relationship.

  5. Atomistic simulations of fracture

    Energy Technology Data Exchange (ETDEWEB)

    Farkas, D. [Virginia Polytechnic Inst. and State Univ., Blacksburg, VA (United States). Dept. of Materials Science and Engineering


    Embedded atom interaction potentials are used to simulate the atomistic aspects of the fracture process. Simulations are presented for the behavior of cracks in pure metals and intermetallics, near the Griffith condition. The materials considered include Fe, Cu, Ni as well as Fe, Ni, Co, and Ti aluminides. The work focuses on the comparative study of fracture behavior in the different materials. The role of the atomic relaxation at the crack tip and of lattice trapping phenomena is analyzed.

  6. Science of Fracture. (United States)


    Fracture Set-Up .............. 163 Dr. Jan T. Lindt 4.i0 Fracture in Fully Plastic Bodies ............................... 171 Dr. Howard Kuhn iii I...Benthem’s results and results obtained by 15 Bazant and Estenssoro (12) who used a finite element method of determining critical eigenvalues. Each of...14) is made by Benthem in (10) and (11) and only che sentence quoted above made by Bazant and Estenssoro (12). This is unfortunate since constructive

  7. Double level Chance-type fractures of spine in ankylosing spondylitis

    Institute of Scientific and Technical Information of China (English)

    Gauresh Shantaram Vargaonkar; Varun Kumar Singh; Abhishek Kashyap; Ramesh Kumar


    Chance fractures are usually associated with seat belt injuries. Mechanism is always related to flexion-distraction at vertebral level. Double level Chance-type fractures have rarely been reported in published literature. We presented such a fracture at D10 and L3 level in a 38-year-old patient with ankylosing spondylitis. Management was done with posterior decompression and short segment fixation separately.

  8. Short QT syndrome

    Directory of Open Access Journals (Sweden)

    Fiorenzo Gaita


    Full Text Available The short QT syndrome (SQTS is a recently described genetic arrhythmogenic disorder, characterized by abnormally short QT intervals on surface electrocardiogram (ECG and a high incidence of sudden death (SD during life, including the first months of life. The inheritance of SQTS is autosomal dominant, with genetic heterogeneity. Gain-of-function mutations in 3 genes encoding potassium channels have been associated to the disease: KCNH2 encoding IKr (SQT1, KCNQ1 encoding IKs (SQT2, and KCNJ2 encoding IK1 (SQT3. Loss-of-function mutations in 3 genes encoding the cardiac L-type calcium channel, CACNA1C, CACNB2b and CACNA2D1 may underlie a mixed phenotype of Brugada pattern ECG (or non-specific repolarization changes in case of CACNA2D1 and shorter than normal QT intervals. Clinical presentation is often severe, as cardiac arrest represents the first clinical presentation in most subjects. Moreover, often a noticeable family history of cardiac SD is present. Atrial fibrillation may be observed, also in young individuals. At electrophysiological study, short atrial and ventricular refractory periods are found, and atrial and ventricular fibrillation are easily induced by programmed electrical stimulation. The outcome of patients with SQTS becomes relatively safe when they are identified and treated. Currently, the suggested therapeutic strategy is an implantable cardioverter- defibrillator (ICD in patients with personal history of aborted SD or syncope. In asymptomatic adult patients from highly symptomatic families and in newborn children pharmacological treatment with hydroquinidine, which has been shown to prolong the QT interval and reduce the inducibility of ventricular arrhythmias, may be proposed.

  9. Subduction of fracture zones (United States)

    Constantin Manea, Vlad; Gerya, Taras; Manea, Marina; Zhu, Guizhi; Leeman, William


    Since Wilson proposed in 1965 the existence of a new class of faults on the ocean floor, namely transform faults, the geodynamic effects and importance of fracture zone subduction is still little studied. It is known that oceanic plates are characterized by numerous fracture zones, and some of them have the potential to transport into subduction zones large volumes of water-rich serpentinite, providing a fertile water source for magma generated in subduction-related arc volcanoes. In most previous geodynamic studies, subducting plates are considered to be homogeneous, and there is no clear indication how the subduction of a fracture zone influences the melting pattern in the mantle wedge and the slab-derived fluids distribution in the subarc mantle. Here we show that subduction of serpentinized fracture zones plays a significant role in distribution of melt and fluids in the mantle wedge above the slab. Using high-resolution tree-dimensional coupled petrological-termomechanical simulations of subduction, we show that fluids, including melts and water, vary dramatically in the region where a serpentinized fracture zone enters into subduction. Our models show that substantial hydration and partial melting tend to concentrate where fracture zones are being subducted, creating favorable conditions for partially molten hydrous plumes to develop. These results are consistent with the along-arc variability in magma source compositions and processes in several regions, as the Aleutian Arc, the Cascades, the Southern Mexican Volcanic Arc, and the Andean Southern Volcanic Zone.

  10. Prevention of hip fractures. (United States)

    Meunier, P J


    For a 50-year old Caucasian woman today, the risk of a hip fracture over her remaining life-time is about 17%. Tomorrow the situation will clearly be worse because the continuous increase in life expectancy will cause a three-fold increase in worldwide fracture incidence over the next 60 years. Through diagnostic bone mass measurements at the hip and assessment of biochemical parameters, a great deal has been learned in recent years about reduction of hip fracture risk. Preventive strategies are based on prevention of falls, use of hip protectors, and prevention of bone fragility. The latter includes the optimization of peak bone mass during childhood, postmenopausal estrogen replacement therapy, and also late prevention consisting in reversing senile secondary hyperparathyroidism, which plays an important role in the decrease of skeletal strength. This secondary hyperparathyroidism, which results from both vitamin D insufficiency and low calcium intake, is preventable with vitamin D3 and calcium supplements. They have recently been shown capable of providing effective prevention of hip fractures in elderly women living in nursing homes, with a reduction of about 25% in the number of hip fractures noted in a 3-year controlled study in 3,270 women (intention-to-treat analysis). In conclusion, it is never too early to reduce the risk of osteoporosis and never too late to prevent hip fractures.


    Energy Technology Data Exchange (ETDEWEB)

    Subhash Shah


    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.

  12. [Subtrochanteric femoral fractures]. (United States)

    Ulmar, B; Simon, S; Eschler, A; Mittlmeier, T


    Subtrochanteric femoral fractures are proximal femoral fractures which are located between the trochanter minor and an area of 3 cm below the minor trochanter on the femoral shaft. About 10-15% of all proximal femoral fractures correspond to this fracture site. Elderly or geriatric patients are generally affected and the injury is often the result of a fall in the home, while high-energy trauma is the cause in a small group of generally younger patients. Clinical evaluation of the affected extremity shows disability of axial weight-bearing and pain during compression and rotation of the hip joint. Basic diagnostics include conventional x-rays of the injured femur in the anterior-posterior and lateral planes. These subtrochanteric femoral fractures are almost always treated surgically due to the inherent high degree of instability. The main goals of surgical intervention are to achieve anatomic fracture reduction and primary full weight-bearing stability of the corresponding leg. Intramedullary interlocking nails are used for primary treatment, while extramedullary implants are often used in revision surgery. Early mobilization and intensive respiratory exercises are necessary to prevent early postoperative complications.

  13. Fracture toughness of graphene. (United States)

    Zhang, Peng; Ma, Lulu; Fan, Feifei; Zeng, Zhi; Peng, Cheng; Loya, Phillip E; Liu, Zheng; Gong, Yongji; Zhang, Jiangnan; Zhang, Xingxiang; Ajayan, Pulickel M; Zhu, Ting; Lou, Jun


    Perfect graphene is believed to be the strongest material. However, the useful strength of large-area graphene with engineering relevance is usually determined by its fracture toughness, rather than the intrinsic strength that governs a uniform breaking of atomic bonds in perfect graphene. To date, the fracture toughness of graphene has not been measured. Here we report an in situ tensile testing of suspended graphene using a nanomechanical device in a scanning electron microscope. During tensile loading, the pre-cracked graphene sample fractures in a brittle manner with sharp edges, at a breaking stress substantially lower than the intrinsic strength of graphene. Our combined experiment and modelling verify the applicability of the classic Griffith theory of brittle fracture to graphene. The fracture toughness of graphene is measured as the critical stress intensity factor of and the equivalent critical strain energy release rate of 15.9 J m(-2). Our work quantifies the essential fracture properties of graphene and provides mechanistic insights into the mechanical failure of graphene.

  14. Data assimilation method for fractured reservoirs using mimetic finite differences and ensemble Kalman filter

    KAUST Repository

    Ping, Jing


    Optimal management of subsurface processes requires the characterization of the uncertainty in reservoir description and reservoir performance prediction. For fractured reservoirs, the location and orientation of fractures are crucial for predicting production characteristics. With the help of accurate and comprehensive knowledge of fracture distributions, early water/CO 2 breakthrough can be prevented and sweep efficiency can be improved. However, since the rock property fields are highly non-Gaussian in this case, it is a challenge to estimate fracture distributions by conventional history matching approaches. In this work, a method that combines vector-based level-set parameterization technique and ensemble Kalman filter (EnKF) for estimating fracture distributions is presented. Performing the necessary forward modeling is particularly challenging. In addition to the large number of forward models needed, each model is used for sampling of randomly located fractures. Conventional mesh generation for such systems would be time consuming if possible at all. For these reasons, we rely on a novel polyhedral mesh method using the mimetic finite difference (MFD) method. A discrete fracture model is adopted that maintains the full geometry of the fracture network. By using a cut-cell paradigm, a computational mesh for the matrix can be generated quickly and reliably. In this research, we apply this workflow on 2D two-phase fractured reservoirs. The combination of MFD approach, level-set parameterization, and EnKF provides an effective solution to address the challenges in the history matching problem of highly non-Gaussian fractured reservoirs.


    Energy Technology Data Exchange (ETDEWEB)

    David S. Schechter


    This report describes the work performed during the fourth year of the project, ''Investigating of Efficiency Improvements during CO{sub 2} Injection in Hydraulically and Naturally Fractured Reservoirs.'' The objective of this project is to perform unique laboratory experiments with artificially fractured cores (AFCs) and X-ray CT scanner to examine the physical mechanisms of bypassing in hydraulically fractured reservoirs (HFR) and naturally fractured reservoirs (NFR) that eventually result in more efficient CO{sub 2} flooding in heterogeneous or fracture-dominated reservoirs. In Chapter 1, we worked with DOE-RMOTC to investigate fracture properties in the Tensleep Formation at Teapot Dome Naval Reserve as part of their CO{sub 2} sequestration project. In Chapter 2, we continue our investigation to determine the primary oil recovery mechanism in a short vertically fractured core. Finally in Chapter 3, we report our numerical modeling efforts to develop compositional simulator with irregular grid blocks.

  16. Importance of greenstick lamina fractures in low lumbar burst fractures (United States)

    Ersozlu, S.; Aydinli, U.


    Lumbar burst fractures (L3–L5) represent a small percentage of all spinal fractures. The treatment of fractures involving the lumbar spine has been controversial. Lamina fractures may be complete or of the greenstick type. Dural tears and nerve root entrapment may accompany these lamina fractures. The aim of this retrospective study was to determine the incidence of dural tear in patients who had lumbar burst fractures with greenstick lamina fractures and the importance of these lamina fractures when choosing the optimum treatment. Twenty-six patients with 28 lumbar burst fractures were treated from 1995 through 2002. The average follow-up was 60 months (range 32–110 months). The male to female ratio was 21:5 and the mean age was 37 years (17–64). Dural tear was detected in seven (25%) out of 28 burst fractures. The functional outcome of the entire study group was assessed using the Smiley-Webster Scale. Good to excellent results were obtained in 24 (92%) of 26 patients. Lumbar burst fractures with greenstick lamina fractures occur mostly in the L2–L4 area. In the surgical treatment, any reduction manoeuvre will close the fracture and crush the entrapped neural elements. Therefore, it may be better to explore the greenstick lamina fracture whether there is any neural entrapment or not, before any reduction manoeuvre is attempted. PMID:16501977

  17. Synkinematic quartz cementation in partially open fractures in sandstones (United States)

    Ukar, Estibalitz; Laubach, Stephen E.; Fall, Andras; Eichhubl, Peter


    have recorded opening histories that lasted several tens of millions of years. Quartz bridges will form when the increase in fracture aperture is small for single fracture events, the rate of precipitation is greater than the rate of fracture aperture, and fresh non-euhedral nucleation surfaces continue to be created by fracturing. Because of the vast difference in growth rates between the c-axis (fast) and the a-axis (slow) of quartz crystals, the crystallographic orientation of quartz may play a role on the morphology and size of such bridges, and therefore degree of cement infill in fractures. SEM-based backscattered electron diffraction (EBSD) was used to explore the effect of the crystallographic orientation of quartz on the growth of quartz bridges in fractures from the Jurassic-Cretaceous Nikanassin Formation, northwestern Alberta Foothills, the Travis Peak Formation, East Texas, and the Cretaceous Mesaverde Group, Piceance Basin, Colorado. We find that, in all samples, most c-axes are oblique rather than perpendicular to the fracture wall, and well-developed bridges that are oriented at a low angle to the fracture wall are widespread. We conclude that precipitation on anhedral (fractured) surfaces exerts a larger control on the growth of quartz bridges than the orientation of the crystallographic c-axis.

  18. 空心钉克氏针内固定治疗儿童陈旧性肱骨外髁骨折近期疗效观察%Short-term effect of cannulated screw with K-wires used as internal fixation in management of pediatric neglected humeral lateral condylar fractures

    Institute of Scientific and Technical Information of China (English)

    易新成; 鲍琨; 陈博昌


    目的:探讨空心钉克氏针内固定手术治疗儿童陈旧性肱骨外髁骨折的临床疗效。方法回顾性分析2009年10月至2012年12月我们收治并获完整随访的的11例肱骨外髁陈旧性骨折患儿临床资料,其中男9例,女2例,年龄2岁1个月至6岁4个月,平均4岁5个月。患儿受伤至手术时间为30~90 d,平均52 d。受伤初期按Milch分型,MilchⅠ型4例,MilchⅡ型7例,肘关节功能有不同程度受限。患儿均切开复位后用1枚空心钉外加2枚交叉克氏针内固定治疗。术后随访观察骨折愈合时间及并发症情况,术后1年采用Dhillon评分值和Baumann角评定疗效。结果所有患儿术后均获12~34个月(平均22.7个月)随访。均在术后6~8周获骨性愈合。术后1年按照Dhillon评分标准,10例为优,1例为良,优良率100%,术前患侧肘关节活动弧度平均为90.5°±27.3°,术后1年时平均为129.1°±11.8°,二者差异有统计学意义(t=6.527,P=0.000)。术后1年所有患儿Baumann角均在正常范围(68°~80°),平均74.3°±4.2°。无一例发生术后感染、骨折延迟愈合、畸形愈合、骨不连、肘内外翻、肱骨小头缺血坏死、医源性血管神经损伤等并发症。结论切开复位后采用1枚空心钉外加2枚交叉克氏针内固定治疗儿童陈旧性肱骨外髁骨折可达到复位满意、内固定稳定和良好的近期疗效,并发症少。%Objetive To discuss the short-term effect of cannulated screw with K-wires used as internal fixation in management of pediatric neglected humeral lateral condylar fractures. Methods The clinical data of 1 1 cases with neglected humeral lateral condylar fracture were analyzed retrospectively.from October 2009 to December 2012.There were 9 boys and 2 girls,aged from 2 years and 1month to 6 year and 4 months old (aver-age,4 years and 5 months).The duration of initially trauma to surgery ranged

  19. High Serum 25-hydroxyvitamin D is Associated with Low Incidence of Stress Fractures (United States)


    of Family and Preventive Medicine, School of Medicine, University of California, San Diego, La Jolla, California 3 Osteoporosis Research (p 0.01) (9). Amenorrhea and age older than 25 years were also predictors of increased risk of stress fracture, while history of exercise was... exercise were independently associated with risk of fractures (9). In this study, it was not possible to include amenorrhea and exercise history (prior to

  20. CT of pelvic fractures

    Energy Technology Data Exchange (ETDEWEB)

    Falchi, Marco E-mail:; Rollandi, Gian Andrea


    Although magnetic resonance imaging has become the dominant modality for cross-sectional musculo-skeletal imaging, the widespread availability, speed, and versatility of computed tomography (CT) continue to make it a mainstay of emergency room (ER) diagnostic imaging. Pelvic ring and acetabular fractures occur as the result of significant trauma secondary to either a motor vehicle accident or a high-velocity fall. These injuries are correlated with significant morbidity and mortality, both from the complications of pelvic ring fractures and from commonly associated injuries. The most commonly used classification of pelvic and acetabular fractures has been based on conventional radiographs that are, in the majority of cases, sufficient to determine the type of injury. However, because of the complexity of pelvic and acetabular fractures, precise pathological anatomy is not easily demonstrated by routine radiographs and in many cases details of fractures are not visible. Moreover, the insufficient co-operation of the patient or the difficulty of maintaining special positions can be overcome by using computed tomography. Spiral computed tomography provides information regarding the extent of the fractures and is complementary to radiography for ascertaining the spatial arrangement of fracture fragments. Spiral computed tomography is an effective tool for understanding complex fracture patterns, particularly when combined with multi-planar reconstruction two-dimensional (MPR 2D) reformatted images or three-dimensional images (3D) images. Including these techniques of reconstruction in routine pelvic imaging protocols can change management in a significant number of cases. Subtle fractures, particularly those oriented in the axial plane, are better seen on MPR images or 3D volume-rendered images. Complex injuries can be better demonstrated with 3D volume-rendered images, and complicated spatial information about the relative positions of fracture fragments can be easily

  1. Fracture of highway and airport pavements (United States)

    Ramsamooj, D. V.


    Existing solutions for the stresses in a cracked slab containing a crack and supported by an elastic foundation are extended to obtain the stress intensity factor (SIF) for a crack in a pavement subjected to moving vehicular loads. In the existing solutions the stresses can be obtained only for a uniform bending stress (before the crack occurs) along the crack surface. For pavements subjected to moving vehicular loads, the stress distribution along the crack surface is not uniform and the approximation of a uniform stress is often unsatisfactory. The present work extends the above solutions to cover more realistic loading of highway and airport pavements. This facilitates the application of the principles of fracture mechanics to the fatigue crack propagation and fracture of pavements. Beginning with a part-through semi-elliptical starter crack, the crack is assumed to grow under load and the SIF is presented at various stages of crack growth, from the starter crack into a short through-crack that eventually becomes a very long through-crack. Some examples of the fracture of typical rigid and flexible highway and airport pavements are presented to show the need to consider fracture in the design of pavements.

  2. Fracture Mechanics Prediction of Fatigue Life of Aluminum Highway Bridges

    DEFF Research Database (Denmark)

    Rom, Søren; Agerskov, Henning


    Fracture mechanics prediction of the fatigue life of aluminum highway bridges under random loading is studied. The fatigue life of welded joints has been determined from fracture mechanics analyses and the results obtained have been compared with results from experimental investigations. The fati......Fracture mechanics prediction of the fatigue life of aluminum highway bridges under random loading is studied. The fatigue life of welded joints has been determined from fracture mechanics analyses and the results obtained have been compared with results from experimental investigations...... against fatigue in aluminum bridges, may give results which are unconservative. Furthermore, it was in both investigations found that the validity of the results obtained from Miner's rule will depend on the distribution of the load history in tension and compression....

  3. External Fixation of Unstable Distal Radius Fracture. A Case Report

    Directory of Open Access Journals (Sweden)

    Yaniel Truffin Rodríguez


    Full Text Available Unstable fracture of the distal radius is a common injury. If not properly treated, it can cause major disturbance in the radiocarpal joint and impaired hand function. A case of a 42-year-old patient of rural origin without a history of previous conditions treated at the Gustavo Aldereguía Lima Hospital in Cienfuegos is presented. He suffered a fall on the outstretched hand, which led to an unstable fracture of the left distal radius. Emergency surgery consisting of manual fracture reduction under general anesthesia and fixation with RALCA minifixator plus a percutaneously placed Kirschner wire was performed. Since this fracture is often inadequately treated, the presentation of this case can be helpful to many orthopedic surgeons.

  4. Percutaneous osteosynthesis of Galeazzi fracture-dislocation. (United States)

    Gadegone, Wasudeo M; Salphale, Yogesh; Magarkar, Ds


    can produce excellent clinical results for Galeazzi fracture-dislocation. It has the advantages of technical simplicity, minimal cost, user-friendly instrumentation, and a short learning curve.

  5. Modeling contaminant plumes in fractured limestone aquifers

    DEFF Research Database (Denmark)

    Mosthaf, Klaus; Brauns, Bentje; Fjordbøge, Annika Sidelmann

    the established approaches of the equivalent porous medium, discrete fracture and dual continuum models. However, these modeling concepts are not well tested for contaminant plume migration in limestone geologies. Our goal was to develop and evaluate approaches for modeling the transport of dissolved contaminant...... in the planning of field tests and to update the conceptual model in an iterative process. Field data includes information on spill history, distribution of the contaminant (multilevel sampling), geology and hydrogeology. To describe the geology and fracture system, data from borehole logs, packer tests, optical...... distribution in the aquifer. Different models were used for the planning and interpretation of the pump and tracer test. The models were evaluated by examining their ability to describe collected field data. The comparison with data showed that the models have substantially different representations...

  6. CT classification of acetabular fractures

    Energy Technology Data Exchange (ETDEWEB)

    Marincek, B.; Porcellini, B.; Robotti, G.


    The contribution of computed tomography (CT) in classifying acetabular fractures was analysed retrospectively in 33 cases. CT and plain radiography classification agreed in 27 cases (82%). CT revealed more extensive fractures in 6 patients (thereof 5 patients with associated fractures). In 10 patients (thereof 9 patients with associated fractures) CT showed intraarticular fragments; radiographically intraarticular fragments were seen only in 2 patients and suspected in 4. CT is of considerable aid in defining the fracture pattern. It should be used mainly in patients with radiographically difficult interpretable associated fractures in order to assess preoperatively the weight-bearing part of the acetabulum, the degree of displacement and the presence of intraarticular fragments.

  7. Atomistic Simulations of Nanotube Fracture

    CERN Document Server

    Belytschko, T; Schatz, G; Ruoff, R S


    The fracture of carbon nanotubes is studied by atomistic simulations. The fracture behavior is found to be almost independent of the separation energy and to depend primarily on the inflection point in the interatomic potential. The rangle of fracture strians compares well with experimental results, but predicted range of fracture stresses is marketly higher than observed. Various plausible small-scale defects do not suffice to bring the failure stresses into agreement with available experimental results. As in the experiments, the fracture of carbon nanotubes is predicted to be brittle. The results show moderate dependence of fracture strength on chirality.

  8. Matematikkens historie

    DEFF Research Database (Denmark)

    Hansen, Vagn Lundsgaard


    Matematikkens historie i syv kapitler: 1. Matematik i støbeskeen; 2. Matematikkens græske arv; 3. Den gyldne tidsalder for hinduer og arabere; 4. Matematik i Kina; 5. Renæssancens matematik; 6. Regning med infinitesimaler ser dagens lys; 7. Matematik i det tyvende århundrede.......Matematikkens historie i syv kapitler: 1. Matematik i støbeskeen; 2. Matematikkens græske arv; 3. Den gyldne tidsalder for hinduer og arabere; 4. Matematik i Kina; 5. Renæssancens matematik; 6. Regning med infinitesimaler ser dagens lys; 7. Matematik i det tyvende århundrede....

  9. Linjefaget historie

    DEFF Research Database (Denmark)

    Rasch-Christensen, Andreas

    Afhandlingen er en undersøgelse af linjefaget historie ved læreruddannelsen. Med fokus på subjektperspektivet peger afhandlingen på en række afgørende udviklingsperspektiver for læreruddannelsen, uddannelsen af historielærere og folkeskolens historieundervisning.......Afhandlingen er en undersøgelse af linjefaget historie ved læreruddannelsen. Med fokus på subjektperspektivet peger afhandlingen på en række afgørende udviklingsperspektiver for læreruddannelsen, uddannelsen af historielærere og folkeskolens historieundervisning....

  10. Matematikkens historie

    DEFF Research Database (Denmark)

    Hansen, Vagn Lundsgaard


    Matematikkens historie i syv kapitler: 1. Matematik i støbeskeen; 2. Matematikkens græske arv; 3. Den gyldne tidsalder for hinduer og arabere; 4. Matematik i Kina; 5. Renæssancens matematik; 6. Regning med infinitesimaler ser dagens lys; 7. Matematik i det tyvende århundrede.......Matematikkens historie i syv kapitler: 1. Matematik i støbeskeen; 2. Matematikkens græske arv; 3. Den gyldne tidsalder for hinduer og arabere; 4. Matematik i Kina; 5. Renæssancens matematik; 6. Regning med infinitesimaler ser dagens lys; 7. Matematik i det tyvende århundrede....

  11. Environmental history

    DEFF Research Database (Denmark)

    Pawson, Eric; Christensen, Andreas Aagaard


    Environmental history is an interdisciplinary pursuit that has developed as a form of conscience to counter an increasingly powerful, forward-looking liberal theory of the environment. It deals with the relations between environmental ideas and materialities, from the work of the geographers George...... risks”. These are exposed by environmental history’s focus on long-run analysis and its narrative form that identifies the stories that we tell ourselves about nature. How a better understanding of past environmental transformations helps to analyse society and agency, and what this can mean...... for solutions and policies, is the agenda for an engaged environmental history from now on....

  12. A Feasibility study on Monitoring of Fracture Healing by Electric Stimulation-A study on 2 tibial fracture cases

    Directory of Open Access Journals (Sweden)

    S. Kumaravel


    Full Text Available Sufferings associated with broken limbs have been on an exponential increase in India, mainly due to road accidents. Conventional healing and uniting methods takes any where between 1 ½ to 6 months depending on the nature of the fracture and the speed of reporting for medical care .In an effort to speed up the healing process low voltage electric stimulation has been tried and has been found to cut down the healing time by nearly 30% depending on the fracture-history. Also the course of fracture healing has been traced and definite trends during the process identified.Two case studies of fractures of the leg bone through electric stimulation indicate identical trends in the healingprocess.

  13. Nothing a very short introduction

    CERN Document Server

    Close, Frank


    What is 'nothing'? What remains when you take all the matter away? Can empty space - a void - exist? This Very Short Introduction explores the science and the history of the elusive void: from Aristotle who insisted that the vacuum was impossible, via the theories of Newton and Einstein, to our very latest discoveries and why they can tell us extraordinary things about the cosmos. Frank Close tells the story of how scientists have explored the elusive void, and the rich discoveries that they have made there. He takes the reader on a lively and accessible history through ancient ideas and cultural superstitions to the frontiers of current research

  14. [Humeral shaft fractures]. (United States)

    Schittko, A


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

  15. Fracture prediction in hydraulic bulging of AISI 304 austenitic steel sheets based on a modified ductile fracture criterion (United States)

    Xu, Y.; Song, H. W.; Zhang, S. H.; Cheng, M.


    The demand for weight reduction in modern vehicle construction has resulted in an increase in the application of hydroforming processes for the manufacture of automotive lightweight components. This trend led to the research of evaluation on formability of the sheet or tube hydroforming to be noted, particularly the prediction of fracture. In this study, a new proposed approach based on damage theory for fracture prediction considering the deformation history was introduced. And the modified ductile fracture criterion was applied to predict the failure for hydraulic bulging of AISI 304 austenitic steel sheets. The material parameters in terms of the function of strain rate in the failure criterion were determined from the equivalent fracture strains corresponding tensile tests under different stress conditions. Then, in the finite element simulation the effect of strain rates and their distribution as well during practical sheet metal forming process was considered. The hydraulic bulging tests were carried out to identify the fracture behavior predicted from FE analysis. A comparison between the prediction and experimental results showed that the proposed approach with a modified ductile fracture criteria can give better fracture predictions than traditional ways.

  16. Fracture-Flow-Enhanced Solute Diffusion into Fractured Rock

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Yu-Shu; Ye, Ming; Sudicky, E.A.


    We propose a new conceptual model of fracture-flow-enhanced matrix diffusion, which correlates with fracture-flow velocity, i.e., matrix diffusion enhancement induced by rapid fluid flow within fractures. According to the boundary-layer or film theory, fracture flow enhanced matrix diffusion may dominate mass-transfer processes at fracture-matrix interfaces, because rapid flow along fractures results in large velocity and concentration gradients at and near fracture-matrix interfaces, enhancing matrix diffusion at matrix surfaces. In this paper, we present a new formulation of the conceptual model for enhanced fracture-matrix diffusion, and its implementation is discussed using existing analytical solutions and numerical models. In addition, we use the enhanced matrix diffusion concept to analyze laboratory experimental results from nonreactive and reactive tracer breakthrough tests, in an effort to validate the new conceptual model.

  17. Bilateral distal fibula fractures in a woman on long-term bisphosphonate therapy. (United States)

    Murray, J C; Audet, M C; Bédard, M; Michou, L


    We report the case of a 53-year-old female, treated by bisphosphonate for 12 years, who presented atraumatic fractures of both fibulas. Her X-rays showed bilateral distal fibula fractures with radiological features similar to atypical femur fractures. The distal fibula should be considered as a potential site for stress fractures in bisphosphonate users. Bisphosphonates are the most widely used drugs in the treatment of osteoporosis. During the last decade, the occurrence of atypical fractures, mostly subtrochanteric and diaphyseal femoral fractures, has been acknowledged in patients with long-term use of bisphosphonates. We report the case of a 53-year-old female on alendronate therapy for the past 12 years who presented with a few months history of atraumatic right, and subsequently left, lateral ankle pain. Her X-rays showed bilateral distal fibula fractures with radiological features similar to atypical femur fractures. She had been treated conservatively with walking boots and her treatment with bisphosphonate had been stopped 5 months prior to the fractures. Callus was progressively seen on serial follow-up X-rays, and both fractures healed completely within a reasonable period of 1 year. Investigations did not reveal any secondary causes of osteoporosis or metabolic bone disorders. To our knowledge, this is the first reported case of bilateral distal fibula fractures in a patient on long-term bisphosphonate therapy.

  18. Management of fractures of the humerus in Ancient Egypt, Greece, and Rome

    DEFF Research Database (Denmark)

    Brorson, Stig


    Fractures of the humerus have challenged medical practitioners since the beginning of recorded medical history. In the earliest known surgical text, The Edwin Smith Papyrus (copied circa 1600 BC), three cases of humeral fractures were described. Reduction by traction followed by bandaging with li...... of written sources points toward a multifaceted approach to the diagnosis, reduction, and bandaging of humeral fracture in Ancient Egypt, Greece, and Rome......., and multifragmented fractures. In Late Antiquity, complications from powerful traction or tight bandaging were described by Paul of Aegina (circa AD 625-690). Illustrations from sixteenth and seventeenth century surgical texts are included to show the ancient methods of reduction and bandaging. The richness...

  19. Persisting upper cervical pain as sole symptom by unstable fractures in the cervical spine

    DEFF Research Database (Denmark)

    Saksø, Henrik; Foldager, Casper Bindzus; Bünger, Cody


    Upper cervical spine fractures can be caused by very low-energy traumas, and the clinical presentation can vary from mild neck pain to paraplegia and ultimately to death. The most common cause of these fractures is trauma but degenerative and pathologic aetiology is also seen. Upper cervical spine...... fractures can be difficult to diagnose because of lack of symptoms. Two case stories describe neck pain as the only symptom to severe and unstable cervical fracture and highlight the importance of an accurate history, thorough physical examination and relevant radiological investigation....

  20. Ultrasound for critical care physicians: neutropenic patient with fever snd shortness of breath

    Directory of Open Access Journals (Sweden)

    Kraai E


    Full Text Available No abstract available. Article truncated after first page. A 63 year old female with a history of acute myelogenous leukemia presents with shortness of breath, fever and hypotension to the ICU. She is in septic shock on norepinephrine, and has been treated on the oncology unit with vancomycin, cefepime, acyclovir and voriconazole. She has been neutropenic for 1 month. The patient develops a progressive right lower chest opacity. This opacity has progressed in spite of antibiotics and antifungals. The portable AP chest radiograph is presented below (Figure 1. An ultrasound of the right chest was performed for further evaluation of the opacity (figure 2. Question: What pathology does the ultrasound reveal in the right hemithorax? 1. Air filled cavity; 2. Chest wall abscess; 3. Fractured ribs; 4. Pleural effusion and suspected empyema; 5. Simple consolidation ...

  1. Cultural history as polyphonic history

    Directory of Open Access Journals (Sweden)

    Burke, Peter


    Full Text Available This texts offers a reflection on the origins and actual development of the field of cultural history through a comparison with the term that has served as title for this seminar: “polyphonic history”. The author provides an overview of the themes that have structured the seminar (the history of representations, the history of the body and the cultural history of science with the aim of making explicit and clarifying this plurality of voices in the field of history as well as its pervasiveness in other research areas.

    En este texto se ofrece una reflexión sobre el origen y actual desarrollo del campo de la historia cultural a través de una comparación con el término que ha dado título a este seminario: “historia polifónica”. El autor propone un recorrido por las áreas temáticas que han conformado la estructura del seminario (la historia de las representaciones, la historia del cuerpo y la historia cultural de la ciencia con el objeto de explicitar y explicar esta pluralidad de voces en el campo de la historia, así como su repercusión en otras áreas del conocimiento.

  2. Chaos a very short introduction

    CERN Document Server

    Smith, Leonard


    Chaos: A Very Short Introduction shows that we all have an intuitive understanding of chaotic systems. It uses accessible maths and physics (replacing complex equations with simple examples like pendulums, railway lines, and tossing coins) to explain the theory, and points to numerous examples in philosophy and literature (Edgar Allen Poe, Chang-Tzu, and Arthur Conan Doyle) that illuminate the problems. The beauty of fractal patterns and their relation to chaos, as well as the history of chaos, and its uses in the real world and implications for the philosophy of science are all discussed in this Very Short Introduction.

  3. A review of lifestyle, smoking and other modifiable risk factors for osteoporotic fractures

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Brask-Lindemann, Dorthe; Rubin, Katrine Hass


    could include reduction of excessive alcohol intake, smoking cessation, adequate nutrition, patient education, daily physical activity and a careful review of medications that could increase the risk of falls and fractures. There remains, however, an unmet need for high-quality intervention studies......Although many strong risk factors for osteoporosis-such as family history, fracture history and age-are not modifiable, a number of important risk factors are potential targets for intervention. Thus, simple, non-pharmacological intervention in patients at increased risk of osteoporotic fractures...

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

    LENUS (Irish Health Repository)

    Burke, Neil G


    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.

  5. Approach to the Child with Fractures (United States)

    Boyce, Alison M.


    Evaluation of the child with fractures is challenging, as no clear guidelines exist to distinguish traumatic from pathological fractures. Although most fractures in childhood are benign, recurrent fractures may be associated with a wide variety of primary skeletal diseases as well as secondary causes, necessitating a careful history and physical exam to guide the evaluation. There is no “gold standard” for the evaluation and treatment of children with fractures and low bone mineral density (BMD); therefore, the diagnosis of osteoporosis in a pediatric patient should be made using a combination of clinical and radiographic features. Interpretation of bone densitometry in growing patients presents a unique set of challenges because areal BMD measured by dual-energy x-ray absorptiometry depends on multiple dynamic variables. Interpretation of pediatric dual-energy x-ray absorptiometry should be based on Z-scores (sd scores compared to age, sex, and ethnicity-matched controls), using normative databases specific to the brand of densitometer and the patient population. Given the skeleton's ability to recover from low BMD through modeling and remodeling, optimizing management of underlying conditions leading to bone fragility is the initial step. Conservative measures including calcium and vitamin D supplementation and weight-bearing physical activity are important interventions that should not be overlooked. The use of bisphosphonates in children and adolescents is controversial due to lack of long-term efficacy and safety data and should be limited to clinical trials and compassionate therapy in children with significantly compromised quality of life. Close monitoring is required, and further study is necessary to assess their long-term safety and efficacy in children. PMID:21734001

  6. Why History? (United States)

    Duffy, Robert E.


    Examines the way in which studying history contributes to intellectual development. Identifies five mental attributes it enhances: perspective--gained from placing people, events, institutions against larger background; encounter--confronting great ideas, personalities, etc.; relativism in a pluralistic world--developed from immersion in other…

  7. Bulletproof History. (United States)

    Roy, R. H.


    Asserts that the writers and producers of the television documentary, "The Valour and the Horror," provided a false impression of an event to fit preconceived and erroneous interpretations of history. Points out specific examples of inaccurate historical presentations and provides contradictory historical interpretations. (CFR)

  8. Business History

    DEFF Research Database (Denmark)

    Hansen, Per H.


    This article argues that a cultural and narrative perspective can enrich the business history field, encourage new and different questions and answers, and provide new ways of thinking about methods and empirical material. It discusses what culture is and how it relates to narratives. Taking...

  9. Potted history

    NARCIS (Netherlands)

    Van Dijk, T.


    The Jordan Valley was once populated by a people, now almost forgotten by historians, with whom the pharaoh of Egypt sought favour. That is the conclusion reached by Niels Groot, the first researcher to take a PhD at the Delft-Leiden Centre for Archaeology, Art History and Science.

  10. Waterproof casts for immobilization of children's fractures and sprains. (United States)

    Shannon, Elizabeth G; DiFazio, Rachel; Kasser, James; Karlin, Lawrence; Gerbino, Peter


    This study was designed to determine the efficacy of waterproof cast-lining materials in children with short-arm, long-arm, and short-leg casts. Eligible patients had healing fractures 2 weeks after reduction, stable fractures requiring no reduction, or sprains. A total of 165 waterproof-lined casts were applied and 124 children and parents completed a survey (76.9%) upon cast removal. Results revealed 79% very satisfied, 21% satisfied, and 0% dissatisfied. There were 16 (12.9%) minor skin integrity issues. Waterproof casts in stable fractures and sprains allow acceptable immobilization with no significant associated unusual risk and allow children to resume their usual recreational water activities and hygiene regimen without risk of adverse results.

  11. Vertebral Geometry Parameters Can Predict Fractures

    Directory of Open Access Journals (Sweden)

    P Tofighi


    Conclusion: Vertebral fractures are common fractures in postmenopausal women. There was a correlation between verte¬bral height and fractures. Vertebral geometric parameters especially height T score can be used for fracture screening.

  12. Galeazzi fractures and dislocations. (United States)

    Giannoulis, Filippos S; Sotereanos, Dean G


    In 1934, fractures of the middle and distal third of the radius associated with instability of the distal radial ulnar joint (DRUJ) were described by Galeazzi. This type of lesion is characterized by its unstable nature and the need for open reduction and internal fixation to achieve a satisfactory functional outcome. A high index of suspicion should be maintained by the surgeon, and a thorough examination for instability of the DRUJ must be conducted. The marked instability of this fracture-dislocation complex is further enhanced by the disruption of the triangular fibrocartilage complex, either with or without ulna styloid fracture. Treatment in adults is surgical, and both bone and soft tissue injuries should be addressed.

  13. DEM Particle Fracture Model

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Boning [Univ. of Colorado, Boulder, CO (United States); Herbold, Eric B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Homel, Michael A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Regueiro, Richard A. [Univ. of Colorado, Boulder, CO (United States)


    An adaptive particle fracture model in poly-ellipsoidal Discrete Element Method is developed. The poly-ellipsoidal particle will break into several sub-poly-ellipsoids by Hoek-Brown fracture criterion based on continuum stress and the maximum tensile stress in contacts. Also Weibull theory is introduced to consider the statistics and size effects on particle strength. Finally, high strain-rate split Hopkinson pressure bar experiment of silica sand is simulated using this newly developed model. Comparisons with experiments show that our particle fracture model can capture the mechanical behavior of this experiment very well, both in stress-strain response and particle size redistribution. The effects of density and packings o the samples are also studied in numerical examples.

  14. Thermal-Hydrologic-Mechanical Behavior of Single Fractures in EGS Reservoirs (United States)

    Zyvoloski, G.; Kelkar, S.; Yoshioka, K.; Rapaka, S.


    Enhanced Geothermal Systems (EGS) rely on the creation a connected fracture system or the enhancement of existing (natural) fractures by hydraulic and chemical treatments. EGS studies at Fenton Hill (New Mexico, USA) and Hijiori (Japan) have revealed that only a limited number of fractures contribute to the effective heat transfer surface area. Thus, the economic viability of EGS depends strongly on the creation and spacing of single fractures in order to efficiently mine heat from given volume of rock. Though there are many similarities between EGS and natural geothermal reservoirs, a major difference between the reservoir types is the (typically) high pumping pressures and induced thermal stresses at the injection wells of an EGS reservoir. These factors can be responsible for fracture dilation/extension and thermal short circuiting and depend strongly on the surrounding state of stress in the reservoir and mechanical properties. We will present results from our study of the thermal-hydrologic-mechanical (THM) behavior of a single fracture in a realistic subsurface stress field. We will show that fracture orientation, the stress environment, fracture permeability structure, and the relationship between permeability changes in a fracture resulting from mechanical displacement are all important when designing and managing an EGS reservoir. Lastly, we present a sensitivity analysis of the important parameters that govern fracture behavior with respect to field measurements. Temperature in high permeability fracture in an EGS reservoir

  15. Atypical subtrochanteric and femoral shaft fractures and possible association with bisphosphonates. (United States)

    Nieves, Jeri W; Cosman, Felicia


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

  16. Application of borehole geophysics to fracture identification and characterization in low porosity limestones and dolostones

    Energy Technology Data Exchange (ETDEWEB)

    Haase, C.S.; King, H.L.


    Geophysical logging was conducted in exploratory core holes drilled for geohydrological investigations at three sites used for waste disposal on the US Department of Energy's Oak Ridge Reservation. Geophysical log response was calibrated to borehole geology using the drill core. Subsequently, the logs were used to identify fractures and fractured zones and to characterize the hydrologic activity of such zones. Results of the study were used to identify zones of ground water movement and to select targets for subsequent piezometer and monitoring well installation. Neutron porosity, long- and short-normal resistivity, and density logs exhibit anomalies only adjacent to pervasively fractured zones and rarely exhibit anomalies adjacent to individual fractures, suggesting that such logs have insufficient resolution to detect individual fractures. Spontaneous potential, single point resistance, acoustic velocity, and acoustic variable density logs, however, typically exhibit anomalies adjacent to both individual fractures and fracture zones. Correlation is excellent between fracture density logs prepared from the examination of drill core and fractures identified by the analysis of a suite of geophysical logs that have differing spatial resolution characteristics. Results of the study demonstrate the importance of (1) calibrating geophysical log response to drill core from a site, and (2) running a comprehensive suite of geophysical logs that can evaluate both large- and small-scale rock features. Once geophysical log responses to site-specific geological features have been established, logs provide a means of identifying fracture zones and discriminating between hydrologically active and inactive fracture zones. 9 figs.

  17. Osteoporotic fractures and vitamin D deficiency. (United States)

    Wong, Phillip; Anpalahan, Mahesan


    A caucasian woman aged 79 years, with a history of hypertension, hyperlipidaemia, and osteoarthritis, was referred for assessment of osteoporosis and generalised musculoskeletal pain after surgery for a right midshaft femoral fracture. Further history revealed she had suffered nonspecific musculoskeletal pain, particularly of the pelvic girdle, and unsteady gait for many weeks, but denied suffering any falls. She had limited mobility due to osteoarthritis of both knees. She had been mostly housebound and was on an animal product restricted diet in view of her history of hypercholesterolaemia. Initial X-rays confirmed an incomplete fracture of the midshaft of the right femur. She had an orthopaedic review, and subsequent bone scan and X-rays (Figure 1) revealed incomplete fractures of the midshaft of both femurs and the seventh rib. She was managed conservatively (alendronate 70 mg per week) and progress was closely monitored. Three weeks later, she presented to the emergency department with worsening right thigh pain and difficulty in weightbearing. X-rays revealed an extension of the right femoral fracture traversing the entire cortex that required surgery. Physical examination revealed a mild thoracic kyphosis. There was no muscle or bone tenderness, proximal muscle weakness, or other significant abnormality. The plasma biochemistry revealed: mild hypocalcaemia (1.98 mmol/L), hypophoshataemia (0.7 mmol/L), raised alkaline phosphatase (ALP) (216 iu/L), low 25-hydroxyvitamin D (250HD) (22 nmol/L), and a mildly raised parathyroid hormone (PTH) level (8 pmol/L). Thyroid, renal, and liver functions were normal. The patient was treated with nine capsules of Ostelin 1000 per day, which was tapered over 8 weeks to one capsule. The repeat plasma 25OHD after 6 weeks was 56 nmol/L, and her musculoskeletal symptoms were completely resolved. There was normalisation of biochemical abnormalities and X-rays demonstrated healing of both femoral fractures. A bone biopsy taken at

  18. Characteristics of the nuclear magnetic resonance logging response in fracture oil and gas reservoirs

    Energy Technology Data Exchange (ETDEWEB)

    Xiao Lizhi; Li Kui, E-mail: [State Key Laboratory of Petroleum Resources and Prospecting, China University of Petroleum, Beijing 102249 (China)


    Fracture oil and gas reservoirs exist in large numbers. The accurate logging evaluation of fracture reservoirs has puzzled petroleum geologists for a long time. Nuclear magnetic resonance (NMR) logging is an effective new technology for borehole measurement and formation evaluation. It has been widely applied in non-fracture reservoirs, and good results have been obtained. But its application in fracture reservoirs has rarely been reported in the literature. This paper studies systematically the impact of fracture parameters (width, number, angle, etc), the instrument parameter (antenna length) and the borehole condition (type of drilling fluid) on NMR logging by establishing the equation of the NMR logging response in fracture reservoirs. First, the relationship between the transverse relaxation time of fluid-saturated fracture and fracture aperture in the condition of different transverse surface relaxation rates was analyzed; then, the impact of the fracture aperture, dip angle, length of two kinds of antennas and mud type was calculated through forward modeling and inversion. The results show that the existence of fractures affects the NMR logging; the characteristics of the NMR logging response become more obvious with increasing fracture aperture and number of fractures. It is also found that T{sub 2} distribution from the fracture reservoir will be affected by echo spacing, type of drilling fluids and length of antennas. A long echo spacing is more sensitive to the type of drilling fluid. A short antenna is more effective for identifying fractures. In addition, the impact of fracture dip angle on NMR logging is affected by the antenna length.

  19. History of Kawasaki disease. (United States)

    Kawasaki, Tomisaku; Naoe, Shiro


    We describe a short history of Kawasaki disease. In 1967, we published a paper entitled 'Infantile acute febrile mucocutaneous lymph node syndrome with specific desquamation of the fingers and toes. Clinical observation of 50 cases'; this was the first report on what is now called Kawasaki disease. Since then, many reports on cardiology, treatment, epidemiology, pathology and etiology of Kawasaki disease have been published. Furthermore, a recent Chapel Hill Consensus Statement on Kawasaki disease in the classification of vasculitis is given, along with a figure on the relationship and classification of childhood vasculitis by autopsy material.

  20. 重建后关节囊及外旋肌群人工全髋关节置换术在股骨颈骨折的临床疗效%Therapeutic effect of total hip replacement with Posterior arthrosis cpsule reconstruction and Short external rotator muscle repair on Femoral neck fractures

    Institute of Scientific and Technical Information of China (English)

    陈春雷; 李拱榆


    Objective To explore the therapeutic effect of total hip replacement with Posterior arthrosis cpsule reconstruction and Short external rotator muscle repair on Femoral neck fractures. Methods Fourty patients with Femoral neck fractures. were select-ed and divided into two groups with 20 cases in each groups. A group was given the treatment of total hip replacement with Poste-rior arthrosis cpsule reconstruction and external rotator muscle repair whiIe B group was given the treatment of traditional total hip replacement only with external rotator muscle repair. The operation incision length, operation time, intraoperative bleeding volume, postoperative drainage volume and hospital stay were all recorded. And postoperative complication in 6 months of two groups in-cluding infection, hematoma, nerve injury, joint dislocation, deep vein thrombosis and Harris hip score were observed and com-pared. Results ①The intraoperative bleeding volume and postoperative drainage volume in A group were less than those in A group (P0.05). ②There was no significant difference of Harris hip score at 6 months after surgery between the two groups (95%VS 85%, P>0.05). ③There were lower incidence of postoperative infection, hematoma and joint dislocation in group A than those in group B (P0.05). Conclusion The therapeutic effect of total hip replacement with Posterior arthrosis cpsule reconstruction and Short external rotator muscle repair on Femoral neck fractures is obvious were less postoperative infection, hematoma and joint disloca-tion, which is worthy of clinical application.%目的:探讨重建后关节囊及外旋肌群人工全髋关节置换术在股骨颈骨折中的临床疗效。方法选择我院2012年3月-2013年3月收治的股骨颈骨折的患者40例,根据手术方式不同随机分为两组,每组20例:A 组采取重建后关节囊及外旋肌群人工全髋关节置换术;B组采取传统经后侧入路行髋关节置换术(仅修补外旋肌群

  1. Complications of mandibular fractures. (United States)

    Zweig, Barry E


    Before any definitive treatment of mandibular fractures, the patient needs to be evaluated for more potentially life-threatening injuries. Complications can and do occur with treatment of mandibular fractures and can occur during any of the phases of treatment. The development of an accurate diagnosis and appropriate treatment plan is vital in achieving optimal success and decreasing complications. Knowledge of the anatomy and the principles of bone healing is also an important factor in preventing complications. To limit long-term untoward effects, complications should be recognized early and the appropriate treatment should be started before a minor complication becomes a complex one that is more difficult to manage.

  2. Fractured Petroleum Reservoirs

    Energy Technology Data Exchange (ETDEWEB)

    Firoozabadi, Dr. Abbas


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

  3. [Supracondylar fractures in children]. (United States)

    Petrov, N; Gucev, S; Kirkov, Lj; Dajljevik, S; Ruso, B


    In the Department of Pediatric surgery, during the last ten years, 190 patients with supracondylar fractures (second and third degree, according to Bauman's classification) have been treated. The operation was performed in only 5% of all hospitalized cases. There were only one patient with neurological and vascular complications in the early stage, but without any complications in the late stage. The presented cases showed a high percentage of flexion type of fractures. The conservative treatment by a reposition has given the most satisfactory results.

  4. Distal Radius Fracture (Broken Wrist) (United States)

    .org Distal Radius Fracture (Broken Wrist) Page ( 1 ) The radius is the larger of the two bones of the forearm. The ... the distal end. A fracture of the distal radius occurs when the area of the radius near ...

  5. Colles wrist fracture – aftercare (United States)

    ... . Prawer A. Radius and ulna fractures. In: Eiff MP, Hatch RL, eds. Fracture Management for Primary Care . 3rd ed. Philadelphia, PA: Elsevier Saunders; 2011:chap ...

  6. Fracture After Total Hip Replacement (United States)

    ... osteolysis. Symptoms The most common symptoms of periprosthetic hip fracture include: • Pain around the hip or thigh • Swelling ... o en very painful, someone with a periprosthetic hip fracture will most likely go directly to the emergency ...

  7. The scapular neck fracture : biomechanical, clinical and surgical aspects

    NARCIS (Netherlands)

    Noort, Arthur van


    After a short introduction to the topics of this thesis, in chapter 2 we described the functional and radiological results of a retrospective study in patients with an ipsilateral scapular neck and clavicular shaft fracture (floating shoulder). Forty-six patients were treated between 1991 and 1996.

  8. Strain rates of opening-mode fractures in deep basinal settings (United States)

    Eichhubl, Peter; Hooker John, N.; Andras, Fall; Laubach Stephen, E.


    Long-term strain rates for geologic processes are characteristically in the range of 10-13 to 10-17 s-1 as measured by a variety of techniques, including geodetic techniques, radiometric dating of tectonic and structural processes, and through stratigraphic correlations. Here, we present strain rates for populations of opening-mode fractures in sandstone in deep basinal settings. Fracture strain is obtained by collecting aperture-frequency data for microfractures along scanlines in weakly deformed sandstone. Opening durations of individual macrofractures in the same population are then obtained through detailed microthermometry of fluid inclusions in crack-seal fracture cement, combined with textural reconstructions of the fracture opening history. Temperature data are then correlated with known burial history models to obtain the duration of fracture opening and the fracture opening strain rate. Individual fractures in deeply buried sandstone of the East Texas basin, a passive margin setting, opened over 48 m.y. with a strain rate of 2x10-18 s-1to 5x10-19 s-1. Similar strain rates are obtained for fractures in the Piceance intermontane basin of Colorado. These ultraslow strain rates compare well to longterm intraplate seismic strain rates suggesting that rates of fracture opening are controlled by intraplate tectonic deformation processes.

  9. Hyponatremia and Fractures: Findings From the MrOS Study. (United States)

    Jamal, Sophie A; Arampatzis, Spyridon; Harrison, Stephanie Litwack; Bucur, Roxana C; Ensrud, Kristine; Orwoll, Eric S; Bauer, Douglas C


    Hyponatremia may be a risk factor for fracture. To determine the relationship between hyponatremia and fracture we conducted cross-sectional and longitudinal analyses using data from the Osteoporotic Fractures in Men (MrOS) study. The MrOS study enrolled 5122 community dwelling men aged ≥65 years from six centers across the United States. We excluded men taking bisphosphonates, those with unknown medication history, those without serum sodium measures, or those with out of range assays for serum sodium. Serum sodium was measured at study entry. Subjects were followed for fractures (nonspine [including hip], hip, incident morphometric, and prevalent morphometric) for up to 9 years. We used Cox proportional hazards models to analyze the association between serum sodium levels (<135 mmol/L versus ≥135 mmol/L) and risk of nonspine and hip fractures, with results presented as hazard ratios (HRs) and 95% confidence intervals (CIs). We examined the association between morphometric vertebral fractures and serum sodium using logistic regression models, presented as odds ratios (ORs) and 95% CI. Hyponatremia was observed in 64 men (1.2% of the cohort). After adjusting for age, BMI, study center, and other covariates, we found that, compared to men with serum sodium ≥135 mmol/L, those with serum sodium <135 mmol/L, had an increased risk of hip fracture (HR = 3.04; 95% CI, 1.37 to 6.75), prevalent morphometric spine fracture (OR = 2.46; 95% CI, 1.22 to 4.95), and incident morphometric spine fracture (OR = 3.53; 95% CI, 1.35 to 9.19), but not nonspine fracture (OR = 1.44; 95% CI, 0.85 to 2.44). Adjusting for bone mineral density (BMD) did not change our findings. Our data show that hyponatremia is associated with up to a doubling in the risk of hip and morphometric spine fractures, independent of BMD. Further studies, to determine how hyponatremia causes fractures and if correction of hyponatremia decreases fractures, are needed.

  10. Stress Fractures of the Foot and Ankle in Athletes (United States)

    Mayer, Stephanie W.; Joyner, Patrick W.; Almekinders, Louis C.; Parekh, Selene G.


    Context: Stress fractures of the foot and ankle are a common problem encountered by athletes of all levels and ages. These injuries can be difficult to diagnose and may be initially evaluated by all levels of medical personnel. Clinical suspicion should be raised with certain history and physical examination findings. Evidence Acquisition: Scientific and review articles were searched through PubMed (1930-2012) with search terms including stress fractures and 1 of the following: foot ankle, medial malleolus, lateral malleolus, calcaneus, talus, metatarsal, cuboid, cuneiform, sesamoid, or athlete. Study Design: Clinical review. Level of Evidence: Level 5. Results: Stress fractures of the foot and ankle can be divided into low and high risk based upon their propensity to heal without complication. A wide variety of nonoperative strategies are employed based on the duration of symptoms, type of fracture, and patient factors, such as activity type, desire to return to sport, and compliance. Operative management has proven superior in several high-risk types of stress fractures. Evidence on pharmacotherapy and physiologic therapy such as bone stimulators is evolving. Conclusion: A high index of suspicion for stress fractures is appropriate in many high-risk groups of athletes with lower extremity pain. Proper and timely work-up and treatment is successful in returning these athletes to sport in many cases. Low-risk stress fracture generally requires only activity modification while high-risk stress fracture necessitates more aggressive intervention. The specific treatment of these injuries varies with the location of the stress fracture and the goals of the patient. PMID:25364480

  11. Women with cardiovascular disease have increased risk of osteoporotic fracture. (United States)

    Chen, Jian Sheng; Hogan, Chris; Lyubomirsky, Greg; Sambrook, Philip N


    This study investigated whether women with cardiovascular disease (CVD) would have an increased risk of fractures as osteoporosis and CVD share many common risk factors. From February 2006 to January 2007, 17,033 women aged ≥50 years (mean 71.8, range 50-106) were recruited by 1,248 primary care practitioners and interviewed by trained nurses. For each woman, 10-year probability of a future major osteoporotic fracture was estimated using the World Health Organization Fracture Risk Assessment Tool (FRAX). The study showed that the 10-year probability of a major osteoporotic fracture was higher for 6,219 CVD women compared to 10,814 non-CVD women after adjustment for age, BMI, current smoking, and alcohol use (adjusted geometric means 14.3 and 13.8%, respectively; P < 0.001). With regard to high risk of fracture (i.e., 10-year probability ≥ 20%), the adjusted odds ratio for CVD was 1.23 (95% CI 1.13-1.35, P < 0.001). However, compared to non-CVD women, CVD women were more likely to report a previous fracture, to have a secondary osteoporosis, and to use glucocorticoids. Among the 4,678 women who were classified as having a high fracture risk, current use rate of bone-related medications (i.e., any one of bisphosphonates, raloxifene, PTH, vitamin D, calcium, or hormone therapy) was 50.2% in the CVD group and 56.9% in the non-CVD group. Women with CVD were at increased risk of fracture partly due to bone-specific risk factors such as history of previous fracture, use of glucocorticoids, and secondary osteoporosis. This risk is not being treated appropriately by primary health physicians.

  12. Fracture characterization and discrimination criteria for karst and tectonic fractures in the Ellenburger Group, West Texas: Implications for reservoir and exploration models

    Energy Technology Data Exchange (ETDEWEB)

    Hoak, T.E. [Science Applications International Corp., Germantown, MD (United States)]|[Kestrel Geoscience, Littleton, CO (United States); Sundberg, K.R. [Phillips Petroleum Co., Bartlesville, OK (United States); Deyhim, P. [Oklahoma State Univ., Stillwater, OK (United States); Ortoleva, P. [Indiana Univ., Bloomington, IN (United States). Lab. for Computational Geodynamics


    In the Ellenburger Group fractured dolomite reservoirs of West Texas, it is extremely difficult to distinguish between multiple phases of karst-related fracturing, modifications to the karst system during burial, and overprinting tectonic fractures. From the analyses of drill core, the authors developed criteria to distinguish between karst and tectonic fractures. In addition, they have applied these criteria within the context of a detailed diagenetic cement history that allows them to further refine the fracture genesis and chronology. In these analyses, the authors evaluated the relationships between fracture intensity, morphologic attributes, host lithology, fracture cement, and oil-staining. From this analysis, they have been able to characterize variations in Ellenburger tectonic fracture intensity by separating these fractures from karst-related features. In general, the majority of fracturing in the Ellenburger is caused by karst-related fracturing although a considerable percentage is caused by tectonism. These findings underscore the importance of considering the complete geologic evolution of a karst reservoir during exploration and field development programs. The authors have been able to more precisely define the spatial significance of the fracture data sets by use of oriented core from Andector Field. They have also demonstrated the importance of these results for exploration and reservoir development programs in West Texas, and the potential to extrapolate these results around the globe. Given the historic interest in the large hydrocarbon reserves in West Texas carbonate reservoirs, results of this study will have tremendous implications for exploration and production strategies targeting vuggy, fractured carbonate systems not only in West Texas, but throughout the globe.

  13. Business History as Cultural History

    DEFF Research Database (Denmark)

    Lunde Jørgensen, Ida

    The paper engages with the larger question of how cultural heritage becomes taken for granted and offers a complimentary view to the anthropological ʻCopenhagen School’ of business history, one that draws attention to the way corporate wealth directly and indirectly influences the culture available...

  14. A brief history of videogames

    Directory of Open Access Journals (Sweden)

    Simone Belli


    Full Text Available The following text contains a brief journey through a short and yet intense adventure, the history of videogames. Since its beginnings in the 1950's decade to the present time, videogames have progressively changed from a hobby for ingeneering studens to the most powerfull leisure industry. In order to gain a better understanding of this phenomenon it is necessary to look over the path of its transformation from a retrospecive point of view. Such a look has necessarily to focus on those devices and games that had made a landmark in the history of videogames, taking them to their current position. Besides, it is crucial to address their implications in contemporary visual culture, along with current prejudices against them. This is a short account about a great history.

  15. Microcracks and Overpressure- Induced Fractures

    Institute of Scientific and Technical Information of China (English)

    Ahmed M. Al - QAHTANI


    The microfractures and natural fractures studies have a great significance in the hydrocarbon accumulation exploration and can be a good supporter for wide geophysical study on the major structures. This paper is a brief review on microcracks and overpressure- induced fracture. It is to discuss different views on the mechanism of fractures in the subsurface of the earth.

  16. Fluid systems and fracture development during syn-depositional fold growth: example from the Pico del Aguilla anticline, Sierras Exteriores, Southern Pyrenees, Spain. (United States)

    Beaudoin, Nicolas; Huyghe, Damien; Bellahsen, Nicolas; Lacombe, Olivier; Emmanuel, Laurent; Mouthereau, Frédéric; Ouanhon, Laure


    This study presents a reconstruction of fold-fracture-fluid evolution at the Pico del Aguila Anticline, located on the southwestern front of the Jaca piggy-back basin, Southern Pyrenees, Spain. The kinematic evolution of the Pico del Aguila anticline is related to the successive development of N-S ramps and reactivation of E-W striking basement thrusts that occurred coevally with sedimentation in the foreland basin. Consequently, this anticline offers an ideal frame to assess the evolution of the fluid system during the syn-depositional deformation at the front of a fold-thrust belt. Eight fracture sets (joints or faults) observed at fold-scale compose the fracture sequence defined by field and micro-scale chronological relationships. This fracture sequence reflects the Middle Eocene to Early Oligocene tectonic events and the progressive rotation of some fracture sets from NE-SW to E-W witnesses the clockwise rotation that occurred during folding. ∂18O and ∂13C values from vein cements suggest a fluid system buffered by host rocks in most cases. Fluid inclusion microthermometry measurements indicate a fluid entrapment temperature <50°C, supporting that the fluid system reflects strata burial during the main part of strata history. Small-scale vertical migrations from reservoir to reservoir are triggered by fractures related to strata-curvature, both during foreland flexure/forebulge and fold development. After folding, fractures developing in shallow sub-continental to continental strata triggered downward migration of surficial fluids, likely of meteoric origin. This phenomenon is poorly developed in early marine deposits but strongly influenced the fluid system recorded in the late continental deposits. The case study of the Pico del Aguila supports recent finding that fold-fluid systems seem to exhibit a common behavior during folding, with development of curvature-related joints triggering vertical migration of fluids from a reservoir to another. It also

  17. Sommerferiens historie

    DEFF Research Database (Denmark)

    Lützen, Karin


    favourite ways for com- mon people to spend their holidays, and with the introduction of holiday pay in the 1930s almost everybody could take a couple of weeks off work in the sum- mer. With the introduction of charter tourism many people went off to Southern Europe to spend their holidays on the same...... pattern. Finally, the history of the special holiday camps is told, which were established by American Jews because they were excluded from many hotels....

  18. Fracture design modelling

    Energy Technology Data Exchange (ETDEWEB)

    Crichlow, H.B.; Crichlow, H.B. (ed.)


    A design tool is discussed whereby the various components that enter the design process of a hydraulic fracturing job are combined to provide a realistic appraisal of a stimulation job in the field. An interactive computer model is used to solve the problem numerically to obtain the effects of various parameters on the overall behavior of the system.

  19. Forearm Fractures in Children (United States)

    ... secure them in place. Your doctor may recommend surgery if: Casts support and protect broken bones while they heal. Reproduced from Pring M, Chambers H: Pediatric forearm fractures. Orthopaedic Knowledge Online Journal 2007; 5(5). Accessed October 2014. • The bone ...

  20. Fracture Toughness Characterization

    Directory of Open Access Journals (Sweden)

    Manuel Beltrán Z


    Full Text Available This paper addresses the fracture toughness ( , or also known as critical stress intensity Factor, according to conditions of Lineal Elastic Fracture Mechanics (LEFM. The characterization of the mechanical properties in tensile and fracture toughness of structural steel pipes API-5L used in hydrocarbons transportation was performed. For fracture toughness, the material was tested through fatigue crack propagation on standardized compact specimen (CT according to ASTM E-399 norm. A thickness (B equal to and a crack size (a equal to 0.5w were used. With the porpoise of establishing the adequate conditions at the crack tip, the specimens were subjected to fatigue pre-cracking by application of repeated cycles of load in tensile-tensile and constant load amplitude with a load ratio of R = 0.1. The experimental Compliance method was used based on data obtained from load vs. Crack Mouth Opening Displacement (CMOD. The results show a Stress Intensity factor of 35.88 MPa√m for a 25 mm crack size specimen. The device used for testing is a MTS-810 machine with capacity of 100KN and 6 kHz sampling rate, which meets the conditions of the ASTM E-399 standard. The cracking susceptibility of steel is influenced by the size, morphology and distribution of non-metallic inclusions, thermochemical interaction with the environment and microstructure.

  1. Neglected hangman fracture

    Directory of Open Access Journals (Sweden)

    Sudhir Kumar Srivastava


    Full Text Available Acute management of hangman fracture is well described; however the surgical management of neglected hangman fracture has not been described in literature. We report the surgical management of an untreated hangman′s fracture. A 30-year-old male had fallen from a tree 12 weeks back. Patient presented with cervical myelopathy and restricted neck movements. Radiographs and computed tomography (CT scan revealed fracture of pars interarticularis of axis with Grade III C2-C3 spondylolisthesis with localized kyphosis of 33°. Gentle reduction under general anesthesia (GA failed to improve the alignment. Patient was operated in three stages in a single setting. In Stage I, release of contracted anterior structures and C2-C3 discectomy was done in supine position followed by C2-C3 posterior fixation and fusion in Stage II. C2-C3 interbody bone grafting and anterior plating completed the third stage. C2-C3 interbody fusion was seen at 5 months and a CT scan at 18 months postoperative confirmed fusion and maintenance of alignment. The satisfactory outcome in our patient leads us to believe that anterior-posterior-anterior is the appropriate surgical approach for treatment of such patients.

  2. Injection through fractures

    Energy Technology Data Exchange (ETDEWEB)

    Johns, R.A.


    Tracer tests are conducted in geothermal reservoirs as an aid in forecasting thermal breakthrough of reinjection water. To interpret tracer tests, mathematical models have been developed based on the various transport mechanisms in these highly fractured reservoirs. These tracer flow models have been applied to interpret field tests. The resulting matches between the model and field data were excellent and the model parameters were used to estimate reservoir properties. However, model fitting is an indirect process and the model's ability to estimate reservoir properties cannot be judged solely on the quality of the match between field data and model predictions. The model's accuracy in determining reservoir characteristics must be independently verified in a closely controlled environment. In this study, the closely controlled laboratory environment was chosen to test the validity and accuracy of tracer flow models developed specifically for flow in fractured rocks. The laboratory tracer tests were performed by flowing potassium iodide (KI) through artificially fractured core samples. The tracer test results were then analyzed with several models to determine which best fit the measured data. A Matrix Diffusion model was found to provide the best match of the tracer experiments. The core properties, as estimated by the Matrix Diffusion model parameters generated from the indirect matching process, were then determined. These calculated core parameters were compared to the measured core properties and were found to be in agreement. This verifies the use of the Matrix Diffusion flow model in estimating fracture widths from tracer tests.

  3. Fracture Mechanics of Concrete

    DEFF Research Database (Denmark)

    Ulfkjær, Jens Peder

    Chapter 1 Chapter l contains the introduction to this thesis. The scope of the thesis is partly to investigate different numerical and analytical models based on fracture mechanical ideas, which are able to predict size effects, and partly to perform an experimental investigation on high-strength......Chapter 1 Chapter l contains the introduction to this thesis. The scope of the thesis is partly to investigate different numerical and analytical models based on fracture mechanical ideas, which are able to predict size effects, and partly to perform an experimental investigation on high......-strength concrete. Chapter 2 A description of the factors which influence the strength and cracking of concrete and high strength concrete is made. Then basic linear fracture mechanics is outlined followed by a description and evaluation of the models used to describe concrete fracture in tension. The chapter ends...... with a description of the different types of size effects. Three examples which discuss the two terms 'size effect' and 'brittleness' and the importance of a stiff test rig. Finally some brittleness numbers are defined. Chapter 3 In chapter 3 the most well-known numerical methods which use the fictitious crack...

  4. A Practical Approach to Children with Recurrent Fractures. (United States)

    Korula, Sophy; Titmuss, Angela T; Biggin, Andrew; Munns, Craig F


    As many as 50% of children will sustain a fracture before 18 years of age, and up to 20% will have two or more fractures. A small proportion of children who experience multiple fractures have osteoporosis, either from a genetic bone disorder (primary osteoporosis) or secondary to another underlying medical condition (secondary osteoporosis). Fracture history, together with bone mineral density assessment and vertebral radiographs, help clinicians to identify children with osteoporosis. Its aetiology can usually be determined through the combination of a detailed medical history and physical examination, laboratory investigations to assess mineral homeostasis, evaluation of secondary causes of osteoporosis and genetic studies to identify the underlying cause of the disorder. Transiliac bone biopsy with histology and histomorphometry should not be overlooked as valuable tools for the investigation of a child with osteoporosis of uncertain aetiology. Optimal management of osteoporosis requires a multidisciplinary team to address physical activity, nutrition, pubertal progression, the management of any underlying medical condition, pharmacotherapy (bisphosphonates) and orthopaedic surgery. This chapter outlines an approach to the evaluation and treatment of children with recurrent fractures and describes three common scenarios involving infants, children with chronic illness and children without chronic illness. © 2015 S. Karger AG, Basel.

  5. Correlation of hip fracture with other fracture types: Toward a rational composite hip fracture endpoint. (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


    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. Cohort study using Veterans Affairs and Medicare administrative data. Male Veterans (n=5,036,536) aged 50-99 years receiving VA primary care between 1999 and 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 regard to the timing of the events. 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, the 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, pfractures 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 the use of a composite endpoint to better estimate hip fracture risk. Published by Elsevier Inc.

  6. Bone health history in breast cancer patients on aromatase inhibitors.

    Directory of Open Access Journals (Sweden)

    Marilyn L Kwan

    Full Text Available A cross-sectional study was performed to assess bone health history among aromatase inhibitor (AI users before breast cancer (BC diagnosis, which may impact fracture risk after AI therapy and choice of initial hormonal therapy. A total of 2,157 invasive BC patients initially treated with an AI were identified from a prospective cohort study at Kaiser Permanente Northern California (KPNC. Data on demographic and lifestyle factors were obtained from in-person interviews, and bone health history and clinical data from KPNC clinical databases. The prevalence of osteoporosis and fractures in postmenopausal AI users was assessed, compared with 325 postmenopausal TAM users. The associations of bone health history with demographic and lifestyle factors in AI users were also examined. Among all initial AI users, 11.2% had a prior history of osteoporosis, 16.3% had a prior history of any fracture, and 4.6% had a prior history of major fracture. Postmenopausal women who were taking TAM as their initial hormonal therapy had significantly higher prevalence of prior osteoporosis than postmenopausal AI users (21.5% vs. 11.8%, p<0.0001. Among initial AI users, the associations of history of osteoporosis and fracture in BC patients with demographic and lifestyle factors were, in general, consistent with those known in healthy older women. This study is one of the first to characterize AI users and risk factors for bone morbidity before BC diagnosis. In the future, this study will examine lifestyle, molecular, and genetic risk factors for AI-induced fractures.

  7. Low evaluation rate for osteoporosis among patients presenting with a rib fracture. (United States)

    Kim, Whang; Gong, Hyun Sik; Lee, Seung Hoo; Park, Jin Woo; Kim, Kahyun; Baek, Goo Hyun


    This study in a regional hospital setting found a low evaluation rate for osteoporosis among patients presenting with a rib fracture. Increased emphasis or education for osteoporosis evaluation may be necessary in case of rib fractures. Rib fractures from a low-energy trauma are common in the elderly, and a history of rib fracture has been reported to increase the risk for a subsequent osteoporotic fracture. The purpose of this study was to evaluate how many of the patients presenting with an isolated rib fracture were being evaluated for osteoporosis and the risk for a subsequent fracture. We retrospectively reviewed all patients aged 50 years or older who were diagnosed with a rib fracture between January 2011 and April 2016 at a regional tertiary care university hospital near Seoul, South Korea. We excluded those who had been treated for osteoporosis or those with other concomitant fractures or fractures from a motor vehicle accident or cancer. We evaluated the frequency of dual energy X-ray absorptiometry (DXA) scan examinations in these patients. There were 231 patients with isolated rib fractures (132 men and 99 women). The mean age was 65 years. Rib fractures were most commonly diagnosed at the emergency department and most of the patients were referred to the department of thoracic surgery for follow-up evaluations. Of these 231 patients, 29 (12%) had DXA examinations after the injury, and only 9 (4%) of them did so within 6 months. Physicians specializing in orthopedic surgery, family medicine, internal medicine, rehabilitation medicine, and emergency medicine were ordering the examination. This study in a regional hospital setting found a low evaluation rate for osteoporosis among patients presenting with a rib fracture. This study suggests that increased emphasis or education for osteoporosis evaluation may be necessary for physicians who are often referred to for care of rib fractures.

  8. Acetabular stress fractures in military endurance athletes and recruits: incidence and MRI and scintigraphic findings

    Energy Technology Data Exchange (ETDEWEB)

    Williams, T.R. [Portsmouth Naval Medical Center, Radiology Department, Charette Health Care Center, Portsmouth, VA (United States); Puckett, M.L.; Shin, A.Y.; Gorman, J.D. [Naval Medical Center San Diego, Radiology Department, San Diego, CA (United States); Denison, G. [US Naval Hospital Guam (United States)


    Objective: To evaluate the incidence and the MRI and scintigraphic appearance of acetabular stress (fatigue) fractures in military endurance athletes and recruits. Design and patients: One hundred and seventy-eight active duty military endurance trainees with a history of activity-related hip pain were evaluated by both MRI and bone scan over a 2-year period. Patients in the study ranged in age from 17 to 45 years. They had hip pain related to activity and had plain radiographs of the hip and pelvis that were interpreted as normal or equivocal. The study was originally designed to evaluate the MRI and scintigraphic appearance of femoral neck stress fractures. Patients had scintigraphy and a limited MRI examination (coronal imaging only) within 48 h of the bone scan. Twelve patients demonstrated imaging findings compatible with acetabular stress fractures. Results: Stress fractures are common in endurance athletes and in military populations; however, stress fracture of the acetabulum is uncommon. Twelve of 178 patients (6.7%) in our study had imaging findings consistent with acetabular stress fractures. Two patterns were identified. Seven of the 12 (58%) patients had acetabular roof stress fractures. In this group, two cases of bilateral acetabular roof stress fractures were identified, one with a synchronous tensile sided femoral neck stress fracture. The remaining five of 12 (42%) patients had anterior column stress fractures, rarely occurring in isolation, and almost always occurring with inferior pubic ramus stress fracture (4 of 5, or 80%). One case of bilateral anterior column stress fractures was identified without additional sites of injury. Conclusions: Stress fractures are commonplace in military populations, especially endurance trainees. Acetabular stress fractures are rare and therefore unrecognized, but do occur and may be a cause for activity-related hip pain in a small percentage of military endurance athletes and recruits. (orig.)

  9. Quantitative geometric description of fracture systems in an andesite lava flow using terrestrial laser scanner data (United States)

    Massiot, Cécile; Nicol, Andrew; Townend, John; McNamara, David D.; Garcia-Sellés, David; Conway, Chris E.; Archibald, Garth


    Permeability hosted in andesitic lava flows is dominantly controlled by fracture systems, with geometries that are often poorly constrained. This paper explores the fracture system geometry of an andesitic lava flow formed during its emplacement and cooling over gentle paleo-topography, on the active Ruapehu volcano, New Zealand. The fracture system comprises column-forming and platy fractures within the blocky interior of the lava flow, bounded by autobreccias partially observed at the base and top of the outcrop. We use a terrestrial laser scanner (TLS) dataset to extract column-forming fractures directly from the point-cloud shape over an outcrop area of ∼3090 m2. Fracture processing is validated using manual scanlines and high-resolution panoramic photographs. Column-forming fractures are either steeply or gently dipping with no preferred strike orientation. Geometric analysis of fractures derived from the TLS, in combination with virtual scanlines and trace maps, reveals that: (1) steeply dipping column-forming fracture lengths follow a scale-dependent exponential or log-normal distribution rather than a scale-independent power-law; (2) fracture intensities (combining density and size) vary throughout the blocky zone but have similar mean values up and along the lava flow; and (3) the areal fracture intensity is higher in the autobreccia than in the blocky zone. The inter-connected fracture network has a connected porosity of ∼0.5 % that promote fluid flow vertically and laterally within the blocky zone, and is partially connected to the autobreccias. Autobreccias may act either as lateral permeability connections or barriers in reservoirs, depending on burial and alteration history. A discrete fracture network model generated from these geometrical parameters yields a highly connected fracture network, consistent with outcrop observations.


    Directory of Open Access Journals (Sweden)

    Đivo Ban


    Full Text Available Children and adolescents today, all before starting with regular sports activities and involvement in semi-professional and top professional sport, so it increases the num- ber of discovered stress fractures in this age. This type of injury can occur as a consequence of action one strong force, or the many repeated small force strength, to be exact, when the load (stress transcend ability reparations bones. Stress fractures are recorded and described up to the lower limbs. Research has been confirmed that the bones of lower leg are mostly made in injury, and with the el- derly and with the population of children and young adolescents. Occur in many sports, something to them is greater when the frequency of running and often are present in the female population. According to the results of numerous investigations, mistakes in the training are the most common cause of the emergence of stress fracture. In a direct comparison with complemented these injuries is the condition of muscles, so it is important that at the sa- me time carry out exercises strengthen muscles and stretching. Typical clinical signs of stress fractures are localized painful sensitivity to palpa- tion and runoff in a small number of cases. The basic diagnostic procedure is a medical check, it is the small, radiology and scintigraphyc diagnostics (most accurate and mag- netic resonance imaging. Treatment is usually without surgery and conservative, with rest and reducing stress, and its activity athlete breaks mainly between four and eight weeks. Only the very need surgical treatment The most important thing is that attention is focused on the proper prevention and to take all that it ever occurred to stress fractures that athletes ramble of the courts and the competition (better education of sports workers, separation of groups with increa- sed risk of the formation of an injury, adaptation activities age and abilities of athletes, adequate sports equipment, high-quality sports

  11. Gout increases risk of fracture: A nationwide population-based cohort study. (United States)

    Tzeng, Huey-En; Lin, Che-Chen; Wang, I-Kuan; Huang, Po-Hao; Tsai, Chun-Hao


    There is still debate on whether high uric acid increases bone mineral density (BMD) against osteoporotic fracture or bone resorption caused by gout inflammation. This study aimed to evaluate whether gout offers a protective effect on bone health or not. We conducted a nationwide population-based retrospective cohort study to evaluate the association between gout history and risk factors of fracture.A retrospective cohort study was designed using the claim data from Longitudinal Health Insurance Database (LHID). A total of 43,647 subjects with gout and a cohort of 87,294 comparison subjects without gout were matched in terms of age and sex between 2001 and 2009, and the data were followed until December 31, 2011. The primary outcome of the study was the fracture incidence, and the impacts of gout on fracture risks were analyzed using the Cox proportional hazards model.After an 11-year follow-up period, 6992 and 11,412 incidents of fracture were reported in gout and comparison cohorts, respectively. The overall incidence rate of fracture in individuals with gout was nearly 23%, which was higher than that in individuals without gout (252 vs 205 per 10,000 person-years) at an adjusted hazard ratio of 1.17 (95% confidence interval = 1.14-1.21). Age, sex, and fracture-associated comorbidities were adjusted accordingly. As for fracture locations, patients with gout were found at significant higher fracture risks for upper/lower limbs and spine fractures. In gout patient, the user of allopurinol or benzbromarone has significantly lower risk of facture than nonusers.Gout history is considered as a risk factor for fractures, particularly in female individuals and fracture sites located at the spine or upper/lower limbs.

  12. Method for detecting moment connection fracture using high-frequency transients in recorded accelerations (United States)

    Rodgers, J.E.; Elebi, M.


    The 1994 Northridge earthquake caused brittle fractures in steel moment frame building connections, despite causing little visible building damage in most cases. Future strong earthquakes are likely to cause similar damage to the many un-retrofitted pre-Northridge buildings in the western US and elsewhere. Without obvious permanent building deformation, costly intrusive inspections are currently the only way to determine if major fracture damage that compromises building safety has occurred. Building instrumentation has the potential to provide engineers and owners with timely information on fracture occurrence. Structural dynamics theory predicts and scale model experiments have demonstrated that sudden, large changes in structure properties caused by moment connection fractures will cause transient dynamic response. A method is proposed for detecting the building-wide level of connection fracture damage, based on observing high-frequency, fracture-induced transient dynamic responses in strong motion accelerograms. High-frequency transients are short (Elsevier B.V. All rights reserved.

  13. The novel as short story

    Directory of Open Access Journals (Sweden)

    Kirk Schlueter


    Full Text Available In recent history, the novel has been thought of and defined primarily as a long prose narrative. However, this has not been the case historically, as the original meaning of "novel" was for "a piece of news" or "a short story or novella." Returning to this original definition, I propose a new way of viewing the work known contemporarily as the novel as a collection, or sequence, of united short stories rather than a single indivisible work, with the component short stories or novellas comprising the sequence renamed as "novels." A brief examination of several classic works traditionally considered novels serves to illustrate how this change in definition will affect reading.

  14. Stress fractures of forearm bones in military recruits of rifle drill training. (United States)

    Kuo, Chun-Lin; Pan, Ru-Yu; Wu, Jia-Lin; Huang, Wen-Sheng; Wang, Shyu-Jye


    Stress fractures rarely occur in the forearms. These injuries usually occur in healthy young patients, which are usually neglected by patients or physicians. Early diagnosis and treatment are important to avoid late complications of these fractures. The purpose of this study was to analyze a case series of military recruits who participated in rifle drill training and presented with forearm stress fractures at our institution. We evaluated 216 military recruits of rifle drill training. Twelve patients were diagnosed with forearm stress fractures by typical history, physical examination, laboratory studies, serial radiographs, and bone scan examinations. Eighteen fractures were found in 12 patients. On initial radiographs, 11 had periosteal reactions, 4 had callus formation with complete fracture lines, and 3 were normal. All 18 fractures had increase radioactivity in the involved middle (15 of 18) or distal (2 of 18) ulnae and one middle radius (1 of 18). Stress fractures of the forearms in military rifle drill training usually occur in middle ulnae. Fifty percent of them were bilateral fractures. A high index of suspicion is the key to diagnosis. Early diagnosis with conservative treatment can achieve satisfactory results and avoid late complications of stress fractures.

  15. Fundamental study of crack initiation and propagation. [Computer model of ductile fracture

    Energy Technology Data Exchange (ETDEWEB)

    Norris, D.M. Jr.; Reaugh, J.E.; Moran, B.; Quinones, D.F.; Wilkins, M.L.


    Objective is to determine the fracture toughness of A533B-1 steel by computer modeling Charpy V-notch tests. A computer model of ductile fracture was developed that predicts fracture initiation. The model contains a set of material-dependent parameters obtained by computer simulations of small specimen tests. The computer calculations give detailed stress and strain histories up to the time of fracture, which are used to determine the model parameter values. The calibrated fracture model, that correctly predicts fracture initiation (and initiation energy) in the Charpy specimen, may then be used to simulate tests of accepted fracture-toughness specimens and hence obtain fracture toughness. The model parameters were calibrated to predict fracture in four different test specimens: two different notched-tension specimens, a simple tension specimen, and a precracked compact-tension specimen. The model was then used in a computer simulation of the Charpy V-notch specimen to initiate and advance a flat fracture. Results were compared with interrupted Charpy tests. Calibration of the model for two additional heat treatments of A533B-1 steel is in progress.

  16. Differentiating the Causes of Spontaneous Rib Fracture After Breast Cancer. (United States)

    Harris, Susan R


    Spontaneous rib fracture after treatment for primary breast cancer is not uncommon. Although metastatic disease accounts for about 30% of spontaneous rib fractures and should constitute the first line of diagnostic investigation, other possible contributors include primary osteoporosis or secondary osteoporosis resulting from cancer treatments. Chemotherapy-induced menopause, aromatase inhibitors, radiation therapy, and long-term bisphosphonate use can all contribute to bone fragility, including spontaneous rib fractures in the latter 3. Drawing on recent breast cancer practice guidelines as well as population-based studies of fracture risk for women with a history of breast cancer and systematic reviews, this Perspective will provide an update on recent developments in understanding how to differentiate the possible reasons for non-traumatic rib fracture in women treated for breast cancer. In addition to describing the various possible causes of spontaneous rib fracture, the recommended medical and imaging procedures for differentiating among the potential causes will be presented. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Isolated osteochondral fracture of the patella without patellar dislocation. (United States)

    Bhatt, Jay; Montalban, Antonio Santa Cruz; Wang, Kook Hyun; Lee, Hee Du; Nha, Kyung Wook


    Chondral fractures of the patella are associated with acute dislocation of the patella. Osteochondral fracture in patellar dislocation is located in the medial facet of the patella. This article presents a case of a 15-year-old female ballerina with isolated displaced osteochondral fracture of the patella without patellar dislocation. She had no history of trauma. A Merchant's view of both knees showed mild subluxation of the patella, a small fragment on the lateral aspect of the knee, and a small defect of the centromedial patella. Axial magnetic resonance imaging (MRI) revealed an osteochondral fragment measuring 13 mm medial to the patella. However, the medial patellofemoral ligament and medial retinaculum were intact. An effusion on the medial side of the patella consistent with hemarthrosis was observed. An absence of a contusion or bone bruise on the lateral femoral condyle was shown. The loose body was removed arthroscopically. Intraoperative findings included a 1.5×2 cm osteochondral fragment. It is unusual that the osteochondral patellar defect site in this patient was in the inferior and central areas of the patella. Patellar chondral fractures without dislocation or patella fracture are rare. Therefore, the possibility of a trivial trauma leading to an osteochondral fracture should be kept in mind in adolescent and young adults who present with knee pain and hemarthrosis. Copyright 2011, SLACK Incorporated.

  18. Modelling karst aquifer evolution in fractured, porous rocks (United States)

    Kaufmann, Georg


    The removal of material in soluble rocks by physical and chemical dissolution is an important process enhancing the secondary porosity of soluble rocks. Depending on the history of the soluble rock, dissolution can occur either along fractures and bedding partings of the rock in the case of a telogenetic origin, or within the interconnected pore space in the case of eogenetic origin. In soluble rocks characterised by both fractures and pore space, dissolution in both flow compartments is possible. We investigate the dissolution of calcite both along fractures and within the pore space of a limestone rock by numerical modelling. The limestone rock is treated as fractured, porous aquifer, in which the hydraulic conductivity increases with time both for the fractures and the pore spaces. We show that enlargement of pore space by dissolution will accelerate the development of a classical fracture-dominated telogenetic karst aquifer, breakthrough occurs faster. In the case of a pore-controlled aquifer as in eogenetic rocks, enlargement of pores results in a front of enlarged pore spaces migrating into the karst aquifer, with more homogeneous enlargement around this dissolution front, and later breakthrough.

  19. Diplopia and orbital wall fractures. (United States)

    Boffano, Paolo; Roccia, Fabio; Gallesio, Cesare; Karagozoglu, K Hakki; Forouzanfar, Tymour


    Diplopia is a symptom that is frequently associated with orbital wall fractures. The aim of this article was to present the incidence and patterns of diplopia after orbital wall blow-out fractures in 2 European centers, Turin and Amsterdam, and to identify any correlation between this symptom and such fractures. This study is based on 2 databases that have continuously recorded data of patients hospitalized with maxillofacial fractures between 2001 and 2010. On the whole, 447 patients (334 males, 113 females) with pure blow-out orbital wall fractures were included. The most frequently involved orbital site was the floor (359 fractures), followed by medial wall (41 fractures) and lateral wall (5 fractures). At presentation, 227 patients (50.7%) had evidence of diplopia. In particular, in most patients, a diplopia in all directions was referred (78 patients). Statistically significant associations were found between diplopia on eye elevation and orbital floor fractures (P diplopia and medial wall fractures (P diplopia on eye elevation and horizontal diplopia at presentation could be useful clinical indicators orbital floor and medial wall fractures, respectively.

  20. Scaphoid fractures in the athlete. (United States)

    Winston, Mark J; Weiland, Andrew J


    Scaphoid fractures are a common wrist injury, especially in athletes. Clinicians should have a high index of suspicion for a scaphoid fracture in any patient complaining of radial-sided wrist pain after a fall on an outstretched hand. Advanced imaging, including CT and MRI scans, may be useful in diagnosis and classification of fracture patterns. Treatment varies based on the fracture location, stability of the fracture, and predictability of the fracture to heal. Treatment involves either non-operative management with a thumb spica cast or brace, or operative fixation with a headless compression screw, k-wires, or scaphoid-specific plates. Return to play is dependent on many variables, including sport, fracture union, and ability to play with cast.

  1. Collagen turnover after tibial fractures

    DEFF Research Database (Denmark)

    Joerring, S; Krogsgaard, M; Wilbek, H


    Collagen turnover after tibial fractures was examined in 16 patients with fracture of the tibial diaphysis and in 8 patients with fracture in the tibial condyle area by measuring sequential changes in serological markers of turnover of types I and III collagen for up to 26 weeks after fracture...... collagen. A group comparison showed characteristic sequential changes in the turnover of types I and III collagen in fractures of the tibial diaphysis and tibial condyles. The turnover of type III collagen reached a maximum after 2 weeks in both groups. The synthesis of type I collagen reached a maximum...... after 2 weeks in the diaphyseal fractures and after 6 weeks in the condylar fractures. The degradation of type I collagen increased after 4 days and reached a maximum at 2 weeks in both groups. The interindividual variation was wide. On a group basis, the turnover of types I and III collagen had...

  2. Periprosthetic fractures evaluation and treatment. (United States)

    Masri, Bassam A; Meek, R M Dominic; Duncan, Clive P


    Periprosthetic fracture is a serious complication of total hip arthroplasty (THA) that can be difficult to treat, and can be potentially fraught with complications. The incidence of such fractures is increasing, especially after the use of cementless revision arthroplasty. The prevention of these fractures is achieved by understanding the risk factors involved. If the risks are not understood, the best outcome is achieved when the surgeon has a thorough understanding of the principles of treatment of these fractures and has access to various fixation and prosthetic devices, and allograft bone when necessary. Acetabular fractures are rare and relatively little has been reported on their treatment. Periprosthetic femoral fracture treatment is based on the site of fracture, implant stability, and bone stock. The Vancouver classification offers a reproducible description of these factors with the subsequently easy formation of a treatment plan.

  3. Identifying individuals at risk for fracture in Guatemala.

    Directory of Open Access Journals (Sweden)

    Keaton M Nasser

    Full Text Available INTRODUCTION: The FRAX calculator combines a set of clinical risk factors with country-specific incidence rates to determine the ten-year absolute risk of major osteoporotic fracture. However, regional or country-specific databases from Central American countries are not available. We compared the use of various FRAX databases and the Pluijm algorithm in determining risk of fracture. METHODS: We collected clinical risk factor data needed for the FRAX calculator and Pluijm algorithm of Hispanic women in Guatemala and calculated the FRAX absolute risk measures of major osteoporotic fracture and hip fracture. Subjects were postmenopausal women greater than age 40 with no history of using medication that affect bone. A random sample of 204 women in 34 different regions women in Guatemala City was visited in their homes to complete the surveys. The Pluijm risk score and FRAX risk score using the US Hispanic, Spain, and Mexican databases were calculated. RESULTS: We used the US NOF guidelines for treatment which suggest a treatment threshold for patients with a 10-year hip fracture probability ≥ 3% or a 10-year major osteoporotic fracture risk ≥ 20%. The number of patients meeting the suggested threshold limits for treatment using the Spain and Mexico calculators were identical. There was 100% conformity in threshold limits for both hip and major osteoporotic fracture risk. The mean conformity for any fracture risk between US Hispanic and the other two databases was 97.5%. Conformity was 99.0% based on major osteoporotic fracture and 97.5% based on risk of hip fracture. The Pluijm evaluation shows conformity of 87.2% and 83.3%, respectively, when compared to the US Hispanic and Spain/Mexico FRAX thresholds for risk of fracture. DISCUSSION: Although the different FRAX databases provide variations in the absolute risk of fracture, the overall conformity to treatment thresholds amongst the US Hispanic, Spain, and Mexico databases show the database

  4. Three-phase flow simulations in discrete fracture networks (United States)

    Geiger, S.; Niessner, J.; Matthai, S. K.; Helmig, R.


    Fractures are often the key conduits for fluid flow in otherwise low permeability rocks. Their presence in hydrocarbon reservoirs leads to complex production histories, unpredictable coupling of wells, rapidly changing flow rates, possibly early water breakthrough, and low final recovery. Recently, it has been demonstrated that a combination of finite volume and finite element discretization is well suited to model incompressible, immiscible two-phase flow in 3D discrete fracture networks (DFN) representing complexly fractured rocks. Such an approach has been commercialized in Golder Associates' FracMan Reservoir Edition software. For realistic reservoir simulations, however, it would be desirable if a third compressible gas phase can be included which is often present at reservoir conditions. Here we present the extension of an existing node-centred finite volume - finite element (FEFV) discretization for the efficient and accurate simulations of three-component - three-phase flow in geologically realistic representations of fractured porous media. Two possible types of fracture networks can be used: In 2D, they are detailed geometrical representations of fractured rock masses mapped in field studies. In 3D, they are geologically constrained, stochastically generated discrete fracture networks. Flow and transport can be simulated for fractures only or for fractures and matrix combined. The governing equations are solved decoupled using an implicit-pressure, explicit-saturation (IMPES) approach. Flux and concentration terms can be treated with higher-order accuracy in the finite volume scheme to preserve shock fronts. The method is locally mass conservative and works on unstructured, spatially refined grids. Flash calculations are carried out by a new description of the Black-Oil model. Capillary and gravity effects are included in this formulation. The robustness and accuracy of this formulation is shown in several applications. First, grid convergence is

  5. Tarlov Cyst Causing Sacral Insufficiency Fracture. (United States)

    Puffer, Ross C; Gates, Marcus J; Copeland, William; Krauss, William E; Fogelson, Jeremy


    Tarlov cysts, also known as perineural cysts, have been described as meningeal dilations of the spinal nerve root sheath between the peri- and endoneurium at the dorsal root ganglion. Most often they are found in the sacrum involving the nerve roots. Normally asymptomatic, they have been reported to present with radiculopathy, paresthesias, and even urinary or bowel dysfunction. Sacral insufficiency has not been a well-documented presentation. The patient is a 38-year-old female who started to develop left low back pain and buttock pain that rapidly progressed into severe pain with some radiation down the posterior aspect of her left leg. There was no recent history of spine or pelvic trauma. These symptoms prompted her initial emergency department evaluation, and imaging demonstrated a large Tarlov cyst with an associated sacral insufficiency fracture. She was noted to have a normal neurological examination notable only for an antalgic gait. She was taken to surgery via a posterior approach and the cyst was identified eccentric to the left. The cyst was fenestrated and the nerve roots identified. Given her large area of bone erosion and insufficiency fractures, fixation of the sacroiliac joints was deemed necessary. Fusion was extended to the L5 vertebral body to buttress the fixation. She tolerated the procedure well and was discharged from the hospital on postoperative day 3. Tarlov cysts of the sacrum can lead to significant bone erosion and subsequent insufficiency fractures, requiring fenestration and in some cases, complex sacropelvic fixation.

  6. Long-term Fracture Risk in Patients with Celiac Disease: A Population-Based Study in Olmsted County, Minnesota


    Jafri, Mohammed R.; Nordstrom, Charles W.; Murray, Joseph A; Van Dyke, Carol T.; Dierkhising, Ross A.; Zinsmeister, Alan R.; Melton, Lee J.


    Celiac disease is associated with decreased bone density, but there are conflicting data regarding fracture risk. We determined the fracture incidence relative to matched controls in a population-based cohort with celiac disease before and after diagnosis. Olmsted County residents with celiac disease (n = 83) diagnosed between 1950 and 2002 were compared with 166 gender and age matched controls. Fracture histories were ascertained from each subject’s medical records. Celiac disease is linked ...

  7. Hip fracture fixation in a patient with below-knee amputation presents a surgical dilemma: a case report


    Rethnam Ulfin; Yesupalan Rajam; Shoaib Amer; Ratnam Thanga K


    Abstract Introduction Hip fracture fixation surgery in patients with below-knee amputations poses a challenging problem to the surgeon in terms of obtaining traction for reduction of the fracture. The absence of the foot and part of the leg in these patients makes positioning on the fracture table difficult. We highlight this difficult problem and suggest techniques to overcome it. Case presentation A 73-year-old man with bilateral below-knee amputations presented with a history of fall. Radi...

  8. Hydraulic fracture propagation modeling and data-based fracture identification (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

  9. Uncovering History for Future History Teachers (United States)

    Fischer, Fritz


    The art of history teaching is at a crossroads. Recent scholarship focuses on the need to change the teaching of history so students can better learn history, and insists that history teachers must move beyond traditional structures and methods of teaching in order to improve their students' abilities to think with history. This article presents…

  10. BMI and fracture risk in older men: the osteoporotic fractures in men study (MrOS). (United States)

    Nielson, Carrie M; Marshall, Lynn M; Adams, Annette L; LeBlanc, Erin S; Cawthon, Peggy M; Ensrud, Kristine; Stefanick, Marcia L; Barrett-Connor, Elizabeth; Orwoll, Eric S


    Low body mass index (BMI) is a risk factor for fracture, but little is known about the association between high BMI and fracture risk. We evaluated the association between BMI and fracture in the Osteoporotic Fractures in Men Study (MrOS), a cohort of 5995 US men 65 years of age and older. Standardized measures included weight, height, and hip bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA); medical history; lifestyle; and physical performance. Only 6 men (0.1%) were underweight (<18.5 kg/m(2)); therefore, men in this category were excluded. Also, 27% of men had normal BMI (18.5 to 24.9 kg/m(2)), 52% were overweight (25 to 29.9 kg/m(2)), 18% were obese I (30 to 34.9 kg/m(2)), and 3% were obese II (35 to 39.9 kg/m(2)). Overall, nonspine fracture incidence was 16.1 per 1000 person-years, and hip fracture incidence was 3.1 per 1000 person-years. In age-, race-, and BMD-adjusted models, compared with normal weight, the hazard ratio (HR) for nonspine fracture was 1.04 [95% confidence interval (CI) 0.87-1.25] for overweight, 1.29 (95% CI 1.00-1.67) for obese I, and 1.94 (95% CI 1.25-3.02) for obese II. Associations were weaker and not statistically significant after adjustment for mobility limitations and walking pace (HR = 1.02, 95% CI 0.84-1.23, for overweight; HR = 1.12, 95% CI 0.86-1.46, for obese I, and HR = 1.44, 95% CI 0.90-2.28, for obese II). Obesity is common among older men, and when BMD is held constant, it is associated with an increased risk of fracture. This association is at least partially explained by worse physical function in obese men.

  11. Ildens historier

    DEFF Research Database (Denmark)

    Lassen, Henrik Roesgaard

    In December 2012 a manuscript entitled "Tællelyset" ['The Tallow Candle'] was discovered in an archive. The story was subsequently presented to the world as Hans Christian Andersen's first fairy tale and rather bombastically celebrated as such. In this book it is demonstrated that the text cannot...... from a point-by-point tracing of 'the origins and history' of Hans Christian Andersen's famous fairy tales. Where did the come from? How did they become the iconic texts that we know today? On this background it becomes quite clear that "Tællelyset" is a modern pastiche and not a genuine Hans Christian...... Andersen fairy tale....

  12. Asisstance Arthroscopy in Juvenile Tillaux Fractures (United States)

    Mañero, Luciano Martin; Arroquy, Damian; Barrios, Juan Manuel; Botta, Juan Martin; Caceres, Carlos Alberto


    short boot. By the third week the plug removal. After the sixth week began with partial load with Walker boot for a month and later full charge. Results: Fracture healing was evident in the eighth week. Now in his eighth postoperative month and has an excellent performance according to the AOFAS score of 96 points, with no pain, full range of motion and return to sport after 4th month. Discussion: There are reports such as A. Kaya (2007) with excellent results (AOFAS 99.3) in a series of 10 patients treated by open reduction and internal fixation and in other hand A. Panagopoulus, L.van Kiekerk (2007) reports excellent results (AOFAS 100) in patients treated under arthroscopic assistance. Assistance arthroscopy in Tillaux fractures allows a reduction more accurate than that provided by percutaneous techniques fluoroscopy guided only by avoiding the problems associated with open techniques (lesion of the superficial peroneal nerve and necrosis of the fragment). It also allows patients to an early return to activities with a lower risk of stiffness and secondary osteoarthritis due to the reduction achieved under direct arthroscopic visualization.

  13. Evaluation of the health-related quality of life in elderly patients according to the type of hip fracture: femoral neck or trochanteric

    Directory of Open Access Journals (Sweden)

    Tânia Maria da Silva Mendonça


    Full Text Available OBJECTIVE: To evaluate the effect the type of hip fracture (femoral neck or trochanteric has on the Health-Related Quality of Life of elderly subjects. METHODS: Forty-five patients with hip fractures (mean 74.30 ± 7.12 years, 24 with a femoral neck fracture and 21 with a trochanteric fracture, completed the 36-item Short Form Health Survey (SF-36 at baseline and four months after fracture. The Health-Related Quality of Life scores were compared according to fracture type, undisplaced and displaced femoral neck fractures, and stable and unstable trochanteric fractures. RESULTS: Compared to baseline, all patients scored lower in the physical functioning, role limitation-physical, bodily pain and vitality categories four months after the fracture had occurred. The SF-36 scores for all the scales did not differ significantly between patients with femoral neck versus trochanteric fractures, or between patients with displaced versus undisplaced femoral neck fractures and stable versus unstable trochanteric fractures. CONCLUSIONS: The mental and physical quality of life of elderly patients with a hip fracture is severely impaired one month after fracture, with partial recovery by the end of the fourth month. The negative impact on the Health-Related Quality of Life did not differ significantly according to fracture type.

  14. Teriparatide Improves Fracture Healing and Early Functional Recovery in Treatment of Osteoporotic Intertrochanteric Fractures. (United States)

    Huang, Tsan-Wen; Chuang, Po-Yao; Lin, Shih-Jie; Lee, Chien-Yin; Huang, Kuo-Chin; Shih, Hsin-Nung; Lee, Mel S; Hsu, Robert Wen-Wei; Shen, Wun-Jer


    Osteoporotic intertrochanteric fractures result in serious health problems and decrease health-related quality of life (HRQoL). Faster time-to-union is important for early return to daily activities and reduction of complications. Teriparatide has been shown to accelerate fracture healing, but the literature is sparse on this topic. The aim of this study is to assess whether teriparatide accelerates fracture healing.Between 2008 and 2014, patients with osteoporotic intertrochanteric fractures who underwent surgical interventions were enrolled in this retrospective cohort study. Group 1 included patients who were not on any osteoporosis medication prior to fracture and who postoperatively received only calcium and vitamin D; patients in Group 2 were not on any osteoporosis medication prior to fracture, and received teriparatide and calcium and vitamin D postoperatively. Patients in Group 3 were those who were on alendronate prior to fracture and postfracture received teriparatide as well as calcium and vitamin D. Demographics, time-to-union, HRQoL (short-form health survey [SF]-12 physical component summary [PCS] and SF-12 mental component summary [MCS]), morbidities, mortalities, and radiographic and functional outcomes between groups were compared.A total of 189 patients were enrolled in this study. There were 83 patients in Group 1, 47 patients in Group 2, and 59 patients in Group 3. A significantly shorter time-to-union was found in the teriparatide-treated groups (mean, 13.6, 12.3, and 10.6 weeks, respectively [P = 0.002]). With regard to SF-12 PCS, the scores were significantly better in teriparatide-treated groups at 3 months (mean, 19, 28, and 29, respectively [P = 0.002]) and 6 months (mean, 28, 37, and 38, respectively [P = 0.008]). Similar inter-group differences were noted when comparing the pain scores, the ability to get around the house, the ability to get out of the house, and the ability to go shopping at 3 and 6 months. Complications

  15. Fracture of sandwiched composites

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Weh-Huei.


    Fracture of a pair of collinear cracks in various materials, such as an isotropic strip, an orthotropic strip, a bonded isotropic adhesive layer, and sandwiched orthotropic layers, is investigated. The crack surfaces are subjected to an arbitrary opening pressure p(x). The problems are formulated in terms of Fredholm integral equation of the second kind by making use the techniques of Fourier transform and finite Hilbert transform. In case of uniform opening pressure p(x)={sigma}, exact expressions for the stress intensity factors and the shape of deformed crack are obtained. Numerical calculations are carried out to study the effects of various boundary geometries and material properties on the fracture of the chosen materials.


    Directory of Open Access Journals (Sweden)

    Deepak Kaladagi


    Full Text Available BACKGROUND: The incidence of humeral fracture has significantly increased during the present years due to the population growth and road traffic, domestic, industrial, automobile accidents & disasters like tsunami, earthquakes, head-on collisions, polytrauma etc. In order to achieve a stable fixation followed by early mobilization, numerous surgical implants have been devised. PURPOSE: The purpose of this study is to analyze the results of intramedullary fixation of proximal 2/3rd humeral shaft fractures using an unreamed interlocking intramedullary nail. INTRODUCTION: In 40 skeletally matured patients with fracture shaft of humerus admitted in our hospital, we used unreamed antegrade interlocking nails. MATERIAL: We carried out a prospective analysis of 40 patients randomly selected between 2001 to 2014 who were operated at JNMC Belgaum, MMC Mysore & Navodaya Medical College, Raichur. All cases were either RTAs, Domestic, Industrial, automobile accidents & also other modes of injury. METHOD: Routine investigations with pre-anaesthetic check-up & good quality X-rays of both sides of humerus was taken. Time of surgery ranged from 5-10 days from the time of admission. Only upper 1/3rd & middle 1/3rd humeral shaft fractures were included in the study. In all the cases antegrade locked unreamed humeral nails were inserted under C-arm. Patient was placed in supine position & the shoulder was kept elevated by placing a sandbag under the scapula. In all patients incision taken from tip of acromion to 3cm over deltoid longitudinally. Postoperatively sling applied with wrist & shoulder movements started after 24 hours. All the patients ranged between the age of 21-50 years. RESULTS: Total 40 patients were operated. Maximum fracture site were in the middle third- 76%, 14% upper 1/3rd. All 40 patients achieved union. The average time of union was 8-10 weeks. All patients regained full range of movements except in few cases, where there was shoulder

  17. Fracture of brittle solids

    CERN Document Server

    Lawn, Brian


    This is an advanced text for higher degree materials science students and researchers concerned with the strength of highly brittle covalent-ionic solids, principally ceramics. It is a reconstructed and greatly expanded edition of a book first published in 1975. The book presents a unified continuum, microstructural and atomistic treatment of modern day fracture mechanics from a materials perspective. Particular attention is directed to the basic elements of bonding and microstructure that govern the intrinsic toughness of ceramics. These elements hold the key to the future of ceramics as high-technology materials--to make brittle solids strong, we must first understand what makes them weak. The underlying theme of the book is the fundamental Griffith energy-balance concept of crack propagation. The early chapters develop fracture mechanics from the traditional continuum perspective, with attention to linear and nonlinear crack-tip fields, equilibrium and non-equilibrium crack states. It then describes the at...

  18. Ultrasound Fracture Diagnosis in Space (United States)

    Dulchavsky, Scott A.; Amponsah, David; Sargsyan, Ashot E.; Garcia, Kathleen M.; Hamilton, Douglas R.; vanHolsbeeck, Marnix


    Introduction: This ground-based investigation accumulated high-level clinical evidence on the sensitivity and specificity of point of care ultrasound performed by expert and novice users for the rapid diagnosis of musculoskeletal (MSK) injuries. We developed preliminary educational methodologies to provide just-in-time training of novice users by creating multi-media training tools and imaging procedures for non expert operators and evaluated the sensitivity and specificity of non-expert performed musculoskeletal ultrasound to diagnose acute injuries in a Level 1 Trauma Center. Methods: Patients with potential MSK injuries were identified in the emergency room. A focused MSK ultrasound was performed by expert operators and compared to standard radiographs. A repeat examination was performed by non-expert operators who received a short, just-in-time multimedia education aid. The sensitivity and specificity of the expert and novice ultrasound examinations were compared to gold standard radiography. Results: Over 800 patients were enrolled in this study. The sensitivity and specificity of expert performed ultrasound exceeded 98% for MSK injuries. Novice operators achieved 97% sensitivity and 99% specificity for targeted examinations with the greatest error in fractures involving the hand and foot. Conclusion: Point of care ultrasound is a sensitive and specific diagnostic test for MSK injury when performed by experts and just-in-time trained novice operators.

  19. Bipolar disorder and the risk of fracture: A nationwide population-based cohort study. (United States)

    Su, Jian-An; Cheng, Bi-Hua; Huang, Yin-Cheng; Lee, Chuan-Pin; Yang, Yao-Hsu; Lu, Mong-Liang; Hsu, Chung-Yao; Lee, Yena; McIntyre, Roger S; Chin Lin, Tzu; Chin-Hung Chen, Vincent


    The co-primary aims are: 1) to compare the risk of fracture between adults with bipolar disorder and those without bipolar disorder; and 2) to assess whether lithium, anticonvulsants and antipsychotics reduce risk of fracture among individuals with bipolar disorder. The analysis herein is a population-based retrospective cohort study, utilizing the National Health Insurance (NHI) medical claims data collected between 1997 and 2013 in Taiwan. We identified 3705 cases with incident diagnoses of bipolar disorder during study period and 37,050 matched controls without bipolar diagnoses. Incident diagnosis of fracture was operationalized as any bone fracture after the diagnosis of bipolar disorder or after the matched index date for controls. Bipolar patients had significantly higher risk of facture when compared to matched controls (17.6% versus 11.7%, respectively pbipolar disorder and a prior history of psychiatric hospitalization were had higher risk for bone fracture than those without prior history of psychiatric hospitalization when compared to match controls. Higher cumulative dose of antipsychotics or mood stabilizers did not increase the risk of fracture. The diagnoses of bipolar disorder were not confirmed with structured clinical interview. Drug adherence, exact exposure dosage, smoking, lifestyle, nutrition and exercise habits were unable to be assessed in our dataset. Bipolar disorder is associated with increased risk of fracture, and higher cumulative dose of mood stabilizers and antipsychotics did not further increase the risk of fracture. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Tibial shaft fracture

    DEFF Research Database (Denmark)

    Larsen, Peter

    IV also showed a significant worse outcome in 3 of the 5 KOOS subscales compared to a reference population at 12-months follow-up. Moreover, this study showed that increasing difference in muscle strength for knee extension between legs was associated with a decreasing QOL. The results of this thesis...... suggested that regaining pre injured QOL and muscle strength following a tibial shaft fracture takes considerable time....