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Sample records for non-union scaphoid four-corner

  1. What is the Optimal Treatment of Atrophic Scaphoid Non-Union?

    Directory of Open Access Journals (Sweden)

    Alper Cirakli

    2016-09-01

    Full Text Available Aim: To evaluate the efficacy of the treatment method of autogenous iliac wing or radius bone graft and fixation with screw applied to cases of scaphoid non-union. Material and Method: A retrospective evaluation was made of 89 cases between 2000 and 2014. Postoperative measurements were taken of both wrists%u2019 movement with a goniometer and muscle strength was assessed with a dynamometer. Fractures were evaluated radiologically according to the Herbert-Fisher System and the functional results according to the Herbert-Fisher Classification System and the Mayo Clinic Modified Wrist Scoring System. The data were input to the SPSS system and evaluated with the Shapiro-Wilk test. Results: Non-union were on the right side in 47 and the left side in 42 cases. The fracture was seen to be in the waist in 60 cases (67.5%, in the proximal third in 27 cases (30.3% and in the distal third in two cases (2.2%. The mean follow-up period was 16.4 months (range, 5-72 months. Definitive findings of union were observed in 71 cases. The mean time to union was 14.9 weeks (range, 8-40 weeks. Discussion: The grafting procedure applied is an invasive technique but if it is considered that there are negative effects of open surgery on the feeding of the scaphoid bone, then in the treatment of scaphoid non-union which is atrophic non-union, ultimately autogenous bone grafting and screw fixation is a safe and successful method and because of the pain created by an iliac wing graft, radius distal bone graft can be considered more appropriate.

  2. Is dynamic contrast-enhanced MRI useful for assessing proximal fragment vascularity in scaphoid fracture delayed and non-union?

    Energy Technology Data Exchange (ETDEWEB)

    Ng, Alex W.H.; Griffith, James F.; Li, Alvin [The Chinese University of Hong Kong, Department of Imaging and Interventional Radiology, Prince of Wales Hospital, Hong Kong, SAR (China); Taljanovic, Mihra S. [The University of Arizona Health Network, Department of Medical Imaging, 1501 N. Campbell Ave., P.O. Box 245067, Tucson, AZ (United States); Tse, W.L.; Ho, P.C. [The Chinese University of Hong Kong, Department of Orthopedics and Traumatology, Prince of Wales Hospital, Hong Kong (China)

    2013-07-15

    To assess dynamic contrast-enhanced magnetic resonance imaging (DCE MRI) as a measure of vascularity in scaphoid delayed-union or non-union. Thirty-five patients (34 male, one female; mean age, 27.4 {+-} 9.4 years; range, 16-51 years) with scaphoid delayed-union and non-union who underwent DCE MRI of the scaphoid between September 2002 and October 2012 were retrospectively reviewed. Proximal fragment vascularity was classified as good, fair, or poor on unenhanced MRI, contrast-enhanced MRI, and DCE MRI. For DCE MRI, enhancement slope, E{sub slope} comparison of proximal and distal fragments was used to classify the proximal fragment as good, fair, or poor vascularity. Proximal fragment vascularity was similarly graded at surgery in all patients. Paired t test and McNemar test were used for data comparison. Kappa value was used to assess level of agreement between MRI findings and surgical findings. Twenty-five (71 %) of 35 patients had good vascularity, four (11 %) had fair vascularity, and six (17 %) had poor vascularity of the proximal scaphoid fragment at surgery. DCE MRI parameters had the highest correlation with surgical findings (kappa = 0.57). Proximal scaphoid fragments with surgical poor vascularity had a significantly lower E{sub max} and E{sub slope} than those with good vascularity (p = 0.0043 and 0.027). The sensitivity, specificity, positive and negative predictive value and accuracy of DCE MRI in predicting impaired vascularity was 67, 86, 67, 86, and 80 %, respectively, which was better than that seen with unenhanced and post-contrast MRI. Flattened time intensity curves in both proximal and distal fragments were a feature of protracted non-union with a mean time interval of 101.6 {+-} 95.5 months between injury and MRI. DCE MRI has a higher diagnostic accuracy than either non-enhanced MRI or contrast enhanced MRI for assessing proximal fragment vascularity in scaphoid delayed-union and non-union. For proper interpretation of contrast

  3. A new variant of scaphoid reconstruction: Treatment of scaphoid non-union with avascular bone interponate and high compression screw (Synthes

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    Eder, Christian

    2015-08-01

    Full Text Available Scaphoid fractures as frequently overseen injuries often result in scaphoid non-unions, that need to be treated to prevent carpal collapse and secondary cartilage damage. Vital bone tissue and compression of fracture and bone graft ends seem to be crucial in for ossification and final bone healing. In the present study we compare our results using a high compression screw (HCS Synthes to results in the literature using different kinds of internal fixation including compression screws of various types. We present 22 patients with scaphoid non-unions treated with a bone graft and a HCS Synthes. We evaluated our post-operative results. The Manchester-Modified Disability of the Shoulder, Arm and Hand–Score (M-Dash imposed with an average of 29.8 points (MD=29 / SD=9.46 / MIN=18 / MAX=48. None of the re-evaluated patients sorrowed for pain in rest. Five patients stated pain (ranging from 4 to 8 on numeric analogue scale after heavy burden (e.g. boxing, weight lifting.In exploring the range of motion of the operated hand we deliver the following results: dorsal extension: average 72.73° (MD=80° / SD=17.23° / MIN=30° / MAX=85°, flexion: average 73.64° (MD=80° / SD=8.97° / MIN=60° / MAX=80°, ulnar deviation: average 39.09°, (MD=40° / SD=2.02° / MIN=35° / MAX=40°, radial deviation: average 29.09°, (MD=30° / SD=3.01° / MIN=20° / MAX=30°. Additionally a performance testing was conducted: fist clenching sign: complete without pain in 100%, pinch grip: complete in 100%, moderate pain in n=1 (8.33%, opposition digitus manus I–V complete in 100%, moderate pain n=2 (16.67%. Three patients with persisting fracture gap had a scaphoid bone fractured in the proximal third; one patient even with a very small proximal fragment. One persisting non-union was localized in the middle third (period between injury and operation = . In conclusion, our patients showed better healing rates compared to results presented in the literature. Non-unions

  4. Mines in the Four Corners anticipate growth

    Energy Technology Data Exchange (ETDEWEB)

    Buchsbaum, L.

    2008-02-15

    Productive mines in the southwest deplete reserves, while the government drags its heels on new power projects. Production in Arizona and New Mexico has fallen 18% over the last four years to 34.1 million tons. With Chevron Mining's McKinley mine rapidly depleting its reserves the industry will continue to contract. In the last three years at least three large mines in the Four Corners have terminated operations. Three others remain captive operations: BHP Billiton's San Juan Underground and Navajo Surface operations and Peabody Energy's Kayenta surface mine. In 2006 the Black Mesa mine stopped producing coal. These four mines are isolated from the national railways. Peabody's new El Segundo surface mine near Grants, NM is increasing production. If the planned $3 billion Desert Rock coal-fired power plant is built this will present a new market for the Navajo mine. The article gives details about the state of the aforementioned mines and of the new King II coal mine on the northern periphery of the San Juan basin and discusses the state of plans for the Desert Rock Energy Project. 5 photos.

  5. Titanium template for scaphoid reconstruction.

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    Haefeli, M; Schaefer, D J; Schumacher, R; Müller-Gerbl, M; Honigmann, P

    2015-06-01

    Reconstruction of a non-united scaphoid with a humpback deformity involves resection of the non-union followed by bone grafting and fixation of the fragments. Intraoperative control of the reconstruction is difficult owing to the complex three-dimensional shape of the scaphoid and the other carpal bones overlying the scaphoid on lateral radiographs. We developed a titanium template that fits exactly to the surfaces of the proximal and distal scaphoid poles to define their position relative to each other after resection of the non-union. The templates were designed on three-dimensional computed tomography reconstructions and manufactured using selective laser melting technology. Ten conserved human wrists were used to simulate the reconstruction. The achieved precision measured as the deviation of the surface of the reconstructed scaphoid from its virtual counterpart was good in five cases (maximal difference 1.5 mm), moderate in one case (maximal difference 3 mm) and inadequate in four cases (difference more than 3 mm). The main problems were attributed to the template design and can be avoided by improved pre-operative planning, as shown in a clinical case. © The Author(s) 2014.

  6. Four Corners Television History: Gallipoli and the Fall of Singapore

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    Kevin Blackburn

    2007-08-01

    Full Text Available This article analyses how the Australian current affairs programme, Four Corners, which follows a style modelled on the BBC programme Panorama, has represented Australian military history in two of its programmes, Gallipoli: The Fatal Shore and No Prisoners on Australian deserters at the fall of Singapore. Chris Masters was the reporter on both programmes. These historical documentaries claim to investigate Australian Anzac mythology. Four Corners is noted for its rigorous pursuit of issues in current affairs. Programmes construct argument that the journalists steadfastly pursue in order to ‘expose the truth’. Rather than neutrally representing both sides of a debate, the programmes tend to take the side that the journalists perceive to be in the public interest. Examining how Four Corners has applied its own style of investigative journalism to the Anzac mythology is explored by outlining whether the programmes follow Ken Burn’s ideas of documentary-makers as ‘tribal story-teller’ crafting stories that uphold national identity or Bill Nichols’ view that documentary is an argument that is representative of reality rather than reflects reality. Examining the history of Gallipoli and the fall of Singapore in the Four Corners programmes tends suggest that the journalists working on the programmes preferred to reaffirm the assumptions of the Anzac legend, but attack or ignore historians and evidence that questions it. The programmes appear to be a mixture of Burns’s and Nichols’ ideas of documentary making.

  7. The Four Corners timber harvest and forest products industry, 2012

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    Colin B. Sorenson; Steven W. Hayes; Todd A. Morgan; Eric A. Simmons; Micah G. Scudder; Chelsea P. McIver; Mike T. Thompson

    2016-01-01

    This report traces the flow of timber harvested in the "Four Corners" States (Arizona, Colorado, New Mexico, and Utah) during calendar year 2012, describes the composition and operations of the region’s primary forest products industry, and quantifies volumes and uses of wood fiber. Recent changes in the wood products industry are discussed, as well as trends...

  8. The Four Corners timber harvest and forest products industry, 2007

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    Steven W. Hayes; Todd A. Morgan; Erik C. Berg; Jean M. Daniels; Mike Thompson

    2012-01-01

    This report traces the flow of timber harvested in the "Four Corners" States (Arizona, Colorado, New Mexico, and Utah) during calendar year 2007, describes the composition and operations of the region's primary forest products industry, and quantifies volumes and uses of wood fiber. Historical wood products industry changes are discussed, as well as...

  9. Scaphoid Fracture

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    Esther Kim, BS

    2018-04-01

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

  10. Integrated study of basins in the Four Corners region

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    Fagbola, Olamide Olawumi

    2007-12-01

    This dissertation is an integrated study of basins in the four corners area of the central part of the Colorado Plateau. The Colorado Plateau is a structurally unique part of the Rocky Mountain region because it has only been moderately deformed when compared to the more intensely deformed areas around it. The Colorado Plateau covers a portion of Utah, Colorado, New Mexico and Arizona. The study area extends from latitude 34°N-40°N to longitude 106°W-111W° encompassing a series of major basins and uplifts: the San Juan, Black Mesa, Paradox, and the Blanding basins; and the Zuni, Defiance, Four Corners, Monument uplifts and the San Juan dome and volcanic field. An analysis of gravity anomalies, basement and crustal structure for basins in the four corners region was carried out. This involved using gravity, magnetic, well, outcrop, seismic estimates of crustal thickness, and geologic data in an integrated fashion. Six filtered gravity and three filtered magnetic maps were generated to aid in the interpretation of the gravity and magnetic anomalies in the study area. A detailed comparison of these maps was carried out. The results show a deep seated mafic structure in the basement acting as a crustal boundary separating the high gravity anomalies from the low. These maps also show that the sources of these anomalies are quite shallow resulting from the upper crust in the study area. The structures in the study area are characterized by northwest and northeast trends which correspond to the Precambrian and the Late Paleozoic structures, respectively. A crustal thickness map of the area was also constructed from seismic estimates of crustal thickness. A comparison was done between the crustal thickness map and the 45 km upward continuation Bouguer anomaly map. The result of this comparison shows that areas of thicker ix crust corresponded to low gravity while areas of thinner crust means mantle material is closer to the surface, thereby producing a high gravity

  11. 40 CFR 81.121 - Four Corners Interstate Air Quality Control Region.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 17 2010-07-01 2010-07-01 false Four Corners Interstate Air Quality Control Region. 81.121 Section 81.121 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED... Quality Control Regions § 81.121 Four Corners Interstate Air Quality Control Region. The Four Corners...

  12. Physics from the four corners of the world

    CERN Multimedia

    2005-01-01

    The field of particle physics is well-known for being a world without frontiers, bringing together researchers of all nationalitie who in spite of their linguistic and cultural differences, work together in the shared pursuit of a fundamental understanding of the universe. On 2nd December, this reality was demonstrated on the internet with a webcast called 'Beyond Einstein', organised by CERN, which for 12 hours brought together physics communities from the four corners of the world. The event, the first of its kind organised on this scale, attracted 30,000 spectators on the Web and in numerous studios. Furthermore, Pakistani national television broadcast all 12 hours of programming, an Italian channel also provided coverage, and many more people tuned in on satellite television. The site of the webcast during the programme from Imperial Colllege London presented by Gareth Mitchell.At Fermilab near Chicago in the US, Nobel-Prize winner Leon Lederman hosted a show called The Late Show with Leon Lederman, feat...

  13. Four Corners project experience - Applications to next generation FGD

    International Nuclear Information System (INIS)

    Wild, R.L.; Grimes, R.L.; Wiggins, D.S.

    1990-01-01

    In June 1984, Arizona Public Service Company started up the flue gas desulfurization system installed on Units 4 and 5 at the Four Corners Power Station. At the time, this represented the largest emissions control retrofit in the industry, and consisted of two 800 MWe units. These units burn a low sulfur subbituminous coal from the adjacent Navajo mine. The FGD system was designed for 72% overall removal, with partial bypass. The SO 2 absorbers were designed for 90% removal. This FGD system is considered to be a second generation design. At the time, it represented state-of-the-art of FGD technology, in terms of both process considerations and materials of construction. In the six years since startup, several modifications have been made in the areas of process chemistry, equipment configuration, and materials of construction. These modifications are applicable to the next generation of FGD systems which will be designed in response to Acid Rain Legislation. This paper presents the original plant design basis, summarizes the operating experience to date, and identifies the modifications and improvements which have been made since startup. In addition, recommendations for new installations are offered

  14. Scaphoid fractures in children

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    Gajdobranski Đorđe

    2014-01-01

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

  15. Baseline ambient gaseous ammonia concentrations in the Four Corners area and eastern Oklahoma, USA.

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    Sather, Mark E; Mathew, Johnson; Nguyen, Nghia; Lay, John; Golod, George; Vet, Robert; Cotie, Joseph; Hertel, Terry; Aaboe, Erik; Callison, Ryan; Adam, Jacque; Keese, Danielle; Freise, Jeremy; Hathcoat, April; Sakizzie, Brenda; King, Michael; Lee, Chris; Oliva, Sylvia; San Miguel, George; Crow, Leon; Geasland, Frank

    2008-11-01

    Ambient ammonia monitoring using Ogawa passive samplers was conducted in the Four Corners area and eastern Oklahoma, USA during 2007. The resulting data will be useful in the multipollutant management of ozone, nitrogen oxides, and visibility (atmospheric regional haze) in the Four Corners area, an area with growing oil/gas production and increasing coal-based power plant construction. The passive monitoring data also add new ambient ammonia concentration information for the U.S. and will be useful to scientists involved in present and future visibility modeling exercises. Three week integrated passive ammonia samples were taken at five sites in the Four Corners area and two sites in eastern Oklahoma from December, 2006 through December, 2007 (January, 2008 for two sites). Results show significantly higher regional background ammonia concentrations in eastern Oklahoma (1.8 parts per billion (ppb) arithmetic mean) compared to the Four Corners area (0.2 ppb arithmetic mean). Annual mean ammonia concentrations for all Four Corners area sites for the 2007 study ranged from 0.2 ppb to 1.5 ppb. Peak ambient ammonia concentrations occurred in the spring and summer in both areas. The passive samplers deployed at the Stilwell, Oklahoma site compared favorably with other passive samplers and a continuous ammonia monitoring instrument.

  16. Neglected isolated scaphoid dislocation

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    Jong-Ryoon Baek

    2016-01-01

    Full Text Available The authors present a case of isolated scaphoid dislocation in a 40-year-old male that was undiagnosed for 2 months. The patient was treated by open reduction, Kirschner wire fixation, interosseous ligament repair using a suture anchor and Blatt's dorsal capsulodesis. At 6 years followup, his radiographs of wrist showed a normal carpal alignment with a scapholunate gap of 3 mm and no evidence of avascular necrosis (AVN of the scaphoid.

  17. Computed tomography versus magnetic resonance imaging versus bone scintigraphy for clinically suspected scaphoid fractures in patients with negative plain radiographs

    NARCIS (Netherlands)

    Mallee, Wouter H.; Wang, Junfeng; Poolman, Rudolf W.; Kloen, Peter; Maas, Mario; de Vet, Henrica C. W.; Doornberg, Job N.

    2015-01-01

    In clinically suspected scaphoid fractures, early diagnosis reduces the risk of non-union and minimises loss in productivity resulting from unnecessary cast immobilisation. Since initial radiographs do not exclude the possibility of a fracture, additional imaging is needed. Computed tomography (CT),

  18. Pulsed Electromagnetic Fields in the treatment of fresh scaphoid fractures. A multicenter, prospective, double blind, placebo controlled, randomized trial.

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    Hannemann, Pascal; Göttgens, Kevin W A; van Wely, Bob J; Kolkman, Karel A; Werre, Andries J; Poeze, Martijn; Brink, Peter R G

    2011-05-06

    The scaphoid bone is the most commonly fractured of the carpal bones. In the Netherlands 90% of all carpal fractures is a fracture of the scaphoid bone. The scaphoid has an essential role in functionality of the wrist, acting as a pivot. Complications in healing can result in poor functional outcome. The scaphoid fracture is a troublesome fracture and failure of treatment can result in avascular necrosis (up to 40%), non-union (5-21%) and early osteo-arthritis (up to 32%) which may seriously impair wrist function. Impaired consolidation of scaphoid fractures results in longer immobilization and more days lost at work with significant psychosocial and financial consequences.Initially Pulsed Electromagnetic Fields was used in the treatment of tibial pseudoarthrosis and non-union. More recently there is evidence that physical forces can also be used in the treatment of fresh fractures, showing accelerated healing by 30% and 71% reduction in nonunion within 12 weeks after initiation of therapy. Until now no double blind randomized, placebo controlled trial has been conducted to investigate the effect of this treatment on the healing of fresh fractures of the scaphoid. This is a multi center, prospective, double blind, placebo controlled, randomized trial. Study population consists of all patients with unilateral acute scaphoid fracture. Pregnant women, patients having a life supporting implanted electronic device, patients with additional fractures of wrist, carpal or metacarpal bones and pre-existing impairment in wrist function are excluded. The scaphoid fracture is diagnosed by a combination of physical and radiographic examination (CT-scanning).Proven scaphoid fractures are treated with cast immobilization and a small Pulsed Electromagnetic Fields bone growth stimulating device placed on the cast. Half of the devices will be disabled at random in the factory.Study parameters are clinical consolidation, radiological consolidation evaluated by CT-scanning, functional

  19. Pulsed Electromagnetic Fields in the treatment of fresh scaphoid fractures. A multicenter, prospective, double blind, placebo controlled, randomized trial

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    Poeze Martijn

    2011-05-01

    Full Text Available Abstract Background The scaphoid bone is the most commonly fractured of the carpal bones. In the Netherlands 90% of all carpal fractures is a fracture of the scaphoid bone. The scaphoid has an essential role in functionality of the wrist, acting as a pivot. Complications in healing can result in poor functional outcome. The scaphoid fracture is a troublesome fracture and failure of treatment can result in avascular necrosis (up to 40%, non-union (5-21% and early osteo-arthritis (up to 32% which may seriously impair wrist function. Impaired consolidation of scaphoid fractures results in longer immobilization and more days lost at work with significant psychosocial and financial consequences. Initially Pulsed Electromagnetic Fields was used in the treatment of tibial pseudoarthrosis and non-union. More recently there is evidence that physical forces can also be used in the treatment of fresh fractures, showing accelerated healing by 30% and 71% reduction in nonunion within 12 weeks after initiation of therapy. Until now no double blind randomized, placebo controlled trial has been conducted to investigate the effect of this treatment on the healing of fresh fractures of the scaphoid. Methods/Design This is a multi center, prospective, double blind, placebo controlled, randomized trial. Study population consists of all patients with unilateral acute scaphoid fracture. Pregnant women, patients having a life supporting implanted electronic device, patients with additional fractures of wrist, carpal or metacarpal bones and pre-existing impairment in wrist function are excluded. The scaphoid fracture is diagnosed by a combination of physical and radiographic examination (CT-scanning. Proven scaphoid fractures are treated with cast immobilization and a small Pulsed Electromagnetic Fields bone growth stimulating device placed on the cast. Half of the devices will be disabled at random in the factory. Study parameters are clinical consolidation

  20. Airborne methane remote measurements reveal heavy-tail flux distribution in Four Corners region.

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    Frankenberg, C.

    2016-12-01

    Methane (CH4) impacts climate as the second strongest anthropogenic greenhouse gas and air quality by influencing tropospheric ozone levels. Space-based observations have identified the Four Corners region in the Southwest United States as an area of large CH4 enhancements. We conducted an airborne campaign in Four Corners during April 2015 with the next-generation Airborne Visible/Infrared Imaging Spectrometer (near-infrared) and Hyperspectral Thermal Emission Spectrometer (thermal infrared) imaging spectrometers to better understand the source of methane by measuring methane plumes at 1- to 3-m spatial resolution. Our analysis detected more than 250 individual methane plumes from fossil fuel harvesting, processing, and distributing infrastructures, spanning an emission range from the detection limit ˜ 2 kg/h to 5 kg/h through ˜ 5,000 kg/h. Observed sources include gas processing facilities, storage tanks, pipeline leaks, natural seeps and well pads, as well as a coal mine venting shaft. Overall, plume enhancements and inferred fluxes follow a lognormal distribution, with the top 10% emitters contributing 49 to 66% to the inferred total point source flux of 0.23 Tg/y to 0.39 Tg/y. We will summarize the campaign results and provide an overview of how airborne remote sensing can be used to detect and infer methane fluxes over widespread geographic areas and how new instrumentation could be used to perform similar observations from space.

  1. Assessing the risk of nitrogen deposition to natural resources in the Four Corners area

    Science.gov (United States)

    Reed, Sasha C.; Belnap, Jayne; Floyd-Hanna, Lisa; Crews, Tim; Herring, Jack; Hanna, Dave; Miller, Mark E.; Duniway, Michael C.; Roybal, Carla M.

    2013-01-01

    Nitrogen (N) deposition in the western U.S. is on the rise and is already dramatically affecting terrestrial ecosystems. For example, N deposition has repeatedly been shown to lower air and water quality, increase greenhouse gas emissions, alter plant community composition, and significantly modify fire regimes. Accordingly, the effects of N deposition represent one of our largest environmental challenges and make difficult the National Park Service’s (NPS) important mission to “preserve the scenery and the natural and historic objects and the wildlife… unimpaired for the enjoyment of future generations”. Due to increased population growth and energy development (e.g., natural gas wells), the Four Corners region has become a notable ‘hotspot’ for N deposition. However, our understanding of how increased N deposition will affect these unique ecosystems, as well as how much deposition is actually occurring, remains notably poor. Here we used a multi-disciplinary approach to gathering information in an effort to help NPS safeguard the Four Corners national parks, both now and into the future. We applied modeling, field, and laboratory techniques to clarify current N deposition gradients and to help elucidate the ecosystem consequences of N deposition to the national parks of the Four Corners area. Our results suggest that NOx deposition does indeed represent a significant source of N to Mesa Verde National Park and, as expected, N deposition significantly affects coupled biogeochemical cycling (N, carbon, and phosphorus) of these landscapes. We also found some surprising results. For example, perhaps due to the low nutrient availability in these (and other) dryland ecosystems, although most other research suggests that adding N reduces N fixation rates, N additions did not consistently reduce natural N inputs via biological N2 fixation at our dryland sites. While the timeline of this pilot project is too brief to elucidate all the potential insight from

  2. Vascularized osseous graft for scaphoid

    International Nuclear Information System (INIS)

    Mendez Daza, Carlos Hernan; Mathoulin, Cristophe

    2004-01-01

    The most commonly used technique for treatment of pseudo-arthrosis of the scaphoid is osteo-synthesis with Kirschnet wires and cortical sponge grafts. Results reported by different teams using this procedure show no more than 90% osseous consolidation, especially in cases where vascularisation of the proximal fragment of the scaphoid is compromised. Here we present a series of ten cases of pseudo-arthrosis of the scaphoid, treated using a new surgical technique involving a vascularized osseous graft of the distal radius. Using this procedure we obtained 100% consolidation, with no complications either during the procedure or immediately post-operatively. Patients returned to work in week 15 on average. In 4 cases we observed discomfort in the area of the scar, which was successfully treated using local cortisone injection. The results obtained are very similar to those seen in the literature on the different techniques for vascularized osseous grafts for pseudo-arthrosis of the scaphoid

  3. Male and Female Social Actor Representation in Four Corners 4: A Critical Discourse Perspective

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    Ali Roohani

    2014-12-01

    Full Text Available This study aims at investigating the linguistic representation of male and female social actors in the Four Corners 4 textbook, drawing on CDA. More specifically, van Leeuwen’s (1996 framework, which highlights the connection of linguistic and social practices, is used as the analytical framework to examine gendered social actors in this English language teaching (ELT textbook. To this end, content analysis was done to explore the frequency and proportion of each social actor. Quantitative and qualitative data analysis showed that there were some differences, though not statistically significant, between males and females regarding substitution, individualization, and activation. Males, in contrast with females, were included more as active and famous actors in social circumstances and they were more individualized. In addition, they were more activated through circumstantialization and participation. On the other hand, the case of formalization was mostly observed for males. Moreover, males and females were distributed equally in the textbook in terms of classification, genericization, and collectivization. The results reveal that the gender bias still exists, though to a small degree, in this ELT textbook, which is taught as a substitution for the previous ELT textbooks in many language schools in Iran.

  4. Analysis of ulnar variance as a risk factor for developing scaphoid nonunion.

    Science.gov (United States)

    Lirola-Palmero, S; Salvà-Coll, G; Terrades-Cladera, F J

    2015-01-01

    Ulnar variance may be a risk factor of developing scaphoid non-union. A review was made of the posteroanterior wrist radiographs of 95 patients who were diagnosed of scaphoid fracture. All fractures with displacement less than 1mm treated conservatively were included. The ulnar variance was measured in all patients. Ulnar variance was measured in standard posteroanterior wrist radiographs of 95 patients. Eighteen patients (19%) developed scaphoid nonunion, with a mean value of ulnar variance of -1.34 (-/+ 0.85) mm (CI -2.25 - 0.41). Seventy seven patients (81%) healed correctly, and the mean value of ulnar variance was -0.04 (-/+ 1.85) mm (CI -0.46 - 0.38). A significant difference was observed in the distribution of ulnar variance (pvariance less than -1mm, and ulnar variance greater than -1mm. It appears that patients with ulnar variance less than -1mm had an OR 4.58 (CI 1.51 to 13.89) with pvariance less than -1mm have a greater risk of developing scaphoid nonunion, OR 4.58 (CI 1.51 to 13.89) with p<.007. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

  5. Gaseous Oxidized Mercury Dry Deposition Measurements in the FourCorners Area and Eastern Oklahoma, U.S.A.

    Science.gov (United States)

    Gaseous oxidized mercury (GOM) dry deposition measurements using surrogate surface passive samplers were collected in the Four Corners area and eastern Oklahoma from August, 2009–August, 2011. Using data from a six site area network, a characterization of the magnitude and spatia...

  6. In Defense of Education's "Wild West": Charter Schools Thrive in the Four Corners States

    Science.gov (United States)

    Ladner, Matthew

    2018-01-01

    The point at which the corners of Arizona, Colorado, New Mexico, and Utah meet is the only spot in the United States where the borders of four states converge. Beyond geography, the Four Corners states share a similar approach to charter schooling. All four states have adopted relatively freewheeling authorization policies, and charter schools…

  7. MR imaging of scaphoid fractures

    DEFF Research Database (Denmark)

    Meincke, Louise; Radev, Dimitar; Eriksen, Rie Østbjerg

    2017-01-01

    the importance of early MRI and hereby predict bone bruise with the help of fat suppression sequence; however, only a limited selection articles compares various fat suppression techniques. The purpose of this prospective study was to compare the short tau inversion recovery (STIR) and T2 fat saturation (FAT SAT......) sequences, sectional directed along the scaphoid bone axis. In relation to background fat intensity suppression, this study sought the sequence that best evaluated posttraumatic bone marrow edema (bone bruise) on scaphoid injury musculoskeletal magnetic resonance imaging (MRI, 1.5 T extremity scanner......). Materials and methods: Two hundred and fifty-one patients with relevant trauma and positive clinical test for scaphoid bone fractures, exceeding no more than 14 days, underwent MRI examinations. A fast STIR and T2 FAT SAT fast spin echo sequence (FSE) were obtained using a comparable parameter setting (scan...

  8. Distribution of Scaphoid Nutrient Foramina

    African Journals Online (AJOL)

    The blood supply to the scaphoid comes mainly from the radial artery and the proximal pole has been shown to have limited interosseous supply. (7, 8). Alternative blood supply comes from the dorsal, laterovolar and distal groups of extraossoeus blood vessels that enter the bone via foramina on the surface of the bone (7).

  9. Top-down constraints on methane and non-methane hydrocarbon emissions in the US Four Corners

    Science.gov (United States)

    Petron, G.; Miller, B. R.; Vaughn, B. H.; Kofler, J.; Mielke-Maday, I.; Sherwood, O.; Schwietzke, S.; Conley, S.; Sweeney, C.; Dlugokencky, E. J.; White, A. B.; Tans, P. P.; Schnell, R. C.

    2017-12-01

    A NASA and NOAA supported field campaign took place in the US Four Corners in April 2015 to further investigate a regional "methane hotspot" detected from space. The Four Corners region is home to the fossil fuel rich San Juan Basin, which extends between SE Colorado and NE New Mexico. The area has been extracting coal, oil and natural gas for decades. Degassing from the Fruitland coal outcrop on the Colorado side has also been reported. Instrumented aircraft, vans and ground based wind profilers were deployed for the campaign with the goal to quantify and attribute methane and non-methane hydrocarbon emissions in the region. A new comprehensive analysis of the campaign data sets will be presented and top-down emission estimates for methane and ozone precursors will be compared with available bottom-up estimates.

  10. Conservative management of fracture scaphoid

    Directory of Open Access Journals (Sweden)

    Mittal V

    2006-01-01

    Full Text Available Background : Conservative management of fracture scaphoid with cast is still the most common modality of management, but the results following this protocol are not always satisfactory. Methods : Twenty five patients with fracture scaphoid were treated with a below elbow scaphoid cast and were followed up for minimum duration of one year. On follow up patients were examined clinicoradiologically and functional results were evaluated using the modification of the Mayo wrist scoring chart. Results : Nineteen fractures showed union, two were malunited and five went for nonunion. Two fractures developed avascular necrosis and three patients had wrist arthritis on follow up. Nineteen patients had excellent functional results, one had good results and six patients had poor results. Patients with delayed diagnosis had nonunion and poor functional results. Patients with premature removal of cast had comparatively inferior results Conclusion : For displaced unstable fracture, open reduction and internal fixation should be the preferred modality of treatment as cast treatment gives unacceptably high rate of malunion and nonunion with poor functional results.

  11. Decoupling the Wrist: A Cadaveric Experiment Examining Wrist Kinematics Following Midcarpal Fusion and Scaphoid Excision

    Science.gov (United States)

    Nichols, Jennifer A.; Bednar, Michael S.; Havey, Robert M.; Murray, Wendy M.

    2016-01-01

    At the wrist, kinematic coupling (the relationship between flexion-extension and radial-ulnar deviation) facilitates function. Although the midcarpal joint is critical for kinematic coupling, many surgeries, such as four-corner fusion (4CF) and scaphoid-excision four-corner fusion (SE4CF), modify the midcarpal joint. This study examines how 4CF and SE4CF influence kinematic coupling by quantifying wrist axes of rotation. Wrist axes of rotation were quantified in eight cadaveric specimens using an optimization algorithm, which fit a two-revolute joint model to experimental data. In each specimen, data measuring the motion of the third metacarpal relative to the radius was collected for three conditions (nonimpaired, 4CF, SE4CF). The calculated axes of rotation were compared using spherical statistics. The angle between the axes of rotation was used to assess coupling, as the nonimpaired wrist has skew axes (i.e., angle between axes approximately 60°). Following 4CF and SE4CF, the axes are closer to orthogonal than those of the nonimpaired wrist. The mean angle (±95 percent confidence interval) between the axes was 92.6° ± 25.2° and 99.8° ± 22.0° for 4CF and SE4CF, respectively. The axes of rotation defined in this study can be used to define joint models, which will facilitate more accurate computational and experimental studies of these procedures. PMID:27705062

  12. Comb-like optical transmission spectrum resulting from a four-cornered two-waveguide-connected network

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Xiangbo, E-mail: xbyang@scnu.edu.cn [MOE Key Laboratory of Laser Life Science and Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631 (China); School of Physical Education and Sports Science, South China Normal University, Guangzhou 510006 (China); Song, Huanhuan [MOE Key Laboratory of Laser Life Science and Institute of Laser Life Science, College of Biophotonics, South China Normal University, Guangzhou 510631 (China); Liu, Timon Chengyi [School of Physical Education and Sports Science, South China Normal University, Guangzhou 510006 (China)

    2013-12-06

    In this Letter a four-cornered two-waveguide-connected network (FCTWCN) is proposed to generate comb-like optical transmission spectrum, where nearest-neighbor nodes are connected by two segments of one-dimensional waveguides. We investigate the band structure and transmission spectrum of electromagnetic waves propagating through FCTWCNs and find that the transmission through a FCTWCN exhibits periodic comb-like characteristic and the range, number and width of continuous equidistant frequency bands can be controlled by adjusting the lengths of the two types of segments. The comb-like frequency bands may be useful for the designing of optical switches, optical narrowband filters, high capacity telecommunications, and multichannel filters, etc.

  13. Climate change in the four corners and adjacent regions: Implications for environmental restoration and land-use planning

    Energy Technology Data Exchange (ETDEWEB)

    Waugh, W.J. [ed.

    1995-09-01

    This document contains the workshop proceedings on Climate Change in the Four Corners and Adjacent Regions: Implications for Environmental Restoration and Land-Use Planning which took place September 12-14, 1994 in Grand Junction, Colorado. The workshop addressed three ways we can use paleoenvironmental data to gain a better understanding of climate change and its effects. (1) To serve as a retrospective baseline for interpreting past and projecting future climate-induced environmental change, (2) To differentiate the influences of climate and humans on past environmental change, and (3) To improve ecosystem management and restoration practices in the future. The papers presented at this workshop contained information on the following subjects: Paleoclimatic data from the Pleistocene and Holocene epochs, climate change and past cultures, and ecological resources and environmental restoration. Selected papers are indexed separately for inclusion in the Energy Science and Technology Database.

  14. Multi-Scale Science Framework for Attributing and Tracking Greenhouse Gas Fluxes at LANL's Four Corners New Mexico Test Bed

    Science.gov (United States)

    Costigan, K. R.; Dubey, M. K.; Chylek, P.; Love, S. P.; Henderson, B. G.; Flowers, B. A.; Reisner, J. M.; Rahn, T.; Quick, C. R.

    2010-12-01

    Agreements to limit greenhouse gas emissions require scientifically valid methods for monitoring and validating anthropogenic emissions. However, the task of monitoring CO2 emissions is difficult because relatively small increases need to be detected against CO2’s variable and large background concentrations. To ensure fair compliance, remotely sensed measurements and an understanding of the atmospheric transport of CO2 from the sources are required. We hypothesize that CO2 from various natural and anthropogenic sources can be distinguished and tracked by monitoring co-emitted gases (e.g. NO2, SO2, and CO) and isotopomers (e.g.13CO2). The ratio of a co-emitted species to CO2 depends on fuel composition and combustion process and thus varies by energy sector. These ratios provide an independent method to quantify CO2 emissions. Their low backgrounds, their large perturbations from energy activities, and our ability to measure them precisely make them sensitive probes to attribute sources, especially when emission ratios of multiple species are used concurrently. This strategy of observing emission ratios of co-emitted species to derive regional and source-specific baselines and CO2 fluxes is being tested in the Four Corners region of northwestern New Mexico. The semi-arid ecology in the region has a weak natural carbon cycle, facilitating our goal of dissection of anthropogenic sector-specific sources. The net Four Corners and San Juan power plant emissions are the largest point source of CO2 and NOx in North America. The Four Corners plant produces much more NOx than the San Juan power plant, while their energy and CO2 outputs, and coal used, are similar. This difference offers us a unique opportunity to test discrimination methods. While their CO2 signals remain elusive for current satellites, their NO2 plumes have recently been resolved from space. The region also experiences dispersed CO2 urban emissions as well as emissions and leaks from thousands of oil

  15. OSTEOID OSTEOMA IN SCAPHOID: CASE REPORT.

    Science.gov (United States)

    Severo, Antônio Lourenço; de Araújo Filho, Raimundo; Puentes, Rulby; Lemos, Marcelo Barreto; Piluski, Paulo Faiad; Lech, Osvandré

    2012-01-01

    Osteoid osteoma is a benign osteoblastic tumor that is unusual in the hand. A location in the carpal bones is infrequent, which leads to errors in diagnosing it because of polymorphism of the clinical symptoms. Reviewing the literature shows that nine cases of osteoid osteoma in the scaphoid have been reported. Here, one case of osteoid osteoma in the scaphoid that was initially treated as De Quervain's stenosing tenosynovitis is reported, with a definitive diagnosis that was delayed for five years.

  16. OSTEOID OSTEOMA IN SCAPHOID: CASE REPORT

    Science.gov (United States)

    Severo, Antônio Lourenço; de Araújo Filho, Raimundo; Puentes, Rulby; Lemos, Marcelo Barreto; Piluski, Paulo Faiad; Lech, Osvandré

    2015-01-01

    Osteoid osteoma is a benign osteoblastic tumor that is unusual in the hand. A location in the carpal bones is infrequent, which leads to errors in diagnosing it because of polymorphism of the clinical symptoms. Reviewing the literature shows that nine cases of osteoid osteoma in the scaphoid have been reported. Here, one case of osteoid osteoma in the scaphoid that was initially treated as De Quervain's stenosing tenosynovitis is reported, with a definitive diagnosis that was delayed for five years. PMID:27047881

  17. Diagnosis of scaphoid fracture: optimal imaging techniques

    Directory of Open Access Journals (Sweden)

    Geijer M

    2013-07-01

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

  18. Scaphoid Waist Internal Fixation for Fractures Trial (SWIFFT) protocol: a pragmatic multi-centre randomised controlled trial of cast treatment versus surgical fixation for the treatment of bi-cortical, minimally displaced fractures of the scaphoid waist in adults.

    Science.gov (United States)

    Dias, Joseph; Brealey, Stephen; Choudhary, Surabhi; Cook, Liz; Costa, Matthew; Fairhurst, Caroline; Hewitt, Catherine; Hodgson, Stephen; Jefferson, Laura; Jeyapalan, Kanagaratnam; Keding, Ada; Leighton, Paul; Rangan, Amar; Richardson, Gerry; Rothery, Claire; Taub, Nicholas; Thompson, John; Torgerson, David

    2016-06-04

    A scaphoid fracture is the most common type of carpal fracture affecting young active people. The optimal management of this fracture is uncertain. When treated with a cast, 88 to 90 % of these fractures unite; however, for the remaining 10-12 % the non-union almost invariably leads to arthritis. The alternative is surgery to fix the scaphoid with a screw at the outset. We will conduct a randomised controlled trial (RCT) of 438 adult patients with a "clear" and "bicortical" scaphoid waist fracture on plain radiographs to evaluate the clinical effectiveness and cost-effectiveness of plaster cast treatment (with fixation of those that fail to unite) versus early surgical fixation. The plaster cast treatment will be immobilisation in a below elbow cast for 6 to 10 weeks followed by mobilisation. If non-union is confirmed on plain radiographs and/or Computerised Tomogram at 6 to 12 weeks, then urgent surgical fixation will be performed. This is being compared with immediate surgical fixation with surgeons using their preferred technique and implant. These treatments will be undertaken in trauma units across the United Kingdom. The primary outcome and end-point will be the Patient Rated Wrist Evaluation (a patient self-reported assessment of wrist pain and function) at 52 weeks and also measured at 6, 12, 26 weeks and 5 years. Secondary outcomes include an assessment of radiological union of the fracture; quality of life; recovery of wrist range and strength; and complications. We will also qualitatively investigate patient experiences of their treatment. Scaphoid fractures are an important public health problem as they predominantly affect young active individuals in the more productive working years of their lives. Non-union, if untreated, can lead to arthritis which can disable patients at a very young age. There is a rapidly increasing trend for immediate surgical fixation of these fractures but there is insufficient evidence from existing RCTs to support

  19. Vegetation productivity responses to drought on tribal lands in the four corners region of the Southwest USA

    Science.gov (United States)

    El-Vilaly, Mohamed Abd Salam; Didan, Kamel; Marsh, Stuart E.; van Leeuwen, Willem J. D.; Crimmins, Michael A.; Munoz, Armando Barreto

    2018-03-01

    For more than a decade, the Four Corners Region has faced extensive and persistent drought conditions that have impacted vegetation communities and local water resources while exacerbating soil erosion. These persistent droughts threaten ecosystem services, agriculture, and livestock activities, and expose the hypersensitivity of this region to inter-annual climate variability and change. Much of the intermountainWestern United States has sparse climate and vegetation monitoring stations, making fine-scale drought assessments difficult. Remote sensing data offers the opportunity to assess the impacts of the recent droughts on vegetation productivity across these areas. Here, we propose a drought assessment approach that integrates climate and topographical data with remote sensing vegetation index time series. Multisensor Normalized Difference Vegetation Index (NDVI) time series data from 1989 to 2010 at 5.6 km were analyzed to characterize the vegetation productivity changes and responses to the ongoing drought. A multi-linear regression was applied to metrics of vegetation productivity derived from the NDVI time series to detect vegetation productivity, an ecosystem service proxy, and changes. The results show that around 60.13% of the study area is observing a general decline of greenness ( pchallenges to the region's already stressed ecosystems. Whereas the results provide additional insights into this isolated and vulnerable region, the drought assessment approach used in this study may be adapted for application in other regions where surface-based climate and vegetation monitoring record is spatially and temporally limited.

  20. Carpal height and postoperative strength after proximal row carpectomy or four-corner arthrodesis: Clinical, anatomical and biomechanical study.

    Science.gov (United States)

    Laronde, Pascale; Christiaens, Nicolas; Aumar, Aurélien; Chantelot, Christophe; Fontaine, Christian

    2016-04-01

    Proximal row carpectomy (PRC) and four-corner arthrodesis (4CA) are the two most commonly performed surgical procedures to treat wrist arthritis. Postoperative strength is one of the criteria for choosing between the two techniques. Some authors believe that strength is correlated with residual carpal height. The goal of this study was to determine if postoperative carpal height was predictive of postoperative strength. This study consisted of two parts: a clinical evaluation of grip strength after 4CA or PRC; anatomical and radiological measurements of carpal height before and after 4CA or PRC. Grip strength was better preserved after PRC (87.5%) than after 4CA (76.1%), when expressed relative to the opposite hand (P=0.053). There was a significant decrease in carpal height for the PRC group with a Youm's index of 0.37 versus 0.50 for the 4CA group (P<0.0001). Our clinical results and analysis of the literature indicate that 4CA is not superior to PRC when it comes to grip strength, whereas carpal height is significantly decreased after PRC. The decreased tendon excursion after PRC is balanced by an increase in joint stresses after 4CA. Copyright © 2016 SFCM. Published by Elsevier Masson SAS. All rights reserved.

  1. Scaphoid pseudo-arthrosis: Frequency, pathogenesis and course

    Energy Technology Data Exchange (ETDEWEB)

    Schunk, K.; Teifke, A.; Benning, R.; Dahm, M.; Thelen, R.; Schild, H.

    1989-06-01

    Eighty-three scaphoid pseudo-arthroses were found amongst 1.104 scaphoid examinations. Sixtyseven were present at the first examination and 16 pseudo-arthroses developed amongst 252 scaphoid fractures. Men were affected predominantly, particularly in the 20 to 40-year old group. Fractures in the proximal third of the scaphoid and vertical oblique fractures had a particular tendency to pseudo-arthrosis formation. The operative treatment of choice is a Matti-Russe bone graft. Only one patient in seven with definite scaphoid pseudo-arthrosis showed firm fusion. (orig.).

  2. Scaphoid pseudo-arthrosis: Frequency, pathogenesis and course

    International Nuclear Information System (INIS)

    Schunk, K.; Teifke, A.; Benning, R.; Dahm, M.; Thelen, R.; Schild, H.; Mainz Univ.

    1989-01-01

    Eighty-three scaphoid pseudo-arthroses were found amongst 1.104 scaphoid examinations. Sixtyseven were present at the first examination and 16 pseudo-arthroses developed amongst 252 scaphoid fractures. Men were affected predominantly, particularly in the 20 to 40-year old group. Fractures in the proximal third of the scaphoid and vertical oblique fractures had a particular tendency to pseudo-arthrosis formation. The operative treatment of choice is a Matti-Russe bone graft. Only one patient in seven with definite scaphoid pseudo-arthrosis showed firm fusion. (orig.) [de

  3. Modified Carpal Box Technique in the Diagnosis of Suspected Scaphoid Fractures

    Energy Technology Data Exchange (ETDEWEB)

    Toth, F.; Mester, S.; Cseh, G.; Bener, A.; Nyarady, J.; Lovasz, G. [Pecs Univ. (Hungary). Medical School

    2003-05-01

    Purpose: To establish and test the clinical efficacy of a new diagnostic algorithm with the extensive utilization of modified carpal box radiography (mX-CB) in the detection of scaphoid fractures. Material and Methods: Initial and early follow-up radiographic evaluation of 146 suspected scaphoid fractures were carried out by mX-CB. Patients with unconfirmed diagnosis were referred to CT. Patients were followed for 1 year after injury. Sensitivity, specificity and interobserver agreement of reading mX-CB images were determined statistically. Results: No non-union or avascular necrosis was seen at 1 year after the injury. 90% of the fractures were diagnosed by mX-CB, only 6.8% of the patients needed referral to CT. Sensitivity of mX-CB at initial presentation was 81.6%. Interobserver agreement was very high among evaluators of mX-CB images. Conclusion: Extensive utilization of mX-CB as primary and early follow-up investigation resulted in high initial diagnostic accuracy and low referral rate to a more expensive diagnostic modality.

  4. Cone-beam CT in diagnosis of scaphoid fractures

    Energy Technology Data Exchange (ETDEWEB)

    Edlund, Rolf; Lapidus, Gunilla; Baecklund, Jenny [Capio St Goeran' s Hospital, Department of Radiology, Stockholm (Sweden); Skorpil, Mikael [Karolinska University Hospital, Department of Radiology, Stockholm (Sweden); Karolinska Institutet, Department of Molecular Medicine and Surgery, Stockholm (Sweden)

    2016-02-15

    This prospective study investigated the sensitivity of cone beam computed tomography (CBCT), a low dose technique recently made available for extremity examinations, in detecting scaphoid fractures. Magnetic resonance imaging (MRI) was used as gold standard for scaphoid fractures. A total of 95 patients with a clinically suspected scaphoid fracture were examined with radiography and CBCT in the acute setting. A negative CBCT exam was followed by an MRI within 2 weeks. When a scaphoid fracture was detected on MRI a new CBCT was performed. Radiography depicted seven scaphoid fractures, all of which were also seen with CBCT. CBCT detected another four scaphoid fractures. With MRI another five scaphoid fractures were identified that were not seen with radiography or with CBCT. These were also not visible on the reexamination CBCT. Sensitivity for radiography was 44, 95 % confidence interval 21-69 %, and for CBCT 69 %, 95 % confidence interval 41-88 % (p = 0.12). Several non-scaphoid fractures in the carpal region were identified, radiography and CBCT depicted 7 and 34, respectively (p < 0.0001). CBCT is a superior alternative to radiography, entailing more accurate diagnoses of carpal region fractures, and thereby requiring fewer follow-up MRI examinations. However, CBCT cannot be used to exclude scaphoid fractures, since MRI identified additional occult scaphoid fractures. (orig.)

  5. Non-Anatomical Surgical Solutions for Difficult Non-Unions: Case Series

    OpenAIRE

    Zaki Said, Galal; Farouk, Osama Ahmed; Galal Said, Hatem; Mohamed El-Sharkawi, Mohamed Mostafa

    2013-01-01

    Abstract Non-union occurs when bone healing ceases and does not continue without some type of intervention. Classification of non-union is traditionally based on the amount of callus or bone healing at the fracture site. Successful treatment of non-union often depends on appropriate reduction and realignment of the fracture, bone grafting if necessary, and stabilization. This may not be possible in some neglected and complicated non-unions. Under these circumstances, modification of the stand...

  6. Chondroblastoma of the scaphoid: A case report

    Directory of Open Access Journals (Sweden)

    Sandeep Vijayan

    2015-01-01

    Full Text Available Benign Chondroblastoma generally occur in the epiphysis of long bones and rarely arise in carpal bones. We report a young male with chondroblastoma of scaphoid treated with curettage, bone grafting and K-wire fixation. At the last follow-up, 4 years after surgery, the patient was asymptomatic without recurrence.

  7. Positioning of the wrist for scaphoid radiography

    International Nuclear Information System (INIS)

    Toth, Ferenc; Sebestyen, Andor; Balint, Lehel; Mester, Sandor; Szabo, Gyorgy; Nyarady, Jozsef; Weninger, Csaba; Angyal, Miklos; Lovasz, Gyorgy

    2007-01-01

    Purpose: The purpose of this cadaver study was to determine the ideal position of the wrist for scaphoid radiography. Materials and methods: Four cadaver wrists were rotated around their longitudinal axis in 15 deg. increments and exposures were taken. Seven postero-anterior images were taken as well. Thus, 18 images of each wrist were available for assessment. Views were determined in which the main anatomic regions of the scaphoid were visualized undistorted. The size and localization of the overlap of other carpal bones were also evaluated. Finally, views with the best visualization of anatomic landmarks were selected. The results of these three investigations were compared to literature data. Results: We consider the following four images the most valuable in the diagnostic imaging of scaphoid bone: (1) Postero-anterior view in ulnar deviation of wrist and fist position of the hand; (2) oblique view in 60 deg. of pronation; (3) oblique view in 60 deg. of supination; (4) lateral view. Conclusion: We concluded that our four views are sufficient for proper radiographic evaluation of the scaphoid

  8. Palmar dislocation of scaphoid and lunate

    Directory of Open Access Journals (Sweden)

    Khalid Koulali Idrissi

    2011-11-01

    Full Text Available A palmar dislocation of scaphoid and lunate is uncommon. We have found only 19 reported cases in the literature. We reported a simultaneous, divergent dislocation. The closed reduction followed by percutaneous pinning has given a good result without avascular necrosis of any carpal bone.

  9. Missed isolated volar dislocation of the scaphoid

    DEFF Research Database (Denmark)

    Kolby, Lise; Larsen, Søren; Jørring, Stig

    2007-01-01

    A patient presented with volar dislocation of the scaphoid, the diagnosis of which had been missed for two weeks. He was treated with open reduction through a combined volar and dorsal approach with decompression of the median nerve, internal fixation, and a cast for eight weeks. One year postope...... postoperatively the functional result was good. A radiograph showed no sign of avascular necrosis....

  10. PSEUDARTHROSIS OF THE SCAPHOID IN IMMATURE SKELETONS

    Science.gov (United States)

    de Lemos, Marcelo Barreto; Bentes, Ádria Simone Ferreira; Neto, Miguel Flores do Amaral; Spinelli, Leandro de Freitas; Severo, Antônio Lourenço; Lech, Osvandré

    2015-01-01

    This paper presents a review of the literature on pseudarthrosis of the scaphoid in skeletally immature individuals, taking into consideration its epidemiology, diagnosis and treatment, as well as its controversies. Knowledge of this subject makes it possible for patients to be given appropriate treatment immediately. Pseudarthrosis of the scaphoid in skeletally immature patients is a rare condition that results from error or lack of diagnosis of a fracture. Thus, careful clinical and radiographic examination should be performed in order to confirm or rule out this diagnosis. Several treatment methods have been reported and have shown good results. These include conservative plaster cast treatment, bone graft without osteosynthesis, bone graft with Kirschner wires, percutaneous screws and bone graft with compression screws. The treatment performed depends on the characteristics of the pseudarthrosis and the surgeon's experience. PMID:27042636

  11. PSEUDARTHROSIS OF THE SCAPHOID IN IMMATURE SKELETONS.

    Science.gov (United States)

    de Lemos, Marcelo Barreto; Bentes, Ádria Simone Ferreira; Neto, Miguel Flores do Amaral; Spinelli, Leandro de Freitas; Severo, Antônio Lourenço; Lech, Osvandré

    2012-01-01

    This paper presents a review of the literature on pseudarthrosis of the scaphoid in skeletally immature individuals, taking into consideration its epidemiology, diagnosis and treatment, as well as its controversies. Knowledge of this subject makes it possible for patients to be given appropriate treatment immediately. Pseudarthrosis of the scaphoid in skeletally immature patients is a rare condition that results from error or lack of diagnosis of a fracture. Thus, careful clinical and radiographic examination should be performed in order to confirm or rule out this diagnosis. Several treatment methods have been reported and have shown good results. These include conservative plaster cast treatment, bone graft without osteosynthesis, bone graft with Kirschner wires, percutaneous screws and bone graft with compression screws. The treatment performed depends on the characteristics of the pseudarthrosis and the surgeon's experience.

  12. Scaphoid Fracture Fixation with an Acutrak? Screw

    OpenAIRE

    Loving, Vilert A.; Richardson, Michael L.

    2015-01-01

    We report a case of fixation of a scaphoid fracture using an Acutrak? screw. This screw is cannulated and headless, which allows it to be implanted below the surface of the bone. It uses the same concept of variable thread pitch as the Herbert screw, but unlike the Herbert screw, is fully threaded, with continuously varying pitch along its length. This variable pitch creates constant compression across a fracture as the screw is advanced, and gives the screw its unique appearance. This featur...

  13. Congenital Scaphoid Megalourethra: A Case Report

    Directory of Open Access Journals (Sweden)

    Kenji Obara

    2017-09-01

    Full Text Available A congenital megalourethra is an enlargement of the pendulous urethra without evidence of distal obstruction. A 1-month-old boy presented to us with complaint of weak stream, ballooning of the penis before and during voiding and post voiding dribbling, since birth. Physical examination and cystourethroscope confirmed the diagnosis of congenital scaphoid megalourethra. He underwent reduction urethroplasty. During postoperative follow up, he had normal looking penis with good urinary stream.

  14. Enchondroma of the scaphoid: a case report | Ali | Pan African ...

    African Journals Online (AJOL)

    Enchondroma represents a common bone tumor of the hand. The scaphoid is a rare location. We report the case of a scaphoid enchondroma presenting as chronic wrist pain following a relatively minor trauma. The diagnosis was suggested by radiological study and then confirmed by histological study after biopsy.

  15. Variable Bone Density of Scaphoid: Importance of Subchondral Screw Placement.

    Science.gov (United States)

    Swanstrom, Morgan M; Morse, Kyle W; Lipman, Joseph D; Hearns, Krystle A; Carlson, Michelle G

    2018-02-01

    Background  Ideal internal fixation of the scaphoid relies on adequate bone stock for screw purchase; so, knowledge of regional bone density of the scaphoid is crucial. Questions/Purpose  The purpose of this study was to evaluate regional variations in scaphoid bone density. Materials and Methods  Three-dimensional CT models of fractured scaphoids were created and sectioned into proximal/distal segments and then into quadrants (volar/dorsal/radial/ulnar). Concentric shells in the proximal and distal pole were constructed in 2-mm increments moving from exterior to interior. Bone density was measured in Hounsfield units (HU). Results  Bone density of the distal scaphoid (453.2 ± 70.8 HU) was less than the proximal scaphoid (619.8 ± 124.2 HU). There was no difference in bone density between the four quadrants in either pole. In both the poles, the first subchondral shell was the densest. In both the proximal and distal poles, bone density decreased significantly in all three deeper shells. Conclusion  The proximal scaphoid had a greater density than the distal scaphoid. Within the poles, there was no difference in bone density between the quadrants. The subchondral 2-mm shell had the greatest density. Bone density dropped off significantly between the first and second shell in both the proximal and distal scaphoids. Clinical Relevance  In scaphoid fracture ORIF, optimal screw placement engages the subchondral 2-mm shell, especially in the distal pole, which has an overall lower bone density, and the second shell has only two-third the density of the first shell.

  16. Gaseous Oxidized Mercury Dry Deposition Measurements in the Southwestern USA: A Comparison between Texas, Eastern Oklahoma, and the Four Corners Area

    Directory of Open Access Journals (Sweden)

    Mark E. Sather

    2014-01-01

    Full Text Available Gaseous oxidized mercury (GOM dry deposition measurements using aerodynamic surrogate surface passive samplers were collected in central and eastern Texas and eastern Oklahoma, from September 2011 to September 2012. The purpose of this study was to provide an initial characterization of the magnitude and spatial extent of ambient GOM dry deposition in central and eastern Texas for a 12-month period which contained statistically average annual results for precipitation totals, temperature, and wind speed. The research objective was to investigate GOM dry deposition in areas of Texas impacted by emissions from coal-fired utility boilers and compare it with GOM dry deposition measurements previously observed in eastern Oklahoma and the Four Corners area. Annual GOM dry deposition rate estimates were relatively low in Texas, ranging from 0.1 to 0.3 ng/m2h at the four Texas monitoring sites, similar to the 0.2 ng/m2h annual GOM dry deposition rate estimate recorded at the eastern Oklahoma monitoring site. The Texas and eastern Oklahoma annual GOM dry deposition rate estimates were at least four times lower than the highest annual GOM dry deposition rate estimate previously measured in the more arid bordering western states of New Mexico and Colorado in the Four Corners area.

  17. Computed tomography for suspected scaphoid fractures: comparison of reformations in the plane of the wrist versus the long axis of the scaphoid

    NARCIS (Netherlands)

    Mallee, Wouter H.; Doornberg, Job N.; Ring, David; Maas, Mario; Muhl, Maaike; van Dijk, C. Niek; Goslings, J. Carel

    2014-01-01

    Definitive diagnosis of occult scaphoid fractures remains difficult. We tested the null hypothesis that, for diagnosis of true fractures among suspected scaphoid fractures, computed tomography (CT) reformations along the long axis of the scaphoid have the same accuracy as reformations made relative

  18. Nontraumatic osteonecrosis of the distal pole of the scaphoid

    Directory of Open Access Journals (Sweden)

    Bhavuk Garg

    2011-01-01

    Full Text Available Post traumatic osteonecrosis of distal pole of scaphoid is very rare. We present a case of 34 years old male, drill operator by occupation with nontraumatic osteonecrosis of distal pole of the scaphoid. The patient was managed conservatively and was kept under regular follow-up every three months. The patient was also asked to change his profession. Two years later, the patient had no pain and had mild restriction of wrist movements (less than 15 degrees in either direction. The radiographs revealed normal density of the scaphoid suggesting revascularization.

  19. scaphoid dimensions and appropriate screw sizes in a kenyan

    African Journals Online (AJOL)

    There were no side to side differences in the total length or the distal pole. Conclusion: Scaphoid screws .... gender differences in prehension may contribute to .... differences between males and females. Sports. Med Arthroscopy Review. 2002 ...

  20. Prune belly syndrome with pouch colon with scaphoid megalourethra

    African Journals Online (AJOL)

    We here report a rare association of megalourethra with pouch colon with prune belly syndrome. We also provide a newer embryological and prognostic perspective to this association. Keywords: megalourethra, prune belly syndrome pouch colon, scaphoid ...

  1. Angular Stable Miniplate Fixation of Chronic Unstable Scaphoid Nonunion.

    Science.gov (United States)

    Schormans, Philip M J; Brink, Peter R G; Poeze, Martijn; Hannemann, Pascal F W

    2018-02-01

    Background  Around 5 to 15% of all scaphoid fractures result in nonunion. Treatment of long-lasting scaphoid nonunion remains a challenge for the treating surgeon. Healing of scaphoid nonunion is essential for prevention of scaphoid nonunion advanced collapse and the subsequent predictable pattern of radiocarpal osteoarthritis. Purpose  The purpose of this study was to investigate the feasibility of fixation of the scaphoid nonunion with a volar angular stable miniplate and cancellous bone grafting. We hypothesized that this technique could be successful, even in patients with previous surgery for nonunion and in patients with a long duration of nonunion. Patients and Methods  A total of 21 patients enrolled in a single-center prospective cohort study. Healing of nonunion was assessed on multiplanar computed tomography scan of the wrist at a 3-month interval. Functional outcome was assessed by measuring grip strength, range of motion, and by means of the patient-rated wrist and hand evaluation (PRWHE) questionnaire. Results  During follow-up, 19 out of 21 patients (90%) showed radiological healing of the nonunion. The range of motion did not improve significantly. Postoperative PRWHE scores decreased by 34 points. Healing occurred regardless of the length of time of the nonunion (range: 6-183 months) and regardless of previous surgery (38% of patients). Conclusion  Volar angular stable miniplate fixation with autologous cancellous bone grafting is a successful technique for the treatment of chronic unstable scaphoid nonunion, even in patients with long-lasting nonunion and in patients who underwent previous surgery for a scaphoid fracture. Rotational interfragmentary stability might be an important determining factor for the successful treatment of unstable scaphoid nonunion. Level of Evidence  Level IV.

  2. Clinical diagnostic evaluation for scaphoid fractures: a systematic review and meta-analysis

    NARCIS (Netherlands)

    Mallee, Wouter H.; Henny, Erik P.; van Dijk, C. Niek; Kamminga, Sjoerd P.; van Enst, Wynanda A.; Kloen, Peter

    2014-01-01

    To provide an overview of available clinical evaluation tests for scaphoid fractures and to compare their diagnostic accuracies. PWe performed a systematic review of all studies assessing diagnostic characteristics of clinical evaluation in scaphoid fractures by searching MEDLINE, EMBASE, Cochrane,

  3. Use of bone marrow derived stem cells in a fracture non-union

    Directory of Open Access Journals (Sweden)

    Binod C. Raulo

    2012-01-01

    Full Text Available This is an attempt of using in vitro cultured mesenchymal stem cells (MSCs from bone marrow in joining of a fracture non-union. Bone marrow cells were obtained and differentially centrifuged for MSCs that were grown in vitro in mesenchymal stem cell basal medium aseptically, for 10 d. The cell mass was injected around the fracture non-union. Healthy conditions of development of tissue regeneration at the trauma site and due bone joining were recorded. It is concluded that in vitro cultured MSCs had a blithesome effect on the fracture non-union.

  4. 21 CFR 888.3760 - Wrist joint carpal scaphoid polymer prosthesis.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Wrist joint carpal scaphoid polymer prosthesis. 888.3760 Section 888.3760 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... scaphoid polymer prosthesis. (a) Identification. A wrist joint carpal scaphoid polymer prosthesis is a one...

  5. Data recovery of North American directional archaeomagnetic records for the development of a robust reference curve for the "Four Corners" region of the American Southwest

    Science.gov (United States)

    Jones-Cervantes, S. A.; Tauxe, L.; Blinman, E.

    2017-12-01

    Since 1964, an academic lineage, including Robert Dubois and three of his students, has been collecting nearly 6000 directional archaeomagnetic samples from sites all over the world with about 4000 samples coming from within the "Four Corners" region of the American Southwest (NM, AZ, UT, CO). Only a small fraction of the results have been published and, when published, typically only at the sample average level within hard-to-access archaeological reports. Fortunately, nearly all the stepwise alternating field measurement data and oriented specimens still exist within four collections. The goal of this data recovery project is to digitize, reanalyze using principle component analysis (where possible), complete the demagnetization where appropriate and publish the results, using the MagIC data base to archive measurement-level results. Additionally, three secular variation (SV) models for the "Four Corners" region have been developed using small and differently selected subsets of the 4000 samples. The details of these models do not agree with each other, but have a few first order similarities. The differing approaches to selection results in ambiguity in their reliability. As such, the final goal of this project is to develop a new, robust, SV model for the region using only the highest quality data with independent geochronology. As of yet, all the measurement-level data for the samples within the Dubois collection have been scanned. Efforts are ongoing to digitize the scanned printouts and handwritten logs into a usable format. Currently, all of the location and geochronological data and about half of the measurement-level magnetic data have been digitized. The combined data from two of the four data collections have been analyzed and subjected to quality thresholds using PmagGUI (Tauxe et al. 2016). The resulting interpretations have been sorted into three bins based on quality. 1) Samples that meet all the quality thresholds. 2) Samples that do not meet the

  6. Biomechanical Strength of Retrograde Fixation in Proximal Third Scaphoid Fractures.

    Science.gov (United States)

    Daly, Charles A; Boden, Allison L; Hutton, William C; Gottschalk, Michael B

    2018-04-01

    Current techniques for fixation of proximal pole scaphoid fractures utilize antegrade fixation via a dorsal approach endangering the delicate vascular supply of the dorsal scaphoid. Volar and dorsal approaches demonstrate equivalent clinical outcomes in scaphoid wrist fractures, but no study has evaluated the biomechanical strength for fractures of the proximal pole. This study compares biomechanical strength of antegrade and retrograde fixation for fractures of the proximal pole of the scaphoid. A simulated proximal pole scaphoid fracture was produced in 22 matched cadaveric scaphoids, which were then assigned randomly to either antegrade or retrograde fixation with a cannulated headless compression screw. Cyclic loading and load to failure testing were performed and screw length, number of cycles, and maximum load sustained were recorded. There were no significant differences in average screw length (25.5 mm vs 25.6 mm, P = .934), average number of cyclic loading cycles (3738 vs 3847, P = .552), average load to failure (348 N vs 371 N, P = .357), and number of catastrophic failures observed between the antegrade and retrograde fixation groups (3 in each). Practical equivalence between the 2 groups was calculated and the 2 groups were demonstrated to be practically equivalent (upper threshold P = .010). For this model of proximal pole scaphoid wrist fractures, antegrade and retrograde screw configuration have been proven to be equivalent in terms of biomechanical strength. With further clinical study, we hope surgeons will be able to make their decision for fixation technique based on approaches to bone grafting, concern for tenuous blood supply, and surgeon preference without fear of poor biomechanical properties.

  7. Fresh fractures of the scaphoid : A rationale method of treatment

    Directory of Open Access Journals (Sweden)

    Chari P

    2006-01-01

    Full Text Available Background : Scaphoid, among all carpal bones, is very vulnerable for fracture due to its unique shape and situation with greater articular surface. All scaphoid fractures are being treated with below elbow POP thumb spica casts keeping hand in ball throwing position. A few scaphoid fractures through the waist take longer time to unite, if not end in nonunion. These fractures were found to be displaced unimpacted trans-scaphoid fractures through the waist. Method : The effect of various positions of hand, wrist and forearm over unimpacted displaced scaphoid fractures through the waist were studied on dissected hand specimens and in patients with skiagrams. It was observed that possible radial deviation of hand over neutrally held wrist and forearm would result in anatomical reduction with impaction between the fragments. Added compression effect at site of fracture, necessary for early fracture healing, is produced by passively abducting the first metacarpal bone. Results : Of 68 scaphoid fractures under study, 24 and 41 were displaced and undisplaced ones through the waist respectively. All of them united in eight to ten weeks time as any fracture, when immobilised undisturbed with anatomic reduction and added compression between the fragments except one displaced fracture which took eight more weeks of immobilization for union and revascularilization of proximal fragment. Conclusion : This study showed that all scaphoid fractures in particular those through waist when rigidly immobilized unite as any fracture in eight to ten weeks provided the proximal fragment maintains proper blood supply. Otherwise it would further eight week of immobilization for the proximal fragment to get revascularize following union.

  8. [NITINOL shape memory staple for osteosynthesis of the scaphoid].

    Science.gov (United States)

    Winkel, Reiner; Schlageter, Michael

    2009-11-01

    Reconstruction of the scaphoid with use of NITINOL shape "memory" staples. Unstable fractures and nonunion of the middle third of the scaphoid, which need open reduction and internal fixation from palmar. The staples can only be used, if the arms of the staples can be inserted parallel to and at a distance of 3 mm to the fracture line. Allergy to nickel. Cases in which the arms of the staple cannot be inserted parallel to and at best 3 mm apart from the fracture line. In fractures, open reduction of the scaphoid through a palmar approach. If necessary, interposition of a bone graft and Kirschner wire transfixation. Drilling of the drill holes parallel and at a distance of 3 mm to the fracture line. Insertion of the NITINOL staple. In nonunion, excision of the fibrous nonunion, refreshening of the fracture surfaces, interposition of a bone graft and, if needed, fixation with a Kirschner wire. Drilling of the drill holes for the NITINOL staple and insertion of the staple. Within a few minutes the warming-up staple contracts and thereby compresses the scaphoid. Immobilization in a short cast with thumb support for 6 weeks. Control for bone healing by radiographs or computed tomography. Staples, which do not cause hardware problems, are not removed. Kirschner wires are removed after bone healing. From October 1995 to December 2006, the authors used NITINOL staples for 65 osteosyntheses of the scaphoid. Indications were 15 unstable fractures, 47 nonunions, and three partial necroses. 61 out of 65 scaphoids healed without further surgery, three of the 61 patients showed a delayed healing. Two of the four nonunions were related to the use of the NITINOL staples. Seven staples were removed, one for loosening. NITINOL shape memory staples have proven to be very helpful for osteosynthesis in fractures and nonunion of the scaphoid, if the prerequisites are given for their use.

  9. MANAGEMENT OF INFECTED NON UNION TIBIAL FRACTURES WITH ILIZAROV EXTERNAL FIXATION

    Directory of Open Access Journals (Sweden)

    Nageshwara Rao

    2015-10-01

    Full Text Available BACKGROUND & OBJECTIVES: Infected non - union of tibia per se is a challenge to treat. Subcutaneous bone causes susceptibility to compartment syndrome, non - responsive infection, non - union, fibrosis, sinuses, deformities, shortening and various other sets of problems which are assoc iated with it. Ilizarov External fixation provides correction of all the complications associated with non - union, bone gap, infection, shortening, and deformities. Objective of this study is to assess the efficacy and safety of Ilizarov fixator method of t reatment in infected non - union tibia and to study various complications associated with Ilizarov external fixation. MATERIALS AND METHODS: 23 patients admitted and treated in Government General Hospital under the Department of Orthopaedics during the perio d of May 2010 to December 2012 were included in the study. Results were evaluated according to ASAMI criteria . 1 RESULTS : 59% patients had excellent bony results, 27.3% had good bony results, 9.1% had fair bony results, 4.6% had poor bony results. 68.1% had excellent functional results, 9.1% had good functional results, 9.1% had fair functional results, 13.7% had poor functional results. CONCLUSION : Ilizarov external fixator system is the best device and best solution for infected non - union tibia management.

  10. Acute peg in hole docking in the management of infected non-union of long bones

    OpenAIRE

    Dhar, Shabir Ahmed; Mir, Mohammed Ramzan; Ahmed, Molvi Sajjad; Afzal, Suhail; Butt, Mohammed Farooq; Badoo, A. R.; Dar, Irshad Tabasum; Hussain, Anwar

    2007-01-01

    The Ilizarov method has been studied extensively in the management of non-union of long bones. In most cases this involves filling of defects present primarily or after débridement by bone transport. Acute docking over gaps longer than 2 cm has not been adequately studied, however. The purpose of this paper is to report the efficacy of acute peg in hole docking as a bone graft-sparing modality in the management of infected non-union of long bones.

  11. Acute peg in hole docking in the management of infected non-union of long bones.

    Science.gov (United States)

    Dhar, Shabir Ahmed; Mir, Mohammed Ramzan; Ahmed, Molvi Sajjad; Afzal, Suhail; Butt, Mohammed Farooq; Badoo, A R; Dar, Irshad Tabasum; Hussain, Anwar

    2008-08-01

    The Ilizarov method has been studied extensively in the management of non-union of long bones. In most cases this involves filling of defects present primarily or after débridement by bone transport. Acute docking over gaps longer than 2 cm has not been adequately studied, however. The purpose of this paper is to report the efficacy of acute peg in hole docking as a bone graft-sparing modality in the management of infected non-union of long bones.

  12. Using Molecular Genetic Markers to Resolve a Subspecies Boundary: The Northern Boundary of the Southwestern Willow Flycatcher in the Four-Corner States

    Science.gov (United States)

    Paxton, Eben H.; Sogge, Mark K.; Theimer, Tad C.; Girard, Jessica; Keim, Paul

    2008-01-01

    *Executive Summary* The northern boundary of the endangered Southwestern Willow Flycatcher (Empidonax traillii extimus) is currently approximated as running through southern Colorado and Utah, but the exact placement is uncertain because this subspecies shares a border with the more northern and non-endangered E. t. adastus. To help resolve this issue, we evaluated the geographic distribution of mitochondrial and nuclear DNA by sampling breeding sites across the four-corner states (Arizona, Colorado, New Mexico, and Utah). We found that breeding sites clustered into two major groups generally consistent with the currently designated boundary, with the exception of three sites situated along the current boundary. However, delineating a precise boundary that would separate the two subspecies is made difficult because (1) we found evidence for a region of intergradation along the boundary area, suggesting the boundary is not discreet, and (2) the boundary region is sparsely populated, with too few extant breeding populations to precisely locate a boundary. The boundary region encompasses an area where elevation changes markedly over relatively short distances, with low elevation deserts to the south and more mesic, higher elevation habitats to the north. We hypothesized that latitudinal and elevational differences and their concomitant ecological effects could form an ecological barrier that inhibited gene flow between the subspecies, forming the basis for the subspecies boundary. We modeled changes in geographic patterns of genetic markers as a function of latitude and elevation finding significant support for this relationship. The model was brought into a GIS environment to create multiple subspecies boundaries, with the strength of each predicted boundary evaluated on the basis of how much genetic variation it explained. The candidate boundary that accounted for the most genetic variation was situated generally near the currently recognized subspecies boundary

  13. Non-union of the trapezium: rare consequence of a rare injury

    Science.gov (United States)

    Samson, Deepak; Jones, Matthew; Mahon, Andrew

    2018-01-01

    Abstract Fractures of the trapezium are rare and easily missed. As these injuries are often imperceptible on plain radiographs, diagnosis in the ED setting is challenging. We report a case of an isolated fracture of the trapezium which was picked up as a non-union 5 months after the injury following persistence of symptoms. PMID:29765589

  14. Does Computed Tomography Change our Observation and Management of Fracture Non-Unions?

    Directory of Open Access Journals (Sweden)

    Ydo V. Kleinlugtenbelt

    2016-10-01

    In this study, the interobserver reliability of MDCT scan is not greater than conventional radiographs for determining non-union. However, a MDCT scan did lead to a more invasive approach in equivocal cases. Therefore a MDCT is only recommended for making treatment strategies in those cases.

  15. Non union of the neck of radius: a case report and review of the ...

    African Journals Online (AJOL)

    Fractures of the neck of radius are frequent in trauma. They happen without being noticed at the moment of injury of the elbow or in the context of polytrauma. A case of non union of the radius neck occurring in a young person due to ignorance, during first consultation has been reported by the authors. They insist on the ...

  16. Implant failure caused by non-union of bisphosphonate-associated subtrochanteric femur fracture.

    LENUS (Irish Health Repository)

    O'Neill, Barry James

    2014-04-03

    Bisphosphonate use has been identified as a contributory factor in atypical subtrochanteric fracture of the femur. These fractures are commonly treated with an intramedullary device. We present a case of implant failure of an intrameduallary device caused by non-union of an atypical subtrochanteric fracture.

  17. MR imaging of avascular scaphoid nonunion before and after vascularized bone grafting

    Energy Technology Data Exchange (ETDEWEB)

    Anderson, Suzanne E.; Tschering-Vogel, Dechen; Martin, Matthias [University Hospital of Bern, Inselspital, Department of Radiology, Bern (Switzerland); Steinbach, Lynne S. [University of California San Francisco, Department of Radiology, San Francisco, California (United States); Nagy, Ladislav [University Hospital of Bern, Inselspital, Department of Orthopedic Surgery, Bern (Switzerland)

    2005-06-01

    To investigate the magnetic resonance (MR) imaging appearances of chronic nonunion of the scaphoid with proximal pole avascular necrosis before and after insertion of a vascularized bone graft, using computed tomography (CT) as the imaging gold standard. A retrospective study was performed involving MR imaging (n=26), CT scans (n=37) and radiographs (n=52) of 13 men (mean age 29 years, age range 20-38 years) with avascular scaphoid nonunion. Avascular necrosis of the scaphoid proximal pole was confirmed intraoperatively (n=13). MR images were acquired preoperatively and following placement of a vascularized bone graft. Scaphoid MR signal characteristics were assessed for evidence of vascular bone graft incorporation and revascularization of the bone marrow of the proximal pole of the scaphoid and compared with the gold standard of CT. Surgical and clinical notes were reviewed with a minimum 3 year imaging and clinical follow-up in all patients. Graft incorporation with revascularization of the proximal pole of the scaphoid was documented in 9 patients (69%). Graft failure with persistent pseudoarthrosis and avascular necrosis of the scaphoid was seen in 4 patients (31%). MR imaging is useful to determine whether vascularized bone graft incorporation and revascularization of the proximal pole of the scaphoid has occurred in the setting of avascular scaphoid nonunion. (orig.)

  18. MR imaging of avascular scaphoid nonunion before and after vascularized bone grafting

    International Nuclear Information System (INIS)

    Anderson, Suzanne E.; Tschering-Vogel, Dechen; Martin, Matthias; Steinbach, Lynne S.; Nagy, Ladislav

    2005-01-01

    To investigate the magnetic resonance (MR) imaging appearances of chronic nonunion of the scaphoid with proximal pole avascular necrosis before and after insertion of a vascularized bone graft, using computed tomography (CT) as the imaging gold standard. A retrospective study was performed involving MR imaging (n=26), CT scans (n=37) and radiographs (n=52) of 13 men (mean age 29 years, age range 20-38 years) with avascular scaphoid nonunion. Avascular necrosis of the scaphoid proximal pole was confirmed intraoperatively (n=13). MR images were acquired preoperatively and following placement of a vascularized bone graft. Scaphoid MR signal characteristics were assessed for evidence of vascular bone graft incorporation and revascularization of the bone marrow of the proximal pole of the scaphoid and compared with the gold standard of CT. Surgical and clinical notes were reviewed with a minimum 3 year imaging and clinical follow-up in all patients. Graft incorporation with revascularization of the proximal pole of the scaphoid was documented in 9 patients (69%). Graft failure with persistent pseudoarthrosis and avascular necrosis of the scaphoid was seen in 4 patients (31%). MR imaging is useful to determine whether vascularized bone graft incorporation and revascularization of the proximal pole of the scaphoid has occurred in the setting of avascular scaphoid nonunion. (orig.)

  19. Fractures of the bilateral distal radius and scaphoid: a case report

    Directory of Open Access Journals (Sweden)

    Ozkan Korhan

    2008-03-01

    Full Text Available Abstract Introduction Bilateral fractures of the distal radius and scaphoid are extremely rare injuries. Case presentation A patient with bilateral comminuted, displaced distal fractures of the radius and bilateral fractures of the scaphoid was treated via internal fixation of the scaphoid fractures with Herbert screws and internal fixation of the distal radius fractures with locked volar plating. Conclusion Rigid internal fixation of distal radius and scaphoid fractures is mandatory to start early active rehabilitation of the wrist without the need for wrist immobilization with a plaster or external skeletal fixation.

  20. Intramedullary nailing for the treatment of aseptic femoral shaft non-unions after plating failure: effectiveness and timing.

    Science.gov (United States)

    Megas, Panagiotis; Syggelos, Spyros A; Kontakis, Georgios; Giannakopoulos, Andreas; Skouteris, Georgios; Lambiris, Elias; Panagiotopoulos, Elias

    2009-07-01

    This retrospective, multicentre study aimed to evaluate reamed intramedullary nailing (IMN) for the treatment of 30 cases of aseptic femoral shaft non-union after plating failure. Following nailing, 29 non-unions had healed by a mean 7.93 months. In one case a hypertrophic non-union required renailing after 8 months, using a nail of greater diameter, and united within five further months. Healing times were not related to whether the fracture was open or closed, the type non-union or the type of fracture. The delay from the initial plating to intramedullary nailing had a statistically significant effect on healing time and final outcome. This treatment is cost effective and should be implemented as soon as the non-union is diagnosed.

  1. Dynamic contrast-enhanced magnetic resonance imaging can assess vascularity within fracture non-unions and predicts good outcome

    Energy Technology Data Exchange (ETDEWEB)

    Schoierer, Oliver; Bender, Daniel; Schmidmaier, Gerhard [University Hospital Heidelberg, Heidelberg Trauma Research Group, Department of Orthopaedic and Trauma Surgery, Heidelberg (Germany); Bloess, Konstantin; Kauczor, Hans-Ulrich; Weber, Marc-Andre [University Hospital Heidelberg, Department of Diagnostic and Interventional Radiology, Heidelberg (Germany); Burkholder, Iris [University of Applied Sciences of the Saarland, Department of Nursing and Health, Saarbruecken (Germany)

    2014-02-15

    To prospectively evaluate whether dynamic contrast-enhanced (DCE) MRI can assess vascularity within non-unions and predicts clinical outcome in combination with the clinical Non-Union Scoring System (NUSS). Fifty-eight patients with non-unions of extremities on CT underwent 3-T DCE MRI. Signal intensity curves obtained from a region-of-interest analysis were subdivided into those with more intense contrast agent uptake within the non-union than in adjacent muscle (vascularised non-union) and those with similar or less contrast uptake. The pharmacokinetic parameters of the Tofts model K{sub trans}, K{sub ep}, iAUC and V{sub e} were correlated with union at CT 1 year later (n = 49). Despite inserted osteosynthetic material, DCE parameters could be evaluated in 57 fractures. The sensitivity/specificity of vascularised non-unions as an indicator of good outcome was 83.9 %/50.0 % compared to 96.8 %/33.3 % using NUSS (n = 49). Logistic regression revealed a significant impact of NUSS on outcome (P = 0.04, odds ratio = 0.93). At first examination, median iAUC (initial area under the enhancement curve) for the ratio non-union/muscle was 10.28 in patients with good outcome compared with 3.77 in non-responders (P = 0.023). K{sub trans}, K{sub ep} and V{sub e} within the non-union were not significantly different initially (n = 57) or 1 year later (n = 19). DCE MRI can assess vascularity in fracture non-unions. A vascularised non-union correlates with good outcome. (orig.)

  2. Dynamic contrast-enhanced magnetic resonance imaging can assess vascularity within fracture non-unions and predicts good outcome

    International Nuclear Information System (INIS)

    Schoierer, Oliver; Bender, Daniel; Schmidmaier, Gerhard; Bloess, Konstantin; Kauczor, Hans-Ulrich; Weber, Marc-Andre; Burkholder, Iris

    2014-01-01

    To prospectively evaluate whether dynamic contrast-enhanced (DCE) MRI can assess vascularity within non-unions and predicts clinical outcome in combination with the clinical Non-Union Scoring System (NUSS). Fifty-eight patients with non-unions of extremities on CT underwent 3-T DCE MRI. Signal intensity curves obtained from a region-of-interest analysis were subdivided into those with more intense contrast agent uptake within the non-union than in adjacent muscle (vascularised non-union) and those with similar or less contrast uptake. The pharmacokinetic parameters of the Tofts model K trans , K ep , iAUC and V e were correlated with union at CT 1 year later (n = 49). Despite inserted osteosynthetic material, DCE parameters could be evaluated in 57 fractures. The sensitivity/specificity of vascularised non-unions as an indicator of good outcome was 83.9 %/50.0 % compared to 96.8 %/33.3 % using NUSS (n = 49). Logistic regression revealed a significant impact of NUSS on outcome (P = 0.04, odds ratio = 0.93). At first examination, median iAUC (initial area under the enhancement curve) for the ratio non-union/muscle was 10.28 in patients with good outcome compared with 3.77 in non-responders (P = 0.023). K trans , K ep and V e within the non-union were not significantly different initially (n = 57) or 1 year later (n = 19). DCE MRI can assess vascularity in fracture non-unions. A vascularised non-union correlates with good outcome. (orig.)

  3. The role of MR imaging in scaphoid disorders

    International Nuclear Information System (INIS)

    Karantanas, Apostolos; Dailiana, Zoe; Malizos, Konstantinos

    2007-01-01

    The scaphoid bone of the wrist is one of the most commonly fractured bones in the body. Due to its importance in the biomechanics and functionality of the wrist, it is important to depict and characterize the type of injury. Plain radiographs and scintigraphy may fail to disclose the type and severity of the injury. In patients with normal initial plain radiographs, MR imaging can discriminate occult fractures from bone bruises and may also demonstrate ligamentous disruption. MR imaging can also discriminate the proximal pole viability versus avascular necrosis secondary to previous fracture, which is important for treatment planning. Treatment of non-united fractures with vascularized grafts can be evaluated with contrast-enhanced MR imaging. Idiopathic osteonecrosis or Preiser's disease was originally described after trauma. The non-traumatic disorders of the scaphoid include post-traumatic osteoarthritis, inflammatory bone marrow edema in patients with rheumatoid arthritis, and osteomyelitis. MR imaging is helpful in all the above disorders to demonstrate early bone marrow edema, cartilage degeneration and associated subchondral marrow changes. The most commonly found tumors in the scaphoid are usually benign and include enchondroma, osteoblastoma and osteoid osteoma. MR imaging is not mandatory for the initial diagnosis, which should be based on plain X-ray findings. (orig.)

  4. The role of MR imaging in scaphoid disorders

    Energy Technology Data Exchange (ETDEWEB)

    Karantanas, Apostolos [University of Crete, Department of Radiology, Medical School, Heraklion (Greece); University Hospital, Department of Radiology, Stavrakia, Heraklion (Greece); Dailiana, Zoe; Malizos, Konstantinos [University of Thessaly, Department of Orthopedic Surgery, School of Health Sciences, Larissa (Greece)

    2007-11-15

    The scaphoid bone of the wrist is one of the most commonly fractured bones in the body. Due to its importance in the biomechanics and functionality of the wrist, it is important to depict and characterize the type of injury. Plain radiographs and scintigraphy may fail to disclose the type and severity of the injury. In patients with normal initial plain radiographs, MR imaging can discriminate occult fractures from bone bruises and may also demonstrate ligamentous disruption. MR imaging can also discriminate the proximal pole viability versus avascular necrosis secondary to previous fracture, which is important for treatment planning. Treatment of non-united fractures with vascularized grafts can be evaluated with contrast-enhanced MR imaging. Idiopathic osteonecrosis or Preiser's disease was originally described after trauma. The non-traumatic disorders of the scaphoid include post-traumatic osteoarthritis, inflammatory bone marrow edema in patients with rheumatoid arthritis, and osteomyelitis. MR imaging is helpful in all the above disorders to demonstrate early bone marrow edema, cartilage degeneration and associated subchondral marrow changes. The most commonly found tumors in the scaphoid are usually benign and include enchondroma, osteoblastoma and osteoid osteoma. MR imaging is not mandatory for the initial diagnosis, which should be based on plain X-ray findings. (orig.)

  5. Comparison of CT and MRI for Diagnosis of Suspected Scaphoid Fractures

    NARCIS (Netherlands)

    Mallee, Wouter; Doornberg, Job N.; Ring, David; van Dijk, C. Niek; Maas, Mario; Goslings, J. Carel

    2011-01-01

    Background: There is no consensus on the optimum imaging method to use to confirm the diagnosis of true scaphoid fractures among patients with suspected scaphoid fractures. This study tested the null hypothesis that computed tomography (CT) and magnetic resonance imaging (MRI) have the same

  6. Training Improves Interobserver Reliability for the Diagnosis of Scaphoid Fracture Displacement

    NARCIS (Netherlands)

    Buijze, Geert A.; Guitton, Thierry G.; van Dijk, C. Niek; Ring, David; Osterman, A. Lee; Wahegaonkar, Abhijeet L.; Ladd, Amy; Barquet, Antonio; van Vugt, Arie B.; Shyam, Ashok K.; Swigart, Carrie; Coles, Chad P.; Zalavras, Charalampos; Goldfarb, Charles A.; Cassidy, Charles; Allan, Christopher; Beingessner, Daphne; Kalainov, David M.; Eygendaal, Denise; Sancheti, Parag; Feibel, Robert J.; Rocha, Steve; Grosso, Elena; Frihagen, Frede; Dyer, George S. M.; Athwal, George S.; Goslings, J. Carel; Della Rocca, Gregory J.; Harris, Ian; Fanuele, Jason C.; Lawton, Jeff; Jiuliano, John; McAuliffe, John; Capo, John T.; Conflitti, Joseph M.; Segalman, Keith; Egol, Kenneth; Ponsen, Kornelis J.; Jeray, Kyle; Lattanza, Lisa; Catalano, Louis; Swiontkowski, Marc; Boyer, Martin; Richardson, Martin; Soong, Maximillian; Baskies, Michael; Prayson, Michael; McKee, Michael; Chen, Neal C.; Kloen, Peter

    2012-01-01

    The diagnosis of displacement in scaphoid fractures is notorious for poor interobserver reliability. We tested whether training can improve interobserver reliability and sensitivity, specificity, and accuracy for the diagnosis of scaphoid fracture displacement on radiographs and CT scans. Sixty-four

  7. Modeling Staphylococcus epidermidis-Induced Non-Unions: Subclinical and Clinical Evidence in Rats.

    Directory of Open Access Journals (Sweden)

    Arianna Barbara Lovati

    Full Text Available S. epidermidis is one of the leading causes of orthopaedic infections associated with biofilm formation on implant devices. Open fractures are at risk of S. epidermidis transcutaneous contamination leading to higher non-union development compared to closed fractures. Although the role of infection in delaying fracture healing is well recognized, no in vivo models investigated the impact of subclinical low-grade infections on bone repair and non-union. We hypothesized that the non-union rate is directly related to the load of this commonly retrieved pathogen and that a low-grade contamination delays the fracture healing without clinically detectable infection. Rat femurs were osteotomized and stabilized with plates. Fractures were infected with a characterized clinical-derived methicillin-resistant S. epidermidis (10(3, 10(5, 10(8 colony forming units and compared to uninfected controls. After 56 days, bone healing and osteomyelitis were clinically assessed and further evaluated by micro-CT, microbiological and histological analyses. The biofilm formation was visualized by scanning electron microscopy. The control group showed no signs of infection and a complete bone healing. The 10(3 group displayed variable response to infection with a 67% of altered bone healing and positive bacterial cultures, despite no clinical signs of infection present. The 10(5 and 10(8 groups showed severe signs of osteomyelitis and a non-union rate of 83-100%, respectively. The cortical bone reaction related to the periosteal elevation in the control group and the metal scattering detected by micro-CT represented limitations of this study. Our model showed that an intra-operative low-grade S. epidermidis contamination might prevent the bone healing, even in the absence of infectious signs. Our findings also pointed out a dose-dependent effect between the S. epidermidis inoculum and non-union rate. This pilot study identifies a relevant preclinical model to assess the

  8. Primary total aseptic necrosis of the scaphoid bone. Report of three cases. Les osteonecroses aseptiques primitives totales du scaphoide. A propos de trois cas

    Energy Technology Data Exchange (ETDEWEB)

    Alnot, J Y; Frajman, J M; Bocquet, L [Hopital Bichat, 75 - Paris (FR)

    1990-11-01

    Idiopathic avascular necrosis of the entire scaphoid bone is uncommon. We report three cases treated by resection of the first row of carpal bones. Scintigraphy, CT-scan and magnetic resonance imaging are helpful for the diagnosis.

  9. Tomosynthesis: A new radiologic technique for rapid diagnosis of scaphoid fractures.

    Science.gov (United States)

    Compton, N; Murphy, L; Lyons, F; Jones, J; MacMahon, P; Cashman, J

    2016-12-21

    Scaphoid fractures constitute 71% of all carpal bone fractures. 1 Early diagnosis and treatment has significant bearing on fracture union rates and better clinical outcomes. While displaced fractures can be readily seen on plain radiograph, undisplaced fractures can require advanced imaging modalities to confirm that diagnosis. Advanced imaging such as Magnetic Resonance Imaging (MRI), Computerised tomography (CT) and bone scintigraphy are routinely used for the diagnosis of scaphoid fractures but require significant radiation exposure, increased cost and can be difficult to access. 2 Tomosynthesis is an emerging imaging modality which uses conventional x-ray systems to produce cross-sectional images. There has yet to be extensive research carried out investigating the diagnostic value of tomosynthesis in scaphoid fractures. The aim of this study is to optimise patient positioning for the diagnosis of scaphoid fractures in a cadaveric model and compare the diagnostic yield of tomography to conventional CT. Using four cadaveric specimens, three limb positions were examined in unfractured and fractured scaphoids to determine the optimal limb positions required for visualisation of the scaphoid. As a result of this study, the optimal position for visualisation of the scaphoid and diagnosis of scaphoid fractures has been determined. The results demonstrate that tomosynthesis is as effective as CT scanning in identifying scaphoid fractures in both sensitivity and specificity. By comparison to CT, tomosynthesis is cheaper, has lower radiation exposure, requires fewer hospital resources and can be performed quickly. Tomosynthesis is a valid diagnostic tool for the diagnosis of scaphoid fractures. Copyright © 2016 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  10. PROXIMAL FEMURAL VALGUS SUBTROCHANTERIC OSTEOTOMY FOR NON UNION OF TROCHANTERIC FRACTURES.

    Science.gov (United States)

    Silva, Paulo; Coelho, Danilo Lopes; Curi, Calim; de Oliveira, Leandro Alves; de Moraes, Frederico Barra; do Amaral, Rogério Andrade; Rebello, Percival Rosa

    2012-01-01

    To evaluate valgus subtrochanteric osteotomy for the treatment of trochanteric non-union. A retrospective study of cases series. From 1998 September to 2009 January, seventeen (17) cases with a diagnosis of non-union of trochanteric fracture were re-operated by the hip group of the Ortophaedic And Traumatology service of the Hospital Geral de Goiania (HGG). The patients presented pain at the fracture site, a femoral varus angle of less than 120°, and non-union of the fracture in the 3(rd) months after the initial surgery. Patients with ages ranging from 30 to 73 years, with a maximum follow-up of 09 years and minimum of 09 years. The mean time from first surgery to osteotomy was six months. Bone union was observed in 16 patients, with a mean union time of 12 weeks after surgery. The mean hip varus angle was 105(0) (120(0) to 90(0)). After surgery, the mean hip valgus angle was 144(0) (155(0) to 135(0)). We had one unsuccessful case; a 78-year old patient who had osteogtomy, fixed with DHS of 150(0), with valgization to 154(0). After six months of follow-up without union of the fracture, it was decided to perform total cemented hip artroplasthy, without complications. Valgus subtrochanteric osteotomies can be indicated for the treatment of trochanteric treatment of pseudoarthroses, with good final results for bone union, avoiding the need for total hip artroplasthy and maintaining biological fixation, as well as reestablishing the mechanical and anatomical axis of the affected limb.

  11. Sport related stress fracture of the clavicle with non-union: Case report and review

    Science.gov (United States)

    Constantinou, Demitri; Kastanos, Konstantinos

    2008-01-01

    Stress fractures are relatively uncommon sports injuries and when they do occur, are mostly found in the lower limb. Stress fractures of the clavicle are particularly rare, having been described in a number of non-sport related pathologies, such as nervous tics and post radical neck dissection. In sport, there have only been seven cases reported in the literature. We report on a clavicle stress fracture in a 47-year-old male, partaking in recreational weight lifting activities. This is the first reported case of a non-union stress fracture of the clavicle. The patient underwent an open reduction and internal fixation and made a full recovery. PMID:21264151

  12. Non-unions force wage cut-backs in pipeline industry

    Energy Technology Data Exchange (ETDEWEB)

    Bain, D

    1984-03-01

    Faced with another year of high unemployment and shrinking markets, Western Canada's unionized pipeline construction trades have taken a step toward stabilizing the industry. The unions have struck a bargain to combat an increasing number of non-union open shops. Management and labor cooperated to insure that the unions regain their share of the pipeline construction market. The pipeline construction boom has ended, with an overcapacity, a downturn in sales, and few major projects on the drawing boards. The bargains included wage reductions of 30%, daily living allowance reductions of nearly 50%, the elimination of double time, and the use of composite crews.

  13. Management of infected non-union tibia by intercalary bone transport

    International Nuclear Information System (INIS)

    Pirwani, M.A.; Siddiqui, A.; Soomro, Y.H.

    2008-01-01

    To evaluate the efficacy of ilizarov ring fixator in treating infected non-union tibia by intercalary bone transport. Sixteen patients, all males, aged 20-60 years (mean 32 years), with infected non-union tibia (Lax/Cierney Type IV Osteomyelitis); the commonest cause being open fracture and the commonest site being lower 1/3rd. In infected non-union of tibia with draining sinus, wound swab was sent for culture and sensitivity, and sinogram done. Debridement and sequestrectomy was done, leaving behind a gap ranging from 2-8 cms (mean 4.5 cms) and ilizarov ring fixator, a transport assembly, applied. A navigation wire was passed through medial malleolus, irrigation system set up and the wound closed in a single layer. Proximal metaphyseal corticotomy was done. Irrigation with 2-3 litres of normal saline with appropriate antibiotic was continued for five days. On the 5th day irrigation system was removed and the transport started. Patients remained on partial weight bearing till soft tissue healing occured. Transport took place over the navigation wire at the rate of 1mm/day till docking achieved. Full weight bearing was allowed after soft tissue healing; knee and ankle physiotherapy was started from day one. Navigation wire was removed after 2-3 weeks of docking. Follow up ranged from 12-27 months (mean 16 months). Union was achieved at the docking site in all the cases at the time of frame removal i.e. 8-13 months. The duration of union at docking site ranged from 3.5 months to 6 months (mean 4.5 months). Two patients needed bone graft at the docking site. The regenerate was broken in one case due to fall which was treated in cast. All the patients were satisfied except a 60 years old who had severe osteoarthritis of knee. Pin tract infection occurred on and off in all the patients; appropriate antibiotic was given. The infection subsided in all the cases except two in whom debridement was followed by application of a local flap. Intercalary bone transport by

  14. Novel Treatment of a Scapholunate Ligament Injury with Proximal Pole Scaphoid Nonunion

    Science.gov (United States)

    Gaspar, Michael P.; Kane, Patrick M.; Jacoby, Sidney M.; Culp, Randall W.

    2016-01-01

    Background  Nonunion of scaphoid proximal pole fractures presents a challenging management dilemma to hand surgeons. This problem is further complicated in the uncommon concurrence of scapholunate (SL) ligament disruption. Case Description  A 39-year-old male patient presented with new-onset wrist pain following a remote history of a proximal pole scaphoid fracture sustained as a teenager, which was treated nonoperatively. Six months before presentation, the patient sustained a fall while snowboarding. The patient was found to have a chronic nonunion of his scaphoid proximal pole with an associated SL ligament disruption. As the proximal fragment was too small to be amenable to fixation, the patient was treated with an arthroscopic partial scaphoid excision and SL ligament reconstruction using a scapholunateintercarpal screw placed percutaneously. At 26 months, the patient exhibited no pain, near-normal strength, and wrist motion, and expressed a high-level of satisfaction from his surgery. Literature Review  Although cases of SL ligament disruption with concomitant proximal scaphoid fractures have been reported, to our knowledge, this is the first report of SL ligament rupture occurring in the setting of a preexisting proximal pole scaphoid nonunion. Clinical Relevance  We report the use of SL ligament reconstruction augmented with intercarpal screw fixation, and excision of the proximal pole scaphoid nonunion. This minimallyinvasive approach may be a particularly useful option in young, active patients such as our own, where a motion-sacrificing salvage procedure would be less than ideal. PMID:27616829

  15. Perspectives and expectations of union member and non- union member teachers on teacher unions

    Directory of Open Access Journals (Sweden)

    Tuncer FİDAN

    2015-12-01

    Full Text Available Unions, which can be regarded as one of the constitutive elements of democracy, are the pressure groups in political and social fields. Unions were born out of industrial confrontations and expanded into the field of public services over time, and thus teachers – who are also public employees-, also obtained the right to establish and affiliate to unions. In this research the views of union member and non-union member teachers on the most important functions and operational effectiveness of unions, teachers’ expectations from unions and teachers’ evaluation of the solidarity, competition and cooperation between unions were determined and the perspectives of teachers on unionization were revealed. qualitative research design was used. The data needed were collected through semi-structured interviews from volunteering union member and non-union member teachers who were working in the primary and secondary schools in Ankara province and who were selected through “maximum variation sampling approach”. The data were then analyzed by using the content analysis technique. In conclusion, it was found that political ideology was the most important reason for membership of teachers’ unions. Protection and development of personal rights was found to be the most important function of teacher unions and unions were thought to be insufficient in performing those functions.

  16. [18F]FDG PET accurately differentiates infected and non-infected non-unions after fracture fixation

    International Nuclear Information System (INIS)

    Wenter, Vera; Albert, Nathalie L.; Brendel, Matthias; Fendler, Wolfgang P.; Bartenstein, Peter; Cyran, Clemens C.; Friederichs, Jan; Mueller, Jan-Philipp; Militz, Matthias; Hungerer, Sven; Hacker, Marcus

    2017-01-01

    Complete fracture healing is crucial for good patient outcomes. A major complication in the treatment of fractures is non-union. The pathogenesis of non-unions is not always clear, although implant-associated infections play a significant role, especially after surgical treatment of open fractures. We aimed to evaluate the value of [ 18 F]FDG PET in suspected infections of non-union fractures. We retrospectively evaluated 35 consecutive patients seen between 2000 and 2015 with suspected infection of non-union fractures, treated at a level I trauma center. The patients underwent either [ 18 F]FDG PET/CT (N = 24), [ 18 F]FDG PET (N = 11) plus additional CT (N = 8), or conventional X-ray (N = 3). Imaging findings were correlated with final diagnosis based on intraoperative culture or follow-up. In 13 of 35 patients (37 %), infection was proven by either positive intraoperative tissue culture (N = 12) or positive follow-up (N = 1). [ 18 F]FDG PET revealed 11 true-positive, 19 true-negative, three false-positive, and two false-negative results, indicating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 85 %, 86 %, 79 %, 90 %, and 86 %, respectively. The SUV max was 6.4 ± 2.7 in the clinically infected group and 3.0 ± 1.7 in the clinically non-infected group (p <0.01). The SUV ratio was 5.3 ± 3.3 in the clinically infected group and 2.6 ± 1.5 in the clinically non-infected group (p <0.01). [ 18 F]FDG PET differentiates infected from non-infected non-unions with high accuracy in patients with suspected infections of non-union fractures, for whom other clinical findings were inconclusive for a local infection. [ 18 F]FDG PET should be considered for therapeutic management of non-unions. (orig.)

  17. Vascularized bone graft in scaphoid fractures. Anatomical details and clinical indications. A cases series

    International Nuclear Information System (INIS)

    Vergara A, Enrique

    2007-01-01

    The fracture of scaphoid continues being a challenge for orthopedist and hand surgeons. Objective. To show the anatomical details of the bony strip from the second metacarpal in corpses injected with green latex and the results of the surgical technique in a series of patients with scaphoid pseudarthrosis. Materials and methods. We carry out an initial anatomical analysis before employing the surgical technique in clinical setting, and then we did a descriptive study of patients with pseudarthrosis of scaphoid,treated with vascularized bony graft by the first metacarpal artery. Results. All patients consolidated and improved in the pain scale, they did not have mobility deterioration or residual carpus instability, after ten years of observations. Conclusions. The vascularized graft is a useful option in the management of the pseudarthrosis of the scaphoid.

  18. Application of Local Vibrations in Delayed and Non-Union Fractures: a Case Study

    Science.gov (United States)

    Trombetta, Chiara; Abundo, Paolo; Foti, Calogero; Rosato, Nicola

    2011-02-01

    The aim of the study was to assess the efficacy of local vibration treatments (LV) in delayed-union and non-union fractures, through therapeutic exercise vibration (TEV) practice, analysing the radiological trend. The Medical Engineering Service of the Fondazione Policlinico Tor Vergata in collaboration with the Chair-Department of Rehabilitation Medicine of the University of Rome Tor Vergata and the Boscosystem company, is developing a device dedicated to LV application, to favour bone regeneration and muscle strengthening. This case report analyses the bone activity of a male patient presenting a right tibial fracture, treated with TEV. At the end of the TEV program, clinical results confirmed independent ambulation with disappearance of perimalleolar edema, while radiographic images revealed the presence of bone repair activity around the fracture line.

  19. Application of Local Vibrations in Delayed and Non-Union Fractures: a Case Study

    International Nuclear Information System (INIS)

    Trombetta, Chiara; Abundo, Paolo; Foti, Calogero; Rosato, Nicola

    2011-01-01

    The aim of the study was to assess the efficacy of local vibration treatments (LV) in delayed-union and non-union fractures, through therapeutic exercise vibration (TEV) practice, analysing the radiological trend. The Medical Engineering Service of the Fondazione Policlinico Tor Vergata in collaboration with the Chair-Department of Rehabilitation Medicine of the University of Rome Tor Vergata and the Boscosystem company, is developing a device dedicated to LV application, to favour bone regeneration and muscle strengthening. This case report analyses the bone activity of a male patient presenting a right tibial fracture, treated with TEV. At the end of the TEV program, clinical results confirmed independent ambulation with disappearance of perimalleolar edema, while radiographic images revealed the presence of bone repair activity around the fracture line.

  20. Scaphoid and lunate movement in different ranges of carpal radioulnar deviation.

    Science.gov (United States)

    Tang, Jin Bo; Xu, Jing; Xie, Ren Guo

    2011-01-01

    We aimed to investigate scaphoid and lunate movement in radial deviation and in slight and moderate ulnar deviation ranges in vivo. We obtained computed tomography scans of the right wrists from 20° radial deviation to 40° ulnar deviation in 20° increments in 6 volunteers. The 3-dimensional bony structures of the wrist, including the distal radius and ulna, were reconstructed with customized software. The changes in position of the scaphoid and lunate along flexion-extension motion (FEM), radioulnar deviation (RUD), and supination-pronation axes in 3 parts--radial deviation and slight and moderate ulnar deviation--of the carpal RUD were calculated and analyzed. During carpal RUD, scaphoid and lunate motion along 3 axes--FEM, RUD, and supination-pronation--were the greatest in the middle third of the measured RUD (from neutral position to 20° ulnar deviation) and the smallest in radial deviation. Scaphoid motion along the FEM, RUD, and supination-pronation axes in the middle third was about half that in the entire motion range. In the middle motion range, lunate movement along the FEM and RUD axes was also the greatest. During carpal RUD, the greatest scaphoid and lunate movement occurs in the middle of the arc--slight ulnar deviation--which the wrist frequently adopts to accomplish major hand actions. At radial deviation, scaphoid and lunate motion is the smallest. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  1. Deceptive appearance of normal variant of scaphoid bone in a teenage patient: a diagnostic challenge

    Directory of Open Access Journals (Sweden)

    Amjad N. Bhatti

    2012-02-01

    Full Text Available Scaphoid fractures are a common injury in late teens and mid twenties with a peak period in skeletally immature children at about 15 years of age, although considered to be rare in first decade of life, its exact incidence in early teen age remains to be a subject of debate. We report an unusual case of anatomical variation of scaphoid bone at the level of waist which could potentially cause diagnostic confusion. A 14-years-old boy presented in the fracture clinic 2 weeks after injury to his Right wrist which was managed in a scaphoid cast. X-ray examinations, both at the time of injury and later on in the fracture clinic revealed features suspicious of a fracture at the level of waist of the scaphoid bone, however the clinical examination did not correlate with imaging, in view of that radiological imaging of the unaffected side was performed for comparison, which revealed it to be an anatomical variant of scaphoid at this age. To our knowledge there are very few cases of such variation reported in literature in this age group of patients. This case highlights the importance of anatomical variants in scaphoid bone in this age group, which might pose a diagnostic challenge and the need for appropriate management plan and reassurance to avoid unnecessary anxiety.

  2. Classifications of Acute Scaphoid Fractures: A Systematic Literature Review.

    Science.gov (United States)

    Ten Berg, Paul W; Drijkoningen, Tessa; Strackee, Simon D; Buijze, Geert A

    2016-05-01

    Background In the lack of consensus, surgeon-based preference determines how acute scaphoid fractures are classified. There is a great variety of classification systems with considerable controversies. Purposes The purpose of this study was to provide an overview of the different classification systems, clarifying their subgroups and analyzing their popularity by comparing citation indexes. The intention was to improve data comparison between studies using heterogeneous fracture descriptions. Methods We performed a systematic review of the literature based on a search of medical literature from 1950 to 2015, and a manual search using the reference lists in relevant book chapters. Only original descriptions of classifications of acute scaphoid fractures in adults were included. Popularity was based on citation index as reported in the databases of Web of Science (WoS) and Google Scholar. Articles that were cited <10 times in WoS were excluded. Results Our literature search resulted in 308 potentially eligible descriptive reports of which 12 reports met the inclusion criteria. We distinguished 13 different (sub) classification systems based on (1) fracture location, (2) fracture plane orientation, and (3) fracture stability/displacement. Based on citations numbers, the Herbert classification was most popular, followed by the Russe and Mayo classifications. All classification systems were based on plain radiography. Conclusions Most classification systems were based on fracture location, displacement, or stability. Based on the controversy and limited reliability of current classification systems, suggested research areas for an updated classification include three-dimensional fracture pattern etiology and fracture fragment mobility assessed by dynamic imaging.

  3. Negligence claims following non-union and malunion of long bone fractures: An analysis of 15 years of data.

    Science.gov (United States)

    Metcalfe, C W; Harrison, W D; Nayagam, S; Narayan, B

    2016-10-01

    Non-unions and malunions are recognised to be complications of the treatment of long bone fractures. No previous work has looked at the implications of these complications from a medicolegal perspective. A complete database of litigation claims in Trauma and Orthopaedic Surgery was obtained from the NHS Litigation Authority. Two separate modalities of the treatment of long bone fractures were examined i) non-union and ii) acquired deformity. The type of complaint, whether defended or not, and costs were analysed. There were claims of which 97 related to non-union and 32 related to postoperative limb deformity. The total cost was £8.2 million over a 15-year period in England and Wales. Femoral and tibial non-unions were more expensive particularly if they resulted in amputation. Rotational deformity cost nearly twice as much as angulation deformities. The cosmetic appearances of rotational malalignment and amputation results in higher compensation; this reinforces an outward perception of outcome as being more important than harmful effects. Notwithstanding the limitations of this database, there are clinical lessons to be gained from these litigation claims. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  4. Role of MRI in the diagnosis and management of patients with clinical scaphoid fracture.

    Science.gov (United States)

    Tibrewal, Saket; Jayakumar, Prakash; Vaidya, Sujit; Ang, Swee Chai

    2012-01-01

    The American College of Radiologists (ACR) recognises the value of magnetic resonance imaging (MRI) as the investigation of choice in patients with a clinically suspected scaphoid fracture but normal plain radiographs. The Royal College of Radiologists (RCR) in the UK produces no similar guidelines, as evidenced by the inconsistent management of such cases in hospitals around the UK. In discussion with our musculoskeletal radiologists, we implemented new guidelines to standardise management of our patients and now report our findings. A consecutive series of 137 patients referred to the orthopaedic department with clinically suspected scaphoid fracture but normal series of plain radiographs were prospectively followed up over a two-year period. We implemented the use of early MRI for these patients and determined its incidence of detected scaphoid injury in addition to other occult injuries. We then prospectively examined results of these findings on patient management. Thirty-seven (27%) MRI examinations were normal with no evidence of a bony or soft-tissue injury. Soft-tissue injury was diagnosed in 59 patients (43.4%). Of those, 46 were triangular fibrocartilage complex (TFCC) tears (33.8%) and 18 were intercarpal ligament injuries (13.2 %). Bone marrow oedema with no distinct fracture was discovered in 55 cases (40.4%). In 17 (12.5%) cases, this involved only the scaphoid. In the remainder, it also involved the other carpal bones or distal radius. Fracture(s) were diagnosed on 30 examinations (22.0%). MRI should be regarded as the gold standard investigation for patients in whom a scaphoid fracture is suspected clinically. It allows the diagnosis of occult bony and soft-tissue injuries that can present clinically as a scaphoid fracture; it also helps exclude patients with no fracture. We believe that there is a need to implement national guidelines for managing occult scaphoid fractures.

  5. [{sup 18}F]FDG PET accurately differentiates infected and non-infected non-unions after fracture fixation

    Energy Technology Data Exchange (ETDEWEB)

    Wenter, Vera; Albert, Nathalie L.; Brendel, Matthias; Fendler, Wolfgang P.; Bartenstein, Peter [University of Munich, Department of Nuclear Medicine, Munich (Germany); Cyran, Clemens C. [University of Munich, Institute for Clinical Radiology, Munich (Germany); Friederichs, Jan; Mueller, Jan-Philipp; Militz, Matthias; Hungerer, Sven [BG Trauma Center Murnau, Department of Reconstructive Arthroplasty, Murnau (Germany); PMU Salzburg, Paracelsus Medical University, Salzburg (Austria); Hacker, Marcus [University of Vienna, Division of Nuclear Medicine, Department of Biomedical Imaging and Image-guided Therapy, Vienna (Austria)

    2017-03-15

    Complete fracture healing is crucial for good patient outcomes. A major complication in the treatment of fractures is non-union. The pathogenesis of non-unions is not always clear, although implant-associated infections play a significant role, especially after surgical treatment of open fractures. We aimed to evaluate the value of [{sup 18}F]FDG PET in suspected infections of non-union fractures. We retrospectively evaluated 35 consecutive patients seen between 2000 and 2015 with suspected infection of non-union fractures, treated at a level I trauma center. The patients underwent either [{sup 18}F]FDG PET/CT (N = 24), [{sup 18}F]FDG PET (N = 11) plus additional CT (N = 8), or conventional X-ray (N = 3). Imaging findings were correlated with final diagnosis based on intraoperative culture or follow-up. In 13 of 35 patients (37 %), infection was proven by either positive intraoperative tissue culture (N = 12) or positive follow-up (N = 1). [{sup 18}F]FDG PET revealed 11 true-positive, 19 true-negative, three false-positive, and two false-negative results, indicating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 85 %, 86 %, 79 %, 90 %, and 86 %, respectively. The SUV{sub max} was 6.4 ± 2.7 in the clinically infected group and 3.0 ± 1.7 in the clinically non-infected group (p <0.01). The SUV{sub ratio} was 5.3 ± 3.3 in the clinically infected group and 2.6 ± 1.5 in the clinically non-infected group (p <0.01). [{sup 18}F]FDG PET differentiates infected from non-infected non-unions with high accuracy in patients with suspected infections of non-union fractures, for whom other clinical findings were inconclusive for a local infection. [{sup 18}F]FDG PET should be considered for therapeutic management of non-unions. (orig.)

  6. Recurrent hydatosis at the site of non-union humerus fracture

    Directory of Open Access Journals (Sweden)

    Mohsen Nourbakhsh

    2012-01-01

    Full Text Available Hydatid disease is still endemic in several regions of the world and is caused by two species of tapeworms, Echinococcus granulosus and Echinococcus alveolaris. It primary involves liver and lung, and bone involvement is relatively rare (0.2-4%, where it is most commonly seen in the spine. The skeletal involvement is usually due to secondary extension such as hematogenous spread. The disease has usually a silent manifestation until a complication exists; so, many cases are diagnosed intraoperatively. Treatment of hydatid disease because of its bone involvement and spillage of fluid with subsequent contamination seeding is difficult, so it has a high mortality rate and many cases will recur. Therefore, we can prevent these occurrences if we treat hydatid disease completely and in the primary stage. Adjuvant medical treatment, if the diagnosis is known, prevents systemic spread and recurrence. Here, we present a primary recurrent hydatosis at the site of non-union humerus fracture. We have pointed out osseous hydatosis as one of the important differential diagnoses in destructive bone lesions and the necessity of its radical resection.

  7. Proximal Pole Scaphoid Nonunion Reconstruction With 1,2 Intercompartmental Supraretinacular Artery Vascularized Graft and Compression Screw Fixation.

    Science.gov (United States)

    Morris, Mark S; Zhu, Andy F; Ozer, Kagan; Lawton, Jeffrey N

    2018-02-06

    To review the incidence of union of patients with proximal pole scaphoid fracture nonunions treated using a 1,2 intercompartmental supraretinacular artery (1,2 ICSRA) vascularized graft and a small compression screw. This is a retrospective case series of 12 patients. Calculations of the size of the proximal pole fragment relative to the total scaphoid were performed using posteroanterior view scaphoid radiographs with the wrist in ulnar deviation and flat on the cassette. Analyses were repeated 3 times per subject, and the average ratio of proximal pole fragment relative to the entire scaphoid was calculated. We reviewed medical records, radiographs, and computed tomography (CT) scans of these 12 patients. The CT scans that were performed after an average of 12 weeks were ultimately used to confirm union of the scaphoid fractures. One patient was unable to have a CT so was excluded from the final calculation. All 11 (100%) scaphoid fractures that were assessed by CT were found to be healed at the 12-week assessment point. The mean proximal pole fragment size was 18% (range, 7%-27%) of the entire scaphoid. The 1,2 ICSRA vascularized graft and compression screw was an effective treatment for patients with proximal pole scaphoid fractures. Therapeutic IV. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  8. Intraosseous rotation of the scaphoid: assessment by using a 3D CT model - an anatomic study

    Energy Technology Data Exchange (ETDEWEB)

    Schmidle, Gernot; Gabl, Markus [Medical University Innsbruck, Department of Trauma Surgery, Innsbruck (Austria); Rieger, Michael [Regional Hospital Hall, Department of Radiology, Hall in Tirol (Austria); Klauser, Andrea Sabine; Thauerer, Michael [Medical University Innsbruck, Department of Radiology, Innsbruck (Austria); Hoermann, Romed [Medical University Innsbruck, Department of Anatomy, Histology and Embryology-Division of Clinical and Functional Anatomy, Innsbruck (Austria)

    2014-06-15

    The purpose of this study was to assess intraosseous rotation as the third dimension of scaphoid anatomy on a 3D CT model using common volume rendering software to impact anatomical reconstruction of scaphoid fractures. CT images of 13 cadaver wrist pairs were acquired. Reference axes for the alignment of distal and proximal scaphoid poles were defined three-dimensionally. Two methods for rotation measurement - the reference axis method (RAM) and the scapho-trapezio-trapezoidal joint method (STTM) - were developed and compared by three independent observers. Rotation measured by the RAM averaged 66.9 ± 7 for the right and 67.2 ± 5.8 for the left wrists. Using the STTM there was a mean rotation of 68.6 ± 6.6 for the right and 68.6 ± 6.8 for the left wrists. The overall results showed a significant variability of the measured values between different specimens (P < 0.05). There was no significant difference between left and right wrists of the same specimen, neither for the RAM (P = 0.268) nor for the STTM (P = 0.774). Repeatability coefficients between the observers were low, indicating good repeatability. The presented methods are practical tools to quantify intraosseous rotation between distal and proximal scaphoid poles using common volume rendering software. For clinical application the opposite side provides the best reference values to assess malrotation in scaphoid fracture cases. (orig.)

  9. Three-Dimensional Assessment of Bilateral Symmetry of the Scaphoid: An Anatomic Study

    Directory of Open Access Journals (Sweden)

    Paul W. L. ten Berg

    2015-01-01

    Full Text Available Preoperative 3D CT imaging techniques provide displacement analysis of the distal scaphoid fragment in 3D space, using the matched opposite scaphoid as reference. Its accuracy depends on the presence of anatomical bilateral symmetry, which has not been investigated yet using similar techniques. Our purpose was to investigate symmetry by comparing the relative positions of distal and proximal poles between sides. We used bilateral CT scans of 19 adult healthy volunteers to obtain 3D scaphoid models. Left proximal and distal poles were matched to corresponding mirrored right sides. The left-to-right positional differences between poles were quantified in terms of three translational and three rotational parameters. The mean (SD of ulnar, dorsal, and distal translational differences of distal poles relative to proximal poles was 0.1 (0.6; 0.4 (1.2; 0.2 (0.6 mm and that of palmar rotation, ulnar deviation, and pronation differences was −1.1 (4.9; −1.5 (3.3; 1.0 (3.7°, respectively. These differences did not significantly differ from zero and thus were not biased to left or right side. We proved that, on average, the articular surfaces of scaphoid poles were symmetrically aligned in 3D space. This suggests that the contralateral scaphoid can serve as reference in corrective surgery. No level of evidence is available.

  10. An alternative graft fixation technique for scaphoid nonunions treated with vascular bone grafting.

    Science.gov (United States)

    Korompilias, Anastasios V; Lykissas, Marios G; Kostas-Agnantis, Ioannis P; Gkiatas, Ioannis; Beris, Alexandros E

    2014-07-01

    To present our experience with vascularized bone grafting based on the 1,2-intercompartmental supraretinacular artery for the management of established scaphoid nonunion and to investigate the efficacy of graft immobilization with a combination of Kirschner wires and transarticular external fixation. A retrospective chart and radiographic review was conducted for patients with the diagnosis of scaphoid nonunion of the proximal pole or the waist treated with the 1,2-intercompartmental supraretinacular artery-based vascularized graft and fixed with a combination of Kirschner wires and transarticular external fixation between 2007 and 2011. We observed 23 consecutive patients for a mean of 34 ± 4 months. All patients were males with mean age of 25 ± 5 years. All patients had scaphoid nonunion and associated humpback deformity. The mean duration of nonunion was 7 ± 1 months. All scaphoid nonunions united after the index procedure at a mean of 10 ± 1 weeks. Two patients had avascular necrosis of the proximal pole based on the preoperative magnetic resonance imaging findings. After surgery, deformity correction was achieved in all patients, as recorded by the decrease in the lateral intrascaphoid angle and the increase in the dorsal scaphoid angle. At the last follow-up, no patients reported wrist pain. The mean Disabilities of the Arm, Shoulder, and Hand score improved significantly from 32 ± 12 before the operation to 5 ± 3 at the last postoperative visit. All patients showed statistically significant improvement in the range of motion and the grip strength of the involved wrist. The results of this study support the combined use of Kirschner wires and transarticular external fixation for fixation of a 1,2-intercompartmental supraretinacular artery-based vascular bone graft in the treatment of scaphoid nonunions. Therapeutic IV. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  11. Shape change in the atlas with congenital midline non-union of its posterior arch: a morphometric geometric study.

    Science.gov (United States)

    Ríos, Luis; Palancar, Carlos; Pastor, Francisco; Llidó, Susana; Sanchís-Gimeno, Juan Alberto; Bastir, Markus

    2017-10-01

    The congenital midline non-union of the posterior arch of the atlas is a developmental variant present at a frequency ranging from 0.7% to 3.9%. Most of the reported cases correspond to incidental findings during routine medical examination. In cases of posterior non-union, hypertrophy of the anterior arch and cortical bone thickening of the posterior arches have been observed and interpreted as adaptive responses of the atlas to increased mechanical stress. We sought to determine if the congenital non-union of the posterior arch results in a change in the shape of the atlas. This study is an analysis of the first cervical vertebrae from osteological collections through morphometric geometric techniques. A total of 21 vertebrae were scanned with a high-resolution three-dimensional scanner (Artec Space Spider, Artec Group, Luxembourg). To capture vertebral shape, 19 landmarks and 100 semilandmarks were placed on the vertebrae. Procrustes superimposition was applied to obtain size and shape data (MorphoJ 1.02; Klingenberg, 2011), which were analyzed through principal component analysis (PCA) and mean shape comparisons. The PCA resulted in two components explaining 22.32% and 18.8% of the total shape variance. The graphic plotting of both components indicates a clear shape difference between the control atlas and the atlas with posterior non-union. This observation was supported by statistically significant differences in mean shape comparisons between both types of vertebra (patlas is associated with significant changes in the shape of the vertebra. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Outcome Analysis following Operative Skeletal Stabilization in Established Non Unions of Malleolar Fractures ? A Series of 11 Cases

    OpenAIRE

    Balasubramanian, Navin; Babu, Ganesh; Prakasam, Sindhuja

    2015-01-01

    Introduction: Established non-unions pose a real nightmare for even the most accomplished surgeon. The variations in anatomy due to extensive fibrous tissue growth, soft tissue contractures around the fracture site and bony alterations like smoothening and sclerosis of the fracture ends must each be addressed as a whole if good outcome is to be expected. Case series: Here we present a series of 11 patients who had bimalleolar fracture of the ankle following which they had native splinting. Th...

  13. Congenital scaphoid megalourethra associated with posterior urethral valve: A case report

    Directory of Open Access Journals (Sweden)

    Apoorva Achyut Kulkarni

    2018-01-01

    Full Text Available Congenital scaphoid megalourethra is a very rare congenital anomaly of the anterior urethra in males. Here, a case of scaphoid megalourethra and posterior urethral valves is presented. A one and half year old male child came to us with complaints of ballooning at the tip of penis since birth. Micturating cystourethrogram showed a dilated glanular urethra. The patient underwent a Nesbitt’s longitudinal reduction urethroplasty with a single-staged, single layered repair. Post-operatively, the child passed a healthy stream of urine without straining

  14. Non-vascularized iliac bone grafting for scaphoid nonunion with avascular necrosis.

    Science.gov (United States)

    Kim, Jihyeung; Park, Jin Woo; Chung, Jeehyeok; Jeong Bae, Kee; Gong, Hyun Sik; Baek, Goo Hyun

    2018-01-01

    We present the surgical outcomes of non-vascularized bone grafting taken from the iliac crest in 24 patients with scaphoid nonunion and avascular necrosis. The Fisk-Fernandez technique was used in 11 patients, and cancellous bone grafting was used in 13 patients. Bony union was achieved in 22 of the 24 patients. Non-vascularized iliac bone grafting can be used for the surgical management of scaphoid nonunion with avascular necrosis. Although revascularization of the proximal fragment after surgery was not evaluated, bony union was confirmed in nearly all patients. IV.

  15. Scaphoid Stress Fracture in High-Level Gymnast: A Case Report

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    J. C. Nakamoto

    2011-01-01

    Full Text Available We present the case of an 18-year-old high-level gymnast who sustained a stress fracture of the scaphoid associated with a distal radial epiphysiolysis. Clinical evaluation demonstrated decreased range of motion of the affected wrist and insidious pain on the snuffbox and tenderness on the distal radial physis. He was submitted to surgical treatment with scaphoid percutaneous fixation and radial styloid process in situ fixation. Clinical features improved, and he got back to competition 6 months after surgery without symptoms and with complete range of motion.

  16. Isolated scaphotrapeziotrapezoid osteoarthritis treatment using resurfacing arthroplasty with scaphoid anchorage.

    Science.gov (United States)

    Humada Álvarez, G; Simón Pérez, C; García Medrano, B; Faour Martín, O; Marcos Rodríguez, J J; Vega Castrillo, A; Martín Ferrero, M A

    The aim of this study is to show the results of scaphotrapeziotrapezoid (STT) joint osteoarthritis treatment performing resurfacing arthroplasty with scaphoid anchorage. An observational, descriptive and retrospective study was performed. Ten patients with isolated STT joint osteoarthritis were studied between 2013 and 2015. The mean follow-up time was 26months. Clinical results, functional and subjective scores were reviewed. The patients were satisfied, achieving an average of 2.1 (0-3) on the VAS score and 16 (2 to 28) in the DASH questionnaire, and returning to work in the first three months post-surgery. Recovery of range of motion compared to the contralateral wrist was 96% in extension, 95% in flexion, 87% in ulnar deviation and 91% in radial deviation. The average handgrip strength of the wrist was 95% and pinch strength was 95% compared to the contralateral side. There were no intraoperative complications or alterations in postoperative carpal alignment. Resurfacing arthroplasty is proposed as a good and novel alternative in treating isolated SST joint arthritis. Achieving the correct balance between the strength and mobility of the wrist, without causing carpal destabilisation, is important to obtain satisfactory clinical and functional results. Copyright © 2017. Publicado por Elsevier España, S.L.U.

  17. A Scaphoid Stress Fracture in a Female Collegiate-Level Shot-Putter and Review of the Literature

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    Jessica M. Kohring

    2016-01-01

    Full Text Available Scaphoid stress fractures are rare injuries that have been described in young, high-level athletes who exhibit repetitive loading with the wrist in extension. We present a case of an occult scaphoid stress fracture in a 22-year-old female Division I collegiate shot-putter. She was successfully treated with immobilization in a thumb spica splint for 6 weeks. Loaded wrist extension activities can predispose certain high-level athletes to sustain scaphoid stress fractures, and a high index of suspicion in this patient population may aid prompt diagnosis and management of this rare injury.

  18. Using computed tomography to assist with diagnosis of avascular necrosis complicating chronic scaphoid nonunion.

    Science.gov (United States)

    Smith, Michael L; Bain, Gregory I; Chabrel, Nick; Turner, Perry; Carter, Chris; Field, John

    2009-01-01

    The primary aim of our study was to investigate use of long axis computed tomography (CT) in predicting avascular necrosis of the proximal pole of the scaphoid and subsequent fracture nonunion after internal fixation. In addition, we describe a new technique of measuring the position of a scaphoid fracture and provide data on its reproducibility. Thirty-one patients operated on by the senior author for delayed union or nonunion of scaphoid fracture were included. Preoperative CT scans were independently assessed for increased radiodensity of the proximal pole, converging trabeculae, degree of deformity, comminution, and fracture position. Intraoperative biopsies of the proximal pole were obtained and histologically assessed for evidence of avascular necrosis. The radiologic variables were statistically compared with the histologic findings. The presence of avascular necrosis was also compared with postoperative union status, identified on longitudinal CT scans. Preoperative CT features that statistically correlated with histologic evidence of avascular necrosis were increased radiodensity of the proximal pole and the absence of any converging trabeculae between the fracture fragments. The radiologic changes of avascular necrosis and the histologic confirmation of avascular necrosis were associated with persistent nonunion. Preoperative longitudinal CT of scaphoid nonunion is of great value in identifying avascular necrosis and predicting subsequent fracture union. If avascular necrosis is suspected based on preoperative CT, management options include vascularized bone grafts and bone morphogenic protein for younger patients and limited wrist arthrodesis for older patients. Diagnostic II.

  19. Factors associated with union time of acute middle-third scaphoid fractures: an observational study

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    Zhao H

    2018-06-01

    Full Text Available Hongfang Zhao,* Siyu Tian,* Lingde Kong,* Jiangbo Bai,* Jian Lu, Bing Zhang, Dehu Tian Department of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, People’s Republic of China *These authors contributed equally to this work Background: The aim of this study was to investigate the union time of acute middle-third scaphoid fractures following treatments and to analyze the effect of different factors on late union.Patients and methods: We retrospectively reviewed patients with acute middle-third scaphoid fracture at our institution between January 2013 and December 2017. Patient demographics, fracture characteristics, and treatment strategy, such as age, gender, body mass index, habit of smoking, sides of injury, dominant hand, ulnar variance, multiple fractures, and treatment methods, were investigated. Univariate and multivariate analyses were used to identify possible predictive factors.Results: A total of 132 patients with scaphoid fracture were included in our study. Operation was performed in 67 patients (50.8%, and conservative treatment was performed in the other 65 patients (49.2%. The union time was 7.2±0.5 weeks. In the multivariate logistic regression analysis, late diagnosis (odds ratio, 1.247; 95% CI, 1.022–1.521 and conservative treatment method (odds ratio, 1.615; 95% CI, 1.031–2.528 were identified as 2 independent predictors of late union in scaphoid fractures patients. Other parameters were not demonstrated to be predictive factors.Conclusion: Late diagnosis and conservative treatment were two factors associated with late union. Long time of follow-up is necessary for patient with these factors. Keywords: predictive factors, union time, nonunion, scaphoid fractures, multivariable analysis

  20. Introducing a Clinical Practice Guideline Using Early CT in the Diagnosis of Scaphoid and Other Fractures

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    Pincus, Steven

    2009-11-01

    Full Text Available Objective: We developed and implemented clinical practice guideline (CPG using computerized tomography (CT as the initial imaging method in the emergency department management of scaphoid fractures. We hypothesized that this CPG would decrease unnecessary immobilization and lead to earlier return to work.Methods: This observational study evaluated implementation of our CPG, which incorporated early wrist CT in patients with “clinical scaphoid fracture”: a mechanism of injury consistent with scaphoid fracture, anatomical snuff box tenderness, and normal initial plain x-rays. Outcome measures were the final diagnosis as determined by orthopaedic review of the clinical and imaging data. Patient outcomes included time to return to work and patient satisfaction as determined by telephone interview at ten days.Results: Eighty patients completed the study protocol in a regional emergency department.In this patient population CT detected 28 fractures in 25 patients, including six scaphoid fractures, five triquetral fractures, four radius fractures, and 13 other related fractures. Fifty-three patients had normal CT. Eight of these patients had significant ongoing pain at follow up and had an MRI, with only two bone bruises identified. The patients with normal CTs avoided prolonged immobilization (mean time in plaster 2.7 days and had no or minimal time off work (mean 1.6 days. Patient satisfaction was an average 4.2/5.Conclusion: This CPG resulted in rapid and accurate management of patients with suspected occult scaphoid injury, minimized unnecessary immobilization and was acceptable to patients.[WestJEM. 2009;10(4:227-232.

  1. Training improves interobserver reliability for the diagnosis of scaphoid fracture displacement.

    Science.gov (United States)

    Buijze, Geert A; Guitton, Thierry G; van Dijk, C Niek; Ring, David

    2012-07-01

    The diagnosis of displacement in scaphoid fractures is notorious for poor interobserver reliability. We tested whether training can improve interobserver reliability and sensitivity, specificity, and accuracy for the diagnosis of scaphoid fracture displacement on radiographs and CT scans. Sixty-four orthopaedic surgeons rated a set of radiographs and CT scans of 10 displaced and 10 nondisplaced scaphoid fractures for the presence of displacement, using a web-based rating application. Before rating, observers were randomized to a training group (34 observers) and a nontraining group (30 observers). The training group received an online training module before the rating session, and the nontraining group did not. Interobserver reliability for training and nontraining was assessed by Siegel's multirater kappa and the Z-test was used to test for significance. There was a small, but significant difference in the interobserver reliability for displacement ratings in favor of the training group compared with the nontraining group. Ratings of radiographs and CT scans combined resulted in moderate agreement for both groups. The average sensitivity, specificity, and accuracy of diagnosing displacement of scaphoid fractures were, respectively, 83%, 85%, and 84% for the nontraining group and 87%, 86%, and 87% for the training group. Assuming a 5% prevalence of fracture displacement, the positive predictive value was 0.23 in the nontraining group and 0.25 in the training group. The negative predictive value was 0.99 in both groups. Our results suggest training can improve interobserver reliability and sensitivity, specificity and accuracy for the diagnosis of scaphoid fracture displacement, but the improvements are slight. These findings are encouraging for future research regarding interobserver variation and how to reduce it further.

  2. Effects of third fragment size and displacement on non-union of femoral shaft fractures after locking for intramedullary nailing.

    Science.gov (United States)

    Lee, J R; Kim, H-J; Lee, K-B

    2016-04-01

    The femoral shaft fractures with large fragments makes anatomical reduction challenging and often results in non-union. In some studies, the degree of fragment displacement was reported to have affected non-union, but the association between the one fragment size and degree of displacement has not been fully clarified. Therefore we performed a retrospective study to assess: (1) the more influential factor of non-union: the degree of fragment displacement, or the fragment size? (2) the non-union rates according to different sizes and degrees of displacement. The degree of displacement is the more potent factor of non-union than the third fragment size in femoral shaft fractures. We assessed retrospectively 64 cases, which could be followed up for longer than one year. Fragments were divided according to the length of their long axis into three groups: group A (0-3.9cm), (n=21); group B (4-7.9cm), (n=22); group C (8cm or more), (n=21). Fragment displacement was also assessed in the proximal (P) or distal (D) end to the nearest cortex of the femoral shaft, and divided into the following groups: group P1 (n=44) or D1 (n=47), (0-9mm); group P2 (n=10) or D2 (n=11), (10-19mm); group P3 (n=7) or D3 (n=3), (20-29mm); and group P4 (n=3) or D4 (n=3), (30mm or more). The bone union rate was 86% in the small (less than 8cm) fragment groups and 71% in the large (8cm or more) fragment group (P=0.046). With respect to the degree of displacement, the union rate was lower (P=0.001) and the average union time was longer (P=0.012) in the 20mm or more group for both the proximal fragment part and the distal fragment part (P=0.002, P=0.014). A logistic regression analysis underlined the displacement in the proximal site (OR: 0.298, 95% CI: 0.118-0.750) as in the distal site (OR: 0.359, 95% CI: 0.162-0.793) as a larger effect on union rate than the fragment size that as no effect in logistic regression (OR 3.8, 95% CI: 0.669-21.6). Non-union develops significantly more frequently in

  3. Utilising magnetic resonance imaging as the gold-standard in management of suspected scaphoid fractures in the emergency department setting

    LENUS (Irish Health Repository)

    Ramasubbu, B

    2017-02-01

    Scaphoid fractures are the most common carpal bone fracture. Up to 40% of scaphoid fractures can be missed at initial presentation and investigation. Follow-up plain film radiograph has overall poor sensitivity and reliability. MRI has been shown to have an almost 100% sensitivity and specificity and so is the gold standard in scaphoid fracture diagnosis. Additionally, early specialist involvement is recommended. We proposed that following a designated pathway, there would be no significant increase in MRI requests. Following implementation of a pathway for the management of suspected scaphoid fractures in St James’s Hospital in 2012 re-auditing demonstrated that management changed to either MRI directly after initial x-ray (16\\/145, 11%), MRI after second x-ray (9\\/28, 32%) or orthopaedic follow-up (19\\/28, 68%). The number of MRIs requested was consistent with our predictors of demand. Thus, our new protocol maximises diagnostics, cost effectiveness and quality of patient care.

  4. Outcome Analysis following Operative Skeletal Stabilization in Established Non Unions of Malleolar Fractures - A Series of 11 Cases.

    Science.gov (United States)

    Balasubramanian, Navin; Babu, Ganesh; Prakasam, Sindhuja

    2015-01-01

    Established non-unions pose a real nightmare for even the most accomplished surgeon. The variations in anatomy due to extensive fibrous tissue growth, soft tissue contractures around the fracture site and bony alterations like smoothening and sclerosis of the fracture ends must each be addressed as a whole if good outcome is to be expected. Here we present a series of 11 patients who had bimalleolar fracture of the ankle following which they had native splinting. These patients presented to us with established non-union. There were 7 males and 4 females in the study. The average age was 44.63 years. Ten out of the 11 patients went on to union (90.1%) following internal fixation with or without immobilization in a plaster cast at an average of 13.8 weeks (range 12-17 weeks). The remaining patient did not progress to union and was advised revision fixation but she refused. She was put on an ankle foot orthoses and mobilized with satisfactory results. There was no infection in any of the patients. Two patients had delayed wound healing with delayed suture removal at 18 days. Weight bearing was started at the end of 16 weeks in all the patients. All patients were assessed using the Karlsson and Peterson functional score for the ankle. Six patients had excellent outcome, 3 had good outcome, 2 had fair with one patient having poor functional result. We conclude that open reduction internal fixation +/- bone grafting provides excellent union rates and good functional results in even the most established non unions of bimalleolar fractures of the ankle.

  5. Reduced rates of non-union with modified periacetabular osteotomy using peracetic-acid sterilized cancellous allografts.

    Science.gov (United States)

    Wassilew, Georgi I; Janz, Viktor; Renner, Lisa; Perka, Carsten; Pruss, Axel

    2016-12-01

    The objective of the present study was to analyze the clinical and radiological results of periacetabular osteotomies (PAO) using Kirschner wire fixation and an allogeneic cancellous bone graft. This retrospective cohort study included 73 patients (85 PAOs). The allografts were processed from distal femur of cadaveric donors, defatted, sterilized with a peracetic-acid ethanol solution and freeze-dried. The clinical outcome, as measured by the Harris Hip Scores (HHS), the complication rate and the acetabular correction, as measured by radiological parameters, were compared. The postoperative femoral head coverage and HSS were significantly improved. Major complications occurred in five cases (6 %), but in no case did we observe a non-union or a graft-associated adverse effect. Fixation of the acetabular fragment with Kirschner wires in combination with an allogeneic cancellous bone graft is a safe method, with a low complication rate, no loss of correction and can prevent the occurrence of non-union with a high degree of probability.

  6. Unicameral bone cyst of the scaphoid: a report of two cases.

    Science.gov (United States)

    Javdan, Mohammad; Zarezadeh, Abolghasem; Gaulke, Raulf; Eshaghi, Mohammad Amin; Shemshaki, Hamidreza

    2012-08-01

    Unicameral bone cysts are benign, fluid-filled lesions that occur mostly in long bones (proximal humerus, 50-60%; femur, 30%) of male children aged 5 to 15 years. Occurrence in the scaphoid of an adult is rare. We report 2 such patients who presented with wrist pain, with and without a history of trauma. Both underwent curettage and bone grafting (harvested from the distal radius) and achieved good functional recovery.

  7. Surfing Behind a Boat: Quality and Reliability of Online Resources on Scaphoid Fractures.

    Science.gov (United States)

    Nassiri, Mujtaba; Mohamed, Osama; Berzins, Arvids; Aljabi, Yasser; Mahmood, Talat; Chenouri, Shojaeddin; O'Grady, Paul

    2016-10-01

    Patients seeking information and advice on treatment of scaphoid fractures unknowingly confront longstanding medical controversies surrounding the management of this condition. However, there are no studies specifically looking into the quality and reliability of online information on scaphoid fractures. We identified 44 unique websites for evaluation using the term "scaphoid fractures". The websites were categorized by type and assessed using the DISCERN score, the Journal of the American Medical Association (JAMA) benchmark criteria and the Health on the net (HON) code. The majority of websites were commercial (n = 13) followed by academic (n = 12). Only seven of the websites were HON certified. The mean DISCERN score was 43.8. Only 4 websites scored 63 or above representing excellent quality with minimal shortcomings but 13 websites scored 38 or below representing poor or very poor quality. The mean JAMA benchmark criteria score was 2.2. The Governmental and Non-Profit Organizations category websites had the highest mean JAMA benchmark score. The websites that displayed the HON-code seal had higher mean DISCERN scores and higher mean JAMA benchmark scores compared to websites that did not display the seal. Good quality health information is certainly available on the Internet. However, it is not possible to predict with certainty which sites are of higher quality. We suggest clinicians should have a responsibility to educate their patients regarding the unregulated nature of medical information on the internet and proactively provide patients with educational resources and thus help them make smart and informed decisions.

  8. Scaphoid fracture: Bone marrow edema detected with dual-energy CT virtual non-calcium images and confirmed with MRI

    Energy Technology Data Exchange (ETDEWEB)

    Dareez, Nazeer M.; Engesland, Eirin; Lindland, Elisabeth S. [Department of Radiology, SSHF Arendal, Arendal (Norway); Dahlslett, Kristine H. [Haukelands Universitetssjukehus, Department of Radiology, Bergen (Norway)

    2017-12-15

    We aimed to determine whether bone marrow edema (BME) in acute traumatic scaphoid fracture could be demonstrated with dual-energy CT (DECT) using MRI as the gold standard. In recent years, virtual non-calcium (VNCa) images have been used to demonstrate BME in trauma cases, for example, in vertebral compression fractures, hip trauma to detect occult fractures and knee fractures. We present three cases of acute scaphoid trauma. Two patients had subtle or invisible fractures on x-ray and conventional CT images, while DECT VNCa images clearly visualized the BME, which was confirmed by MRI. One patient had negative findings on both VNCa and MRI images. The DECT VNCa algorithm is a promising technique to demonstrate BME in scaphoid fractures, with potential for increasing the diagnostic value of CT in this type of injury. (orig.)

  9. Evaluation of a prototype correction algorithm to reduce metal artefacts in flat detector computed tomography of scaphoid fixation screws.

    Science.gov (United States)

    Filli, Lukas; Marcon, Magda; Scholz, Bernhard; Calcagni, Maurizio; Finkenstädt, Tim; Andreisek, Gustav; Guggenberger, Roman

    2014-12-01

    The aim of this study was to evaluate a prototype correction algorithm to reduce metal artefacts in flat detector computed tomography (FDCT) of scaphoid fixation screws. FDCT has gained interest in imaging small anatomic structures of the appendicular skeleton. Angiographic C-arm systems with flat detectors allow fluoroscopy and FDCT imaging in a one-stop procedure emphasizing their role as an ideal intraoperative imaging tool. However, FDCT imaging can be significantly impaired by artefacts induced by fixation screws. Following ethical board approval, commercially available scaphoid fixation screws were inserted into six cadaveric specimens in order to fix artificially induced scaphoid fractures. FDCT images corrected with the algorithm were compared to uncorrected images both quantitatively and qualitatively by two independent radiologists in terms of artefacts, screw contour, fracture line visibility, bone visibility, and soft tissue definition. Normal distribution of variables was evaluated using the Kolmogorov-Smirnov test. In case of normal distribution, quantitative variables were compared using paired Student's t tests. The Wilcoxon signed-rank test was used for quantitative variables without normal distribution and all qualitative variables. A p value of < 0.05 was considered to indicate statistically significant differences. Metal artefacts were significantly reduced by the correction algorithm (p < 0.001), and the fracture line was more clearly defined (p < 0.01). The inter-observer reliability was "almost perfect" (intra-class correlation coefficient 0.85, p < 0.001). The prototype correction algorithm in FDCT for metal artefacts induced by scaphoid fixation screws may facilitate intra- and postoperative follow-up imaging. Flat detector computed tomography (FDCT) is a helpful imaging tool for scaphoid fixation. The correction algorithm significantly reduces artefacts in FDCT induced by scaphoid fixation screws. This may facilitate intra

  10. Genetic predisposition to fracture non-union: a case control study of a preliminary single nucleotide polymorphisms analysis of the BMP pathway

    Directory of Open Access Journals (Sweden)

    Giannoudis Peter V

    2011-02-01

    Full Text Available Abstract Background Despite the known multi-factorial nature of atrophic fracture non-unions, a possible genetic predisposition for the development of this complication after long bone fractures remains unknown. This pilot study aimed to address this issue by performing a preliminary SNP analysis of specific genes known to regulate fracture healing. Methods A total of fifteen SNPs within four genes of the Bone Morphogenetic Protein (BMP pathway (BMP-2, BMP-7, NOGGIN and SMAD6 were examined, in 109 randomly selected patients with long bone fractures as a result of motor vehicle accident, fall or direct blow. There were sixty-two patients with atrophic non-union and forty-seven patients (54 fractures with uneventful fracture union. Overall SNPs frequencies were computed with respect to patient's age, gender, smoking habits, fracture-associated parameters and the use of nonsteroidal anti-inflammatory drugs (NSAIDs, and tested for their association to the impaired bone healing process, using binary logistic regression (STATA 11.1; StataCorp, Texas USA. Results Statistical analysis revealed age to be an important covariate in the development of atrophic non-union (p = 0.01, OR 1.05 [per year], and two specific genotypes (G/G genotype of the rs1372857 SNP, located on NOGGIN and T/T genotype of the rs2053423 SNP, located on SMAD6 to be associated with a greater risk of fracture non-union (p = 0.02, OR 4.56 and p = 0.04, OR 10.27, respectively, after adjustment for age. Conclusions This is the first clinical study to investigate the potential existence of genetic susceptibility to fracture non-union. Even though no concrete conclusions can be obtained from this pilot study, our results indicate the existence of a potential genetically predetermined impairment within the BMP signalling cascade, initiated after a fracture and when combined with other risk factors could synergistically increase the susceptibility of a patient to develop non-union. Further

  11. What is the Effect of 90-Degree Double-Plate Fixation with Grafting on Healing of Humeral Shaft Non-unions

    Directory of Open Access Journals (Sweden)

    Mutlu Çobanoğlu

    2016-08-01

    Full Text Available Objective: Our aim was to investigate the clinical and radiological outcomes of double-plate fixation with grafting in the treatment of non-union of humeral shaft fractures. Materials and Methods: We performed a retrospective chart review of patients operated between 2006 and 2012 due to humeral shaft non-union. Patients undergoing surgery with double-plate fixation were included and those treated with external fixator, single plate, intramedullary nails and patients with pathological fractures and infected non-unions were excluded. Surgical intervention via anterolateral or posterior approach included radial nerve identification, decortication and reestablishment of medullary canal followed by compression plating with double-plate fixation and frequent application of autogenous grafts or allografts. Main outcome measures were success rate of non-union repair, rate of re-intervention and complications, range of motion, assessment of pain Visual analogue scale (VAS and function Disabilities of the arm, shoulder and hand (DASH and overall outcome Stewart-Hundley classification. Results: Ten patients were treated with double-plate fixation. The study group included six females and four males aged 36 to 70 years. Union was achieved within 4.5 and 8 months in all cases. The mean preoperative VAS score of 6.1 decreased to 2, postoperatively, with an associated decrease in the mean DASH score from 74.1 to 23.4. Excellent or good results were obtained in nine cases. There was no incidence of radial nerve palsy or infection. Conclusion: Our study provides level 4 evidence of the effectiveness of treating non-union fractures of the humeral shaft with double-plate fixation and grafting in providing good-to-excellent functional results and high union rate without any significant complication.

  12. Spatial resolution requirements in digital radiography of scaphoid fractures. An ROC analysis

    International Nuclear Information System (INIS)

    Jonsson, A.; Laurin, S.; Karner, G.; Herrlin, K.; Hochbergs, P.; Jonsson, K.; Rudling, O.; Sandstroem, S.; Sloth, M.; Svahn, G.; Pettersson, H.

    1996-01-01

    Purpose: To investigate the spatial resolution requirements in digital radiography of scaphoid fractures. Material and Methods: Included in the study were 60 scaphoid radiographs with and 60 without fractures of the scaphoid bone. The film-screen images were digitized using pixel sizes of 115, 170, and 340 μm along with 170 μm with a 10:1 wavelet compression. The digital images were displayed on a 1280 x 1024 x 8 bits monitor, and 5 observers evaluated the images in 5 randomized sessions. The results for each pixel size were then compared to the film-screen images by ROC analysis. Results: The mean area under the ROC curves was larger for the film-screen images than for the digital images at all resolutions. However, this difference was not significant when the areas under the ROC curves for the film-screen images were compared to the digital images of 115, 170, and 170 μm with 10:1 compression. There was a significant difference for the 340-μm pixel size in favour of the film-screen images. The mean ROC curves for the digital images were very similar for the 115 and 170 μm pixel sizes, although slightly better for 115 μm. At 170 μm, the compression seemed to have a relatively small negative effect on the diagnostic performance; the deterioration was greater when the pixel size was increased to 340 μm. There was no obvious correlation between diagnostic performance and the experience of the observers in using workstations. Conclusions: The pixel size of 170 μm is adequate for the detection of subtle fractures, even after wavelet compression by a ratio of 10:1. (orig.)

  13. Management of scaphoid nonunion with avascular necrosis using 1,2 intercompartmental supraretinacular arterial bone graft

    Directory of Open Access Journals (Sweden)

    Mohamad Dehghani

    2014-01-01

    Full Text Available Background: 1,2 ICSRA, introduced by Aidembery et al., is a well-established technique, with up to 100% union rate among different studies . The purpose of our study was to evaluate the outcome of scaphoid nonunion undergoing 1,2 ICSRA bone graft in Iran. Materials and Methods: All participants who presented sequentially over a period of 24 months between 2010 and 2013 with nonunion scaphoid fracture with AVN in proximal pole were included in the study. Anteroposterior and lateral view plain radiographs of carpal bones were obtained for diagnosis of nonunion, and a diagnosis of avascular necrosis was made by MRI of the scaphoid. Subjects underwent 1,2 ICSRA bone graft surgery. Patients were assessed based on radiographs and the Mayo Wrist Score (MWS questionnaire on before and after surgery. Data were analyzed using SPSS ver. 18 by paired t test. Results: Overall, 16 patients (100% male were included in the study. Mean age of subjects was 27.50 ± 5.86 (18 to 38. Mean Mayo score was 36.63 ± 8.92 and 83.75 ± 9.22 before and 6 month after surgery, respectively, and the difference was statistically significant (P < 0.001. after 8 weeks, 10 (62.5% had union, and after 12 weeks, all subjects had union. Nine (56.25% of our patients had excellent functional outcome, 5 (31.25% had good and 2 (12.5% had satisfactory functional outcome. Conclusion: 1,2 ICSRA is a proper pedicle of vascularized bone graft due to the ease of visibility and dissection. The functional results and union rates were satisfactory in our study.

  14. A Rare Complete Metacarpal Pseudoepiphysis in a Teenager With a Scaphoid Fracture.

    Science.gov (United States)

    Geffen, Rachel B; Colberg, Ricardo E

    2017-11-01

    A 13-yr-old adolescent boy presented with wrist pain after falling off a scooter onto his outstretched hand. Radiographs revealed a nondisplaced hairline fracture of the scaphoid bone and an irregular radiolucent line in the proximal metaphysis of the second metacarpal bone, consistent with an anomalous growth plate, or complete pseudoepiphysis. Complete pseudoepiphysis is a rare finding, with only a few cases reported. Learning about the common locations of growth plates and the radiographic differences between normal, injured, and anomalous growth plates can help decrease physician error and improve patient outcomes.

  15. Usefulness of dynamic contrast-enhanced MRI in the evaluation of the viability of acute scaphoid fracture

    Energy Technology Data Exchange (ETDEWEB)

    Larribe, Maud [Hopital La Conception, Service d' imagerie medicale, Marseille (France); Hopital Sainte Marguerite, Service d' imagerie medicale, Marseille (France); Gay, Andre [Hopital La Conception, Service de chirurgie de la main, Marseille (France); Freire, Veronique [Centre hospitalier de l' Universite de Montreal, Department of Radiology, Notre-Dame Hospital, Montreal, QC (Canada); Bouvier, Corinne [Hopital La Timone, Service d' anatomopathologie, Marseille (France); Chagnaud, Christophe; Souteyrand, Philippe [Hopital La Conception, Service d' imagerie medicale, Marseille (France)

    2014-12-15

    To evaluate the usefulness of dynamic gadolinium-enhanced magnetic resonance imaging (MRI) for assessing the viability of the proximal pole of the scaphoid in patients with acute scaphoid fractures. Eighteen consecutive patients with acute scaphoid fracture who underwent dynamic gadolinium-enhanced MRI 7 days or less before surgery were prospectively included between August 2011 and December 2012. All patients underwent MR imaging with unenhanced images, enhanced images, and dynamic enhanced images. A radiologist first classified the MRI results as necrotic or viable based on T1- and T2-weighted images only, followed by a second blinded interpretation, this time including analysis of pre- and post-gadolinium administration images and a third blinded interpretation based on the time-intensity curve of the dynamic enhanced study. The standard of reference was the histologic assessment of a cylindrical specimen of the proximal pole obtained during surgery in all patients. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for unenhanced, enhanced, and dynamic gadolinium-enhanced MRI studies. The sensitivity, specificity, PPV, and NPV were 67, 67, 50, and 80 % for unenhanced images, 83, 100, 100, and 92 for enhanced images, and 83, 92, 83, and 92 for dynamic contrast-enhanced images. Our data are consistent with previously reported data supporting contrast-enhanced MRI for assessment of viability, and showing that dynamic imaging with time-intensity curve analysis does not provide additional predictive value over standard delayed enhanced imaging for acute scaphoid fracture. (orig.)

  16. Multiplanar reconstruction computed tomography for diagnosis of scaphoid waist fracture union: a prospective cohort analysis of accuracy and precision

    Energy Technology Data Exchange (ETDEWEB)

    Hannemann, P.F.W.; Brouwers, L.; Gottgens, K.W.A.; Poeze, M.; Brink, P.R.G. [Maastricht University Medical Centre, Department of Surgery and Traumasurgery, PO Box 5800, Maastricht (Netherlands); Zee, D. van der; Stadler, A.; Weijers, R. [Maastricht University Medical Centre, Department of radiology, PO Box 5800, Maastricht (Netherlands)

    2013-10-15

    To examine reliability and validity concerning union of scaphoid fractures determined by multiplanar reconstruction computed tomography randomized at 6, 12, and 24 weeks after injury. We used Fleiss' kappa to measure the opinions of three observers reviewing 44 sets of computed tomographic scans of 44 conservatively treated scaphoid waist fractures. We calculated kappa for the extent of consolidation (0-24 %, 25-49 %, 50-74 %, or 75-100 %) on the transverse, sagittal and coronal views. We also calculated kappa for no union, partial union, and union, and grouped the results for 6, 12, and 24 weeks after injury. As the reference standard for union, CT scans were performed at a minimum of 6 months after injury to determine validity. Overall inter-observer agreement was found to be moderate ({kappa} = 0.576). No union ({kappa} = 0.791), partial union ({kappa} = 0.502), and union ({kappa} = 0.683) showed substantial, moderate, and substantial agreement, respectively. The average sensitivity of multiplanar reconstruction CT for diagnosing union of scaphoid waist fractures was 73 %. The average specificity was 80 %. Our results suggest that multiplanar reconstruction computed tomography is a reliable and accurate method for diagnosing union or nonunion of scaphoid fractures. However, inter-observer agreement was lower with respect to partial union. (orig.)

  17. Multiplanar reconstruction computed tomography for diagnosis of scaphoid waist fracture union: a prospective cohort analysis of accuracy and precision

    International Nuclear Information System (INIS)

    Hannemann, P.F.W.; Brouwers, L.; Gottgens, K.W.A.; Poeze, M.; Brink, P.R.G.; Zee, D. van der; Stadler, A.; Weijers, R.

    2013-01-01

    To examine reliability and validity concerning union of scaphoid fractures determined by multiplanar reconstruction computed tomography randomized at 6, 12, and 24 weeks after injury. We used Fleiss' kappa to measure the opinions of three observers reviewing 44 sets of computed tomographic scans of 44 conservatively treated scaphoid waist fractures. We calculated kappa for the extent of consolidation (0-24 %, 25-49 %, 50-74 %, or 75-100 %) on the transverse, sagittal and coronal views. We also calculated kappa for no union, partial union, and union, and grouped the results for 6, 12, and 24 weeks after injury. As the reference standard for union, CT scans were performed at a minimum of 6 months after injury to determine validity. Overall inter-observer agreement was found to be moderate (κ = 0.576). No union (κ = 0.791), partial union (κ = 0.502), and union (κ = 0.683) showed substantial, moderate, and substantial agreement, respectively. The average sensitivity of multiplanar reconstruction CT for diagnosing union of scaphoid waist fractures was 73 %. The average specificity was 80 %. Our results suggest that multiplanar reconstruction computed tomography is a reliable and accurate method for diagnosing union or nonunion of scaphoid fractures. However, inter-observer agreement was lower with respect to partial union. (orig.)

  18. Usefulness of dynamic contrast-enhanced MRI in the evaluation of the viability of acute scaphoid fracture

    International Nuclear Information System (INIS)

    Larribe, Maud; Gay, Andre; Freire, Veronique; Bouvier, Corinne; Chagnaud, Christophe; Souteyrand, Philippe

    2014-01-01

    To evaluate the usefulness of dynamic gadolinium-enhanced magnetic resonance imaging (MRI) for assessing the viability of the proximal pole of the scaphoid in patients with acute scaphoid fractures. Eighteen consecutive patients with acute scaphoid fracture who underwent dynamic gadolinium-enhanced MRI 7 days or less before surgery were prospectively included between August 2011 and December 2012. All patients underwent MR imaging with unenhanced images, enhanced images, and dynamic enhanced images. A radiologist first classified the MRI results as necrotic or viable based on T1- and T2-weighted images only, followed by a second blinded interpretation, this time including analysis of pre- and post-gadolinium administration images and a third blinded interpretation based on the time-intensity curve of the dynamic enhanced study. The standard of reference was the histologic assessment of a cylindrical specimen of the proximal pole obtained during surgery in all patients. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for unenhanced, enhanced, and dynamic gadolinium-enhanced MRI studies. The sensitivity, specificity, PPV, and NPV were 67, 67, 50, and 80 % for unenhanced images, 83, 100, 100, and 92 for enhanced images, and 83, 92, 83, and 92 for dynamic contrast-enhanced images. Our data are consistent with previously reported data supporting contrast-enhanced MRI for assessment of viability, and showing that dynamic imaging with time-intensity curve analysis does not provide additional predictive value over standard delayed enhanced imaging for acute scaphoid fracture. (orig.)

  19. Longitudinal analysis of osteogenic and angiogenic signaling factors in healing models mimicking atrophic and hypertrophic non-unions in rats.

    Directory of Open Access Journals (Sweden)

    Susann Minkwitz

    Full Text Available Impaired bone healing can have devastating consequences for the patient. Clinically relevant animal models are necessary to understand the pathology of impaired bone healing. In this study, two impaired healing models, a hypertrophic and an atrophic non-union, were compared to physiological bone healing in rats. The aim was to provide detailed information about differences in gene expression, vascularization and histology during the healing process. The change from a closed fracture (healing control group to an open osteotomy (hypertrophy group led to prolonged healing with reduced mineralized bridging after 42 days. RT-PCR data revealed higher gene expression of most tested osteogenic and angiogenic factors in the hypertrophy group at day 14. After 42 days a significant reduction of gene expression was seen for Bmp4 and Bambi in this group. The inhibition of angiogenesis by Fumagillin (atrophy group decreased the formation of new blood vessels and led to a non-healing situation with diminished chondrogenesis. RT-PCR results showed an attempt towards overcoming the early perturbance by significant up regulation of the angiogenic regulators Vegfa, Angiopoietin 2 and Fgf1 at day 7 and a further continuous increase of Fgf1, -2 and Angiopoietin 2 over time. However µCT angiograms showed incomplete recovery after 42 days. Furthermore, lower expression values were detected for the Bmps at day 14 and 21. The Bmp antagonists Dan and Twsg1 tended to be higher expressed in the atrophy group at day 42. In conclusion, the investigated animal models are suitable models to mimic human fracture healing complications and can be used for longitudinal studies. Analyzing osteogenic and angiogenic signaling patterns, clear changes in expression were identified between these three healing models, revealing the importance of a coordinated interplay of different factors to allow successful bone healing.

  20. MRT of scaphoid pseudo-arthrosis using Gd-DTPA. Staging and clinical correlation

    International Nuclear Information System (INIS)

    Vogl, T.J.; Beutel, F.; Wilhelm, K.; Tempka, A.; Schedel, H.; Haas, R.; Felix, R.

    1994-01-01

    During a period of two years, 134 patients with pseudo-arthrosis of the scaphoid were examined by conventional radiography and by MRI in the course of a prospective study. The aim of the study was to define radiological staging using contrast enhanced MRI in order to improve the prognostic criteria. All MRI examinations were carried out with a 1.5 Tesla scanner (SP63) using a surface coil and T 1 weighted spin echo sequences in sagittal and frontal projection and frontal FLASH T 2 -sequences and axial spin echo T 2 sequences. The T 1 weighted SE sequences in frontal projection were carried out before and after iv contrast (0.1 mmol Gd-DTPA/kg KG). All sequences were compared with conventional radiographs and the operative findings. Eight patients in stage 0 showed high signal intensity of both fragments in T 1 weighted SE sequences and at surgery there was good vascularisation. In 22 cases there was reduced signal intensity in at least one fragment (stage I). 45 patients with scaphoid pseudo-arthrosis showed complete signal loss but marked contrast uptake with still vital nuclei at surgery (stage II). In 22 patients, there was no increase in signal intensity after contrast and complete loss of vitality of the fragments at surgery. Staging was not possible in 37 patients because of previous operative intervention. The use of contrast enhanced MRI provides additional information compared with conventional radiography or plain MRI. (orig.) [de

  1. Osteoma osteoide em escafoide: relato de caso Osteoid osteoma in scaphoid: case report

    Directory of Open Access Journals (Sweden)

    Antônio Lourenço Severo

    2012-10-01

    Full Text Available O osteoma osteoide é um tumor benigno osteoblástico, incomum na mão. A localização nos ossos do carpo é infrequente, a qual leva a erros no diagnóstico em decorrência do polimorfismo de sinais clínicos. Na revisão bibliográfica foram referidos nove casos de osteoma osteoide no escafoide. Relata-se um caso de osteoma osteoide no escafoide, tratado inicialmente como tenossinovite estenosante de De Quervain, tendo diagnóstico definitivo retardado por cinco anos.Osteoid osteoma is a benign osteoblastic tumor that is unusual in the hand. A location in the carpal bones is infrequent, which leads to errors in diagnosing it because of polymorphism of the clinical symptoms. Reviewing the literature shows that nine cases of osteoid osteoma in the scaphoid have been reported. Here, one case of osteoid osteoma in the scaphoid that was initially treated as De Quervain's stenosing tenosynovitis is reported, with a definitive diagnosis that was delayed for five years.

  2. Avascular necrosis (AVN) of the proximal fragment in scaphoid nonunion: Is intravenous contrast agent necessary in MRI?

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, R., E-mail: schmitt.radiologie@herzchirurgie.de [Department of Diagnostic and Interventional Radiology, Cardiovascular Center, Bad Neustadt an der Saale (Germany); Christopoulos, G.; Wagner, M. [Department of Diagnostic and Interventional Radiology, Cardiovascular Center, Bad Neustadt an der Saale (Germany); Krimmer, H. [Department of Hand Surgery, Cardiovascular Center, Bad Neustadt an der Saale (Germany); Fodor, S. [Department of Diagnostic and Interventional Radiology, Cardiovascular Center, Bad Neustadt an der Saale (Germany); Schoonhoven, J. van; Prommersberger, K.J. [Department of Hand Surgery, Cardiovascular Center, Bad Neustadt an der Saale (Germany)

    2011-02-15

    Purpose: The purpose of this prospective study is to assess the diagnostic value of intravenously applied contrast agent for diagnosing osteonecrosis of the proximal fragment in scaphoid nonunion, and to compare the imaging results with intraoperative findings. Materials and methods: In 88 patients (7 women, 81 men) suffering from symptomatic scaphoid nonunion, preoperative MRI was performed (coronal PD-w FSE fs, sagittal-oblique T1-w SE nonenhanced and T1-w SE fs contrast-enhanced, sagittal T2*-w GRE). MRI interpretation was based on the intensity of contrast enhancement: 0 = none, 1 = focal, 2 = diffuse. Intraoperatively, the osseous viability was scored by means of bleeding points on the osteotomy site of the proximal scaphoid fragment: 0 = absent, 1 = moderate, 2 = good. Results: Intraoperatively, 17 necrotic, 29 compromised, and 42 normal proximal fragments were found. In nonenhanced MRI, bone viability was judged necrotic in 1 patient, compromised in 20 patients, and unaffected in 67 patients. Contrast-enhanced MRI revealed 14 necrotic, 21 compromised, and 53 normal proximal fragments. Judging surgical findings as the standard of reference, statistical analysis for nonenhanced MRI was: sensitivity 6.3%, specificity 100%, positive PV 100%, negative PV 82.6%, and accuracy 82.9%; statistics for contrast-enhanced MRI was: sensitivity 76.5%, specificity 98.6%, positive PV 92.9%, negative PV 94.6%, and accuracy 94.3%. Sensitivity for detecting avascular proximal fragments was significantly better (p < 0.001) in contrast-enhanced MRI in comparison to nonenhanced MRI. Conclusion: Viability of the proximal fragment in scaphoid nonunion can be significantly better assessed with the use of contrast-enhanced MRI as compared to nonenhanced MRI. Bone marrow edema is an inferior indicator of osteonecrosis. Application of intravenous gadolinium is recommended for imaging scaphoid nonunion.

  3. Avascular necrosis (AVN) of the proximal fragment in scaphoid nonunion: Is intravenous contrast agent necessary in MRI?

    International Nuclear Information System (INIS)

    Schmitt, R.; Christopoulos, G.; Wagner, M.; Krimmer, H.; Fodor, S.; Schoonhoven, J. van; Prommersberger, K.J.

    2011-01-01

    Purpose: The purpose of this prospective study is to assess the diagnostic value of intravenously applied contrast agent for diagnosing osteonecrosis of the proximal fragment in scaphoid nonunion, and to compare the imaging results with intraoperative findings. Materials and methods: In 88 patients (7 women, 81 men) suffering from symptomatic scaphoid nonunion, preoperative MRI was performed (coronal PD-w FSE fs, sagittal-oblique T1-w SE nonenhanced and T1-w SE fs contrast-enhanced, sagittal T2*-w GRE). MRI interpretation was based on the intensity of contrast enhancement: 0 = none, 1 = focal, 2 = diffuse. Intraoperatively, the osseous viability was scored by means of bleeding points on the osteotomy site of the proximal scaphoid fragment: 0 = absent, 1 = moderate, 2 = good. Results: Intraoperatively, 17 necrotic, 29 compromised, and 42 normal proximal fragments were found. In nonenhanced MRI, bone viability was judged necrotic in 1 patient, compromised in 20 patients, and unaffected in 67 patients. Contrast-enhanced MRI revealed 14 necrotic, 21 compromised, and 53 normal proximal fragments. Judging surgical findings as the standard of reference, statistical analysis for nonenhanced MRI was: sensitivity 6.3%, specificity 100%, positive PV 100%, negative PV 82.6%, and accuracy 82.9%; statistics for contrast-enhanced MRI was: sensitivity 76.5%, specificity 98.6%, positive PV 92.9%, negative PV 94.6%, and accuracy 94.3%. Sensitivity for detecting avascular proximal fragments was significantly better (p < 0.001) in contrast-enhanced MRI in comparison to nonenhanced MRI. Conclusion: Viability of the proximal fragment in scaphoid nonunion can be significantly better assessed with the use of contrast-enhanced MRI as compared to nonenhanced MRI. Bone marrow edema is an inferior indicator of osteonecrosis. Application of intravenous gadolinium is recommended for imaging scaphoid nonunion.

  4. Avascular necrosis (AVN) of the proximal fragment in scaphoid nonunion: is intravenous contrast agent necessary in MRI?

    Science.gov (United States)

    Schmitt, R; Christopoulos, G; Wagner, M; Krimmer, H; Fodor, S; van Schoonhoven, J; Prommersberger, K J

    2011-02-01

    The purpose of this prospective study is to assess the diagnostic value of intravenously applied contrast agent for diagnosing osteonecrosis of the proximal fragment in scaphoid nonunion, and to compare the imaging results with intraoperative findings. In 88 patients (7 women, 81 men) suffering from symptomatic scaphoid nonunion, preoperative MRI was performed (coronal PD-w FSE fs, sagittal-oblique T1-w SE nonenhanced and T1-w SE fs contrast-enhanced, sagittal T2*-w GRE). MRI interpretation was based on the intensity of contrast enhancement: 0 = none, 1 = focal, 2 = diffuse. Intraoperatively, the osseous viability was scored by means of bleeding points on the osteotomy site of the proximal scaphoid fragment: 0=absent, 1 = moderate, 2 = good. Intraoperatively, 17 necrotic, 29 compromised, and 42 normal proximal fragments were found. In nonenhanced MRI, bone viability was judged necrotic in 1 patient, compromised in 20 patients, and unaffected in 67 patients. Contrast-enhanced MRI revealed 14 necrotic, 21 compromised, and 53 normal proximal fragments. Judging surgical findings as the standard of reference, statistical analysis for nonenhanced MRI was: sensitivity 6.3%, specificity 100%, positive PV 100%, negative PV 82.6%, and accuracy 82.9%; statistics for contrast-enhanced MRI was: sensitivity 76.5%, specificity 98.6%, positive PV 92.9%, negative PV 94.6%, and accuracy 94.3%. Sensitivity for detecting avascular proximal fragments was significantly better (p<0.001) in contrast-enhanced MRI in comparison to nonenhanced MRI. Viability of the proximal fragment in scaphoid nonunion can be significantly better assessed with the use of contrast-enhanced MRI as compared to nonenhanced MRI. Bone marrow edema is an inferior indicator of osteonecrosis. Application of intravenous gadolinium is recommended for imaging scaphoid nonunion. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  5. Ipsilateral Femoral Fracture Non-Union and Delayed Union Treated By Hybrid Plate Nail Fixation and Vascularized Fibula Bone Grafting: A Case Report

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    CK Chan

    2013-07-01

    Full Text Available Non-union is a well recognized complication of femoral neck fractures. The decision whether to attempt fracture fixation or to resort to hip replacement is particularly difficult in patients in the borderline age group in whom complex attempts at gaining union may fail and later present a difficult revision. On the other hand the patient may be young enough that arthroplasty best be avoided . Besides, presence of ipsilateral femoral shaft fracture with delayed union in addition to the femoral neck non-union will pose major problems at operation. We share our experience in treating a femoral neck fracture non-union with ipsilateral femoral shaft delayed union in the shaft and in the distal femur in a fifty years old patient. The fracture was treated with an angle blade plate and supracondylar nail supplemented with a free vascularised fibular bone grafting and autologous cancellous graft. There was radiological union at fourth month. At sixth months, the patient was free of pain and able to walk without support. Thus, we would like to suggest that vascularised fibula bone grafting with supracondylar nailing is a viable option for this pattern of fracture.

  6. The use of bone morphogenic protein-7 (OP-1) in the management of resistant non-unions in the upper and lower limb.

    Science.gov (United States)

    Papanna, M C; Al-Hadithy, N; Somanchi, B V; Sewell, M D; Robinson, P M; Khan, S A; Wilkes, R A

    2012-07-01

    The aim of the present study was to investigate the safety and efficacy of local implantation of BMP-7 for the treatment of resistant non-unions in the upper and lower limb. Fifty-two patients (30 males, mean age 52.8 years; range 20-81) were treated with local BMP-7 implantation in a bovine bone-derived collagen paste with or without revision of fixation. Thirty-six patients had closed injuries, ten had open injuries and six had infected non-unions. Patients had undergone a mean of 2 (1-5) operations prior to implantation of BMP-7. Clinical and radiological union was achieved in 94% at a mean time of 5.6 months (3-19). Two patients with subtrochanteric femoral fractures failed to achieve union secondary to inadequate fracture stabilisation, persistent unfavourable biological environment and systemic co-morbidities. One patient developed synostosis attributed to the BMP-7 application. This study demonstrates BMP-7 implanted in a bovine-derived collagen paste is an effective adjunctive treatment for resistant non-unions in the upper and lower limb. Copyright © 2012 Elsevier Ltd. All rights reserved.

  7. Risk Factors for Non-:union: Fractures of the Clavicle Mid-shift Following the Use of Non-surgical Treatment on Patients Admitted to Poursina Hospital, 2010 - 2012

    Directory of Open Access Journals (Sweden)

    kamran Asadi

    2015-02-01

    Conclusions: Recognition and predicting the risk factors of non-:::union::: in patients with fractures of the middle third of the clavicle could be a clinical guideline for the selection of surgical or non-surgical treatment.

  8. Bone graft in the treatment of nonunion of the scaphoid with necrosis of the proximal pole: a literature review.

    Science.gov (United States)

    Severo, Antônio Lourenço; Lemos, Marcelo Barreto; Lech, Osvandré Luiz Canfield; Barreto Filho, Danilo; Strack, Daniel Paulo; Candido, Larissa Knapp

    2017-01-01

    Scaphoid fractures are the most common fractures of the carpal bones, corresponding to 60%. Of these, 10% progress to nonunion; moreover, 3% can present necrosis of the proximal pole. There are various methods of treatment using vascularized and non-vascularized bone grafts. To evaluate and compare the rate of scaphoid consolidation with necrosis of the proximal pole using different surgical techniques. The authors conducted a review of the literature using the following databases: PubMed and BIREME/LILACS, where 13 case series were selected (ten with use of vascularized bone grafts and three of non-vascularized bone grafts), according to inclusion and exclusion criteria. In most cases VBGs were used, especially those based on the 1,2 intercompartmental supraretinacular artery, due to greater reproducibility in performing the surgical technique.

  9. Safety study: is there a pathologic IGF-1, PDGF and TGF-ß cytokine expression caused by adjunct BMP-7 in tibial and femoral non-union therapy?

    Directory of Open Access Journals (Sweden)

    Fischer C

    2018-04-01

    Full Text Available Christian Fischer,1 Christian Reiner,2 Gerhard Schmidmaier,1 Julian Doll,1 Christopher Child,3 Paul Alfred Grützner,4 Bahram Biglari,4 Sonja Boxriker,5 Arash Moghaddam5 1Center for Orthopedics, Trauma Surgery and Spinal Cord Injury, HTRG – Heidelberg Trauma Research Group, Heidelberg University Hospital, Heidelberg, Germany; 2Department of Trauma and Orthopedic Surgery, Paracelsus Medical University, Nuremberg Hospital South, Nuremberg, Germany; 3Department of Trauma Surgery, University Hospital Zurich, Zurich, Switzerland; 4Trauma and Orthopedics, BG Trauma Center Ludwigshafen, Ludwigshafen, Germany; 5Center of Orthopedics, Trauma Surgery and Sport Medicine, ATORG Aschaffenburg-Alzenau, Aschaffenburg, Germany Background: In this prospective safety study, we investigated if the characteristic cytokine expression during bone regeneration is manipulated by the local application of bone morphogenetic protein-7 (BMP-7 in non-union surgery. Therefore, the levels of insulin like growth factor 1 (IGF-1, platelet-derived growth factor AB (PDGF-AB and transforming growth factor beta (TGF-β were compared between patients with the gold standard use of autologous bone graft (ABG and those with additional application of BMP-7 as part of the diamond concept.Patients and methods: Between 2009 and 2014, of the 153 patients with tibial and femoral non-unions, a matched pair analysis was performed to compare the serological cytokine expressions. Blood samples were collected preoperatively, 1, 2 and 6 weeks as well as 3 and 6 months after non-union surgery. Matching criteria were smoking status, fracture location, gender, age and body mass index (BMI. Patients in G1 (n=10 were treated with ABG and local BMP-7 while their matching partners in G2 (n=10 received ABG only. The routine clinical and radiologic follow-up was 1 year.Results: Although the IGF-1 quantification in G2 showed higher pre- and postoperative values compared to G1 (p<0.05, the courses of both

  10. Evaluation of a prototype correction algorithm to reduce metal artefacts in flat detector computed tomography of scaphoid fixation screws

    Energy Technology Data Exchange (ETDEWEB)

    Filli, Lukas; Finkenstaedt, Tim; Andreisek, Gustav; Guggenberger, Roman [University Hospital of Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); Marcon, Magda [University Hospital of Zurich, Department of Diagnostic and Interventional Radiology, Zurich (Switzerland); University of Udine, Institute of Diagnostic Radiology, Department of Medical and Biological Sciences, Udine (Italy); Scholz, Bernhard [Imaging and Therapy Division, Siemens AG, Healthcare Sector, Forchheim (Germany); Calcagni, Maurizio [University Hospital of Zurich, Division of Plastic Surgery and Hand Surgery, Zurich (Switzerland)

    2014-12-15

    The aim of this study was to evaluate a prototype correction algorithm to reduce metal artefacts in flat detector computed tomography (FDCT) of scaphoid fixation screws. FDCT has gained interest in imaging small anatomic structures of the appendicular skeleton. Angiographic C-arm systems with flat detectors allow fluoroscopy and FDCT imaging in a one-stop procedure emphasizing their role as an ideal intraoperative imaging tool. However, FDCT imaging can be significantly impaired by artefacts induced by fixation screws. Following ethical board approval, commercially available scaphoid fixation screws were inserted into six cadaveric specimens in order to fix artificially induced scaphoid fractures. FDCT images corrected with the algorithm were compared to uncorrected images both quantitatively and qualitatively by two independent radiologists in terms of artefacts, screw contour, fracture line visibility, bone visibility, and soft tissue definition. Normal distribution of variables was evaluated using the Kolmogorov-Smirnov test. In case of normal distribution, quantitative variables were compared using paired Student's t tests. The Wilcoxon signed-rank test was used for quantitative variables without normal distribution and all qualitative variables. A p value of < 0.05 was considered to indicate statistically significant differences. Metal artefacts were significantly reduced by the correction algorithm (p < 0.001), and the fracture line was more clearly defined (p < 0.01). The inter-observer reliability was ''almost perfect'' (intra-class correlation coefficient 0.85, p < 0.001). The prototype correction algorithm in FDCT for metal artefacts induced by scaphoid fixation screws may facilitate intra- and postoperative follow-up imaging. (orig.)

  11. Evaluation of a prototype correction algorithm to reduce metal artefacts in flat detector computed tomography of scaphoid fixation screws

    International Nuclear Information System (INIS)

    Filli, Lukas; Finkenstaedt, Tim; Andreisek, Gustav; Guggenberger, Roman; Marcon, Magda; Scholz, Bernhard; Calcagni, Maurizio

    2014-01-01

    The aim of this study was to evaluate a prototype correction algorithm to reduce metal artefacts in flat detector computed tomography (FDCT) of scaphoid fixation screws. FDCT has gained interest in imaging small anatomic structures of the appendicular skeleton. Angiographic C-arm systems with flat detectors allow fluoroscopy and FDCT imaging in a one-stop procedure emphasizing their role as an ideal intraoperative imaging tool. However, FDCT imaging can be significantly impaired by artefacts induced by fixation screws. Following ethical board approval, commercially available scaphoid fixation screws were inserted into six cadaveric specimens in order to fix artificially induced scaphoid fractures. FDCT images corrected with the algorithm were compared to uncorrected images both quantitatively and qualitatively by two independent radiologists in terms of artefacts, screw contour, fracture line visibility, bone visibility, and soft tissue definition. Normal distribution of variables was evaluated using the Kolmogorov-Smirnov test. In case of normal distribution, quantitative variables were compared using paired Student's t tests. The Wilcoxon signed-rank test was used for quantitative variables without normal distribution and all qualitative variables. A p value of < 0.05 was considered to indicate statistically significant differences. Metal artefacts were significantly reduced by the correction algorithm (p < 0.001), and the fracture line was more clearly defined (p < 0.01). The inter-observer reliability was ''almost perfect'' (intra-class correlation coefficient 0.85, p < 0.001). The prototype correction algorithm in FDCT for metal artefacts induced by scaphoid fixation screws may facilitate intra- and postoperative follow-up imaging. (orig.)

  12. Identifying markets for pinyon pine in the Four Corners Region

    Science.gov (United States)

    Kurt H. Mackes

    2008-01-01

    A search for opportunities to use pinyon pine is currently being conducted at Colorado State University by the Colorado Wood Utilization and Marketing Program as part of an effort to improve financial feasibility of forest restoration and hazardous fuel reduction work in pinyon-juniper stands. The properties of pinyon wood reveal that it is suitable for a range of...

  13. Time-lagged effects of weather on plant demography: drought and Astragalus scaphoides.

    Science.gov (United States)

    Tenhumberg, Brigitte; Crone, Elizabeth E; Ramula, Satu; Tyre, Andrew J

    2018-04-01

    Temperature and precipitation determine the conditions where plant species can occur. Despite their significance, to date, surprisingly few demographic field studies have considered the effects of abiotic drivers. This is problematic because anticipating the effect of global climate change on plant population viability requires understanding how weather variables affect population dynamics. One possible reason for omitting the effect of weather variables in demographic studies is the difficulty in detecting tight associations between vital rates and environmental drivers. In this paper, we applied Functional Linear Models (FLMs) to long-term demographic data of the perennial wildflower, Astragalus scaphoides, and explored sensitivity of the results to reduced amounts of data. We compared models of the effect of average temperature, total precipitation, or an integrated measure of drought intensity (standardized precipitation evapotranspiration index, SPEI), on plant vital rates. We found that transitions to flowering and recruitment in year t were highest if winter/spring of year t was wet (positive effect of SPEI). Counterintuitively, if the preceding spring of year t - 1 was wet, flowering probabilities were decreased (negative effect of SPEI). Survival of vegetative plants from t - 1 to t was also negatively affected by wet weather in the spring of year t - 1 and, for large plants, even wet weather in the spring of t - 2 had a negative effect. We assessed the integrated effect of all vital rates on life history performance by fitting FLMs to the asymptotic growth rate, log(λt). Log(λt) was highest if dry conditions in year t - 1 were followed by wet conditions in the year t. Overall, the positive effects of wet years exceeded their negative effects, suggesting that increasing frequency of drought conditions would reduce population viability of A. scaphoides. The drought signal weakened when reducing the number of monitoring years. Substituting space for time

  14. The Role of Dynamic Contrast-Enhanced MRI in a Child with Sport-Induced Avascular Necrosis of the Scaphoid: A Case Report and Literature Review

    Directory of Open Access Journals (Sweden)

    Baris Beytullah Koc

    2016-01-01

    Full Text Available Avascular necrosis (AVN of the scaphoid in children is very rare and there is currently no consensus when conservative or operative treatment is indicated. A 10-year-old boy, practicing karate, presented with acute pain in his left wrist after falling on the outstretched hand. Imaging showed a scaphoid waist fracture with signs of an ongoing AVN. The diagnosis of AVN was confirmed with signal loss of the scaphoid on MRI T1. A dynamic contrast-enhanced MRI was performed for further assessment of the proximal pole vascularity and treatment planning. As dynamic contrast-enhanced MRI showed fair perfusion of the proximal pole, an adequate healing potential with conservative treatment was estimated. We achieved union and good function with cast immobilization for fourteen weeks. This case study showed dynamic contrast-enhanced MRI to be a valuable tool in assessing whether conservative or operative treatment is indicated to achieve union and good functional outcome.

  15. Clinical and Radiologic Outcomes After Scaphoid Fracture: Injury and Treatment Patterns in National Football League Combine Athletes Between 2009 and 2014.

    Science.gov (United States)

    Moatshe, Gilbert; Godin, Jonathan A; Chahla, Jorge; Cinque, Mark E; Kennedy, Nicholas I; Sanchez, George; Beaulieu-Jones, Brendin R; LaPrade, Robert F; Provencher, Matthew T

    2017-12-01

    To report on the clinical and radiologic outcomes and complications after surgical treatment in National Football League (NFL) Combine athletes with a history of a scaphoid fracture. The medical records of 2,285 athletes participating in the NFL Combine from 2009 to 2015 were evaluated for a history of scaphoid, hand, or wrist injury. Clinical outcomes, including grip strength, pinch test, range of motion, and presence of pain and stiffness, were recorded. Imaging studies were evaluated for the percentage of healing, fixation treatment type, hardware complications, radiographic deformity, and presence of osteoarthritis. Of the 2,285 athletes evaluated, 56 presented with a history of a scaphoid fracture. Most fractures were in the middle and proximal aspects of the scaphoid. Of the scaphoid fractures, 76% (43 players) were treated with screw fixation. Of the athletes, 36 (72%) had normal range of motion of the affected wrist, 52 (93%) reported no pain, and 44 (83%) reported no stiffness in the affected wrist. The grip strength and pinch strength were 91% and 96%, respectively, of the uninjured side. The fracture was healed in 75% of the cases; however, 34% had degenerative changes. Hardware complications were found in 15% of the athletes. Good clinical outcomes can be achieved after scaphoid fractures in prospective NFL athletes. However, the rates of nonunion (25%), degenerative changes (34%), and hardware complications (15%) in this study suggest the need for close postoperative radiographic follow-up in this population of patients because their athletic demands may lead to higher rates of the aforementioned complications. Level IV, retrospective study. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  16. The Comparison Of Results For The Bone Grafting In Treatment Of Scaphoid Nonunion With And Without Avascular Necrosis

    Directory of Open Access Journals (Sweden)

    Iman Qomashi

    2011-02-01

    Full Text Available Background: The varieties of treatment methods for the scaphoid nonunion have always been a discussable issue for orthopaedic surgeons. The current study, considered to be review for treatment results of the patients who sustained the scaphoid nonunion with or without avascular necrosis and compared these two groups clinically and radiologically. Methods: The clinical and radiologic files of the patients who sustained the scaphoid nonunion and underwent surgical treatment between 2004 and 2009 in our hospital, were collected and in the final follow-up, 37 patients and 38 nonunions underwent physical exam, grip power test, DASH questionnaire and radiography. Results: Avascular necrosis was detected in 22 cases and 16 cases had no avascular necrosis changes. Following open reduction and bone grafing, union was seen in 36 cases, and nonunion in 2 cases which one was in the avascular necrosis group and another in without avascular necrosis group. The comparison of the residual pain, range of motion, DASH score and grip power in two groups, did not show a meaningful difference (p>0.05. Conclusion: Although multiple studies indicated that in the presence of the avascular necrosis in the proximal fragment of the scaphiod, possibility of union in the conventional graft methods was lower than vascular pedicle grafts, but this study demonstrated that the conventional treatment method yet was associated with a considerable successs and a reliable treatment method.

  17. Two-dimensional fusion imaging of planar bone scintigraphy and radiographs in patients with clinical scaphoid fracture: an imaging study

    DEFF Research Database (Denmark)

    Henriksen, Otto Mølby; Lonsdale, Markus Georg; Jensen, T D

    2009-01-01

    . Bone scintigraphy is highly sensitive for the detection of fractures, but exact localization of scintigraphic lesions may be difficult and can negatively affect diagnostic accuracy. PURPOSE: To investigate the influence of image fusion of planar bone scintigraphy and radiographs on image interpretation......BACKGROUND: Although magnetic resonance imaging (MRI) is now considered the gold standard in second-line imaging of patients with suspected scaphoid fracture and negative radiographs, bone scintigraphy can be used in patients with pacemakers, metallic implants, or other contraindications to MRI....... CONCLUSION: Image fusion of planar bone scintigrams and radiographs has a significant influence on image interpretation and increases both diagnostic confidence and interobserver agreement....

  18. Cast immobilization with and without immobilization of the thumb for nondisplaced and minimally displaced scaphoid waist fractures: a multicenter, randomized, controlled trial

    NARCIS (Netherlands)

    Buijze, G. A.; Goslings, J. C.; Rhemrev, S. J.; Weening, A. A.; van Dijkman, B.; Doornberg, J. N.; Ring, D.; Terra, Maaike P.; Macmahon, Peter J.; Coerkamp, Emile G.; van der Woude, H. J.; de Jong, Vincent M.; Beeres, Frank J. P.; de Haseth, Kristin B.; Souer, J. Sebastiaan; Jupiter, Jesse B.; Mudgal, Chaitanya S.; van der Vlies, Cees H.; Blazar, Philip; Day, Charles S.; Fostvedt, Sigi; Kloen, Peter; van Dijk, C. Niek; Maas, Mario; Poolman, Rudolf W.; Haverlag, Robert; Scholtes, Vanessa A. B.; Jellema-de Bont, Jolanda J. M.; Thomassen, Bregje J.; Hollander, Peter den; de Muinck Keizer, Robert-Jan

    2014-01-01

    The aim of this prospective randomized trial was to test the null hypothesis that there was no difference in the percentage of the fracture line of scaphoid waist fractures that demonstrated bridging bone on computed tomography (CT) 10 weeks after injury between patients treated in a below-elbow

  19. Two-Dimensional Image Fusion of Planar Bone Scintigraphy and Radiographs in Patients with Clinical Scaphoid Fracture: An Imaging Study

    DEFF Research Database (Denmark)

    Henriksen, O.M.; Lonsdale, M.N.; Jensen, T.D.

    2008-01-01

    . Bone scintigraphy is highly sensitive for the detection of fractures, but exact localization of scintigraphic lesions may be difficult and can negatively affect diagnostic accuracy. Purpose: To investigate the influence of image fusion of planar bone scintigraphy and radiographs on image interpretation......Background: Although magnetic resonance imaging (MRI) is now considered the gold standard in second-line imaging of patients with suspected scaphoid fracture and negative radiographs, bone scintigraphy can be used in patients with pacemakers, metallic implants, or other contraindications to MRI....... Conclusion: Image fusion of planar bone scintigrams and radiographs has a significant influence on image interpretation and increases both diagnostic confidence and interobserver agreement Udgivelsesdato: 2008/12/3...

  20. Accuracy of enhanced and unenhanced MRI in diagnosing scaphoid proximal pole avascular necrosis and predicting surgical outcome

    Energy Technology Data Exchange (ETDEWEB)

    Fox, M.G. [University of Virginia, Department of Radiology and Medical Imaging, Charlottesville, VA (United States); Wang, D.T. [University of Virginia, Department of Radiology and Medical Imaging, Charlottesville, VA (United States); Medical College of Wisconsin, Milwaukee, WI (United States); Chhabra, A.B. [University of Virginia Health System, Department of Orthopedics, Charlottesville, VA (United States)

    2015-11-15

    Determine the sensitivity, specificity and accuracy of unenhanced and enhanced MRI in diagnosing scaphoid proximal pole (PP) avascular necrosis (AVN) and correlate whether MRI can help guide the selection of a vascularized or nonvascularized bone graft. The study was approved by the IRB. Two MSK radiologists independently performed a retrospective review of unenhanced and enhanced MRIs from 18 patients (16 males, 2 females; median age, 17.5 years) with scaphoid nonunions and surgery performed within 65 days of the MRI. AVN was diagnosed on the unenhanced MRI when a diffusely decreased T1-W signal was present in the PP and on the enhanced MRI when PP enhancement was less than distal pole enhancement. Surgical absence of PP bleeding was diagnostic of PP AVN. Postoperative osseous union (OU) was assessed with computed tomography and/or radiographs. Sensitivity, specificity and accuracy for PP AVN were 71, 82 and 78 % for unenhanced and 43, 82 and 67 % for enhanced MRI. Patients with PP AVN on unenhanced MRI had 86 % (6/7) OU; 100 % (5/5) OU with vascularized bone grafts and 50 % (1/2) OU with nonvascularized grafts. Patients with PP AVN on enhanced MRI had 80 % (4/5) OU; 100 % (3/3) OU with vascularized bone grafts and 50 % (1/2) OU with nonvascularized grafts. Patients with viable PP on unenhanced and enhanced MRI had 91 % (10/11) and 92 % (12/13) OU, respectively, all but one with nonvascularized graft. When PP AVN is evident on MRI, OU is best achieved with vascularized grafts. If PP AVN is absent, OU is successful with nonvascularized grafts. (orig.)

  1. Accuracy of enhanced and unenhanced MRI in diagnosing scaphoid proximal pole avascular necrosis and predicting surgical outcome

    International Nuclear Information System (INIS)

    Fox, M.G.; Wang, D.T.; Chhabra, A.B.

    2015-01-01

    Determine the sensitivity, specificity and accuracy of unenhanced and enhanced MRI in diagnosing scaphoid proximal pole (PP) avascular necrosis (AVN) and correlate whether MRI can help guide the selection of a vascularized or nonvascularized bone graft. The study was approved by the IRB. Two MSK radiologists independently performed a retrospective review of unenhanced and enhanced MRIs from 18 patients (16 males, 2 females; median age, 17.5 years) with scaphoid nonunions and surgery performed within 65 days of the MRI. AVN was diagnosed on the unenhanced MRI when a diffusely decreased T1-W signal was present in the PP and on the enhanced MRI when PP enhancement was less than distal pole enhancement. Surgical absence of PP bleeding was diagnostic of PP AVN. Postoperative osseous union (OU) was assessed with computed tomography and/or radiographs. Sensitivity, specificity and accuracy for PP AVN were 71, 82 and 78 % for unenhanced and 43, 82 and 67 % for enhanced MRI. Patients with PP AVN on unenhanced MRI had 86 % (6/7) OU; 100 % (5/5) OU with vascularized bone grafts and 50 % (1/2) OU with nonvascularized grafts. Patients with PP AVN on enhanced MRI had 80 % (4/5) OU; 100 % (3/3) OU with vascularized bone grafts and 50 % (1/2) OU with nonvascularized grafts. Patients with viable PP on unenhanced and enhanced MRI had 91 % (10/11) and 92 % (12/13) OU, respectively, all but one with nonvascularized graft. When PP AVN is evident on MRI, OU is best achieved with vascularized grafts. If PP AVN is absent, OU is successful with nonvascularized grafts. (orig.)

  2. Accuracy of enhanced and unenhanced MRI in diagnosing scaphoid proximal pole avascular necrosis and predicting surgical outcome.

    Science.gov (United States)

    Fox, M G; Wang, D T; Chhabra, A B

    2015-11-01

    Determine the sensitivity, specificity and accuracy of unenhanced and enhanced MRI in diagnosing scaphoid proximal pole (PP) avascular necrosis (AVN) and correlate whether MRI can help guide the selection of a vascularized or nonvascularized bone graft. The study was approved by the IRB. Two MSK radiologists independently performed a retrospective review of unenhanced and enhanced MRIs from 18 patients (16 males, 2 females; median age, 17.5 years) with scaphoid nonunions and surgery performed within 65 days of the MRI. AVN was diagnosed on the unenhanced MRI when a diffusely decreased T1-W signal was present in the PP and on the enhanced MRI when PP enhancement was less than distal pole enhancement. Surgical absence of PP bleeding was diagnostic of PP AVN. Postoperative osseous union (OU) was assessed with computed tomography and/or radiographs. Sensitivity, specificity and accuracy for PP AVN were 71, 82 and 78% for unenhanced and 43, 82 and 67% for enhanced MRI. Patients with PP AVN on unenhanced MRI had 86% (6/7) OU; 100% (5/5) OU with vascularized bone grafts and 50% (1/2) OU with nonvascularized grafts. Patients with PP AVN on enhanced MRI had 80% (4/5) OU; 100% (3/3) OU with vascularized bone grafts and 50% (1/2) OU with nonvascularized grafts. Patients with viable PP on unenhanced and enhanced MRI had 91% (10/11) and 92% (12/13) OU, respectively, all but one with nonvascularized graft. When PP AVN is evident on MRI, OU is best achieved with vascularized grafts. If PP AVN is absent, OU is successful with nonvascularized grafts.

  3. A Scapholunate Ligament-Sparing Technique Utilizing the Medial Femoral Condyle Corticocancellous Free Flap to Reconstruct Scaphoid Nonunions With Proximal Pole Avascular Necrosis.

    Science.gov (United States)

    Kazmers, Nikolas H; Thibaudeau, Stephanie; Levin, L Scott

    2016-09-01

    This article demonstrates a technique for the treatment of scaphoid fracture waist and proximal pole nonunions with avascular necrosis using a free vascularized medial femoral condyle flap. We present our surgical technique and representative case examples in which the scapholunate ligament, a key structure required to preserve carpal kinematics, is spared. Copyright © 2016 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  4. Radiologically occult scaphoid and wrist fractures. Preliminary results in comparison of 0.2-T and 1.0-T units

    International Nuclear Information System (INIS)

    Breitenseher, M.J.; Trattnig, S.; Happel, B.; Bankier, A.; Rand, T.; Imhof, H.; Gaebler, C.; Kukla, C.

    1997-01-01

    The study was performed to determine the diagnostic value of different MR systems and field strengths in patients with occult scaphoid and wrist fractures. Twelve patients with clinical suspicion of a scaphoid fracture but normal plain radiographs were examined by MRI. A dedicated 0.2-T unit (Esaote) and a 1.0-T unit (NT10, Philips) were used. Coronal T1W-SE, STIR, and T2*W-GE sequences were obtained with both systems. Images were evaluated for a bone marrow abnormality, a trabecular or cortical fracture line, and were compared to the 6-week follow-up radiographs. Seven wrist fractures were found at 0.2 T and 1.0 T, proven in the follow-up radiographs. A bone marrow abnormality was present in all seven fractures on both systems. Trabecular and cortical fracture lines were visualized at 0.2 T in four cases and at 1.0 T in seven cases. Low-field MR imaging at 0.2 T and mid-field MR imaging at 1.0 T seem to be equivalent in the diagnosis of a fracture in radiographically occult scaphoid and wrist fractures. In the visualization of fracture details, important for therapeutic and prognostic considerations, 1.0 T seems to be superior. (orig.) [de

  5. Proximal Row Carpectomy for Coexisting Kienböck’s Disease and Giant Intraosseous Ganglion of the Scaphoid: A Case Report and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Miguel Morón

    2014-01-01

    Full Text Available The etiologies of Keinböck’s disease and intraosseous ganglion remain unknown. Both entities are rare and the coexistence of these two pathologies in the same patient and hand is even less frequent. We report the case of a 40-year-old man with a longstanding history of martial arts practice (karate who developed an avascular necrosis of the lunate concomitant with a giant intraosseous ganglion of the scaphoid bone successfully managed by proximal row carpectomy. We review the literature of these two diseases.

  6. Feasibility and safety of treating non-unions in tibia, femur and humerus with autologous, expanded, bone marrow-derived mesenchymal stromal cells associated with biphasic calcium phosphate biomaterials in a multicentric, non-comparative trial.

    Science.gov (United States)

    Gómez-Barrena, Enrique; Rosset, Philippe; Gebhard, Florian; Hernigou, Philippe; Baldini, Nicola; Rouard, Helène; Sensebé, Luc; Gonzalo-Daganzo, Rosa M; Giordano, Rosaria; Padilla-Eguiluz, Norma; García-Rey, Eduardo; Cordero-Ampuero, José; Rubio-Suárez, Juan Carlos; Stanovici, Julien; Ehrnthaller, Christian; Huber-Lang, Markus; Flouzat-Lachaniette, Charles Henri; Chevallier, Nathalie; Donati, Davide Maria; Ciapetti, Gabriela; Fleury, Sandrine; Fernandez, Manuel-Nicolás; Cabrera, José-Rafael; Avendaño-Solá, Cristina; Montemurro, Tiziana; Panaitescu, Carmen; Veronesi, Elena; Rojewski, Markus Thomas; Lotfi, Ramin; Dominici, Massimo; Schrezenmeier, Hubert; Layrolle, Pierre

    2018-03-19

    ORTHO-1 is a European, multicentric, first in human clinical trial to prove safety and feasibility after surgical implantation of commercially available biphasic calcium phosphate bioceramic granules associated during surgery with autologous mesenchymal stromal cells expanded from bone marrow (BM-hMSC) under good manufacturing practices, in patients with long bone pseudarthrosis. Twenty-eight patients with femur, tibia or humerus diaphyseal or metaphyso-diaphyseal non-unions were recruited and surgically treated in France, Germany, Italy and Spain with 100 or 200 million BM-hMSC/mL associated with 5-10 cc of bioceramic granules. Patients were followed up during one year. The investigational advanced therapy medicinal product (ATMP) was expanded under the same protocol in all four countries, and approved by each National Competent Authority. With safety as primary end-point, no severe adverse event was reported as related to the BM-hMSC. With feasibility as secondary end-point, the participating production centres manufactured the BM-hMSC as planned. The ATMP combined to the bioceramic was surgically delivered to the non-unions, and 26/28 treated patients were found radiologically healed at one year (3 out of 4 cortices with bone bridging). Safety and feasibility were clinically proven for surgical implantation of expanded autologous BM-hMSC with bioceramic. EU-FP7-HEALTH-2009, REBORNE Project (GA: 241876). Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. The treatment of scaphoid nonunion using the Ilizarov fixator without bone graft, a study of 18 cases

    Directory of Open Access Journals (Sweden)

    Bumbaširević Marko

    2011-11-01

    Full Text Available Abstract Objectives Evaluating the safety and efficacy of the Ilizarov fine-wire compression/distraction technique in the treatment of scaphoid nonunion (SNU, without the use of bone graft. Design A retrospective review of 18 consecutive patients in one centre. Patients and Methods 18 patients; 17 males; 1 female, with a mean SNU duration of 13.9 months. Patients with carpal instability, humpback deformity, carpal collapse, avascular necrosis or marked degenerative change, were excluded. Following frame application the treatment consisted of three stages: the frame was distracted 1 mm per day until radiographs showed a 2-3 mm opening at the SNU site (mean 10 days; the SNU site was then compressed for 5 days, at a rate of 1 mm per day, with the wrist in 15 degrees of flexion and 15 degrees of radial deviation; the third stage involved immobilization with the Ilizarov fixator for 6 weeks. The technique is detailed herein. Results Radiographic (CT and clinical bony union was achieved in all 18 patients after a mean of 89 days (70-130 days. Mean modified Mayo wrist scores improved from 21 to 86 at a mean follow-up of 37 months (24-72 months, with good/excellent results in 14 patients. All patients returned to their pre-injury occupations and levels of activity at a mean of 117 days. Three patients suffered superficial K-wire infections, which resolved with oral antibiotics. Conclusions In these selected patients this technique safely achieved bony union without the need to open the SNU site and without the use of bone graft.

  8. Predictors of the accuracy of quotation of references in peer-reviewed orthopaedic literature in relation to publications on the scaphoid.

    Science.gov (United States)

    Buijze, G A; Weening, A A; Poolman, R W; Bhandari, M; Ring, D

    2012-02-01

    Using inaccurate quotations can propagate misleading information, which might affect the management of patients. The aim of this study was to determine the predictors of quotation inaccuracy in the peer-reviewed orthopaedic literature related to the scaphoid. We randomly selected 100 papers from ten orthopaedic journals. All references were retrieved in full text when available or otherwise excluded. Two observers independently rated all quotations from the selected papers by comparing the claims made by the authors with the data and expressed opinions of the reference source. A statistical analysis determined which article-related factors were predictors of quotation inaccuracy. The mean total inaccuracy rate of the 3840 verified quotes was 7.6%. There was no correlation between the rate of inaccuracy and the impact factor of the journal. Multivariable analysis identified the journal and the type of study (clinical, biomechanical, methodological, case report or review) as important predictors of the total quotation inaccuracy rate. We concluded that inaccurate quotations in the peer-reviewed orthopaedic literature related to the scaphoid were common and slightly more so for certain journals and certain study types. Authors, reviewers and editorial staff play an important role in reducing this inaccuracy.

  9. Functional outcome and cost-effectiveness of pulsed electromagnetic fields in the treatment of acute scaphoid fractures: a cost-utility analysis.

    Science.gov (United States)

    Hannemann, Pascal F W; Essers, Brigitte A B; Schots, Judith P M; Dullaert, Koen; Poeze, Martijn; Brink, Peter R G

    2015-04-11

    Physical forces have been widely used to stimulate bone growth in fracture repair. Addition of bone growth stimulation to the conservative treatment regime is more costly than standard health care. However, it might lead to cost-savings due to a reduction of the total amount of working days lost. This economic evaluation was performed to assess the cost-effectiveness of Pulsed Electromagnetic Fields (PEMF) compared to standard health care in the treatment of acute scaphoid fractures. An economic evaluation was carried out from a societal perspective, alongside a double-blind, randomized, placebo-controlled, multicenter trial involving five centres in The Netherlands. One hundred and two patients with a clinically and radiographically proven fracture of the scaphoid were included in the study and randomly allocated to either active bone growth stimulation or standard health care, using a placebo. All costs (medical costs and costs due to productivity loss) were measured during one year follow up. Functional outcome and general health related quality of life were assessed by the EuroQol-5D and PRWHE (patient rated wrist and hand evaluation) questionnaires. Utility scores were derived from the EuroQol-5D. The average total number of working days lost was lower in the active PEMF group (9.82 days) compared to the placebo group (12.91 days) (p = 0.651). Total medical costs of the intervention group (€1594) were significantly higher compared to the standard health care (€875). The total amount of mean QALY's (quality-adjusted life year) for the active PEMF group was 0.84 and 0.85 for the control group. The cost-effectiveness plane shows that the majority of all cost-effectiveness ratios fall into the quadrant where PEMF is not only less effective in terms of QALY's but also more costly. This study demonstrates that the desired effects in terms of cost-effectiveness are not met. When comparing the effects of PEMF to standard health care in terms of QALY's, PEMF

  10. Metallic artifacts from internal scaphoid fracture fixation screws: comparison between C-arm flat-panel, cone-beam, and multidetector computed tomography.

    Science.gov (United States)

    Finkenstaedt, Tim; Morsbach, Fabian; Calcagni, Maurizio; Vich, Magdalena; Pfirrmann, Christian W A; Alkadhi, Hatem; Runge, Val M; Andreisek, Gustav; Guggenberger, Roman

    2014-08-01

    The aim of this study was to compare image quality and extent of artifacts from scaphoid fracture fixation screws using different computed tomography (CT) modalities and radiation dose protocols. Imaging of 6 cadaveric wrists with artificial scaphoid fractures and different fixation screws was performed in 2 screw positions (45° and 90° orientation in relation to the x/y-axis) using multidetector CT (MDCT) and 2 flat-panel CT modalities, C-arm flat-panel CT (FPCT) and cone-beam CT (CBCT), the latter 2 with low and standard radiation dose protocols. Mean cartilage attenuation and metal artifact-induced absolute Hounsfield unit changes (= artifact extent) were measured. Two independent radiologists evaluated different image quality criteria using a 5-point Likert-scale. Interreader agreements (Cohen κ) were calculated. Mean absolute Hounsfield unit changes and quality ratings were compared using Friedman and Wilcoxon signed-rank tests. Artifact extent was significantly smaller for MDCT and standard-dose FPCT compared with CBCT low- and standard-dose acquisitions (all P 0.05). Both MDCT and FPCT standard-dose protocols showed equal ratings for screw bone interface, fracture line, and trabecular bone evaluation (P = 0.06, 0.2, and 0.2, respectively) and performed significantly better than FPCT low- and CBCT low- and standard-dose acquisitions (all P < 0.05). Good interreader agreement was found for image quality comparisons (Cohen κ = 0.76-0.78). Both MDCT and FPCT standard-dose acquisition showed comparatively less metal-induced artifacts and better overall image quality compared with FPCT low-dose and both CBCT acquisitions. Flat-panel CT may provide sufficient image quality to serve as a versatile CT alternative for postoperative imaging of internally fixated wrist fractures.

  11. Integrated surface management for pipeline construction: The Mid-America Pipeline Company Four Corners Project

    Science.gov (United States)

    Maria L. Sonett

    1999-01-01

    Integrated surface management techniques for pipeline construction through arid and semi-arid rangeland ecosystems are presented in a case history of a 412-mile pipeline construction project in New Mexico. Planning, implementation and monitoring for restoration of surface hydrology, soil stabilization, soil cover, and plant species succession are discussed. Planning...

  12. 40 CFR 49.23 - Federal Implementation Plan Provisions for Four Corners Power Plant, Navajo Nation.

    Science.gov (United States)

    2010-07-01

    ... the following formula: Is = 2(%Sf)/GCV × 104 English units Where: Is = sulfur dioxide inlet... data, or one-hour averages deviating by more than 30 percent from the levels measured during the last... otherwise, to the Director, Navajo Environmental Protection Agency, P.O. Box 339, Window Rock, Arizona 86515...

  13. MX Missile MOA Between Four Corners Regional Commission and the United States Air Force.

    Science.gov (United States)

    1981-08-20

    rodents, the genus ofthe porcupine is mis spelled. Under carnivores, the specific name of the grey fox is misspelled. li I SPAGE PARAGRAPH SENTENCE...to Native Ameri- can people. Request: plan of operation that would Include equity in dispersal of funds to Native American peoples and tribal govern

  14. MRT of scaphoid pseudo-arthrosis using Gd-DTPA. Staging and clinical correlation; MRT der Skaphoidpseudarthrose mit Gd-DTPA. Stadieneinteilung und klinische Korrelation

    Energy Technology Data Exchange (ETDEWEB)

    Vogl, T.J. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Beutel, F. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Wilhelm, K. [LMU Muenchen (Germany). Abt. fuer Handchirurgie; Tempka, A. [Freie Univ. Berlin (Germany). Klinik fuer Unfall- und Wiederherstellungschirurgie; Schedel, H. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Haas, R. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik; Felix, R. [Freie Univ. Berlin (Germany). Strahlenklinik und Poliklinik

    1994-11-01

    During a period of two years, 134 patients with pseudo-arthrosis of the scaphoid were examined by conventional radiography and by MRI in the course of a prospective study. The aim of the study was to define radiological staging using contrast enhanced MRI in order to improve the prognostic criteria. All MRI examinations were carried out with a 1.5 Tesla scanner (SP63) using a surface coil and T{sub 1} weighted spin echo sequences in sagittal and frontal projection and frontal FLASH T{sub 2}-sequences and axial spin echo T{sub 2} sequences. The T{sub 1} weighted SE sequences in frontal projection were carried out before and after iv contrast (0.1 mmol Gd-DTPA/kg KG). All sequences were compared with conventional radiographs and the operative findings. Eight patients in stage 0 showed high signal intensity of both fragments in T{sub 1} weighted SE sequences and at surgery there was good vascularisation. In 22 cases there was reduced signal intensity in at least one fragment (stage I). 45 patients with scaphoid pseudo-arthrosis showed complete signal loss but marked contrast uptake with still vital nuclei at surgery (stage II). In 22 patients, there was no increase in signal intensity after contrast and complete loss of vitality of the fragments at surgery. Staging was not possible in 37 patients because of previous operative intervention. The use of contrast enhanced MRI provides additional information compared with conventional radiography or plain MRI. (orig.) [Deutsch] Im Rahmen einer prospektiven Studie wurden in einem Zeitraum von 2 Jahren 134 Patienten mit einer Skaphoidpseudarthrose (SPA) vergleichend konventionell roentgenologisch und magnetresonanztomographisch untersucht. Ziel der Studie war die Erstellung einer klinisch radiologischen Stadieneinteilung mit Hilfe der kontrastverstaerkten MRT zur Verbesserung von Prognosekriterien. Alle MRT-Untersuchungen wurden an einem 1,5 Tesla-Geraet (SP63) mittels einer Oberflaechenspule unter Verwendung von T{sub 1

  15. Gaseous Oxidized Mercury Dry Deposition Measurements in Southwestern USA: Comparison between texas, Eastern Oklahoma, and the Four Corners Area

    Science.gov (United States)

    Gaseous oxidized mercury (GOM) dry deposition measurements using aerodynamic surrogate surface passive samplers were collected in central and eastern Texas and eastern Oklahoma, from September 2011 to September 2012.The purpose of this study was to provide an initial characteriza...

  16. Multiscale observations of CO2, 13CO2, and pollutants at Four Corners for emission verification and attribution

    Science.gov (United States)

    Lindenmaier, Rodica; Dubey, Manvendra K.; Henderson, Bradley G.; Butterfield, Zachary T.; Herman, Jay R.; Rahn, Thom; Lee, Sang-Hyun

    2014-01-01

    There is a pressing need to verify air pollutant and greenhouse gas emissions from anthropogenic fossil energy sources to enforce current and future regulations. We demonstrate the feasibility of using simultaneous remote sensing observations of column abundances of CO2, CO, and NO2 to inform and verify emission inventories. We report, to our knowledge, the first ever simultaneous column enhancements in CO2 (3–10 ppm) and NO2 (1–3 Dobson Units), and evidence of δ13CO2 depletion in an urban region with two large coal-fired power plants with distinct scrubbing technologies that have resulted in ∆NOx/∆CO2 emission ratios that differ by a factor of two. Ground-based total atmospheric column trace gas abundances change synchronously and correlate well with simultaneous in situ point measurements during plume interceptions. Emission ratios of ∆NOx/∆CO2 and ∆SO2/∆CO2 derived from in situ atmospheric observations agree with those reported by in-stack monitors. Forward simulations using in-stack emissions agree with remote column CO2 and NO2 plume observations after fine scale adjustments. Both observed and simulated column ∆NO2/∆CO2 ratios indicate that a large fraction (70–75%) of the region is polluted. We demonstrate that the column emission ratios of ∆NO2/∆CO2 can resolve changes from day-to-day variation in sources with distinct emission factors (clean and dirty power plants, urban, and fires). We apportion these sources by using NO2, SO2, and CO as signatures. Our high-frequency remote sensing observations of CO2 and coemitted pollutants offer promise for the verification of power plant emission factors and abatement technologies from ground and space. PMID:24843169

  17. Four-Corner Arthrodesis Versus Proximal Row Carpectomy. A Retrospective Study With a Mean Follow-Up of 17 Years

    NARCIS (Netherlands)

    Berkhout, M.J.L.; Bachour, Y.; Zheng, K.H.; Mullender, M.G.; Strackee, S.D.; Ritt, M.J.P.F.

    2015-01-01

    Purpose To compare the long-term outcomes of proximal row carpectomy (PRC) and 4-corner arthrodesis (FCA) in a consecutive series of patients surgically treated between 1989 and 1998 in a single teaching hospital. Methods We included 12 patients (14 wrists) in the PRC group and 8 patients (8 wrists)

  18. Indians' Problems in Acquiring Development Capital. Four Corners Agriculture and Forestry Development Study. Special Report No. 11.

    Science.gov (United States)

    Fuller, Stephen W.

    The difficulty with which American Indians acquire equity capital and an examination of selected Federal programs which make this type of credit available to this minority group are discussed in this report. Specifically, collateral, fractional heirship, ownership of chattels, managerial training, repayment, and servicing of loans are discussed as…

  19. Outcome of Management of Humerus Diaphysis Non-union This ...

    African Journals Online (AJOL)

    jen

    patients with nonunion of the humeral diaphysis were reviewed. ... 3 failures occurred of whom one was a smoker and diabetic, another had a loose ... as absence of radiographic signs of union and persistent pain on clinical ... Elbow Surgeons (ASES) Score for 13 activities of daily living 9 requiring full shoulder and elbow.

  20. Outcome of Management of Humerus Diaphysis Non-union This ...

    African Journals Online (AJOL)

    jen

    East and Central African Journal of Surgery - Volume 14 Number 2 – July/August 2009. 13. Outcome of ... 3 failures occurred of whom one was a smoker and diabetic, another had a loose plate and ..... Basel experience. J Trauma. 1993 ...

  1. Computerising the Salesforce: The Introduction of Technical Change in a Non-Union Workforce.

    Science.gov (United States)

    Newell, Helen; Lloyd, Caroline

    1998-01-01

    Results of interviews with 13 pharmaceutical sales representatives, five sales managers, and six human-resource managers and 47 survey responses showed that introduction of information technology was seen as purely technical; human-resources departments played no role; and informal communication procedures enabled management to ignore individual…

  2. Non union of an epiphyseal fibular fracture in a pediatric patient.

    Science.gov (United States)

    Mirmiran, Roya; Schuberth, John M

    2006-01-01

    There are few reports on delayed or nonunion in the pediatric ankle fracture. The authors present a case of a nonunion of a mid-epiphyseal fracture of the distal fibula, described as a type 7 pediatric fracture. Both the occurrence of this injury pattern and a nonunion has not been reported in the same patient. Operative reduction of the nonunion resulted in a satisfactory outcome.

  3. The Seminole Serpent Warrior At Miramar, FL, Shows Settlement Locations Enabled Environmental Monitoring Reminiscent Of the Four-corners Kokopelli-like EMF Phenomena, and Related to Earthquakes, Tornados and Hurricanes.

    Science.gov (United States)

    Balam Matagamon, Chan; Pawa Matagamon, Sagamo

    2004-03-01

    Certain Native Americans of the past seem to have correctly deduced that significant survival information for their tradition-respecting cultures resided in EMF-based phenomena that they were monitoring. This is based upon their myths and the place or cult-hero names they bequeathed us. The sites we have located in FL have been detectable by us visually, usually by faint blue light, or by the elicitation of pin-like prickings, by somewhat intense nervous-system response, by EMF interactions with aural electrochemical systems that can elicit tinitus, and other ways. In the northeast, Cautantowit served as a harbinger of Indian summer, and appears to be another alter ego of the EMF. The Miami, FL Tequesta site along the river clearly correlates with tornado, earthquake and hurricane locations. Sites like the Mohave Deserts giant man may have had similar significance.

  4. Order Granting the Petition to Object to Williams Four Corners, LLC - Sims Mesa Central Delivery Point natural gas processing plant and compressor station, Rio Arriba County, New Mexico, Title V Operating Permit

    Science.gov (United States)

    This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Petition Database available at www2.epa.gov/title-v-operating-permits/title-v-petition-database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  5. Petition to Object to the Williams Four Corners, LLC - Sims Mesa Central Delivery Point natural gas processing plant and compressor station, Rio Arriba County, New Mexico, Title V Operating Permit

    Science.gov (United States)

    This document may be of assistance in applying the Title V air operating permit regulations. This document is part of the Title V Petition Database available at www2.epa.gov/title-v-operating-permits/title-v-petition-database. Some documents in the database are a scanned or retyped version of a paper photocopy of the original. Although we have taken considerable effort to quality assure the documents, some may contain typographical errors. Contact the office that issued the document if you need a copy of the original.

  6. Statistical descriptions of scaphoid and lunate bone shapes

    NARCIS (Netherlands)

    van de Giessen, Martijn; Foumani, Mahyar; Streekstra, Geert J.; Strackee, Simon D.; Maas, Mario; van Vliet, Lucas J.; Grimbergen, Kees A.; Vos, Frans M.

    2010-01-01

    Diagnosing of injuries of the wrist bones is problematic due to a highly complex and variable geometry. knowledge of variations of healthy bone shapes is essential to detect wrist pathologies, developing prosthetics and investigating biomechanical properties of the wrist joint. In previous

  7. TWO-STAGE REOSTEOSYNTHESIS OF TIBIA IN THE PATIENT WITH FRACTURE NON-UNION COMPLICATED BY POSTOPERATIVE OSTEOMYELITIS

    Directory of Open Access Journals (Sweden)

    I. M. Efremov

    2018-01-01

    Full Text Available The authors present a case report of a patient with pseudarthrosis of the right tibia complicated by chronic postoperative osteomyelitis. The development of the osteomyelitis process is caused by locked intramedullary fixation of the right tibia by a retrograde nail. Unstable fixation led to the development of acute periimplant infection and osteomyelitis.A radical surgical debridement of the focus site of chronic infection was performed by removing locking screws and nail, removal of necrotic bone tissues by handling the tibial medullary cavity by special reamers. The authors used the pulse lavage with active removal of the solution for an additional sterilization of the surgical wound and medullary cavity. A reinforced spacer impregnated with vancomycin and polyvalent bacteriophage was placed in the medullary cavity to ensure local prolonged antimicrobial therapy. Instead of the removed monomer the polyvalent bacteriophage was introduced into the polymer composition including phages against the main infectious agents in patients of traumatology and orthopedics clinic.Three months after the first stage of treatment and stabilization of laboratory parameters the patient was readmitted to the clinic. The second stage of procedure included removal of spacer, closed antegrade locked internal fixation of the right tibia and talus by a nail with an antimicrobial coating of bone cement impregnated with vancomycin and a polyvalent bacteriophage. Antimicrobial coating of the nail was made intraoperatively using an original mold.Two stage procedure allowed to achieve a stable remission of chronic osteomyelitis and stable internal fixation of tibia pseudarthrosis with preservation of the supporting function of the lower limb.

  8. Evaluation of LANDSAT-4 Thematic Mapper Data as Applied to Geologic Exploration: Summary of Results. [Death Valley, California, Cement-Velma, Oklahoma; Big Horn and Wind River Basins, Wyoming; Spanish Peaks, Colorado; and the Four Corners area (Paradox Basin of Utah and Colorado)

    Science.gov (United States)

    Dykstra, J. D.; Sheffield, C. A.; Everett, J. R.

    1984-01-01

    As with any tool applied to geologic exploration, maximum value results from the innovative integration of optimally processed LANDSAT-4 data with existing pertinent information and perceptive geologic thinking. The synoptic view of the satellite images and the relatively high resolution of the data permits recognization of regional tectonic patterns and their detailed mapping. The refined spatial and spectral characteristics and digital nature surface alterations associated with hydrothermal activity and microseepage of hydrocarbons. In general, as vegetation and soil cover increase, the value of spectral components of TM data decreases with respect to the value of the spatial component of the data. This observation reinforces the experience from working with MSS data that digital processing must be optimized both for the area and for the application.

  9. Rib plating of acute and sub-acute non-union rib fractures in an adult with cystic fibrosis: a case report.

    Science.gov (United States)

    Dean, Nathan C; Van Boerum, Don H; Liou, Theodore G

    2014-10-01

    Rib fractures associated with osteoporosis have been reported to occur ten times more frequently in adults with cystic fibrosis. Fractures cause chest pain, and interfere with cough and sputum clearance leading to worsened lung function and acute exacerbations which are the two main contributors to early mortality in cystic fibrosis. Usual treatment involves analgesics and time for healing; however considerable pain and disability result due to constant re-injury from chronic repetitive cough. Recently, surgical plating of rib fractures has become commonplace in treating acute, traumatic chest injuries. We describe here successful surgical plating in a White cystic fibrosis patient with multiple, non-traumatic rib fractures. A-37-year old White male with cystic fibrosis was readmitted to Intermountain Medical Center for a pulmonary exacerbation. He had developed localized rib pain while coughing 2 months earlier, with worsening just prior to hospital admission in conjunction with a "pop" in the same location while bending over. A chest computerized tomography scan at admission demonstrated an acute 5th rib fracture and chronic non-united 6th and 7th right rib fractures. An epidural catheter was placed both for analgesia and to make secretion clearance possible in preparation for the surgery performed 2 days later. Under general anesthesia, he had open reduction and internal fixation of the right 5th, 6th and 7th rib fractures with a Synthes Matrix rib set. After several days of increased oxygen requirements, fever, fluid retention, and borderline vital signs, he stabilized. Numerical pain rating scores from his ribs were lower post-operatively and he was able to tolerate chest physical therapy and vigorous coughing. In our case report, rib plating with bone grafting improved rib pain and allowed healing of the fractures and recovery, although the immediate post-op period required close attention and care. We believe repair may be of benefit in selected cystic fibrosis patients, such as our patient who had suffered multiple rib fractures that were healing poorly.

  10. Rib plating of acute and sub-acute non-union rib fractures in an adult with cystic fibrosis: a case report

    OpenAIRE

    Dean, Nathan C; Van Boerum, Don H; Liou, Theodore G

    2014-01-01

    Background Rib fractures associated with osteoporosis have been reported to occur ten times more frequently in adults with cystic fibrosis. Fractures cause chest pain, and interfere with cough and sputum clearance leading to worsened lung function and acute exacerbations which are the two main contributors to early mortality in cystic fibrosis. Usual treatment involves analgesics and time for healing; however considerable pain and disability result due to constant re-injury from chronic repet...

  11. TO EVALUATE THE SURGICAL OUTCOME OF NON-UNION CLAVICLE USING PLATE AND SLIVERS OF AUTOLOGOUS ILIAC CREST CORTICOCANCELLOUS BONE GRAFT

    Directory of Open Access Journals (Sweden)

    Mohammed

    2016-03-01

    Full Text Available INTRODUCTION Clavicle fracture is one of the most common fracture presenting to the fracture clinic, accounting for about 5-10% of all the adult trauma reported but still the controversy exists with regards to the definitive management. AIM To evaluate the surgical outcome of nonunion clavicle in patients treated previously with surgical management or conservative management, using plate and slivers of autologous iliac crest corticocancellous bone. DESIGN Retrospective analysis of patients operated between May 2005 and February 2013 for nonunion of the clavicle. METHODS AND MATERIALS Twenty patients who were operated between May 2005 and February 2013 for nonunion of the clavicle at our hospital were recruited for our study and followup data was collected from our hospital records till their last outpatient visit. Inclusion criteria included patients with no evidence of radiological union, persistence of pain, cosmetic deformity, dysfunction or gross movement at the fracture site even after 16 weeks of conservative treatment or in cases of primary fixation failure. STATISTICAL ANALYSIS All Statistical analyses were made using Statistical Package Software for Social Sciences (SPSS version 17.0 software (Chicago, IL, USA for descriptive data. Chi2 test was used to compare the categorical data. RESULTS At the end of an average followup of 19 months, the average Visual Analogue Score for pain was 1.9±2.2 (range 0-6, the mean ASES score was 81±18.5 (51-100, and the mean Constant–Murley score was 80±17 (51-100. All the patients had a stable radiological union at the end of the followup period. There were no complications pertaining to the hardware or infection. CONCLUSION Treatment of nonunion of clavicle by using corticocancellous bone is well documented; however, use of iliac corticocancellous bone graft shaped in long slivers will give mechanical stability to the plate reconstruct in addition to providing a scaffold for new bone formation than just pieces of corticocancellous bone graft.

  12. 4-corner arthrodesis and proximal row carpectomy: a biomechanical comparison of wrist motion and tendon forces.

    Science.gov (United States)

    Debottis, Daniel P; Werner, Frederick W; Sutton, Levi G; Harley, Brian J

    2013-05-01

    Controversy exists as to whether a proximal row carpectomy (PRC) is a better procedure than scaphoid excision with 4-corner arthrodesis for preserving motion in the painful posttraumatic arthritic wrist. The purpose of this study was to determine how the kinematics and tendon forces of the wrist are altered after PRC and 4-corner arthrodesis. We tested 6 fresh cadaver forearms for the extremes of wrist motion and then used a wrist simulator to move them through 4 cyclic dynamic wrist motions, during which time we continuously recorded the tendon forces. We repeated the extremes of wrist motion measurements and the dynamic motions after scaphoid excision with 4-corner arthrodesis, and then again after PRC. We analyzed extremes of wrist motion and the peak tendon forces required for each dynamic motion using a repeated measures analysis of variance. Wrist extremes of motion significantly decreased after both the PRC and 4-corner arthrodesis compared with the intact wrist. Wrist flexion decreased on average 13° after 4-corner arthrodesis and 12° after PRC. Extension decreased 20° after 4-corner arthrodesis and 12° after PRC. Four-corner arthrodesis significantly decreased wrist ulnar deviation from the intact wrist. Four-corner arthrodesis allowed more radial deviation but less ulnar deviation than the PRC. The average peak tendon force was significantly greater after 4-corner arthrodesis than after PRC for the extensor carpi ulnaris during wrist flexion-extension, circumduction, and dart throw motions. The peak forces were significantly greater after 4-corner arthrodesis than in the intact wrist for the extensor carpi ulnaris during the dart throw motion and for the flexor carpi ulnaris during the circumduction motion. The peak extensor carpi radialis brevis force after PRC was significantly less than in the intact wrist. The measured wrist extremes of motion decreased after both 4-corner arthrodesis and PRC. Larger peak tendon forces were required to achieve

  13. Surgical Simulations Based on Limited Quantitative Data: Understanding How Musculoskeletal Models Can Be Used to Predict Moment Arms and Guide Experimental Design.

    Directory of Open Access Journals (Sweden)

    Jennifer A Nichols

    Full Text Available The utility of biomechanical models and simulations to examine clinical problems is currently limited by the need for extensive amounts of experimental data describing how a given procedure or disease affects the musculoskeletal system. Methods capable of predicting how individual biomechanical parameters are altered by surgery are necessary for the efficient development of surgical simulations. In this study, we evaluate to what extent models based on limited amounts of quantitative data can be used to predict how surgery influences muscle moment arms, a critical parameter that defines how muscle force is transformed into joint torque. We specifically examine proximal row carpectomy and scaphoid-excision four-corner fusion, two common surgeries to treat wrist osteoarthritis. Using models of these surgeries, which are based on limited data and many assumptions, we perform simulations to formulate a hypothesis regarding how these wrist surgeries influence muscle moment arms. Importantly, the hypothesis is based on analysis of only the primary wrist muscles. We then test the simulation-based hypothesis using a cadaveric experiment that measures moment arms of both the primary wrist and extrinsic thumb muscles. The measured moment arms of the primary wrist muscles are used to verify the hypothesis, while those of the extrinsic thumb muscles are used as cross-validation to test whether the hypothesis is generalizable. The moment arms estimated by the models and measured in the cadaveric experiment both indicate that a critical difference between the surgeries is how they alter radial-ulnar deviation versus flexion-extension moment arms at the wrist. Thus, our results demonstrate that models based on limited quantitative data can provide novel insights. This work also highlights that synergistically utilizing simulation and experimental methods can aid the design of experiments and make it possible to test the predictive limits of current computer

  14. Two-stage bargaining with coverage extension in a dual labour market

    DEFF Research Database (Denmark)

    Roberts, Mark A.; Stæhr, Karsten; Tranæs, Torben

    2000-01-01

    in extending coverage of a minimum wage to the non-union sector. Furthermore, the union sector does not seek to increase the non-union wage to a level above the market-clearing wage. In fact, it is optimal for the union sector to impose a market-clearing wage on the non-union sector. Finally, coverage...

  15. Grid for nuclear fuel rod assembly

    International Nuclear Information System (INIS)

    Brayman, K.W.; George, D.K.; Rawlings, J.C.; Dix, G.E.

    1976-01-01

    A grid is described for placing a least four corner fuel rods in a tubular flow channel of a nuclear reactor. It includes a bearer component composed of four side strips joined by four corner strips so as to form a rigid unit structure, each side strip having an L-shaped piece adjacent at each of its ends to a lug of each L-shaped piece extending to the adjacent end of its associated side strip [fr

  16. Trends in lumber processing in the western United States. Part I: board foot Scribner volume per cubic foot of timber

    Science.gov (United States)

    Charles E. Keegan; Todd A. Morgan; Keith A. Blatner; Jean M. Daniels

    2010-01-01

    This article describes trends in board foot Scribner volume per cubic foot of timber for logs processed by sawmills in the western United States. Board foot to cubic foot (BF/CF) ratios for the period from 2000 through 2006 ranged from 3.70 in Montana to 5.71 in the Four Corners Region (Arizona, Colorado, New Mexico, and Utah). Sawmills in the Four Corners Region,...

  17. Case report

    African Journals Online (AJOL)

    ebutamanya

    2015-06-17

    Jun 17, 2015 ... work is properly cited. Pan African Medical ... in a reactive fibroblastic connective tissue stroma, consistent with an enchondroma. Four .... Said W, Bouhaouala MH, Ennouri K, Kerkeni W, Bahri H. Carpal scaphoid chondroma ...

  18. G7 BiSpherical Acetabular Shell PMCF Study

    Science.gov (United States)

    2017-11-22

    Rheumatoid Arthritis; Osteoarthritis; Noninflammatory Degenerative Joint Disease; Avascular Necrosis; Correction of Functional Deformity; Non-Union Fracture; Femoral Neck Fractures; Trochanteric Fractures

  19. Evaluation of BiliCare™ transcutaneous bilirubin device in Japanese newborns.

    Science.gov (United States)

    Yamana, Keiji; Morioka, Ichiro; Kurokawa, Daisuke; Fukushima, Sachiyo; Nishida, Kosuke; Ohyama, Shohei; Nishimura, Noriyuki; Nozu, Kandai; Taniguchi-Ikeda, Mariko; Nagase, Hiroaki; Fujioka, Kazumichi; Iwatani, Sota; Nakamura, Hajime; Iijima, Kazumoto

    2017-10-01

    Non-invasive transcutaneous bilirubin (TcB) monitoring has been widely used to screen for hyperbilirubinemia. TcB measured using the recently developed BiliCare™ system, however, has not been fully evaluated. One hundred and seven TcB measurements were obtained from 82 Japanese newborns ≥35 weeks' gestational age within 2 weeks after birth. Measurements were taken at the scaphoid fossa, conchal cavity, and lobe of the ear using BiliCare. BiliCare TcB were compared with total serum bilirubin (TB) and TcB obtained using another bilirubinometer (JM-105™). Transcutaneous bilirubin measured at all three sites significantly correlated with TB (r = 0.91, 0.93, and 0.93 at the scaphoid fossa, conchal cavity, and lobe, respectively). The mean differences were 0.1, -0.3, and 3.6 at the scaphoid fossa, conchal cavity, and lobe, respectively. BiliCare TcB at the scaphoid fossa significantly correlated with that using the JM-105 (r = 0.91). The mean difference was 0.0. BiliCare, however, produced a significantly higher and lower TcB than the JM-105 for TB bilirubin measurements taken at the scaphoid fossa or conchal cavity using BiliCare were more reliable than those at the earlobe. BiliCare TcB differed from those of the JM-105, for TB <7 or ≥15 mg/dL. © 2017 Japan Pediatric Society.

  20. A Debilitating Orthopaedic Complication following Corticosteroid Therapy for Polymyalgia Rheumatica

    Directory of Open Access Journals (Sweden)

    Paul Rai

    2014-01-01

    Full Text Available Avascular necrosis (AVN of the scaphoid secondary to corticosteroid use is a rare entity. Previous reports in the literature refer to chronic steroid intake. We report a case secondary to low dose, short term use. AVN has a multifactorial cellular and genetic aetiology and most frequently affects the femoral head. Diagnosis relies on a high index of suspicion and early magnetic resonance (MR scanning. Treatment options are similar to those of traumatic scaphoid nonunions and include vascularised bone grafting and scaphoid excision. Polymyalgia Rheumatica is a common condition and its treatment is led by corticosteroid use. Mild to moderate strengths are advocated. However in our report we show that even with small doses serious adverse effects can be encountered.

  1. Stress views in the radiography of scapholunate instability

    International Nuclear Information System (INIS)

    Ozcelik, Abdurrahman; Guenal, Izge; Koese, Nusret

    2005-01-01

    Aim: On the suspected carpal instabilities stress views are recommended but not often used. The present study evaluates the reliability of the dorsal and volar stress radiographs on patients with posttraumatic wrist pain. Patients and methods: Stress radiographs of the wrists were examined in 22 patients with chronic wrist pain and the results were compared with scaphoid shift test and standard and positional views. The stress examination consists of applying to the wrist dorsal and volar stresses on the hand. Results: Static scapholunate instability was diagnosed in 4 patients in whom 3 of them had positive scaphoid shift test sign as well. There were, however, 18 patients with dynamic scapholunate instability in whom the standard films were normal but dorsal stress radiography showed gap greater than 3 mm between the scaphoid and lunate. Conclusion: Stress tests may provide considerable information in the evaluation of a patient who has a painful wrist in whom routine and special views do not demonstrate scapholunate dissociation

  2. CT-based three-dimensional kinematic comparison of dart-throwing motion between wrists with malunited distal radius and contralateral normal wrists

    International Nuclear Information System (INIS)

    Lee, S.; Kim, Y.S.; Park, C.S.; Kim, K.G.; Lee, Y.H.; Gong, H.S.; Lee, H.J.; Baek, G.H.

    2014-01-01

    Aim: To compare motion of the capitate, scaphoid, and lunate in wrists with a malunited distal radius and contralateral normal wrists during dart-throwing motion (DTM) by three-dimensional kinematic studies using computed tomography (CT) images. Materials and methods: CT was performed simultaneously on both wrists in six patients with a unilateral distal radius malunion at three stepwise positions simulating DTM. Using volume registration technique, the kinematic variables of helical axis motion of the capitate, scaphoid, and lunate were calculated and compared between both wrists. The helical motion of the capitate was also evaluated in a scaphoid- and lunate-based coordinate system. Results: Among the average rotation and translation of the scaphoid, lunate, and capitate during DTM, only the average rotation of the capitate was significantly different between the uninjured (88.9°) and the injured (70°) wrist (p = 0.0075). Rotation of the capitate relative to the scaphoid (26.3° versus 37.8°, p = 0.029) or lunate (39.2° versus 59.3°, p = 0.028) was smaller in the malunited wrist. The centres of helical axis motion of the three carpal bones were located more dorsally and radially in the injured wrist. Conclusions: The present study showed that decreased DTM in wrists with a distal radius malunion resulted from decreased midcarpal motion. The present study of the capitate, scaphoid, and lunate in wrists with distal radius malunion might be the first to present a 3D kinematic analysis of the effect of distal radius malunion on the carpal bones

  3. Brief Report: Broad Autism Phenotype in Adults Is Associated with Performance on an Eye-Tracking Measure of Joint Attention

    Science.gov (United States)

    Swanson, Meghan R.; Siller, Michael

    2014-01-01

    The current study takes advantage of modern eye-tracking technology and evaluates how individuals allocate their attention when viewing social videos that display an adult model who is gazing at a series of targets that appear and disappear in the four corners of the screen (congruent condition), or gazing elsewhere (incongruent condition). Data…

  4. Polydactyly in the Southwest: art or anatomy-a photo essay.

    Science.gov (United States)

    Hirthler, Maureen A; Hutchison, Richard L

    2012-12-01

    Rock art in the Four Corners area often includes pictures of hands and feet, which may be representational or symbolic. There is correlation between actual metatarsal bones and carvings of polydactyl feet. No duplicated hand bones have been found, but we postulate petroglyphs of polydactyl hands are a reflection of a real congenital difference.

  5. Far from City Lights: Current TCJ Staff Brings Variety of Talents, Enthusiasm for Their Work

    Science.gov (United States)

    Talahongva, Patty

    2009-01-01

    Far from the glitzy streets of New York or Los Angeles... where many of this nation's magazines are published... and on the edge of the famed Four Corners Region in the town of Mancos, Colorado ...is the home of the Tribal College Journal (TCJ). Tucked away in the Rocky Mountains, it's much like the tribal colleges it serves, far from big city…

  6. 78 FR 41731 - Source Specific Federal Implementation Plan for Implementing Best Available Retrofit Technology...

    Science.gov (United States)

    2013-07-11

    ... ENVIRONMENTAL PROTECTION AGENCY 40 CFR Part 49 [EPA-R09-OAR-2013-0489; FRL-9830-5] Source Specific Federal Implementation Plan for Implementing Best Available Retrofit Technology for Four Corners Power... Implementation Plan (FIP) to implement the Best Available Retrofit Technology (BART) requirement of the Regional...

  7. 76 FR 6163 - Notice of Applications for Deregistration Under Section 8(f) of the Investment Company Act of 1940

    Science.gov (United States)

    2011-02-03

    .../Four Corners Senior Floating Rate Income Fund [File No. 811-21344] Summary: Applicant, a closed-end... SECURITIES AND EXCHANGE COMMISSION [Release No. IC-29573] Notice of Applications for... hearing may request notification by writing to the Secretary, U.S. Securities and Exchange Commission, 100...

  8. UNM in the Community.

    Science.gov (United States)

    Quantum: Research & Scholarship, 1998

    1998-01-01

    Profiles 10 University of New Mexico community programs: University Art Museum, Rio Grande and Four Corners Writing Projects, Blacks in the Southwest (exhibit), New Mexico Engineering Research Institute's Environmental Finance Center, Adolescent Social Action Program, Minority Engineering Programs, Rural Community College Initiative, Valencia…

  9. Write Is Right: Using Graphic Organizers to Improve Student Mathematical Problem Solving

    Science.gov (United States)

    Zollman, Alan

    2012-01-01

    Teachers have used graphic organizers successfully in teaching the writing process. This paper describes graphic organizers and their potential mathematics benefits for both students and teachers, elucidates a specific graphic organizer adaptation for mathematical problem solving, and discusses results using the "four-corners-and-a-diamond"…

  10. Case report

    African Journals Online (AJOL)

    raoul

    2011-04-03

    Apr 3, 2011 ... This is an Open Access article distributed under the terms of the Creative Commons ... gadolinium showed an intraosseous mass, with partial erosion of the scaphoid; coupled to ... MRI is often superior to CT scanning with regard to the detection .... Figure 3: T1-weighted sagittal magnetic resonance image.

  11. Evaluation and diagnosis of wrist pain: a case-based approach.

    Science.gov (United States)

    Shehab, Ramsey; Mirabelli, Mark H

    2013-04-15

    Patients with wrist pain commonly present with an acute injury or spontaneous onset of pain without a definite traumatic event. A fall onto an outstretched hand can lead to a scaphoid fracture, which is the most commonly fractured carpal bone. Conventional radiography alone can miss up to 30 percent of scaphoid fractures. Specialized views (e.g., posteroanterior in ulnar deviation, pronated oblique) and repeat radiography in 10 to 14 days can improve sensitivity for scaphoid fractures. If a suspected scaphoid fracture cannot be confirmed with plain radiography, a bone scan or magnetic resonance imaging can be used. Subacute or chronic wrist pain usually develops gradually with or without a prior traumatic event. In these cases, the differential diagnosis is wide and includes tendinopathy and nerve entrapment. Overuse of the muscles of the forearm and wrist may lead to tendinopathy. Radial pain involving mostly the first extensor compartment is commonly de Quervain tenosynovitis. The diagnosis is based on history and examination findings of a positive Finkelstein test and a negative grind test. Nerve entrapment at the wrist presents with pain and also with sensory and sometimes motor symptoms. In ulnar neuropathies of the wrist, the typical presentation is wrist discomfort with sensory changes in the fourth and fifth digits. Activities that involve repetitive or prolonged wrist extension, such as cycling, karate, and baseball (specifically catchers), may increase the risk of ulnar neuropathy. Electrodiagnostic tests identify the area of nerve entrapment and the extent of the pathology. Copyright © 2013 American Academy of Family Physicians.

  12. South African Medical Journal - Vol 86, No 5 (1996)

    African Journals Online (AJOL)

    Is there a place for radionuclide bone scintigraphy in the management of radiograph-negative scaphoid trauma? EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Basil C. Vretlos, Bruce K. Adams, John D. Knotlenbelt, Andrew Lee ...

  13. Annals of Pediatric Surgery - Vol 11, No 1 (2015)

    African Journals Online (AJOL)

    Prune belly syndrome with pouch colon with scaphoid megalourethra: A newer embryological and prognostic perspective · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Saurabh Garge, Monika Bawa, Katragadda Lakshmi Narasimha Rao, 42-45 ...

  14. Case report

    African Journals Online (AJOL)

    ebutamanya

    28 août 2015 ... (intra-osseous synovial cyst) Clinical and therapeutic aspect: case report. Chir Main. 2009 Feb; 28(1):37-41. PubMed |. Google Scholar. 10. Chantelot C, Laffargue P, Masmejean E, Peltier B, Barouk P,. Fontaine C. Fracture of the scaphoid carpal bone secondary to an intraosseous cyst: apropos of a case.

  15. Images in medicine

    African Journals Online (AJOL)

    abp

    11 mars 2016 ... Vissage percutané rétrograde du scaphoïde. Retrograde percutaneous screwing of the scaphoid. Younes Mhammdi1,&, Berrada Mohamed Saleh1. 1Service de Traumatologie Orthopédie, Hopital Ibn Sina, CHU Rabat, Maroc. &Corresponding author: Younes Mhammdi, Service de Traumatologie ...

  16. Is there a place for radionuclide bone scintigraphy in the ...

    African Journals Online (AJOL)

    ... shown the importance of bone scintigraphy in the detection of fractures in radiographnegative skeletal trauma.T-3 The early detection and immobilisation of fractures of the scaphoid are thought to be essential in preventing the disabling sequelae of avascular necrosis and pseudo-arthrosis,4 Several studies allude to the

  17. On the history and definition of Preiser's disease

    NARCIS (Netherlands)

    Kallen, A. M.; Strackee, S. D.

    2014-01-01

    In 1910, Georg Preiser (1876-1913) described five cases of rarifying osteitis. Based on his imaging studies, he diagnosed post-traumatic avascular necrosis (AVN) of the scaphoid without any sign of primary fracture. This was followed by an article in 1911 in which Preiser related his findings to

  18. Author Details

    African Journals Online (AJOL)

    Kigera, James. Vol 13, No 2 (2016) - Articles Distribution of Scaphoid Nutrient Foramina Abstract PDF · Vol 13, No 2 (2016) - Articles Semitendinosus Tendon for Solitary Use in Anterior Cruciate Ligament Reconstruction Abstract PDF · Vol 13, No 2 (2016) - Articles Dupuytren's Diathesis in an African Male Abstract PDF.

  19. Download this PDF file

    African Journals Online (AJOL)

    Valued eMachines Customer

    Internal fixation of fractures with implants such as intramedullary nail, Dynamic Compression plate ... good biomechanical environment for healing2. .... Non union was the leading cause of implant failure in this study, accounting for 47.4%.

  20. Use of Pulsing Electromagnetic Fields for the Treatment of Pelvic Stress Fractures Among Female Soldiers

    National Research Council Canada - National Science Library

    Jones, D

    1995-01-01

    .... Pulsing electromagnetic fields (PEMFs)have been shown to speed the healing of non-union fractures and we have used them successfully to treat stress fractures in the lower limbs. All women at Ft...

  1. Download this PDF file

    African Journals Online (AJOL)

    daddy

    malunion and non-union which each accounted for 27 (16.1%) cases. ... Key words: Traditional Bone Setter, Fractures, Complications. *Department of ..... Acetabulum Pattela Ankle Hand Humerus Radius Fibula Tibia Femur Ulna. Figure 1: ...

  2. Complications of Fracture and Dislocation Treatment By Traditional ...

    African Journals Online (AJOL)

    Alasia Datonye

    TBS treatment of fractures and dislocations at a private ... gangrene, delayed union and pressure ulcer. The most frequent ... common complications include non-union, malunion .... nonunions in the patella and 2 nonunions in the ankle. The.

  3. New Neandertal wrist bones from El Sidrón, Spain (1994-2009).

    Science.gov (United States)

    Kivell, Tracy L; Rosas, Antonio; Estalrrich, Almudena; Huguet, Rosa; García-Tabernero, Antonio; Ríos, Luis; de la Rasilla, Marco

    2018-01-01

    Twenty-nine carpal bones of Homo neanderthalensis have been recovered from the site of El Sidrón (Asturias, Spain) during excavations between 1994 and 2009, alongside ∼2500 other Neandertal skeletal elements dated to ∼49,000 years ago. All bones of the wrist are represented, including adult scaphoids (n = 6), lunates (n = 2), triquetra (n = 4), pisiforms (n = 2), trapezia (n = 2), trapezoids (n = 5), capitates (n = 5), and hamates (n = 2), as well as one fragmentary and possibly juvenile scaphoid. Several of these carpals appear to belong to the complete right wrist of a single individual. Here we provide qualitative and quantitative morphological descriptions of these carpals, within a comparative context of other European and Near Eastern Neandertals, early and recent Homo sapiens, and other fossil hominins, including Homo antecessor, Homo naledi, and australopiths. Overall, the El Sidrón carpals show characteristics that typically distinguish Neandertals from H. sapiens, such as a relatively flat first metacarpal facet on the trapezium and a more laterally oriented second metacarpal facet on the capitate. However, there are some distinctive features of the El Sidrón carpals compared with most other Neandertals. For example, the tubercle of the trapezium is small with limited projection, while the scaphoid tubercle and hamate hamulus are among the largest seen in other Neandertals. Furthermore, three of the six adult scaphoids show a distinctive os-centrale portion, while another is a bipartite scaphoid with a truncated tubercle. The high frequency of rare carpal morphologies supports other evidence of a close genetic relationship among the Neandertals found at El Sidrón. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. ATLAS TileCal Sub-Module Production at UIUC - Production Submodule Photos (current)

    CERN Multimedia

    Errede, Steve

    2000-01-01

    Step 5 - Welding tacl_weld - Our Welder from Nucor (Tuscola, IL) tack-welds each of the four corners of the submodule. The submodule can then be safely lifted out of the stacking fixture by crane. Step 5 - WELDING tack_weld - Stan Lamb, our welder from Nucor (Tuscola, IL) tack-welds each of the four corners of the submodule. The submodule can then be safely lifted out of the stacking fixture by crane. Photo 9 - This is our handy Submodule Final Welding Jig designed and built by our very own Fred Cogswell. Photo 10 - A submodule being lowered into the welding jig for final welding. Photo 11 - Stan Lamb final-welds the submodule. The welding jig saves us an enormous amount of time, since the submodule can be easily be rotated by hand for each weld.

  5. Extraordinary lateral beaming of sound from a square-lattice phononic crystal

    Energy Technology Data Exchange (ETDEWEB)

    Bai, Xiaoxue; Qiu, Chunyin; He, Hailong; Peng, Shasha; Ke, Manzhu [Key Laboratory of Artificial Micro- and Nano-structures of Ministry of Education and School of Physics and Technology, Wuhan University, Wuhan 430072 (China); Liu, Zhengyou, E-mail: zyliu@whu.edu.cn [Key Laboratory of Artificial Micro- and Nano-structures of Ministry of Education and School of Physics and Technology, Wuhan University, Wuhan 430072 (China); Institute for Advanced Studies, Wuhan University, Wuhan 430072 (China)

    2017-03-03

    Highlights: • An extraordinary lateral beaming phenomenon is observed in a finite phononic crystal made of square lattice. • The phenomenon can be explained by the equivalence of the states located around the four corners of the first Brillouin zone. • The lateral beaming behavior enables a simple design of acoustic beam splitters. • In some sense, the phenomenon can be described by a near zero refractive index. - Abstract: This work revisits the sound transmission through a finite phononic crystal of square lattice. In addition to a direct, ordinary transmission through the sample, an extraordinary lateral beaming effect is also observed. The phenomenon stems from the equivalence of the states located around the four corners of the first Brillouin zone. The experimental result agrees well with the theoretical prediction. The lateral beaming behavior enables a simple design for realizing acoustic beam splitters.

  6. Engineer: The Professional Bulletin of Army Engineers. Volume 38, PB 5-08-3/4, July-December 2008

    Science.gov (United States)

    2008-12-01

    companies can tailor lane specifics to meet their training objectives. ■ ■ ■ ■ ■ ■ ■ ■ STX lanes execution is normally conducted at the platoon lev- el for...area of operations. The counter-IED fight incorporates all ele - ments—to include battalion and brigade staff integration—as well as the planning...Corners, the rock quarry, and the southeast corner of Area of Operation Bronco , along Alternate Supply Route Long Island. The mission at Four Corners was

  7. Graphene Nanowalls as Ingenious Material for Catalysts and Superconductors

    Science.gov (United States)

    2011-03-12

    whole transferred graphene films by using ECOPIA Hall measurement system HMS-3000 with silver paint used as electrodes at the four corners of graphene ...introduced for 15 min during growth stage. On the right: (a) A picture of the transferred graphene on SiO2/Si wafer with silver paint as electrodes at...Final Report for AOARD Grant 104057 “ Graphene Nanowalls as Ingenious Material for Catalysts and Superconductors” March 12, 2011 Name of

  8. Adaptive PVD Steganography Using Horizontal, Vertical, and Diagonal Edges in Six-Pixel Blocks

    Directory of Open Access Journals (Sweden)

    Anita Pradhan

    2017-01-01

    Full Text Available The traditional pixel value differencing (PVD steganographical schemes are easily detected by pixel difference histogram (PDH analysis. This problem could be addressed by adding two tricks: (i utilizing horizontal, vertical, and diagonal edges and (ii using adaptive quantization ranges. This paper presents an adaptive PVD technique using 6-pixel blocks. There are two variants. The proposed adaptive PVD for 2×3-pixel blocks is known as variant 1, and the proposed adaptive PVD for 3×2-pixel blocks is known as variant 2. For every block in variant 1, the four corner pixels are used to hide data bits using the middle column pixels for detecting the horizontal and diagonal edges. Similarly, for every block in variant 2, the four corner pixels are used to hide data bits using the middle row pixels for detecting the vertical and diagonal edges. The quantization ranges are adaptive and are calculated using the correlation of the two middle column/row pixels with the four corner pixels. The technique performs better as compared to the existing adaptive PVD techniques by possessing higher hiding capacity and lesser distortion. Furthermore, it has been proven that the PDH steganalysis and RS steganalysis cannot detect this proposed technique.

  9. Approach to valuing visual pollution from Western Electricity Production. [For Western Systems Coordinating Council area

    Energy Technology Data Exchange (ETDEWEB)

    Erickson, L.E.

    1977-02-01

    This paper outlines an approach to valuing visual pollution from electric power plants. The differences between public-good pollution externalities, such as these aesthetic damages, and other market failures are discussed. Approaches generally used to value externalities are briefly described. The approach used relies heavily on an earlier application of bidding games to estimate people's willingness to pay for abatement of emissions from the Four Corners fossil-fuel power plant in northwestern New Mexico. The results of these surveys were used here to estimate the value of visual pollution from electric power plants for residents of and visitors to the Four Corners Air Quality Control Region, as a function of power plant emissions in that region. The approach presented here for the Four Corners region is structured so that replication for other air quality control regions is relatively easy. Preliminary results of this procedure for all of the air quality control regions in the Western Systems Coordinating Council area are presented. Visual pollution damages from electric power plants to residents of and recreational visitors to these western regions are estimated to total more than $100 million annually by 1985. These damages are expected to occur unless additional pollution controls are implemented, even if these subject populations do not increase.

  10. For early diagnosis of the fracture healing, nonunion and avascular necorsis

    International Nuclear Information System (INIS)

    Kim, Y. C.; Lee, S. H.; Lee, Y. C.; Whang, I. S.; Kim, H. S.

    1981-01-01

    Complications of non-union and avascular necrosis during fracture healing process are the most important problems. Early detection of the evidence of non-union and avascular necrosis and follow-up study of fracture healing process will reduce complications and sequellae in fracture patients. Femoral neck and tibial shaft are the most important fracture sites where non-union and/or avascular necorsis are frequently developed. Osteomedullography was performed in 30 cases of fracture, 21 femoral neck, 8 tibial shafts and 1 talar neck, in the Department of Radiology of national Medical Center during the period form August 1977 to March 1981. The following results were obtained: 1. 16 patients of femoral neck fracture were performed osteomedullography one. Non-union showing no crossing vein through the fracture site was noted in 12 cases from 16 patients. 4 cases from the 12 patients of non-union showed decreased viability but 2 case revealed good viability of the femoral head. 1 case from 4 case of good union of fracture showed no evidence of viability of the femoral head. 2. More than twice of osteomedullography were performed in 5 cases of femoral neck fracture, and crossing vein was not appeared in 4 cases at 3 weeks after fracture. 3 cases showed crossing veins at 6 weeks, and 1 case revealed evidence of avascular necrosis of the femoral head at 9 weeks. 3. In 8 cases of tibial shaft fracture, 4 cases were non-union. Another 4 cases revealed intraosseous veins crossing in fracture site or additional Kaski's osteomedullographic signs, indicating bony union. 4. One talar neck fracture showed bony union with decreased viability of the bony on 12 months after fracture. 5. Osteomedullography is considered as very important study for the early diagnosis of the fracture healing, non-union and avascular necrosis

  11. For early diagnosis of the fracture healing, nonunion and avascular necorsis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Y C; Lee, S H; Lee, Y C; Whang, I S; Kim, H S [National Medical Center, Seoul (Korea, Republic of)

    1981-09-15

    Complications of non-union and avascular necrosis during fracture healing process are the most important problems. Early detection of the evidence of non-union and avascular necrosis and follow-up study of fracture healing process will reduce complications and sequellae in fracture patients. Femoral neck and tibial shaft are the most important fracture sites where non-union and/or avascular necorsis are frequently developed. Osteomedullography was performed in 30 cases of fracture, 21 femoral neck, 8 tibial shafts and 1 talar neck, in the Department of Radiology of national Medical Center during the period form August 1977 to March 1981. The following results were obtained: 1. 16 patients of femoral neck fracture were performed osteomedullography one. Non-union showing no crossing vein through the fracture site was noted in 12 cases from 16 patients. 4 cases from the 12 patients of non-union showed decreased viability but 2 case revealed good viability of the femoral head. 1 case from 4 case of good union of fracture showed no evidence of viability of the femoral head. 2. More than twice of osteomedullography were performed in 5 cases of femoral neck fracture, and crossing vein was not appeared in 4 cases at 3 weeks after fracture. 3 cases showed crossing veins at 6 weeks, and 1 case revealed evidence of avascular necrosis of the femoral head at 9 weeks. 3. In 8 cases of tibial shaft fracture, 4 cases were non-union. Another 4 cases revealed intraosseous veins crossing in fracture site or additional Kaski's osteomedullographic signs, indicating bony union. 4. One talar neck fracture showed bony union with decreased viability of the bony on 12 months after fracture. 5. Osteomedullography is considered as very important study for the early diagnosis of the fracture healing, non-union and avascular necrosis.

  12. Osteomedullography: for early diagnosis of the fracture healing, nonunion and avascular necrosis

    International Nuclear Information System (INIS)

    Kim, Y. C.; Lee, S. H.; Lee, Y. C.; Whang, I. S.; Kim, H. S.

    1981-01-01

    Complications of non-union and avascular necrosis during fracture healing process are the most important problem. Early detection of the evidence of non-union and avascular necrosis and follow-up study of fracture healing process will reduce complications and sequellae in fracture patients. Femoral neck and tibial shaft are the most important fracture sites where non-union and/or avascular necrosis are frequently developed. Osteomedullography was performed in 30 cases of fracture, 21 femoral neck, 8 tibial shafts and 1 talar neck, in the Department of Radiology of National Medical Center during the period from August 1977 to March 1981. The following results were obtained: 1. 16 patients of femoral neck fracture were performed osteomedullography once. Non-union showing no crossing vein through the fracture site was noted in 12 cases from 16 patients. 4 cases from the 12 patients of non-union showed decreased viability but 2 case revealed good viability of the femoral head. 1 case from 4 cases of good union of fracture showed no evidence of viability of the femoral head. 2. More than twice of osteomedullography were performed in 5 cases of femoral neck fracture, and crossing vein was not appeared in 4 cases at 3 weeks after fracture. 3 cases showed crossing veins at 6 weeks, and 1 case revealed evidence of avascular necrosis of the femoral head at 9 weeks. 3. In 8 cases of tibial shaft fracture, 4 cases were non-union. Another 4 cases revealed intraosseous veins crossing in fracture site or additional Kaski's osteomedullographic signs, indicating bony union. 4. One talar neck fracture showed bony union with decreased viability of the body on 12 month after fracture. 5. Osteomedullography is considered as very important study for the early diagnosis of the fracture healing, non-union and avascular necrosis

  13. Osteomedullography: for early diagnosis of the fracture healing, nonunion and avascular necrosis

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Y C; Lee, S H; Lee, Y C; Whang, I S; Kim, H S [National Medical Center, Seoul (Korea, Republic of)

    1981-12-15

    Complications of non-union and avascular necrosis during fracture healing process are the most important problem. Early detection of the evidence of non-union and avascular necrosis and follow-up study of fracture healing process will reduce complications and sequellae in fracture patients. Femoral neck and tibial shaft are the most important fracture sites where non-union and/or avascular necrosis are frequently developed. Osteomedullography was performed in 30 cases of fracture, 21 femoral neck, 8 tibial shafts and 1 talar neck, in the Department of Radiology of National Medical Center during the period from August 1977 to March 1981. The following results were obtained: 1. 16 patients of femoral neck fracture were performed osteomedullography once. Non-union showing no crossing vein through the fracture site was noted in 12 cases from 16 patients. 4 cases from the 12 patients of non-union showed decreased viability but 2 case revealed good viability of the femoral head. 1 case from 4 cases of good union of fracture showed no evidence of viability of the femoral head. 2. More than twice of osteomedullography were performed in 5 cases of femoral neck fracture, and crossing vein was not appeared in 4 cases at 3 weeks after fracture. 3 cases showed crossing veins at 6 weeks, and 1 case revealed evidence of avascular necrosis of the femoral head at 9 weeks. 3. In 8 cases of tibial shaft fracture, 4 cases were non-union. Another 4 cases revealed intraosseous veins crossing in fracture site or additional Kaski's osteomedullographic signs, indicating bony union. 4. One talar neck fracture showed bony union with decreased viability of the body on 12 month after fracture. 5. Osteomedullography is considered as very important study for the early diagnosis of the fracture healing, non-union and avascular necrosis.

  14. Diagnosis-Related Groups in Hand Surgery – a comparison of six European countries [Fallpauschalen in der Handchirurgie – ein Vergleich von sechs europäischen Ländern

    Directory of Open Access Journals (Sweden)

    Stahl, Stephane

    2012-04-01

    Full Text Available [english]
    Diagnosis-Related Group (DRG is a classification system, which groups patients according to their diagnosis and resource consumption. Common hand surgical diagnoses and procedures were processed using national DRG-groupers of six European countries. The upper thresholds of length of stay (LoS are indicated for every country with the exception of Spain. The mean value in the series was 9.9 days for Germany, 4.5 days for Austria, 10.7 days for Italy, 9.7 days for Sweden and 9.4 days for the United Kingdom (UK. Germany and Austria also have lower thresholds of LoS and the average LoS.Multiple finger replantation presented the highest single case reimbursement in Germany, Austria and the UK (13,825 €, 10,576 € and Scaphoid non-union had the highest single case reimbursement in Italy (2,676 €, flap coverage of wounds in Spain (5,506 € and trapeziometacarpal arthritis in Sweden (5,350 €. The mean values for single case reimbursement were as follows: Germany 3,211 €, Austria 2,821 €, Italy 1,947 €, Spain 3,594 €, Sweden 2,403 € and the UK 3,253 €. Ten out of 19 cases showed the highest reimbursement in Spain, followed by the UK (5 cases, Sweden (2 cases, Germany and Austria (1 case each. Applying the case numbers of our clinic to the reimbursement system of each country, total proceeds would be 2.25 million € in Spain, in Germany as well as the UK, 1.75 million € in Austria, in Sweden and 1.22 million € in Italy. The consequences of international differences in efficiency and reimbursement are hard to assess as they are influenced by multiple factors that are seldom purely market-driven. However, the consideration of international data for benchmarking and refinement of national compensation systems should be a useful instrument. [german]
    Diagnosis-Related Groups (DRG bezeichnet ein Klassifikationssystem, welches Patienten anhand ihrer Diagnosen und des Ressourcenverbrauchs einteilt. H

  15. Carpal instabilities and secondary degenerative changes due to lesions of the radiocarpal ligament complex

    International Nuclear Information System (INIS)

    Stabler, A.; Berger, H.; Lissner, J.

    1990-01-01

    This paper reports on trauma, rheumatoid arthritis, calcium pyrophosphate dihydrate crystal deposition (CPDD), neurologic disease, and beta 2 -microglobulin-related amyloid deposits in patients undergoing chronic hemodialysis that can lead to distinct lesions of the radiocarpal ligament complex, causing rotational subluxation of the scaphoid and ulnar translocation of the carpus. The clinical and radiologic findings were analyzed in 35 patients, examined from 1985 to 1989. Degenerative changes in rotational subluxation of the scaphoid develop in three steps. First there is osteoarthritis at the styloid process, then the degeneration progresses into the central midcarpal joint, and finally it progresses to the ulnar midcarpal joint. Despite different etiologies of ligament failure, the radiologic features are very similar, because the mechanism of degeneration is identical in posttraumatic, inflammatory, neurogenic, CPDD, or beta 2 -microglobulin-related instability. However, there are some distinct radiologic differences in relation to the primary cause of the ligament defect

  16. Diagnostic imaging of the hand. 3. rev. and enl. ed.; Bildgebende Diagnostik der Hand

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, Rainer [Herz und Gefaessklinik GmbH, Bad Neustadt (Germany). Klinik fuer Diagnostische und Interventionelle Radiologie; Lanz, Ulrich

    2015-07-01

    The book on diagnostic imaging of the hand covers the following issues: projection radiography, cinematography, MRT and CR arthrography, arthroscopy, arteriography, skeleton scintiscanning, sonography, computerized tomography, magnetic resonance tomography, anatomy of forearm and carpus, anatomy of metacarpus and fingers, carpal function and morphometry, postoperative X-ray diagnostic, growing hand skeleton, normative variants, malformations and deformities, trauma of the distal forearm, lesions of the ulnocarpal complex (TFCC), scaphoid fractures, scaphoid arthrosis, fractures of other carpus bones, carpal luxations and luxation fractures, carpal instabilities, fractures of the metacarpalla, finger fractures, arthrosis deformans, enthesiopathies, sport induced soft tissue lesions, osteonecrosis, impingement syndromes, osteopenic skeletal diseases, metabolis diseases, crystal-induced osteoarthropaties, rheumatoid arthritis, spondyloarthritis, rheumatic fever, collagenoses, infective arthritis, osteomyelitis, soft tissue infections, cystoids bone lesions, skeletal tumors, soft tissue tumors, carpal tunnel syndrome, nerve compression syndrome, arterial perfusion disturbances, differential diagnostic tables on hand lesions.

  17. Diagnostic imaging of the hand. 3. rev. and enl. ed.

    International Nuclear Information System (INIS)

    Schmitt, Rainer; Lanz, Ulrich

    2015-01-01

    The book on diagnostic imaging of the hand covers the following issues: projection radiography, cinematography, MRT and CR arthrography, arthroscopy, arteriography, skeleton scintiscanning, sonography, computerized tomography, magnetic resonance tomography, anatomy of forearm and carpus, anatomy of metacarpus and fingers, carpal function and morphometry, postoperative X-ray diagnostic, growing hand skeleton, normative variants, malformations and deformities, trauma of the distal forearm, lesions of the ulnocarpal complex (TFCC), scaphoid fractures, scaphoid arthrosis, fractures of other carpus bones, carpal luxations and luxation fractures, carpal instabilities, fractures of the metacarpalla, finger fractures, arthrosis deformans, enthesiopathies, sport induced soft tissue lesions, osteonecrosis, impingement syndromes, osteopenic skeletal diseases, metabolis diseases, crystal-induced osteoarthropaties, rheumatoid arthritis, spondyloarthritis, rheumatic fever, collagenoses, infective arthritis, osteomyelitis, soft tissue infections, cystoids bone lesions, skeletal tumors, soft tissue tumors, carpal tunnel syndrome, nerve compression syndrome, arterial perfusion disturbances, differential diagnostic tables on hand lesions.

  18. Post Traumatic Avascular Necrosis of the Proximal Carpal Row--A Case Report.

    Science.gov (United States)

    Manohara, Ruben; Sebastin, Sandeep Jacob; Puhaindran, Mark Edward

    2015-10-01

    We report a case of avascular necrosis of the scaphoid, lunate and triquetrum in a young 21-year-old patient, after a purely ligamentous peri-lunate dislocation of the wrist. He presented with a Mayfield III peri-lunate dislocation after a road traffic accident and underwent an open reduction and internal fixation. Post-operatively, the scapho-lunate gap widened after removal of the temporary K-wires, and he gradually developed avascular necrosis of the scaphoid, lunate and triquetrum, and osteoarthritis of his wrist. We present this unusual case of simultaneous avascular necrosis of multiple carpal bones and discuss the possible risk factors and subsequent management plans for this complex injury. Our patient has no identifiable contributing factors to developing avascular necrosis. We suspect that the violence of the injury and surgery may have compromised the circulation, and advise caution when treating and counseling these patients pre-operatively.

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

    LENUS (Irish Health Repository)

    Burke, Neil G

    2014-01-01

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

  20. High-resolution MRI of the ulnar and radial collateral ligaments of the wrist.

    Science.gov (United States)

    Nozaki, Taiki; Wu, Wei Der; Kaneko, Yasuhito; Rafijah, Gregory; Yang, Lily; Hitt, Dave; Yoshioka, Hiroshi

    2017-12-01

    Background Accurate diagnosis of injuries to the collateral ligaments of the wrist is technically challenging on MRI. Purpose To investigate usefulness of high-resolution two-dimensional (2D) and isotropic three-dimensional (3D) magnetic resonance imaging (MRI) for identifying and classifying the morphology of the ulnar and radial collateral ligaments (UCL and RCL) of the wrist. Material and Methods Thirty-seven participants were evaluated using 3T coronal 2D and isotropic 3D images by two radiologists independently. The UCL was classified into four types: 1a, narrow attachment to the tip of the ulnar styloid (Tip); 1b, broad attachment to the Tip; 2a, narrow attachment to the medial base of the ulnar styloid (Base); and 2b, broad attachment to the Base. The RCL was also classified into four types: 1a, separate radioscaphoid and scaphotrapezial ligaments (RS + ST) with narrow scaphoid attachment; 1b, RS + ST with broad scaphoid attachment; 2a, continuous radio-scapho-trapezial ligaments (RST) with narrow scaphoid attachment; and 2b, RST with broad scaphoid attachment. The inter-observer reliability of these classifications was calculated. Results Type 1a was the most common of both collateral ligaments. Of UCL classifications, 31.4% were revised after additional review of multiplanar reconstruction (MPR) images from isotropic data. The inter-observer reliability of UCL classification was substantial (k = 0.62) without MPR, and almost perfect (k = 0.84) with MPR. The inter-observer reliability of RCL classification was almost perfect (k = 0.89). Anatomic delineation between the two sequences was not statistically different. Conclusion The UCL and RCL were each identified on high-resolution 2D and isotropic 3D MRI equally well. MPR allows accurate identification of the UCL attachment to the ulnar styloid.

  1. Adverse Effects of Smoking on Outcomes of Orthopaedic Surgery

    OpenAIRE

    Sheung-tung Ho

    2017-01-01

    Smoking has many adverse effects on the musculoskeletal system, particularly on the outcomes after orthopaedic surgery. Smoking is associated with surgical site infection and postoperative wound complications after spine surgery, total joint arthroplasty, and fracture fixation; nonunion after spinal fusion, ankle fusion, osteotomy, and internal fixation and bone grafting for scaphoid nonunion; worse outcomes after lumbar disc prolapse, spinal stenosis, and cervical myelopathy surgery; peripro...

  2. Annual Progress Report, Fiscal Year 1981.

    Science.gov (United States)

    1981-09-30

    Reaction After Ingestion of Local Bee Pollen. Annals of Allergy Moreno AL, Spicer MG, Old C, Morrison RE: Varicella Pneumonia in Pregnancy with Lactate...Presented at the New Mexico State University College of Education Dialogue Series, Apr 21, 1981. DEPARTMENT OF ORTHOPAEDIC SURGERY Copeland R: Tendon...Nov 1980. Huntt HA: Fractures of the Carpal Scaphoid in Children. Presented at the Carrie Tingley Hospital and New Mexico Chapter, Western

  3. Extranodal Rosai-Dorfman disease in a carpal bone

    Directory of Open Access Journals (Sweden)

    Kalpalata Tripathy

    2012-01-01

    Full Text Available We report a case of extranodal Rosai-Dorfman Disease (RDD of the scophoid in a 52-year old female. The patient presented with pain, swelling, and tenderness on deep palpation of the left wrist. Clinicoradiological diagnosis was osteomyelitis or tenosynovitis and curettage was performed on the lytic lesion over scaphoid to procure tissue. Diagnosis was made by histomorphology supported by immunostaining. The patient was managed conservatively with resolution of the lesion.

  4. Labor Market Institutions and the Industry Wage Distribution: Evidence from Austria, Norway, and the U.S.

    OpenAIRE

    Barth, Erling; Zweimuller, Josef

    1992-01-01

    The paper compares the industry wage structures of Austria, Norway, the union sector of the U.S. as well as the non-union sector of the U.S. We make comparable regressions for each country, and are thus able to compare the sectoral earnings patterns controlling for the usual individual characteristics. Our results confirm the hypothesis that the patterns of the inter-industry pay structure is largely independent of labor market institutions: High paying industries in a non-union environment t...

  5. Novel speed test for evaluation of badminton specific movements

    DEFF Research Database (Denmark)

    Madsen, Christian Møller; Karlsen, Anders; Nybo, Lars

    2015-01-01

    In this study we developed a novel badminton speed test (BST). The test was designed to mimic match play. The test starts in the center of the court and consists of five maximal actions to sensors located in each of the four corners of the court. The 20 actions are performed in randomized order...... as dictated by computer screen shots displayed one second following completion of the previous action. We assessed day-to-day variation in elite players and specificity of the test was evaluated by comparing 30 meter sprint performance and time to complete the BST in 20 elite, 21 skilled players and 20 age...

  6. Transient thermal stresses in an orthotropic finite rectangular plate due to arbitrary surface heat-generations

    International Nuclear Information System (INIS)

    Sugano, Y.

    1980-01-01

    The transient thermal stresses in an orthotropic finite rectangular plate due to arbitrary surface heat-generations on two edges are studied by means of the Airy stress function. The purposes of this paper are to present a method of determing the transient thermal stresses in an orthographic rectangular plate with four edges of distinct thermal boundary condition of the third kind which exactly satisfy the traction-free conditions of shear stress over all boundaries including four corners of the plate, and to consider the effects of the anisotropies of material properties and the convective heat transfer on the upper and lower surfaces on the thermal stress distribution. (orig.)

  7. Portrait of a Contender: Corey Morris

    Directory of Open Access Journals (Sweden)

    Corey Morris

    2010-03-01

    Full Text Available “Language at Work – Bridging Theory and Practice” caught up with busy Corey Morris on a cold and rainy November day in Denmark. We had two main reasons for looking up Corey at his work. First, we knew that his work takes him to the four corners of the world of branding on a daily basis. Second, we were well aware that Corey would be the right person to ask questions as to where branding is going these days.

  8. Reworking labour practices : On the agency of unorganized mobile migrant construction workers

    NARCIS (Netherlands)

    Berntsen, Lisa

    2016-01-01

    In an attempt to probe the nuanced processes of non-unionization, this article analyses the agency of migrant construction workers and the ways they negotiate and navigate an increasingly flexible and pan-European labour market. Drawing upon qualitative interview data, the article argues that the

  9. Proximal tibia stress fracture with Osteoarthritis of knee − Radiological and functional analysis of one stage TKA with long stem

    Directory of Open Access Journals (Sweden)

    Soundarrajan Dhanasekaran

    2018-01-01

    Conclusion: TKA with long stem gives excellent outcome, irrespective of severity of arthritis associated with stress fracture. By restoring limb alignment and bypassing the fracture site, it facilitates fracture healing. Early detection and prompt intervention is necessary to prevent the progression to recalcitrant non-union or malunion.

  10. The effect of concentrated bone marrow aspirate in operative treatment of fifth metatarsal stress fractures; a double-blind randomized controlled trial

    NARCIS (Netherlands)

    Weel, Hanneke; Mallee, Wouter H.; van Dijk, C. Niek; Blankevoort, Leendert; Goedegebuure, Simon; Goslings, J. Carel; Kennedy, John G.; Kerkhoffs, Gino M. M. J.

    2015-01-01

    Fifth metatarsal (MT-V) stress fractures often exhibit delayed union and are high-risk fractures for non-union. Surgical treatment, currently considered as the gold standard, does not give optimal results, with a mean time to fracture union of 12-18 weeks. In recent studies, the use of bone marrow

  11. Use of bone morphogenetic proteins in traumatology

    NARCIS (Netherlands)

    Westerhuis, R. J.; van Bezooijen, R. L.; Kloen, P.

    2005-01-01

    An estimated 5-10% of all fractures show impaired heating, leading to delayed union, or non-union. Chemical, or physical methods to accelerate bone heating are of great interest to the orthopaedic and trauma community. Research over the last 20 years has established that successful fracture heating

  12. Actis Total Hip System 2 Year Follow-up

    Science.gov (United States)

    2017-08-14

    Osteoarthritis; Traumatic Arthritis; Rheumatoid Arthritis; Congenital Hip Dysplasia; Avascular Necrosis of the Femoral Head; Acute Traumatic Fracture of the Femoral Head or Neck; Certain Cases of Ankylosis; Non-union of Femoral Neck Fractures; Certain High Sub-Capital & Femoral Neck Fractures in Elderly

  13. Two-stage bargaining with coverage extension in a dual labour market

    DEFF Research Database (Denmark)

    Roberts, Mark A.; Stæhr, Karsten; Tranæs, Torben

    2000-01-01

    This paper studies coverage extension in a simple general equilibrium model with a dual labour market. The union sector is characterized by two-stage bargaining whereas the firms set wages in the non-union sector. In this model firms and unions of the union sector have a commonality of interest...

  14. ISSN 2073-9990 East Cent. Afr. J. s East Cent. Afr. J. s

    African Journals Online (AJOL)

    dell

    Results of Operative Fixation of Fractures of the Ankle at a Tertiary Hospital in a Developing. Country. ... Complications included wound infection 14.3%, wound dehiscence with exposed implants 2.9%, malunion 8.6% and non union 5.7%.

  15. Learning and Adapting for Organisational Change: Researching Union Education in Australia

    Science.gov (United States)

    Brown, Tony; Yasukawa, Keiko

    2010-01-01

    The last quarter century saw a restructuring of employment, production and trade and a dramatic decline in union membership and density levels. There are many explanations for this, including the hostile industrial relations framework imposed by many governments, but there have been other factors such as the growth of new non-unionized industries…

  16. An evaluation of the effect of bone morphogenetic protein-2 in a ...

    African Journals Online (AJOL)

    There was progressive filling of osseous defects in group 1, which was total at the 16th week post-surgical (PS); group 2 dogs had radiographic non-union at the 16th PS week. It was concluded that BMP implanted with a hydroxyapatite carrier significantly enhanced the rate of cortical restoration of massive bone defects in ...

  17. The effects of extracorporeal shockwave on acute high-energy long bone fractures of the lower extremity.

    Science.gov (United States)

    Wang, Ching-Jen; Liu, Hao-Chen; Fu, Te-Hu

    2007-02-01

    High-energy long bone fractures of the lower extremity are at risk of poor fracture healing and high rate of non-union. Extracorporeal shockwave was shown effective to heal non-union of long bone fracture. However, the effect of shockwave on acute fractures is unknown. The purpose of this study was to investigate the effects of shockwave on acute high-energy fractures of the lower extremity. Between January and October 2004, 56 patients with 59 acute high-energy fractures were enrolled in this study. Patients were randomly divided into two groups with 28 patients with 28 fractures in the study group and 28 patients with 31 fractures in the control group. Both groups showed similar age, gender, type of fracture and follow-up time. Patients in the study group received open reduction and internal fixation and shockwave treatment immediately after surgery on odd-numbered days of the week, whereas, patients in the control group received open reduction and internal fixation without shockwave treatment on even-numbered days of the week. Postoperative managements were similarly performed in both groups including crutch walking with non-weight bearing on the affected limb until fracture healing shown on radiographs. The evaluation parameters included clinical assessments of pain score and weight bearing status of the affected leg and serial radiographs at 3, 6 and 12 months. The primary end-point is the rate of non-union at 12 months, and the secondary end point is the rate of fracture healing at 3, 6 and 12 months. At 12 months, the rate of non-union was 11% for the study group versus 20% for the control group (P fracture healing was noted in the study group than the control group at 3, 6 and 12 months (P fracture healing and decreasing the rate of non-union in acute high-energy fractures of the lower extremity.

  18. CT arthrography of the wrist using a novel, mobile, dedicated extremity cone-beam CT (CBCT)

    Energy Technology Data Exchange (ETDEWEB)

    Koskinen, Seppo K. [Helsinki University Central Hospital, Department of Radiology, HUS Helsinki Medical Imaging Center, Helsinki (Finland); Helsinki University Hospital, Toeoeloe Trauma Center, Department of Radiology, HUS Helsinki Medical Imaging Center, Helsinki (Finland); Haapamaeki, Ville V.; Kortesniemi, Mika [Helsinki University Central Hospital, Department of Radiology, HUS Helsinki Medical Imaging Center, Helsinki (Finland); Salo, Jari [Helsinki University Central Hospital, Department of Orthopedic and Trauma Surgery, Helsinki (Finland); Kuopio University Hospital, UEF, Department of Orthopedics, Traumatology and Hand Surgery, Kuopio (Finland); Lindfors, Nina C. [Helsinki University Central Hospital, Department of Orthopedic and Hand Surgery, Helsinki (Finland); Seppaelae, Lauri [Planmed Oy, Helsinki (Finland); Mattila, Kimmo T. [Turku University Central Hospital, Department of Diagnostic Radiology, Turku (Finland)

    2013-05-15

    To evaluate the feasibility and intra- and interobserver agreement of CBCT arthrography of wrist ligaments, triangular fibrocartilaginous complex (TFCC), and to assess the sensitivity (SE), specificity (SP), accuracy (ACC), and positive and negative predictive value (PPV, NPV) of CBCT arthrography in the diagnosis of scapholunate (SLL) and lunotriquetral (LTL) ligament tears, TFCC, and cartilage abnormalities of the scaphoid and lunate with their corresponding radial surfaces (scaphoid and lunate fossa) using a novel, mobile, dedicated extremity CBCT scanner. Fifty-two consecutively enrolled subjects (26 M, 26 F, mean age 38 years, range 18-66 years) with suspected wrist ligament tears underwent CBCT-arthrography before normally scheduled MR arthrography.An extremity CBCT was used for imaging with isotropic voxel size of 0.4 x 0.4 x 0.4 mm{sup 3}. Subsequent routine 1.5 T MRI was performed using a dedicated wrist coil.Two observers reviewed the anonymized CBCT images twice for contrast enhancement (CE) and technical details (TD), for tears of the SLL, LTL, and TFCC. Also, cartilage abnormalities of the scaphoid and lunate with their corresponding radial surfaces (scaphoid and lunate fossa) were evaluated. Inter- and intraobserver agreement was determined using weighted kappa statistics. Since no surgery was performed, MRI served as a reference standard, and SE and SP, ACC, PPV, and NPV were calculated. Intra- and interobserver kappa values for both readers (reader 1/reader 2; first reading/second reading) with 95 % confidence limits were: CE 0.54 (0.08-1.00)/ 0.75 (0.46-1.00); 0.73 (0.29-1.00)/ 0.45 (0.07-0.83), TD 0.53 (0.30-0.88)/ 0.86 (0.60-1.00); 0.56 (0.22-0.91)/ 0.67 (0.37-0.98), SLL 0.59 (0.25-0.93)/ 0.66 (0.42-0.91); 0.31 (0.06-0.56)/ 0.49 (0.26-0.73), LTL 0.83 (0.66-1.00)/ 0.68 (0.46-0.91); 0.90 (0.79-1.00)/ 0.48 (0.22-0.74); TFCC (0.72-1.00)/ (0.79-1.00); 0.65 (0.43-0.87)/ 0.59 (0.35-0.83), radius (scaphoid fossa) 0.45 (0.12-0.77)/ 0.64 (0.31-0.96); 0

  19. Post-Closure Challenges of U.S. Department of Energy Sites in Desert Environments of the Southwestern United States - 12095

    Energy Technology Data Exchange (ETDEWEB)

    Gil, April; Steckley, Deborah [U.S. Department of Energy Office of Legacy Management (United States); Gauthier, Cassie; Miller, David [S.M. Stoller Company, Contractor to the U.S. Department of Energy (United States)

    2012-07-01

    U.S. Department of Energy (DOE) sites located in harsh desert environments of the Four Corners region of the southwestern United States require diligence and continual maintenance to ensure the remediation systems function as designed to protect human health and the environment. The geology and climate of this area create issues that are unique to these sites. Geologic formations contain naturally occurring constituents that are often the same as the residual contaminants remaining from historical milling activities at the sites. Although annual precipitation is low, when precipitation events occur they can be of extreme intensity, resulting in erosion and flooding that can quickly destroy infrastructure and rapidly change site conditions. Winds can cause sand storms and sand mounding that effect site features. These challenging environmental conditions, along with the remote locations of the sites, require active management beyond what was originally envisioned for uranium disposal sites to address concerns in a safe and cost-effective manner. The unique environment of the Four Corners region creates many challenges to the LTSM of LM sites in southwestern United States. The remediation efforts and approaches to infrastructure have to be specifically structured to work in this environment. Often, the systems and structures have to be modified based on lessons learned on how to best adapt to these difficult conditions and remote locations. These sites require continual maintenance and additional efforts compared to many other LM sites. (authors)

  20. Infrared optical properties of a coal-fired power plant plume

    International Nuclear Information System (INIS)

    Stearns, L.P.; Pueschel, R.F.

    1983-01-01

    Infrared measurements in the 8--14-μm spectral region were made of two coal-fired power plant plumes and area haze in the Four Corners region of New Mexico from 1 to 7 Nov. 1980. The layer tranmittance, optical depth, and volume extinction coefficient derived from measurements on four nonconsecutive days show the effects of the plumes on the IR optical properties of the atmosphere. The average contribution of the plume alone to the IR extinction coefficient was 74% at the Four Corners plant; the background haze contributed 7--11%. More efficient particulate emission control at the San Juan power plant reduced the average contribution of its plume to 57% of the extinction coefficient. The haze contributed an average of 16%. The results show an increase with time of the haze bulk extinction coefficient during a persistent anticyclonic synoptic situation. Extinction coefficients of the haze showed a linearity with particulate loading, which led to estimates of IR volume extinctions of the free troposphre from aerosol measurements

  1. MOX fuel assembly and reactor core

    International Nuclear Information System (INIS)

    Shimada, Hidemitsu; Koyama, Jun-ichi; Aoyama, Motoo

    1998-01-01

    The MOX fuel assembly of the present invention is of a c-lattice type loaded to a BWR type reactor. 74 MOX fuel rods filled with mixed oxides of uranium and plutonium and two water rods disposed to a space equal to that for 7 MOX fuel rods are arranged in 9 x 9 matrix. MOX fuel rods having the lowest enrichment degree are disposed to four corners of the 9 x 9 matrix. The enrichment degree means a ratio of the weight of fission products based on the total weight of fuels. Two MOX fuel rods having the same enrichment degree are arranged in each direction so as to be continuous from the MOX fuel rods at four corners in the direction of the same row and different column and same column and the different row. In addition, among the outermost circumferential portion of the 9 x 9 matrix, MOX fuel rods having a lower enrichment degree next to the MOX fuel rods having the lowest enrichment degree are arranged, each by three to a portion where MOX fuel rods having the lowest enrichment degree are not disposed. (I.N.)

  2. Is the early percutaneous spine total care to treat the polytrauma patient a good way?

    Directory of Open Access Journals (Sweden)

    Gabriele Falzarano

    2015-03-01

    Full Text Available The “ideal“ timing and modality of fracture fixation for unstable thoracolumbar spine fractures in multiply injured patients remains controversial. The concept of “damage control orthopedics” is expressed. We presented a case report of a 27 years' old male who sustained a multilevel spine fractures associated a floating knee (Fraser's Type A, ulna fracture and carpal scaphoid fracture in July 2014 after car accident (very high energy trauma. All these fractures were treated in early total care. We reported a case control to discuss about the early spinal total care associated at orthopedic total care in patients with multiple trauma.

  3. Acute hand and wrist injuries in athletes: evaluation and management.

    Science.gov (United States)

    Morgan, W J; Slowman, L S

    2001-01-01

    Acute hand and wrist injuries in the athlete constitute a unique orthopaedic challenge. Because of the particular demands on the athlete (e.g., financial implications, coaching and administration pressures, self-esteem issues), a specialized management approach is often necessary. Common sites of injury include the ulnar collateral ligament of the thumb metacarpophalangeal joint, proximal interphalangeal joint, metacarpals and phalanges, scaphoid, hamate, and distal radius. Treatment of these injuries varies depending on the patient's age, sport, position played, and level of competition, but departures from standard practice as regards surgery, rehabilitation, and return to competition should never compromise care.

  4. TREATMENT OF FRACTURES TO THE HAND

    Directory of Open Access Journals (Sweden)

    Valentina Colombo

    2012-03-01

    Full Text Available The aim of this article is to discuss the treatment of fractures to the hand given the importance of this organ in terms of functional anatomy. After classifying the various types of fractures, surgery and rehabilitation options for all types are discussed. Particular emphasis is placed on therapy for the most frequently seen lesions such as fractures to the scaphoid, the fifth metacarpal and the base of the first metacarpal. The importance of the use of prophylaxis against stiffness and treatment for oedema, which are commonly seen in fractures to the hand, is also highlighted.

  5. Prosthesis of the wrist-joint

    Energy Technology Data Exchange (ETDEWEB)

    Feldmeier, C.

    1983-02-25

    Function of the hand-joint and the well-being of patients can be severely affected by arthrosis of the wrist-joint. Therapeutically, arthrodesis usually results in a painfree status of stiffness. A painless and well functioning joint can be achieved by alloplastic joint replacement or resurfacing. The possibilities and clinical results in cases of arthrosis of the carpo-metacarpal joint of the thumb, pseudarthrosis of the scaphoid, aseptic necrosis of the Lunate and severe arthrosis of the radio-carpal joint are demonstrated.

  6. Prosthesis of the wrist-joint

    International Nuclear Information System (INIS)

    Feldmeier, C.

    1983-01-01

    Function of the hand-joint and the well-being of patients can be severely affected by arthrosis of the wrist-joint. Therapeutically, arthrodesis usually results in a painfree status of stiffness. A painless and well functioning joint can be achieved by alloplastic joint replacement or resurfacing. The possibilities and clinical results in cases of arthrosis of the carpo-metacarpal joint of the thumb, pseudarthrosis of the scaphoid, aseptic necrosis of the Lunate and severe arthrosis of the radio-carpal joint are demonstrated. (orig.) [de

  7. MR imaging of avascular necrosis of carpal bones

    International Nuclear Information System (INIS)

    Taniguchi, Yasunori; Funaoka, Nobuhiko; Yoshida, Munehito; Iwahashi, Toshiyuki; Egawa, Hiromitsu; Shima, Kimihiro; Tamaoki, Tetsuya.

    1991-01-01

    The usefulness of MRI in carpal avascular necrosis was investigated in 20 cases, 16 in lunates, 3 in scaphoids and 1 in triquetrum, with T1 and T2 weighted images of the spin echo and T2 weighted images of the field echo. Early diagnosis of carpal bone necrosis was possible when the T1 weighted image showed a moderate low intensity signal. A high intensity signal in the T2 weighted image indicated the onset of revascularization, and a favorable prognosis. A normal signal indicated healing of carpal avascular necrosis. MRI was found to be very useful in establishing the diagnosis and in determining the prognosis of carpal osteonecrosis. (author)

  8. MR imaging of avascular necrosis of carpal bones

    Energy Technology Data Exchange (ETDEWEB)

    Taniguchi, Yasunori; Funaoka, Nobuhiko; Yoshida, Munehito [Kinan General Hospital, Wakayama (Japan); Iwahashi, Toshiyuki; Egawa, Hiromitsu; Shima, Kimihiro; Tamaoki, Tetsuya

    1991-03-01

    The usefulness of MRI in carpal avascular necrosis was investigated in 20 cases, 16 in lunates, 3 in scaphoids and 1 in triquetrum, with T1 and T2 weighted images of the spin echo and T2 weighted images of the field echo. Early diagnosis of carpal bone necrosis was possible when the T1 weighted image showed a moderate low intensity signal. A high intensity signal in the T2 weighted image indicated the onset of revascularization, and a favorable prognosis. A normal signal indicated healing of carpal avascular necrosis. MRI was found to be very useful in establishing the diagnosis and in determining the prognosis of carpal osteonecrosis. (author).

  9. [Cinematography, a new diagnostic procedure in evaluation of the injured painful wrist joint].

    Science.gov (United States)

    Werber, K D; Wuttge-Hannig, A; Hannig, C

    1990-01-01

    By the X-ray Cineradiografie we are able to examine and to judge the dynamic of the wrist bones by 50 pictures/sec. in comparison to one another and also depending on their ligaments. We did an investigation of 170 patients with painful wrist. With the method we were able to make up a clear diagnosis and to propose the therapy. I.e.: If consecutive shortening of the radius after distal radius fracture resulting ingruency of the wrist joint is relevant, or a scaphoid pseudarthrosis is fixed elastically, or a scaphoic dissociation is effective. The variations were shown in comparison to normal circumstances.

  10. Autologous bone graft versus demineralized bone matrix in internal fixation of ununited long bones.

    Science.gov (United States)

    Pieske, Oliver; Wittmann, Alexandra; Zaspel, Johannes; Löffler, Thomas; Rubenbauer, Bianka; Trentzsch, Heiko; Piltz, Stefan

    2009-12-15

    Non-unions are severe complications in orthopaedic trauma care and occur in 10% of all fractures. The golden standard for the treatment of ununited fractures includes open reduction and internal fixation (ORIF) as well as augmentation with autologous-bone-grafting. However, there is morbidity associated with the bone-graft donor site and some patients offer limited quantity or quality of autologous-bone graft material. Since allogene bone-grafts are introduced on the market, this comparative study aims to evaluate healing characteristics of ununited bones treated with ORIF combined with either iliac-crest-autologous-bone-grafting (ICABG) or demineralized-bone-matrix (DBM). From 2000 to 2006 out of sixty-two consecutive patients with non-unions presenting at our Level I Trauma Center, twenty patients had ununited diaphyseal fractures of long bones and were treated by ORIF combined either by ICABG- (n = 10) or DBM-augmentation (n = 10). At the time of index-operation, patients of the DBM-group had a higher level of comorbidity (ASA-value: p = 0.014). Mean duration of follow-up was 56.6 months (ICABG-group) and 41.2 months (DBM-group). All patients were clinically and radiographically assessed and adverse effects related to bone grafting were documented. The results showed that two non-unions augmented with ICABG failed osseous healing (20%) whereas all non-unions grafted by DBM showed successful consolidation during the first year after the index operation (p = 0.146). No early complications were documented in both groups but two patients of the ICABG-group suffered long-term problems at the donor site (20%) (p = 0.146). Pain intensity were comparable in both groups (p = 0.326). However, patients treated with DBM were more satisfied with the surgical procedure (p = 0.031). With the use of DBM, the costs for augmentation of the non-union-site are more expensive compared to ICABG (calculated difference: 160 euro/case). Nevertheless, this study demonstrated that the

  11. Evaluation of the performance of three tenodesis techniques for the treatment of scapholunate instability: flexion-extension and radial-ulnar deviation.

    Science.gov (United States)

    Alonso-Rasgado, Teresa; Zhang, Qing-Hang; Jimenez-Cruz, David; Bailey, Colin; Pinder, Elizabeth; Mandaleson, Avanthi; Talwalkar, Sumedh

    2017-11-25

    Chronic scapholunate ligament (SL) injuries are difficult to treat and can lead to wrist dysfunction. Whilst several tendon reconstruction techniques have been employed in the management of SL instability, SL gap reappearance after surgery has been reported. Using a finite element model and cadaveric study data, we investigated the performance of the Corella, scapholunate axis (SLAM) and modified Brunelli tenodesis (MBT) techniques. Scapholunate dorsal and volar gap and angle were obtained following virtual surgery undertaken using each of the three reconstruction methods with the wrist positioned in flexion, extension, ulnar deviation and radial deviation, in addition to the ulnar-deviated clenched fist and neutral positions. From the study, it was found that, following simulated scapholunate interosseous ligament rupture, the Corella technique was better able to restore the SL gap and angle close to the intact ligament for all wrist positions investigated, followed by SLAM and MBT. The results suggest that for the tendon reconstruction techniques, the use of multiple junction points between scaphoid and lunate may be of benefit. Graphical abstract The use of multiple junction points between scaphoid and lunate may be of benefit for tendon reconstruction techniques.

  12. Tendon Interposition and Ligament Reconstruction with ECRL Tendon in the Late Stages of Kienböck’s Disease: A Cadaver Study

    Directory of Open Access Journals (Sweden)

    Nazım Karalezli

    2013-01-01

    Full Text Available Background. The optimal surgical treatment for Kienböck’s disease with stages IIIB and IV remains controversial. A cadaver study was carried out to evaluate the use of coiled extensor carpi radialis longus tendon for tendon interposition and a strip obtained from the same tendon for ligament reconstruction in the late stages of Kienböck’s disease. Methods. Coiled extensor carpi radialis longus tendon was used to fill the cavity of the excised lunate, and a strip obtained from this tendon was sutured onto itself after passing through the scaphoid and the triquetrum acting as a ligament to preserve proximal row integrity. Biomechanical tests were carried out in order to evaluate this new ligamentous reconstruction. Results. It was biomechanically confirmed that the procedure was effective against axial compression and distributed the upcoming mechanical stress to the distal row. Conclusion. Extensor carpi radialis longus tendon has not been used for tendon interposition and ligament reconstruction in the treatment of this disease before. In view of the biomechanical data, the procedure seems to be effective for the stabilization of scaphoid and carpal bones.

  13. Cartilage quantification using contrast-enhanced MRI in the wrist of rheumatoid arthritis: cartilage loss is associated with bone marrow edema.

    Science.gov (United States)

    Fujimori, Motoshi; Nakamura, Satoko; Hasegawa, Kiminori; Ikeno, Kunihiro; Ichikawa, Shota; Sutherland, Kenneth; Kamishima, Tamotsu

    2017-08-01

    To quantify wrist cartilage using contrast MRI and compare with the extent of adjacent synovitis and bone marrow edema (BME) in patients with rheumatoid arthritis (RA). 18 patients with RA underwent post-contrast fat-suppressed T 1 weighted coronal imaging. Cartilage area at the centre of the scaphoid-capitate and radius-scaphoid joints was measured by in-house developed software. We defined cartilage as the pixels with signal intensity between two thresholds (lower: 0.4, 0.5 and 0.6 times the muscle signal, upper: 0.9, 1.0, 1.1, 1.2 and 1.3 times the muscle signal). We investigated the association of cartilage loss with synovitis and BME score derived from RA MRI scoring system. Cartilage area was correlated with BME score when thresholds were adequately set with lower threshold at 0.6 times the muscle signal and upper threshold at 1.2 times the muscle signal for both SC (r s =-0.469, p cartilage in the wrist and BME associated with cartilage loss in patients with RA. Advances in knowledge: Our software can quantify cartilage using conventional MR images of the wrist. BME is associated with cartilage loss in RA patients.

  14. Use of the medial femoral condyle vascularized bone flap in traumatic avascular necrosis of the navicular: a case report.

    Science.gov (United States)

    Holm, Janson; Vangelisti, Garrett; Remmers, Jared

    2012-01-01

    The medial femoral condyle vascularized bone flap has a high success rate in published literature regarding its use in nonunions and avascular necrosis of the upper and lower extremities. It is reported to have minimal donor site morbidity and the ability to provide structural support and torsional strength to load-bearing areas. The flap has found particular success in the treatment of scaphoid nonunions. The tarsal navicular, similar to the scaphoid, is largely articular cancellous bone with little surface area for vascular inflow. These anatomic features make the navicular prone to nonunion and avascular necrosis in traumatic scenarios. We describe a case of nonunion and avascular necrosis of the tarsal navicular occurring as sequelae of a high-impact midfoot injury sustained in an automobile accident. After an initial attempt at open reduction and internal fixation with midfoot bridge plating, subsidence and nonunion resulted. An attempt at arthrodesis of the talonavicular and naviculocuneiform joints was then undertaken. This too failed, leading to the development of additional collapse and avascular necrosis. The site was treated with a medial femoral condyle vascularized bone flap. In this single case, the patient returned to pain-free ambulation and reported excellent outcomes and functional capacity. Although we present a successful case, a larger case series is necessary to establish the use of this flap as a reliable option for the treatment of nonunion and avascular necrosis of the tarsal navicular. Copyright © 2012 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  15. Immediate mobilisation with complete weight bearing after uncemented total hip replacement in elderly

    Directory of Open Access Journals (Sweden)

    Sankarlingam P, Shivraj V, V R Subramaniyam

    2014-11-01

    Full Text Available This prospective study was analyzed in 23 patients who were allowed to do immediate weight bearing after uncemented total hip arthroplasty. Immediate mobilization shortened the hospital stay and facilitated early rehabilitation of hip. Immediate mobilization was started on postoperative Day 3 rather than Day 7 without any adverse consequences to the patients. A series of 23 elderly patients of age more than 60 years, who were diagnosed with conditions such as avascular necrosis of hip, non union of fracture neck of femur, trochanteric non union and rheumatoid arthritis, underwent uncemented total hip replacement and immediate mobilization was started in our hospital. Patients were evaluated by Harris Hip Scoring Scale. All ambulated patients had painless hip and the mean Harris Hip Score was 85. There were no incidence of stem subsidence, acetabular component loosening, and heterotrophic ossification. This data concluded that early intensive rehabilitation yielded faster attainment of short-term functional milestones in fewer days.

  16. Geochemistry and hydrodynamics of the Paradox Basin region, Utah, Colorado and New Mexico

    Science.gov (United States)

    Hanshaw, B.B.; Hill, G.A.

    1969-01-01

    The Paradox Basin region is approximately bounded by the south flank of the Uinta Basin to the north, the Uncompahgre uplift and San Juan Mountains to the east, the Four Corners structural platform to the southeast, the north rim of the Black Mesa Basin and the Grand Canyon to the south and southwest, and the Wasatch Plateau and Hurricane fault system to the west. Some of these geologic features are areas of ground-water recharge or discharge whereas others such as the Four Corners platform do not directly influence fluid movement. The aquifer systems studied were: (1) Mississippian rocks; (2) Pinkerton Trail Limestone of Wengerd and Strickland, 1954; (3) Paradox Member of the Hermosa Formation; (4) Honaker Trail Formation of Wengerd and Matheny, 1958; (5) Permian rocks. Recharge in the Paradox Basin occurs on the west flank of the San Juan Mountains and along the west side of the Uncompahgre uplift. The direction of ground-water movement in each analyzed unit is principally southwest-ward toward the topographically low outcrop areas along the Colorado River in Arizona. However, at any point in the basin, flow may be in some other direction owing to the influence of intrabasin recharge areas or local obstructions to flow, such as faults or dikes. A series of potentiometric surface maps was prepared for the five systems studied. Material used in construction of the maps included outcrop altitudes of springs and streams, drill-stem tests, water-well records, and an electric analog model of the entire basin. Many structurally and topographically high areas within the basin are above the regional potentiometric surface; recharge in these areas will drain rapidly off the high areas and adjust to the regional water level. With a few exceptions, most wells in formations above the Pennsylvanian contain fresh ( 35,000 mg/l T.D.S.) reported. Most water samples from strata below the Permian are brines of the sodium chloride type but with large amounts of calcium sulfate or

  17. Sliding-screw plate fixation of proximal femoral fractures: Radiographic assessment

    Energy Technology Data Exchange (ETDEWEB)

    Sartoris, D.J.; Resnick, D.; Kerr, R.; Goergen, T.

    1985-07-01

    The sliding compression screw-sideplate combination is currently the most widely employed device for internal fixation of stable and unstable intertrochanteric fractures of the femur. The normal and abnormal radiographic appearances of this device in the immediate post-operative period are discussed. Potential long-term complications including mal- or non-union, intra-articular penetration, metal failure, rotation of the proximal fracture fragment, disengagement, trochanteric bursitis, leg length discrepancy, delayed cervical stress fracture, and ischemic necrosis are reviewed.

  18. Sliding-screw plate fixation of proximal femoral fractures: Radiographic assessment

    International Nuclear Information System (INIS)

    Sartoris, D.J.; Resnick, D.; California Univ., San Diego, La Jolla; Kerr, R.; Goergen, T.

    1985-01-01

    The sliding compression screw-sideplate combination is currently the most widely employed device for internal fixation of stable and unstable intertrochanteric fractures of the femur. The normal and abnormal radiogrpahic appearances of this device in the immediate post-operative period are discussed. Potential long-term complications including mal- or non-union, intra-articular penetration, metal failure, rotation of the proximal fracture fragment, disengagement, trochanteric bursitis, leg length discrepancy, delayed cervical stress fracture, and ischemic necrosis are reviewed. (orig.)

  19. Considering the impact of the 'Right to Bargain' Legislation in Ireland: A Review

    OpenAIRE

    Cullinane, Niall; Dobbins, Anthony

    2014-01-01

    Ireland is rare among advanced economies in not having statutory trade union recognition legislation for collective bargaining purposes. The matter has been a source of policy contention over the years with attempts to resolve it encapsulated in the so-called ‘Right to Bargain’ legislation, introduced in 2001. This legislation has sought to circumvent statutory recognition in Ireland by putting in place an alternative mechanism for unions to represent members in non-union firms where collecti...

  20. Comparative analysis of uniplanar external fixator and retrograde intramedullary nailing for ankle arthrodesis in diabetic Charcot′s neuroarthropathy

    Directory of Open Access Journals (Sweden)

    Nakul S Shah

    2011-01-01

    Results: All five (100% patients treated by intramedullary nailing achieved radiological union on an average follow-up of 16 weeks. The external fixation group had significantly higher rate of complications with one amputation, four non unions (66.7% and a delayed union which went on to full osseous union. Conclusion: The retrograde intramedullary nailing for tibio-talar arthrodesis in Charcot′s neuroarthropathy yielded significantly better outcomes as compared to the use of uniplanar external fixator.

  1. A different trauma, a different fracture

    Directory of Open Access Journals (Sweden)

    Ü. Kaldırım

    2013-12-01

    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

  2. MANAGEMENT OF PSEUDOARTHROSIS OF SHAFT HUMERUS BY PLATING (FIVE YEARS FOLLOW UP – A CASE STUDY

    Directory of Open Access Journals (Sweden)

    Shirish Virupanna

    2016-02-01

    Full Text Available Pseudoarthrosis is a condition where union at fracture site is very difficult to obtain. But sticking to the very basic principles of management of non-union – that is freshening at fracture site, removal of sclerotic bone, reaming of medullary canal, rigid fixation and abundant bone grafting-helps in achieving the goal. In the below case, all the steps were carried out and the fracture has healed two months postoperatively.

  3. Unions and the Sword of Justice: Unions and Pay Systems, Pay Inequality, Pay Discrimination and Low Pay

    OpenAIRE

    A Charlwood; K Hansen; David Metcalf

    2000-01-01

    Dispersion in pay is lower among union members than among non-unionists. This reflects two factors. First, union members and jobs are more homogeneous than their non-union counterparts. Second, union wage policies within and across firms lower pay dispersion. Unions'' minimum wage targets also truncate the lower tail of the union distribution. There are two major consequences of these egalitarian union wage policies. First, the return to human capital is lower in firms which recognise unions ...

  4. Explaining Leaving Union Membership by the Degree of Labour Market Attachment

    DEFF Research Database (Denmark)

    Leschke, Janine; Vandaele, Kurt

    2018-01-01

    By particularly stressing the weaker labour market attachment of workers with non-standard contracts, this article contributes to the rather unexplored issue of mainly non-union-related reasons for leaving trade unions. Germany has been selected as a case study because German unions experienced....... Their analysis shows the impact of labour market attachment and firm-level characteristics on union leaving and points especially to important differences across gender....

  5. Coating of Biomaterial Scaffolds with the Collagen-Mimetic Peptide GFOGER for Bone Defect Repair

    OpenAIRE

    Wojtowicz, Abigail M.; Shekaran, Asha; Oest, Megan E.; Dupont, Kenneth M.; Templeman, Kellie L.; Hutmacher, Dietmar W.; Guldberg, Robert E.; García, Andrés J.

    2009-01-01

    Healing large bone defects and non-unions remains a significant clinical problem. Current treatments, consisting of auto- and allografts, are limited by donor supply and morbidity, insufficient bioactivity and risk of infection. Biotherapeutics, including cells, genes and proteins, represent promising alternative therapies, but these strategies are limited by technical roadblocks to biotherapeutic delivery, cell sourcing, high cost, and regulatory hurdles. In the present study, the collagen-m...

  6. Developmental feature of the lumbosacral vertebral arch in childhood

    International Nuclear Information System (INIS)

    Yoshifuji, Kazuhisa; Morota, Nobuhito; Ihara, Satoshi

    2007-01-01

    We investigated a developmental feature of the lumbosacral vertebral arch in childhood that has rarely been reported previously. Sixty-seven patients underwent functional posterior rhizotomy from September 2000 to June 2006 at National Center for Child Health and Development. Sixty of these patients, who had no deformity in their lumbosacral spine, were included in this study and their Computed Tomography (CT) images were analyzed retrospectively. There were 36 boys and 24 girls, aged from 2-12 years. The rate and mean number of non-union vertebral arches between L1 and S3 were 78.3% (95% CI, 65.8-87.9%) and 1.7 (standard deviation (SD), 1.3). The non-union arch was most frequently found at the S1 level, and was more significantly observed in the younger age group (2-5 years of age). The S4 and S5 arches, which often remained open as the sacral hiatus, were constantly open in childhood. This study demonstrates that the vertebral arches of the lumbosacral spine in normal development are often not fused during childhood. It is important to differentiate normal non-union arches from pathological spina bifida. (author)

  7. New options for vascularized bone reconstruction in the upper extremity.

    Science.gov (United States)

    Houdek, Matthew T; Wagner, Eric R; Wyles, Cody C; Nanos, George P; Moran, Steven L

    2015-02-01

    Originally described in the 1970s, vascularized bone grafting has become a critical component in the treatment of bony defects and non-unions. Although well established in the lower extremity, recent years have seen many novel techniques described to treat a variety of challenging upper extremity pathologies. Here the authors review the use of different techniques of vascularized bone grafts for the upper extremity bone pathologies. The vascularized fibula remains the gold standard for the treatment of large bone defects of the humerus and forearm, while also playing a role in carpal reconstruction; however, two other important options for larger defects include the vascularized scapula graft and the Capanna technique. Smaller upper extremity bone defects and non-unions can be treated with the medial femoral condyle (MFC) free flap or a vascularized rib transfer. In carpal non-unions, both pedicled distal radius flaps and free MFC flaps are viable options. Finally, in skeletally immature patients, vascularized fibular head epiphyseal transfer can provide growth potential in addition to skeletal reconstruction.

  8. First Metatarsophalangeal Joint Arthrodesis in Hallux Valgus Versus Hallux Rigidus Using Cup and Cone Preparation Compression Screw and Dorsal Plate Fixation.

    Science.gov (United States)

    Chien, Calvin; Alfred, Terrence; Freihaut, Richard; Pit, Sabrina

    2017-10-19

    Various techniques have been described for first metatarsophalangeal (MTP) joint arthrodesis. The purpose of this study was to determine if cup and cone preparation by a single surgeon with an interfragmentary screw and dorsal plate fixation provides a comparable union rate in hallux valgus versus hallux rigidus. Our study included all patients who underwent first MTP joint fusions using cup and cone preparation with an interfragmentary compression screw and dorsal plate fixation from 2010 to 2015. We compared union rates in 65 patients with hallux rigidus with 47 who had hallux valgus. One of 65 hallux rigidus cases developed non-union and underwent revision surgery. One of 47 patients in the hallux valgus group developed a painless non-union. All other patients achieved union based on post operative radiographs. Our rate of painful non-union was 1.5% for hallux rigidus and 0% for hallux valgus, which is lower than recent published literature of 7% for hallux valgus and 3.7% for hallux rigidus. We found no difference between the two groups suggesting this method may provide stronger fixation and may be preferable when dealing with hallux valgus. First metatarsophalangeal joint fusion in patients with severe hallux valgus and hallux rigidus, using spherical reamers, compression screw and dorsal plate fixation is equally successful at achieving clinical and radiographic fusion in both hallux valgus and hallux rigidus.

  9. Characterization of seven United States coal regions. The development of optimal terrace pit coal mining systems

    Energy Technology Data Exchange (ETDEWEB)

    Wimer, R.L.; Adams, M.A.; Jurich, D.M.

    1981-02-01

    This report characterizes seven United State coal regions in the Northern Great Plains, Rocky Mountain, Interior, and Gulf Coast coal provinces. Descriptions include those of the Fort Union, Powder River, Green River, Four Corners, Lower Missouri, Illinois Basin, and Texas Gulf coal resource regions. The resource characterizations describe geologic, geographic, hydrologic, environmental and climatological conditions of each region, coal ranks and qualities, extent of reserves, reclamation requirements, and current mining activities. The report was compiled as a basis for the development of hypothetical coal mining situations for comparison of conventional and terrace pit surface mining methods, under contract to the Department of Energy, Contract No. DE-AC01-79ET10023, entitled The Development of Optimal Terrace Pit Coal Mining Systems.

  10. Estimation of Atmospheric Path Delays in TerraSAR-X Data using Models vs. Measurements

    Directory of Open Access Journals (Sweden)

    Donat Perler

    2008-12-01

    Full Text Available Spaceborne synthetic aperture radar (SAR measurements of the Earth’s surface depend on electromagnetic waves that are subject to atmospheric path delays, in turn affecting geolocation accuracy. The atmosphere influences radar signal propagation by modifying its velocity and direction, effects which can be modeled. We use TerraSAR-X (TSX data to investigate improvements in the knowledge of the scene geometry. To precisely estimate atmospheric path delays, we analyse the signal return of four corner reflectors with accurately surveyed positions (based on differential GPS, placed at different altitudes yet with nearly identical slant ranges to the sensor. The comparison of multiple measurements with path delay models under these geometric conditions also makes it possible to evaluate the corrections for the atmospheric path delay made by the TerraSAR processor and to propose possible improvements.

  11. The power of stars

    CERN Document Server

    Penprase, Bryan E

    2017-01-01

    Completely revised and updated, this new edition provides a readable, beautifully illustrated journey through world cultures and the vibrant array of sky mythology, creation stories, models of the universe, temples and skyscrapers that each culture has created to celebrate and respond to the power of the night sky. Sections on the archaeoastronomy of South Asia and South East Asia have been expanded, with original photography and new research on temple alignments in Southern India, and new material describing the astronomical practices of Indonesia, Malaysia and other Southeast Asian countries. Beautiful photographs of temples in India and Asia have been added, as well as new diagrams explaining the alignment of these structures and the astronomical underpinnings of temples within the Pallava and Chola cultures. From new fieldwork in the Four Corners region of North America, Dr. Penprase has included accounts of Pueblo skywatching and photographs of ceremonial kivas that help elucidate the rich astronomical k...

  12. Pseudo-self-organized topological phases in glassy selenides for IR photonics

    Energy Technology Data Exchange (ETDEWEB)

    Shpotyuk, O. [Lviv Institute of Materials of Scientific Research Company ' ' Carat' ' 202, Stryjska str., 79031 Lviv (Ukraine); Institute of Physics of Jan Dlugosz University 13/15, al. Armii Krajowej, 42201 Czestochowa (Poland); Golovchak, R. [Lviv Institute of Materials of Scientific Research Company ' ' Carat' ' 202, Stryjska str., 79031 Lviv (Ukraine)

    2011-09-15

    Network-forming cluster approach is applied to As-Se and Ge-Se glasses to justify their tendency to self-organization. It is shown that reversibility windows determined by temperature-modulated differential scanning calorimetry using short-term aged or as-prepared samples do not necessary coincide with self-organized phase in these materials. The obtained results testify also pseudo-self-organization phenomenon in Ge-Se glasses: over-constrained outrigger raft structural units built of two edge- and four corner-shared tetrahedra are interconnected via optimally-constrained {identical_to}Ge-Se-Se-Ge{identical_to} bridges within the range of compositions identified previously as self-organized phase by temperature modulated differential scanning calorimetry technique. (copyright 2011 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim) (orig.)

  13. Photoactivated toxicity of PAH to endangered fishes and standard laboratory test species

    International Nuclear Information System (INIS)

    Buckler, D.R.; Mount, D.R.; Tillitt, D.E.

    1994-01-01

    Polynuclear aromatic hydrocarbons (PAH) have been detected in water and sediment from the San Juan River Basin, located in the Four Corners area of the southwestern US. In addition to possessing extensive oil and gas deposits, the San Juan contains several threatened or endangered fish species such as Colorado squawfish and razorback suckers. Proposed expansion of oil and gas development in the basin has sparked concerns that potential increases in PAH loading may jeopardize these and other native fishes. In response, the authors conducted laboratory exposures of threatened and endangered species to various PAH both with and without accompanying exposure to UV light. As predicted from the literature, exposure to UV light caused a marked photo-activated toxicity response in all species; however, the sensitivity to PAH both with and without UV exposure varied among species and lifestages. Supplemental studies were conducted to evaluate the physiological mechanisms for variation in sensitivity between species and lifestage

  14. A Capacitive Humidity Sensor Based on Multi-Wall Carbon Nanotubes (MWCNTs

    Directory of Open Access Journals (Sweden)

    Zhen-Gang Zhao

    2009-09-01

    Full Text Available A new type of capacitive humidity sensor is introduced in this paper. The sensor consists of two plate electrodes coated with MWCNT films and four pieces of isolating medium at the four corners of the sensor. According to capillary condensation, the capacitance signal of the sensor is sensitive to relative humidity (RH, which could be transformed to voltage signal by a capacitance to voltage converter circuit. The sensor is tested using different saturated saline solutions at the ambient temperature of 25 °C, which yielded approximately 11% to 97% RH, respectively. The function of the MWCNT films, the effect of electrode distance, the temperature character and the repeatability of the sensor are discussed in this paper.

  15. Multilayer X-ray mirrors for formation of sub-nanometer wavelength range beams

    International Nuclear Information System (INIS)

    Akhsakhalyan, A.A.; Akhsakhalyan, A.D.; Klyuenkov, E.B.; Murav'ev, V.A.; Salashchenko, N.N.; Kharitonov, A.I.

    2005-01-01

    Paper reviews the efforts undertaken in the RF Academy of Sciences IPM within recent 5 years to design multilayer mirror systems to produce X-ray wavelength subnanometer range beams. Paper describes a process to fabricate the mentioned systems covering the procedures to obtain supersmooth surfaces of the specified shape, to deposit gradient multilayer structures on the mentioned surfaces and describes the rules to calculate the optimal parameters of mirrors. Paper presents characteristics of mirror system two types: a mirror in the shape of a parabolic cylinder to collimate radiation in the DRON-4, DRON-6 production-type X-ray diffractometers and in the shape of a quadraelliptic reflector - a new wide-aperture four-corner focusing system [ru

  16. Measurement of volatile organic compounds during start-up of bioremediation of French limited superfund site in Crosby Texas using wind dependent whole-air sampling

    International Nuclear Information System (INIS)

    Pleil, J.D.; Fortune, C.R.; Yoong, M.; Oliver, K.D.

    1993-01-01

    Whole-air sampling was performed before and after the start-up of the bioremediation of an industrial (primarily petrochemical) waste lagoon in Crosby Texas, near Houston. Four 'Sector Samplers' were deployed at the four corners of the French Limited Superfund Site. These samplers collect air into one of two SUMMA polished canisters depending upon wind direction and speed. When the wind blows at the sampler from across the waste lagoon, air is routed to the 'IN' sector canister, otherwise sample is collected in the 'OUT' sector canister. As such, each sampler provides its own background sample, and, upon gas chromatographic analysis, individual compounds can be associated with the waste lagoon. Five sets of 24-hour sector samples were taken; the first set was collected prior to the start of the bioremediation effort and the remaining four sets were taken sequentially for four 24-hour periods after the start-up of the procedure

  17. Fossil Energy Planning for Navajo Nation

    Energy Technology Data Exchange (ETDEWEB)

    Acedo, Margarita [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

    2017-08-11

    This project includes fossil energy transition planning to find optimal solutions that benefit the Navajo Nation and stakeholders. The majority of the tribe’s budget currently comes from fossil energy-revenue. The purpose of this work is to assess potential alternative energy resources including solar photovoltaics and biomass (microalgae for either biofuel or food consumption). This includes evaluating carbon-based reserves related to the tribe’s resources including CO2 emissions for the Four Corners generating station. The methodology for this analysis will consist of data collection from publicly available data, utilizing expertise from national laboratories and academics, and evaluating economic, health, and environmental impacts. Finally, this report will highlight areas of opportunities to implement renewable energy in the Navajo Nation by presenting the technology requirements, cost, and considerations to energy, water, and environment in an educational structure.

  18. Hydrologic properties and ground-water flow systems of the Paleozoic rocks in the upper Colorado River basin in Arizona, Colorado, New Mexico, Utah, and Wyoming, excluding the San Juan Basin

    Science.gov (United States)

    Geldon, Arthur L.

    2003-01-01

    The hydrologic properties and ground-water flow systems of Paleozoic sedimentary rocks in the Upper Colorado River Basin were investigated under the Regional Aquifer-System Analysis (RASA) program of the U.S. Geological Survey in anticipation of the development of water supplies from bedrock aquifers to fulfill the region's growing water demands. The study area, in parts of Arizona, Colorado, New Mexico, Utah, and Wyoming, covers about 100,000 square miles. It includes parts of four physiographic provinces--the Middle Rocky Mountains, Wyoming Basin, Southern Rocky Mountains, and Colorado Plateaus. A variety of landforms, including mountains, plateaus, mesas, cuestas, plains, badlands, and canyons, are present. Altitudes range from 3,100 to 14,500 feet. Precipitation is distributed orographically and ranges from less than 6 inches per year at lower altitudes to more than 60 inches per year in some mountainous areas. Most of the infrequent precipitation at altitudes of less than 6,000 feet is consumed by evapotranspiration. The Colorado and Green Rivers are the principal streams: the 1964-82 average discharge of the Colorado River where it leaves the Upper Colorado River Basin is 12,170 cubic feet per second (a decrease of 5,680 cubic feet per second since construction of Glen Canyon Dam in 1963). On the basis of their predominant lithologic and hydrologic properties, the Paleozoic rocks are classified into four aquifers and three confining units. The Flathead aquifer, Gros Ventre confining unit, Bighorn aquifer, Elbert-Parting confining unit, and Madison aquifer (Redwall-Leadville and Darwin-Humbug zones) make up the Four Corners aquifer system. A thick sequence, composed mostly of Mississippian and Pennsylvanian shale, anhydrite, halite, and carbonate rocks--the Four Corners confining unit (Belden-Molas and Paradox-Eagle Valley subunits)--overlies the Four Corners aquifer system in most areas and inhibits vertical ground-water flow between the Four Corners aquifer

  19. Testing of badminton specific endurance

    DEFF Research Database (Denmark)

    Madsen, Christian Møller; Højlyng, Mads; Nybo, Lars

    2016-01-01

    In the present study, a novel intermittent badminton endurance test (B-ENDURANCE) was developed and tested in elite (n=17) and skilled (n=9) badminton players as well as in age-matched physically active men (non-badminton players; n=8). In addition, B-ENDURANCE test-retest reproducibility...... was evaluated in nine badminton players.B-ENDURANCE is an incremental test where each level consists of repeated sequences of badminton specific actions towards the four corners on the court. The subject starts in the center of the court in front of a computer screen and within each sequence he must...... decreases until the subjects cannot follow the dictated tempo.B-ENDURANCE performance for elite players was better (Pbadminton players. In addition, B-ENDURANCE performance correlated (r=0.8; P

  20. Navajo transmission project. Final Environmental Impact Statement (FEIS)

    International Nuclear Information System (INIS)

    1997-08-01

    Dine Power Authority, a Navajo Nation enterprise, proposes to construct a 500 kilovolt transmission line planned to deliver electrical power from the Shiprock Substation in northwestern New Mexico to the Marketplace Substation in southern Nevada. The line would relieve constraints on transmission of electricity west from the Four Corners area; improve operational flexibility and reliability of the overall system; and allow increased economical transfers, sales, and purchases in the Rocky Mountains/Four Corners/Desert Southwest region. Also, the project allows an opportunity for the Navajo Nation to participate in the electrical utility industry and promote economic development to benefit the people of the Navajo Nation. Six alternatives were considered and include (1) energy conservation and electric load management, (2) new generation facilities, (3) use of existing transmission systems, (4) alternative transmission technologies, (5) no action, and (6) the proposed action. For the proposed action, the following alternative routes and ancillary facility locations are addressed in the EIS: four alternative routes and five substations in the eastern portion of the project area; and six alternative routes, three substation sites, and a microwave communication facility in the western portion of the project area. The existing condition of the environmental resources in the project area is described, and potential impacts on those resources as a result of the proposed action are addressed. The impacts of the proposed action would be caused mainly by access roads, tower sites, and other associated facilities on soils, vegetation, wildlife, and cultural and paleontological resources; and the impact of the transmission line's presence on visual resources and land uses. Public comments on the draft EIS are addressed in this FEIS

  1. Applying complexity theory: A primer for identifying and modeling firm anomalies

    Directory of Open Access Journals (Sweden)

    Arch G. Woodside

    2018-01-01

    Full Text Available This essay elaborates on the usefulness of embracing complexity theory, modeling outcomes rather than directionality, and modeling complex rather than simple outcomes in strategic management. Complexity theory includes the tenet that most antecedent conditions are neither sufficient nor necessary for the occurrence of a specific outcome. Identifying a firm by individual antecedents (i.e., non-innovative versus highly innovative, small versus large size in sales or number of employees, or serving local versus international markets provides shallow information in modeling specific outcomes (e.g., high sales growth or high profitability—even if directional analyses (e.g., regression analysis, including structural equation modeling indicates that the independent (main effects of the individual antecedents relate to outcomes directionally—because firm (case anomalies almost always occur to main effects. Examples: a number of highly innovative firms have low sales while others have high sales and a number of non-innovative firms have low sales while others have high sales. Breaking-away from the current dominant logic of directionality testing—null hypotheses statistic testing (NHST—to embrace somewhat precise outcome testing (SPOT is necessary for extracting highly useful information about the causes of anomalies—associations opposite to expected and “statistically significant” main effects. The study of anomalies extends to identifying the occurrences of four-corner strategy outcomes: firms doing well in favorable circumstances, firms doing badly in favorable circumstances, firms doing well in unfavorable circumstances, and firms doing badly in unfavorable circumstances. Models of four-corner strategy outcomes advances strategic management beyond the current dominant logic of directional modeling of single outcomes.

  2. Treatment of Oil & Gas Produced Water.

    Energy Technology Data Exchange (ETDEWEB)

    Dwyer, Brian P. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2016-02-01

    Production of oil and gas reserves in the New Mexico Four Corners Region results in large volumes of "produced water". The common method for handling the produced water from well production is re-injection in regulatory permitted salt water disposal wells. This is expensive (%7E $5/bbl.) and does not recycle water, an ever increasingly valuable commodity. Previously, Sandia National Laboratories and several NM small business tested pressure driven membrane-filtration techniques to remove the high TDS (total dissolved solids) from a Four Corners Coal Bed Methane produced water. Treatment effectiveness was less than optimal due to problems with pre-treatment. Inadequate pre-treatment allowed hydrocarbons, wax and biological growth to foul the membranes. Recently, an innovative pre-treatment scheme using ozone and hydrogen peroxide was pilot tested. Results showed complete removal of hydrocarbons and the majority of organic constituents from a gas well production water. ACKNOWLEDGEMENTS This report was made possible through funding from the New Mexico Small Business Administration (NMSBA) Program at Sandia National Laboratories. Special thanks to Juan Martinez and Genaro Montoya for guidance and support from project inception to completion. Also, special thanks to Frank McDonald, the small businesses team POC, for laying the ground work for the entire project; Teresa McCown, the gas well owner and very knowledgeable- fantastic site host; Lea and Tim Phillips for their tremendous knowledge and passion in the oil & gas industry.; and Frank Miller and Steve Addleman for providing a pilot scale version of their proprietary process to facilitate the pilot testing.

  3. The Colorado Plateau III: integrating research and resources management for effective conservation

    Science.gov (United States)

    Sogge, Mark K.; van Riper, Charles

    2008-01-01

    Roughly centered on the Four Corners region of the southwestern United States, the Colorado Plateau covers an area of 130,000 square miles. The relatively high semi-arid province boasts nine national parks, sixteen national monuments, many state parks, and dozens of wilderness areas. With the highest concentration of parklands in North America and unique geological and ecological features, the area is of particular interest to researchers. Derived from the Eighth Biennial Conference of Research on the Colorado Plateau, this third volume in a series of research on the Colorado Plateau expands upon the previous two books. This volume focuses on the integration of science into resource management issues, summarizes what criteria make a successful collaborative effort, outlines land management concerns about drought, provides summaries of current biological, sociological, and archaeological research, and highlights current environmental issues in the Four Corner States of Arizona, New Mexico, Colorado, and Utah. With broad coverage that touches on topics as diverse as historical aspects of pronghorn antelope movement patterns through calculating watershed prescriptions to the role of wind-blown sand in preserving archaeological sites on the Colorado River, this volume stands as a compendium of cuttingedge management-oriented research on the Colorado Plateau. The book also introduces, for the first time, tools that can be used to assist with collaboration efforts among landowners and managers who wish to work together toward preserving resources on the Colorado Plateau and offers a wealth of insights into land management questions for many readers, especially people interested in the natural history, biology, anthropology, wildlife, and cultural management issues of the region.

  4. Stress fractures of ankle and wrist in childhood: nature and frequency

    International Nuclear Information System (INIS)

    Oestreich, Alan E.; Bhojwani, Nicholas

    2010-01-01

    Stress fractures of many etiologies are found not infrequently in various tarsal bones but are less commonly recognized in carpal bones. To assess the distribution of tarsal and carpal stress fractures. During the last three decades, the senior author collected locations of tarsal and carpal bone stress fracture callus seen on plain radiographs. 527 children with tarsal and carpal stress fractures were identified (88 children had multiple bones involved). The totals were: calcaneus 244, cuboid 188, talus 121, navicular 24, cuneiforms 23, capitate 18, lunate 1, and scaphoid 1. Stress fractures were more frequently seen once we became aware each particular bone could be involved. Tarsal and carpal stress fractures in children are not rare. Careful perusal of these bones is urged in all susceptible children with limping or wrist pain. (orig.)

  5. Absence of uptake of the rib cage; diagnosis of a Poland's syndrome with the bone SPECT-CT; Absence de fixation du gril costal: diagnostic d'un syndrome de Poland par la TEMP-TDM osseuse

    Energy Technology Data Exchange (ETDEWEB)

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

    2008-09-15

    We report the case of a 37-year-old man, investigated for pains of the right upper limb impairing the hand, the wrist and the shoulder after a surgery for fracture of the radius and the scaphoid. The {sup 99m}Tc-H.D.P. three-phase bone scintigraphy confirmed the diagnosis of acute phase of a reflex sympathetic dystrophy. The delayed images highlighted a focal absence of tracer uptake of the left anterior rib cage. The single photon emission computerized tomography guided by computerized tomography showed that it was related to the absence of the anterior part of the third and the fourth left ribs highlighting an aplasia of the left pectoralis major muscle. These anomalies led to the diagnosis of congenital malformation in connection with a Poland's syndrome. The differential diagnosis of this syndrome resulted in discussing the multiple etiologies of the photopenic lesions of the rib cage. (authors)

  6. Absence of uptake of the rib cage; diagnosis of a Poland's syndrome with the bone SPECT-CT

    International Nuclear Information System (INIS)

    Granier, P.; Mourad, M.

    2008-01-01

    We report the case of a 37-year-old man, investigated for pains of the right upper limb impairing the hand, the wrist and the shoulder after a surgery for fracture of the radius and the scaphoid. The 99m Tc-H.D.P. three-phase bone scintigraphy confirmed the diagnosis of acute phase of a reflex sympathetic dystrophy. The delayed images highlighted a focal absence of tracer uptake of the left anterior rib cage. The single photon emission computerized tomography guided by computerized tomography showed that it was related to the absence of the anterior part of the third and the fourth left ribs highlighting an aplasia of the left pectoralis major muscle. These anomalies led to the diagnosis of congenital malformation in connection with a Poland's syndrome. The differential diagnosis of this syndrome resulted in discussing the multiple etiologies of the photopenic lesions of the rib cage. (authors)

  7. Squamous cell carcinoma in Hand – Case reportCarcinoma de células escamosas na mão - Estudo de caso

    Directory of Open Access Journals (Sweden)

    Joaquim José de Lima Silva

    2016-03-01

    Full Text Available Introduction: Squamous cell carcinoma (SCC is a type of skin malignancy that originates in the squamous layer of the epidermis.  A lower incidence than basal cell carcinomas is reported. There is a predominance of areas heavily exposed to sunlight Objectives: To report a case of squamous cell carcinoma in left hand compromising the hypothenar region. To carry out a literature review and emphasize the main methods of diagnosis and treatment. Methods: Information obtained from medical records, photographic record of pre and post-operative. Result: Histopathological diagnosis was made, confirming squamous cell carcinoma due to the evolution of metastatic basal cell carcinoma, with the removal of bones: 5th metacarpal and scaphoid. After relapse, requiring amputation of the left hand. Conclusion: To report a rare case of bone metastasis derived from a skin cancer.

  8. Enthesopathic reactions at the wrist in psoriatic arthritis, rheumatoid arthritis and diffuse idiopathic skeletal hyperostosis. Results of low-kV radiographs in three views

    International Nuclear Information System (INIS)

    Fischer, E.

    1989-01-01

    Twenty-six sites of muscle and ligament attachment around the wrist were evaluated for enthesopathic proliferative bone changes in psoriatic arthritis (PA), rheumatoid arthritis (RA), and diffuse idiopathic skeletal hyperostosis (DISH). Proliferations were found to be most frequent, most irregular, and largest in PA, followed in declining order by RA and DISH. In PA only, the bony proliferations and the underlying bone often had the appearance of mineralized woven bone, though smooth proliferations with a regular bone structure do occur in PA as well as in RA. The entheses of the trapezium, scaphoid and the radial styloid process are most frequently affected, followed by the bases of the first and fifth metacarpals and the pisiform. It is exceptional for huge bony proliferations to be observed at the entheses in DISH. (orig.) [de

  9. Neonatal vitamin D status from archived dried blood spots and future risk of fractures in childhood

    DEFF Research Database (Denmark)

    Händel, Mina Nicole; Frederiksen, Peder; Cohen, Arieh

    2017-01-01

    : In a register-based case-cohort study design, the case group was composed of 1039 individuals who were randomly selected from a total of 82,154 individuals who were born during 1989–1999 and admitted to a Danish hospital with a fracture of the forearm, wrist, scaphoid bone, clavicle, or ankle at age 6–13 y....... The subcohort was composed of 1600 individuals randomly selected from all Danish children born during 1989–1999. The neonatal 25(OH)D3 concentrations in DBS samples were assessed by using highly sensitive chromatography-tandem mass spectrometry. Results: The mean ± SD 25(OH)D3 concentration for all subjects...

  10. Magnetic resonance imaging of the wrist in early rheumatoid arthritis: a pictorial essay

    International Nuclear Information System (INIS)

    Stewart, N.R.; Crabbe, J.P.; McQueen, F.M.

    2001-01-01

    This pictorial essay describes the changes seen in the wrist in early rheumatoid arthritis (RA) on MRI. Magnetic resonance imaging can demonstrate bone erosions, bone marrow signal changes, synovitis and tenosynovitis in early rheumatoid arthritis. Magnetic resonance imaging of the wrist can identify erosions in RA earlier than plain radiographs and can detect more erosions. Common sites include the capitate, lunate and scaphoid. Bone marrow signal changes occur frequently and are most common in the capitate, lunate and triquetrum. Synovial thickening and enhancement are clearly demonstrated with MRI and are most commonly seen in the radiocarpal joint (RCJ). Tenosynovitis can be seen in the wrist in more than half of patients presenting with RA. This most commonly involves the extensor carpi ulnaris tendon and is seen as sheath fluid, thickening and enhancement. Copyright (2001) Blackwell Science Pty Ltd

  11. Location and incidence of localized juxta-articular demineralizations and erosions at the wrist in early rheumatoid arthritis

    International Nuclear Information System (INIS)

    Fischer, E.

    1988-01-01

    In early rheumatoid arthritis the location and incidence of localized juxta-articular demineralizations and erosions were investigated at 53 points of the wrist. On the level of the metacarpal bases, the distal and proximal row of the carpal bones more changes are seen in the oblique vd. and the lateral view than in the dv. view. At the distal bones of the forearm more changes are seen at the radius than at the ulnar styloid. The most often changes at all occur at the volar middle third of the triquetrum in the oblique view and at the distal volar articular facet of the scaphoid in the lateral view. Close relations between localized juxta-articular demineralizations and erosions do not exist. If the early bone changes at the wrist in rheumatoid arthritis are to be detected additional oblique and lateral view are prerequisite. (orig.) [de

  12. Unusual localizations of unicameral bone cysts and aneurysmal bone cysts: A retrospective review of 451 cases.

    Science.gov (United States)

    Aycan, Osman Emre; Çamurcu, İsmet Yalkın; Özer, Devrim; Arıkan, Yavuz; Kabukçuoğlu, Yavuz Selim

    2015-06-01

    Unicameral bone cysts (UBC) and aneurysmal bone cysts (ABC) are benign cystic lesions of bone which are easily diagnosed. However, unusual locations may lead to a false diagnosis. Therefore the aim of this retrospective study was to determine the frequency of unusual localizations. The authors studied 451 cases with histopathologically confirmed diagnosis of UBC or ABC, seen between 1981 and 2012. In the UBC group (352 cases) humerus, femur and calcaneus were found to be the most common sites, while acetabulum, scapula, scaphoid, lunatum, metacarpals, metatarsals, toe phalanges and ulna each accounted for less than 1%. In the ABC group (99 cases) the most common sites of involvement were femur, humerus and tibia, while finger phalanges, ilium, acetabulum, pubis, calcaneus, cuboid, and toe phalanges each accounted for only 1%. The differential diagnosis of cystic bone lesions should include both UBC and ABC. Pain complaints plead for the latter, except in case of fracture.

  13. ARTHROSCOPIC FOR TREATMENT OF WRIST PATHOLOGIES

    Directory of Open Access Journals (Sweden)

    I. O. Golubev

    2018-01-01

    Full Text Available Diagnostics and treatment of wrist joint pathologies still remain one the key problems in hand traumatology and orthopaedics. Extremal sports availability as well as new options for recreation transportation means only sustains the statistics of such injuries. On the other hand, the technological improvements allowed to develop precise optics for surgeries on small joints. Possibilities of minimally invasive closer visualization at magnification substantially changed not only the approach to treatment of wrist joint pathology but also allowed to describe types of lesions unknown earlier. The authors describe basic principles of wrist joint arthroscopy and features of its application in various injuries: scaphoid fractures, intraarticular fractures of distal radius metaepiphysis, triangular fibrocartilage complex injuries.

  14. Preiser’s disease: two cases report

    Directory of Open Access Journals (Sweden)

    G.P. Ferrari

    2011-09-01

    Full Text Available Preiser’s syndrome is a rare osteochondrosis affecting the carpal scaphoid, frequently related with an avascular necrosis. Osteoarthritic changes of the articular cartilage, local synovitis, and loose fragments are the most common findings associated with this syndrome. We report here two patients with Preiser’s syndrome, one with and one without a traumatic history, both presenting with pain, swelling and functional impairement of the wrist. In one patient radiography was sufficient for the diagnosis, in the other NMR was necessary to clearly establish type and extension of the lesion. Differential diagnosis may be sometimes difficult and the therapeutic approach on depends on several aspects, including etiology and type of occupational activity.

  15. A Case of Trapezium Avascular Necrosis Treated Conservatively.

    Science.gov (United States)

    Petsatodis, Evangelos; Ditsios, Konstantinos; Konstantinou, Panagiotis; Pinto, Iosafat; Kostretzis, Lazaros; Theodoroudis, Ioannis; Pilavaki, Mayia

    2017-01-01

    Avascular necrosis (AVN) of the bones of the wrist most commonly involves the lunate followed by the proximal pole of the scaphoid and the capitate. Trapezium avascular necrosis is extremely rare with only two cases reported in the literature, both of which were treated surgically. In this article, we report a unique case of trapezium avascular necrosis treated conservatively. A 38-year-old man complaining of a 4-month history of mild pain on the base of his right thumb. MRI scan was performed. The clinical presentation and the imaging findings indicated avascular osteonecrosis of the trapezium. The patient was treated with immobilization of the wrist joint for a period of six weeks. Three months later, the patient was free of symptoms and the MRI scan revealed a normal trapezium. AVN of trapezium is extremely rare. Our case shows that immobilization of an early stage avascular necrosis of the trapezium might be a treatment option.

  16. A Case of Trapezium Avascular Necrosis Treated Conservatively

    Directory of Open Access Journals (Sweden)

    Evangelos Petsatodis

    2017-01-01

    Full Text Available Introduction. Avascular necrosis (AVN of the bones of the wrist most commonly involves the lunate followed by the proximal pole of the scaphoid and the capitate. Trapezium avascular necrosis is extremely rare with only two cases reported in the literature, both of which were treated surgically. In this article, we report a unique case of trapezium avascular necrosis treated conservatively. Case Presentation. A 38-year-old man complaining of a 4-month history of mild pain on the base of his right thumb. MRI scan was performed. The clinical presentation and the imaging findings indicated avascular osteonecrosis of the trapezium. The patient was treated with immobilization of the wrist joint for a period of six weeks. Three months later, the patient was free of symptoms and the MRI scan revealed a normal trapezium. Conclusion. AVN of trapezium is extremely rare. Our case shows that immobilization of an early stage avascular necrosis of the trapezium might be a treatment option.

  17. Automatic Quantification of Radiographic Wrist Joint Space Width of Patients With Rheumatoid Arthritis.

    Science.gov (United States)

    Huo, Yinghe; Vincken, Koen L; van der Heijde, Desiree; de Hair, Maria J H; Lafeber, Floris P; Viergever, Max A

    2017-11-01

    Objective: Wrist joint space narrowing is a main radiographic outcome of rheumatoid arthritis (RA). Yet, automatic radiographic wrist joint space width (JSW) quantification for RA patients has not been widely investigated. The aim of this paper is to present an automatic method to quantify the JSW of three wrist joints that are least affected by bone overlapping and are frequently involved in RA. These joints are located around the scaphoid bone, viz. the multangular-navicular, capitate-navicular-lunate, and radiocarpal joints. Methods: The joint space around the scaphoid bone is detected by using consecutive searches of separate path segments, where each segment location aids in constraining the subsequent one. For joint margin delineation, first the boundary not affected by X-ray projection is extracted, followed by a backtrace process to obtain the actual joint margin. The accuracy of the quantified JSW is evaluated by comparison with the manually obtained ground truth. Results: Two of the 50 radiographs used for evaluation of the method did not yield a correct path through all three wrist joints. The delineated joint margins of the remaining 48 radiographs were used for JSW quantification. It was found that 90% of the joints had a JSW deviating less than 20% from the mean JSW of manual indications, with the mean JSW error less than 10%. Conclusion: The proposed method is able to automatically quantify the JSW of radiographic wrist joints reliably. The proposed method may aid clinical researchers to study the progression of wrist joint damage in RA studies. Objective: Wrist joint space narrowing is a main radiographic outcome of rheumatoid arthritis (RA). Yet, automatic radiographic wrist joint space width (JSW) quantification for RA patients has not been widely investigated. The aim of this paper is to present an automatic method to quantify the JSW of three wrist joints that are least affected by bone overlapping and are frequently involved in RA. These joints

  18. Stress fractures of ankle and wrist in childhood: nature and frequency

    Energy Technology Data Exchange (ETDEWEB)

    Oestreich, Alan E. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Bhojwani, Nicholas [University of Cincinnati College of Medicine, Cincinnati, OH (United States)

    2010-08-15

    Stress fractures of many etiologies are found not infrequently in various tarsal bones but are less commonly recognized in carpal bones. To assess the distribution of tarsal and carpal stress fractures. During the last three decades, the senior author collected locations of tarsal and carpal bone stress fracture callus seen on plain radiographs. 527 children with tarsal and carpal stress fractures were identified (88 children had multiple bones involved). The totals were: calcaneus 244, cuboid 188, talus 121, navicular 24, cuneiforms 23, capitate 18, lunate 1, and scaphoid 1. Stress fractures were more frequently seen once we became aware each particular bone could be involved. Tarsal and carpal stress fractures in children are not rare. Careful perusal of these bones is urged in all susceptible children with limping or wrist pain. (orig.)

  19. Different evolutionary pathways underlie the morphology of wrist bones in hominoids.

    Science.gov (United States)

    Kivell, Tracy L; Barros, Anna P; Smaers, Jeroen B

    2013-10-23

    The hominoid wrist has been a focus of numerous morphological analyses that aim to better understand long-standing questions about the evolution of human and hominoid hand use. However, these same analyses also suggest various scenarios of complex and mosaic patterns of morphological evolution within the wrist and potentially multiple instances of homoplasy that would benefit from require formal analysis within a phylogenetic context.We identify morphological features that principally characterize primate - and, in particular, hominoid (apes, including humans) - wrist evolution and reveal the rate, process and evolutionary timing of patterns of morphological change on individual branches of the primate tree of life. Linear morphological variables of five wrist bones - the scaphoid, lunate, triquetrum, capitate and hamate - are analyzed in a diverse sample of extant hominoids (12 species, 332 specimens), Old World (8 species, 43 specimens) and New World (4 species, 26 specimens) monkeys, fossil Miocene apes (8 species, 20 specimens) and Plio-Pleistocene hominins (8 species, 18 specimens). Results reveal a combination of parallel and synapomorphic morphology within haplorrhines, and especially within hominoids, across individual wrist bones. Similar morphology of some wrist bones reflects locomotor behaviour shared between clades (scaphoid, triquetrum and capitate) while others (lunate and hamate) indicate clade-specific synapomorphic morphology. Overall, hominoids show increased variation in wrist bone morphology compared with other primate clades, supporting previous analyses, and demonstrate several occurrences of parallel evolution, particularly between orangutans and hylobatids, and among hominines (extant African apes, humans and fossil hominins). Our analyses indicate that different evolutionary processes can underlie the evolution of a single anatomical unit (the wrist) to produce diversity in functional and morphological adaptations across individual wrist

  20. The effect of unions on the distribution of wages of hospital-employed registered nurses in the United States.

    Science.gov (United States)

    Spetz, Joanne; Ash, Michael; Konstantinidis, Charalampos; Herrera, Carolina

    2011-01-01

    We estimate the impact of unionisation on the wage structure of hospital-employed registered nurses in the USA. We examine whether unions have an effect on wage differences associated with race, gender, immigration status, education and experience, as well as whether there is less unexplained wage variation among unionised nurses. In the past decade, there has been resurgence in union activity in the health care industry in the USA, particularly in hospitals. Numerous studies have found that unions are associated with higher wages. Unions may also affect the structure of wages paid to workers, by compressing the wage structure and reducing unexplained variation in wages. Cross-sectional analysis of pooled secondary data from the United States Current Population Survey, 2003-2006. Multivariate regression analysis of factors that predict wages, with models derived from labour economics. There are no wage differences associated with gender, race or immigration status among unionised nurses, but there are wage penalties for black and immigrant nurses in the non-union sector. For the most part, the pay structures of the union and non-union sectors do not significantly differ. The wage penalty associated with diploma education for non-union nurses disappears among unionised nurses. Unionised nurses receive a lower return to experience, although the difference is not statistically significant. There is no evidence that unexplained variation in wages is lower among unionised nurses. While in theory unions may rationalise wage-setting and reduce wage dispersion, we found no evidence to support this hypothesis. The primary effect of hospital unions is to raise wages. Unionisation does not appear to have other important wage effects among hospital-employed nurses. © 2010 Blackwell Publishing Ltd.

  1. Sequential chimeric medial femoral condyle and anterolateral thigh flow-through flaps for one-stage reconstructions of composite bone and soft tissue defects: Report of three cases.

    Science.gov (United States)

    Henn, Dominic; Abouarab, Mohamed H; Hirche, Christoph; Hernekamp, Jochen F; Schmidt, Volker J; Kneser, Ulrich; Kremer, Thomas

    2017-10-01

    Small recalcitrant non-unions with poor perfusion require reconstruction with vascularized bone flaps. Cases with concomitant large soft tissue defects are especially challenging, since vascularized soft tissue transfer is often indicated and distant microvascular anastomoses may be required. We introduce a sequential chimeric free flap composed of a medial femoral condyle corticoperiosteal flap anastomosed to an anterolateral thigh flow-through flap (MFC-ALT flap) and report its use for reconstruction of small non-unions with concomitant large soft tissue defects in three exemplary patients. Two female and one male patients ages 39-58 years suffered from composite bone and soft tissue defects of the lower extremity and clavicle caused by tumor resection and postoperative radiation resp. infected tibial pilon fracture. The sizes of the soft tissue defects ranged from 15-23 × 4.5-6 cm and the sizes of the bone defects ranged from 1.5-4 × 2-4 cm. Defect reconstructions were performed in all cases with sequential chimeric MFC-ALT flaps with sizes ranging from 2-4 × 1.6-4 cm for the MFC and 21-23 × 7-8 cm for the ALT skin paddles. Functional reconstructions were achieved in all cases resulting in stable unions and soft tissue coverage enabling the patients to bear full weight without assistance on 5-months follow-up. Postoperative course was uneventful and complications were restricted to a small skin necrosis at the suture line in one case. MFC-ALT flaps may be a safe, and effective procedure for one-stage reconstructions of small, irregularly shaped bone defects with concomitant large soft tissue loss or surrounding instable scarring, particularly in cases of recalcitrant non-unions after radiation exposure. © 2017 Wiley Periodicals, Inc.

  2. Limited open reduction is better for simple- distal tibial shaft fractures than minimally invasive plate osteosynthesis.

    Science.gov (United States)

    Li, Q; Zeng, B F; Luo, C F; Song, S; Zhang, C Q; Kong, W Q

    2014-07-24

    The aim of this study was to compare the effects and indications of minimally invasive plate osteosynthesis (MIPO) and limited open reduction (LOR) for managing distal tibial shaft fractures. A total of 79 cases of distal tibial shaft fractures were treated surgically in our trauma center. The 79 fracture cases were classified into type A, B, and C (C1) according to the Arbeitsgemeinschaft für Osteosynthesefragen (AO) classification, with 28, 32, and 19 cases, respectively. Among the 79 fracture cases, 52 were closed fractures and 27 were open fractures (GUSTILO, I-II). After adequate preparation, 48 cases were treated with LOR and 31 cases were treated with MIPO. All cases were followed up for 12 to 18 months, with an average of 16.4 months. During the follow-up period, 76 fracture cases were healed in the first stage, whereas the 3 cases that developed non-union were treated by changing the fixation device and autografting. For types A, B, and some of C simple fractures (C1), LOR accelerated the fracture healing and lowered the non-union rate. One case suffered from regional soft tissue infection, which was controlled by wound dressing and intravenous antibiotics. Another case that developed local skin necrosis underwent local flap transplant. LOR promoted bone healing and lowered the non-union rate of several simple-distal tibial shaft fractures. Thereafter, the incidence of soft tissue complication was not significantly increased. However, for complex and comminuted fractures, MIPO was the preferred method for correcting bone alignment and protecting soft tissue, leading to functional recovery.

  3. SOUND LABOR RELATIONS AT ENTERPRISE LEVEL IN THAILAND

    Directory of Open Access Journals (Sweden)

    Vichai Thosuwonchinda

    2016-07-01

    Full Text Available The objective of this research was to study the pattern of sound labor relations in Thailand in order to reduce conflicts between employers and workers and create cooperation. The research was based on a qualitative approach, using in-depth interview with 10 stakeholder groups of Thai industrial relations system. They were employees of non unionized companies at the shop floor level, employees of non unionized companies at the supervisor level, trade union leaders at the company level, trade union leaders at the national level, employers of non-unionized companies, employers’ organization leaders, and human resource managers, members of tripartite bodies, government officials and labor academics. The findings were presented in a model identifying 5 characteristics that enhance sound relations in Thailand, i.e. recognition between employer and workers, good communication, trust, data revealing and workers’ participation. It was suggested that all parties, employers, workers and the government should take part in the promotion of sound labor relations. The employer have to acknowledge labor union with a positive attitude, have good communication with workers , create trust with workers, disclose information, create culture of mutual benefits as well as accept sincerely the system that include workers’ participation. Workers need a strong labor union, good and sincere representatives for clear communication, trust, mutual benefits and seek conflict solutions with employer by win-win strategy. The government has a supporting role in adjusting the existing laws in the appropriate way, by creating policy for sound labor relations, and putting the idea of sound labor relations into practice.

  4. The early functional outcome of Mau osteotomy for the correction of moderate-severe hallux valgus

    Directory of Open Access Journals (Sweden)

    Tanujan Thangarajah

    2013-11-01

    Full Text Available Hallux valgus is one of the commonest conditions of the foot and has been reported to affect nearly half of the adult population. It is most effectively treated by a corrective osteotomy of which there a numerous subtypes. The Mau osteotomy confers the greatest structural stability but is not thought to provide adequate correction of moderate-severe deformities. Accordingly, complications such as under correction and non-union are common. The aim of this study was to determine the functional outcome in patients with moderate-severe hallux valgus following a Mau osteotomy. A retrospective review of 23 patients with moderate-severe hallux valgus treated by Mau osteotomy was conducted. Patients were assessed clinically by the American Orthopedic Foot and Ankle Society (AOFAS scoring system and radiologically by measuring the first intermetatarsal (IM and hallux abductovalgus angles (HAV. The mean AOFAS score had improved from 47 preoperatively to 92 postoperatively (P<0.01. Additionally, preoperative HAV and IM angles improved from 39° and 15° respectively to 15° and 9° respectively (P<0.01. There were no cases of undercorrection or non-union. In this series, the Mau osteotomy was able to achieve good correction of the IM and HAV angles in patients with moderate-severe hallux valgus. This was reflected in a significantly higher postoperative AOFAS score. Contrary to other studies there were no cases of undercorrection and despite allowing patients to fully weight-bear postoperatively there were no cases of non-union.

  5. Medical Services: Standards of Medical Fitness

    Science.gov (United States)

    2002-03-28

    Prosthetic replacement Head, 3–19 Joints, 3–14g(5) Valve , 3–24a Protozoal infestations, 2–35n Psoriasis, 2–36q, 2–38w Parapsoriasis, 3–38u Psoriatic...832), or knee (836); or instability of any major joint such as shoulder (718.1), elbow (718.3), or hip (718.5). d. Fractures . (1) Malunion or non...union of any fracture (733.8), except ulnar styloid process. (2) Orthopedic hardware (733.99), including plates, pins, rods, wires, or screws used for

  6. An unusual cause of pain post ankle arthrodesis in patients with rheumatoid arthritis.

    LENUS (Irish Health Repository)

    Burke, Neil G

    2012-02-01

    Rheumatoid arthritis is an autoimmune disease which frequently affects the ankle and foot. End stage ankle arthritis from rheumatic disease is commonly managed by the established practice of ankle arthrodesis. Among the adverse sequelae causing pain following this surgery is infection, pseudo-arthrosis and non-union. Stress fracture of the distal third is a recognised but unusual cause of pain of tibia following ankle arthrodesis. The authors\\' present three patients with rheumatoid arthritis who sustained a stress fracture of the distal tibia following arthrodesis, and discuss the contributing factors and highlight the need for orthopaedic surgeons to be suspicious of this complication post surgery.

  7. Asking about wages: Results from the Bank of Canada's Wage Setting Survey of Canadian companies

    OpenAIRE

    Amirault, David; Fenton, Paul; Laflèche, Thérèse

    2013-01-01

    The Bank of Canada conducted a Wage Setting Survey with a sample of 200 private sector firms from mid-October 2007 to May 2008. Results indicate that wage adjustments for the Canadian non-union private workforce are overwhelmingly time dependent, with a fixed duration of one year, and are clustered in the first four months of the year, suggesting that wage stickiness may not be constant over the year. Ad hoc adjustments between these fixed dates are rare, but when they do occur they are almos...

  8. Complications after osteosynthesis and their causes

    International Nuclear Information System (INIS)

    Lechner, S.

    1982-01-01

    From 1976 to 1981, 1,426 osteosyntheses were carried through according to the methods of the study group on questions of osteosynthesis. Complications occurred in 73 patients and consisted in the fracture or bending of the implant, or non-union. This led to an epicritical scrutiny of the case histories and X-ray images of these 73 patients in order to ascertain the causes underlying these complications, and to find out to what extent these problems can be recognized at an early date after the operation. (orig./MG) [de

  9. Anaesthetic Implications in Primary Hyperparathyroidism with Severe Hypercalcaemia; a Case Report

    Directory of Open Access Journals (Sweden)

    Pranav Bansal

    2013-07-01

    Full Text Available Primary hyperparathyroidism is a rare endocrinal disorder of excess production of parathormone. A wide array of presenting symptoms may occur from parathormone induced hypercalcaemia leading to nephrolithiasis, osteoporosis, muscle weakness and cardiac arrhythmias. We present a case of young female who presented with non union of an operated fracture femur and generalized bony pains and frequent complaints of vomiting, polyuria and polydipsia. She was diagnosed to have primary hyperparathyroidism with hypercalcaemia and underwent parathyroidectomy. The potential perioperative problems and anaesthetic concerns require a focused management and are discussed.

  10. Hamate hook stress fracture in a professional bowler: Case report of an unusual causal sport.

    Science.gov (United States)

    How Kit, N; Malherbe, M; Hulet, C

    2017-02-01

    Stress fracture of the hook of the hamate is uncommon and is usually seen in sports involving a club, racquet or bat (i.e., golf, tennis or baseball). It is caused by direct blunt trauma. We report an unusual case of stress fracture with non-union in a 23-year-old professional bowler, probably caused by endogenous constraints, 1 year after the start of symptoms. Treatment consisted of surgical resection of the hook of the hamate. Multimodal imaging of this fracture is reviewed. Copyright © 2016. Published by Elsevier Masson SAS.

  11. Radium-226 in vegetation and substrates at inactive uranium mill sites

    International Nuclear Information System (INIS)

    Marple, M.L.

    1980-01-01

    Results of a study of the content of radium-226 in plants growing on inactive uranium mill tailings sites in the Four Corners Region of the southwestern United States and in plants grown under greenhouse conditions with minimal surficial contamination are reported. Field plant samples and associated substrates were analyzed from two carbonate tailings sites in the Grants Mineral Belt of New Mexico. Radium activities in air-cleaned samples ranged from 5 to 368 pCi/g (dry weight) depending on species and location: activities in plants growing on local soils averaged 1.0 pCi/g. The talings and local soils contain 140 to 1400 pCi/g and 2.1 pCi/g, respectively. An evaluation of cleaning methods on selected samples showed that from 17 to 79% of the radium activity measured in air-cleaned samples was due to surficial contamination, which varied with species and location. A survey of 18 inactive uranium mill sites in the Four Corners Region was performed. Radium activity in plant tissues from nine species ranged from 2 to 210 pCi/g on bare tailings and from 0.3 to 30 pCi/g on covered tailings The radium content in most of the soil overburdens on the covered tailings piles was 10 to 17 pCi/g. An experiment was performed to measure radium-226 uptake by two species grown on tailings covered with a shallow (5 cm) soil layer. A grass, Sporobolus airoides (alkali sacaton) and a shrub, Atriplex canescens (four-wing saltbush), were studied. The tailings were a mixture of sands and slimes from a carbonate pile. The tailings treatments were plants grown in a soil cover over tailings; the controls were plants grown only in soil. Three soil types, dune sand, clay loam, and loam, were used. The radium activity of the plant tissue from the tailings treatment compared to that of the appropriate control was 1 to 19 times greater for the grass and 4 to 27 times greater for the shrub

  12. Radium-226 in vegetation and substrates at inactive uranium mill sites

    Energy Technology Data Exchange (ETDEWEB)

    Marple, M.L.

    1980-01-01

    Results of a study of the content of radium-226 in plants growing on inactive uranium mill tailings sites in the Four Corners Region of the southwestern United States and in plants grown under greenhouse conditions with minimal surficial contamination are reported. Field plant samples and associated substrates were analyzed from two carbonate tailings sites in the Grants Mineral Belt of New Mexico. Radium activities in air-cleaned samples ranged from 5 to 368 pCi/g (dry weight) depending on species and location: activities in plants growing on local soils averaged 1.0 pCi/g. The talings and local soils contain 140 to 1400 pCi/g and 2.1 pCi/g, respectively. An evaluation of cleaning methods on selected samples showed that from 17 to 79% of the radium activity measured in air-cleaned samples was due to surficial contamination, which varied with species and location. A survey of 18 inactive uranium mill sites in the Four Corners Region was performed. Radium activity in plant tissues from nine species ranged from 2 to 210 pCi/g on bare tailings and from 0.3 to 30 pCi/g on covered tailings The radium content in most of the soil overburdens on the covered tailings piles was 10 to 17 pCi/g. An experiment was performed to measure radium-226 uptake by two species grown on tailings covered with a shallow (5 cm) soil layer. A grass, Sporobolus airoides (alkali sacaton) and a shrub, Atriplex canescens (four-wing saltbush), were studied. The tailings were a mixture of sands and slimes from a carbonate pile. The tailings treatments were plants grown in a soil cover over tailings; the controls were plants grown only in soil. Three soil types, dune sand, clay loam, and loam, were used. The radium activity of the plant tissue from the tailings treatment compared to that of the appropriate control was 1 to 19 times greater for the grass and 4 to 27 times greater for the shrub.

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

    Science.gov (United States)

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

    2013-06-01

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

  14. Comparative analysis of treatment outcomes in patients with femoral neck fracture using monolateral wire and half-pin fixator of the authors' design and transosseous fixation wires

    Directory of Open Access Journals (Sweden)

    Allakhverdiev A.S.

    2014-12-01

    fractures of the proximal femur. Two groups of patients were studied: duration of surgery, duration of osteosynthesis, complications, and outcomes (in terms of one year after the dismantling clips using the modified scale Luboshyce — Mattis — Schwartzberg. Results. Fracture repair was achieved in 40 patients (62,5% of the 1st group. The following complications were observed in this group: non-union and pseudarthrosis — in 21 (32,8% case; aseptic necrosis of the femoral head in 3 (4,7% cases; hip ankyloses — in one (1,6% case, breakage and migration of wires into the joint cavity and smaller pelvis — 3 (4,7% patients and cutting out of wires from the femoral head was observed in 3 (4,7% cases. Totally 61 complication were revealed. In the second group of the patients non-union was found in one patient (64 years old. Complications were observed in 6 patients of this group — pint-tract infection, moderate secondary displacement of the fragments (the patient fell down on the operated limb and wire breakage. Conclusion. The efficiency of the femoral neck osteosynthesis with application of elaborated monolateral wire- and half-pin fixator made up 95,7% of the positive outcomes (in osteosynthesis using bunch of wires with llizarov frame fixation the same 60,9% of the positive outcomes.

  15. Implant failure in lower limb long bone diaphyseal fractures at a tertiary hospital in Ile- Ife. Nigeria.

    Science.gov (United States)

    Esan, O; Ikem, I C; Orimolade, E A; Esan, O T

    2014-06-01

    This included determining aetiology of failure and comparing the failure rate in implant fixations using solid intramedullary nail and DCP. A retrospective study conducted at the Orthopaedic Department, Obafemi Awolowo University Teaching Hospital, Ile-Ife,Nigeria. Records of all operated cases of lower limb long bone diaphyseal fractures including those with failed fixations from August 2006-July 2011 were reviewed. Data retrieved included type of implant used, aetiology and characteristics of Implant failure. Data were analysed using SPSS version 16. Frequency distribution of the variables of interest was done. Difference in failure rate of intramedullary nail versus DCP was tested using chi-square. Statistical significance was inferred at pfractures and met inclusion criteria, of which 135 had intramedullary nail fixation and 86 had DCP. The rate of implant failure in intramedullary nail was 1.5% while it was 5.8% in patients with DCP (p=0.113; 0R=4.10; 95% CI=0.65- 43.77). Implant fracture was the commonest type of failure seen (100% versus 60%) and non union was the commonest cause of failure seen (50% versus 40%) in the intramedullary nailing and DCP groups respectively. The likelihood of a failed implant is higher in fixations done with DCP compared with intramedullary nail though the difference was not statistically significant. Commonest reason for failure in both groups was non-union. Findings from this study may guide surgeons in choice of implant in the management of long bone fractures.

  16. Delayed healing of lower limb fractures with bisphosphonate therapy.

    Science.gov (United States)

    Yue, B; Ng, A; Tang, H; Joseph, S; Richardson, M

    2015-07-01

    Bisphosphonate therapy (BT) is used commonly in the management of osteoporosis. A systematic review was conducted investigating delayed union of lower limb, long bone fractures in patients on BT. We specifically assessed whether BT increases the risk of delayed union or non-union in lower limb, long bone fractures. A literature search was conducted in the PubMed and Embase™ on 4 November 2014. Articles that investigated lower limb fractures, history of BT and fracture union were included in the review. A total of 9,809 papers were retrieved and 14 were deemed suitable for this review. The mean time to union in patients on BT was 8.5 months. A longer time to union was reported in a study investigating BT users versus controls (6.5 vs 4.8 months respectively). The mean rate of delayed or non-union for BT associated atypical fractures was 20% per fracture. Specifically in one study, delayed union was more common in the cohort with more than three years of BT (67%) than in the group with less than three years of BT (26%). Surgical fixation was associated with improved outcomes compared with non-operative management. BT has been described to be associated with multiple adverse outcomes related to atypical fractures. Current evidence recommends operative management for this patient group. Further investigation is required to evaluate the exact effects of BT on lower limb fractures, in particular typical femoral fractures.

  17. Progression of a fracture site impaction as a prognostic indicator of impacted femoral neck fracture treated with multiple pinning.

    Science.gov (United States)

    Yoon, Pil Whan; Shin, Young Ho; Yoo, Jeong Joon; Yoon, Kang Sup; Kim, Hee Joong

    2012-03-01

    We evaluated the clinical and radiologic results of impacted femoral neck fractures treated with multiple pinning and determined the influence of the progression of impaction at the fracture site on clinical outcome. There were 34 patients with a mean age of 65.5 years. The mean follow-up period was 3.4 years. Progression of fracture site impaction was measured using an articulo-trochanteric distance index and the percentage decrease in the articulo-trochanteric distance index between follow-up intervals. The failure of treatment was clarified as non-union and avascular necrosis. Other characteristics of the patients, including mean waiting time for surgery, preoperative Singh index score, and body mass index, were also measured to evaluate the influence on the clinical outcome of surgery. There were 6 fractures which were not treated successfully (3 non-union, 8.8% and 3 avascular necrosis, 8.8%). The mean percentage decrease of the articulo-trochanteric distance index within the first 6 weeks after surgery was 4.5% in the successful group and 25.1% in the failure group (p articulo-trochanteric distance index between 6 weeks and 3 months (p articulo-trochanteric distance index between the successful group and the failure group, we could not verify it as a risk factor for failure of treatment because the odds ratio was not statistically significant.

  18. The role of 3D plating system in mandibular fractures: A prospective study

    Directory of Open Access Journals (Sweden)

    Rajendra Prasad

    2013-01-01

    Full Text Available Aim: The aim of our study was to evaluate the advantages and disadvantages of 3D plating system in the treatment of mandibular fractures. Patients and Methods: 20 mandibular fractures in 18 patients at various anatomic locations and were treated by open reduction and internal fixation using 3D plates. All patients were followed at regular intervals of 4 th , 8 th and 12 th weeks respectively. Patients were assessed post-operatively for lingual splay and occlusal stability. The incidence of neurosensory deficit, infection, masticatory difficulty, non-union, malunion was also assessed. Results: A significant reduction in lingual splay (72.2% and occlusal stability (72.2% was seen. The overall complication rate was (16.6% which included two patients who developed post-operative paresthesia of lip, three patients had infection and two cases of masticatory difficulty which later subsided by higher antibiotics and 4 weeks of MMF. No evidence of non-union, malunion was noted. Conclusion: A single 3D 2 mm miniplate with 2 mm × 8 mm screws is a reliable and an effective treatment modality for mandibular fracture.

  19. The modernization of the port area of Bejaia and its impact on the architectural heritage

    Directory of Open Access Journals (Sweden)

    Walid Hamma

    2018-09-01

    Full Text Available Bejaia, a city of light, art, history and knowledge, is no longer the university that attracted scholars from all four corners of the world during the Middle Ages. It suffers from many problems such as the degradation and demolition of its heritage, pollution, accessibility, under-equipment and unorganized mass tourism. In order to resolve part of this problem, the local authorities decided to modernize the port area of the city. The plan of this intervention unfortunately did not foresee a study of impact on the heritage since the zone is historical. To detect actions that had negative impacts, we investigated by comparing the current state with the old. Then we checked the compatibility of these with the national legislation and the international regulations on intervention on the heritage. It appears that certain actions in the plan to modernize the port area of Bejaia have had negative impacts, such as the demolition of old buildings, non-compliance with heritage easements, encroachment of archaeological areas, attacks on authenticity , increased traffic and poor integration of new buildings. These actions also violate national and international regulations.

  20. Parallel-plate submicron gap formed by micromachined low-density pillars for near-field radiative heat transfer

    International Nuclear Information System (INIS)

    Ito, Kota; Miura, Atsushi; Iizuka, Hideo; Toshiyoshi, Hiroshi

    2015-01-01

    Near-field radiative heat transfer has been a subject of great interest due to the applicability to thermal management and energy conversion. In this letter, a submicron gap between a pair of diced fused quartz substrates is formed by using micromachined low-density pillars to obtain both the parallelism and small parasitic heat conduction. The gap uniformity is validated by the optical interferometry at four corners of the substrates. The heat flux across the gap is measured in a steady-state and is no greater than twice of theoretically predicted radiative heat flux, which indicates that the parasitic heat conduction is suppressed to the level of the radiative heat transfer or less. The heat conduction through the pillars is modeled, and it is found to be limited by the thermal contact resistance between the pillar top and the opposing substrate surface. The methodology to form and evaluate the gap promotes the near-field radiative heat transfer to various applications such as thermal rectification, thermal modulation, and thermophotovoltaics

  1. Episodic Late Holocene dune movements on the sand-sheet area, Great Sand Dunes National Park and Preserve, San Luis Valley, Colorado, USA

    Science.gov (United States)

    Forman, S. L.; Spaeth, M.; Marín, L.; Pierson, J.; Gómez, J.; Bunch, F.; Valdez, A.

    2006-07-01

    The Great Sand Dunes National Park and Preserve (GSDNPP) in the San Luis Valley, Colorado, contains a variety of eolian landforms that reflect Holocene drought variability. The most spectacular is a dune mass banked against the Sangre de Cristo Mountains, which is fronted by an extensive sand sheet with stabilized parabolic dunes. Stratigraphic exposures of parabolic dunes and associated luminescence dating of quartz grains by single-aliquot regeneration (SAR) protocols indicate eolian deposition of unknown magnitude occurred ca. 1290-940, 715 ± 80, 320 ± 30, and 200-120 yr ago and in the 20th century. There are 11 drought intervals inferred from the tree-ring record in the past 1300 yr at GSDNPP potentially associated with dune movement, though only five eolian depositional events are currently recognized in the stratigraphic record. There is evidence for eolian transport associated with dune movement in the 13th century, which may coincide with the "Great Drought", a 26-yr-long dry interval identified in the tree ring record, and associated with migration of Anasazi people from the Four Corners areas to wetter areas in southern New Mexico. This nascent chronology indicates that the transport of eolian sand across San Luis Valley was episodic in the late Holocene with appreciable dune migration in the 8th, 10-13th, and 19th centuries, which ultimately nourished the dune mass against the Sangre de Cristo Mountains.

  2. Model for the analysis of transitories and stability of a BWR reactor with fuel of thorium

    International Nuclear Information System (INIS)

    Nunez C, A.; Espinosa P, G.; Francois L, J.L.

    2004-01-01

    In this work it is described the thermo hydraulic and neutronic pattern used to simulate the behavior of a nucleus of thorium-uranium under different conditions of operation. The analysed nucleus was designed with base to assemblies that operate under the cover-seed concept. The pattern was proven to conditions of stationary state and transitory state. Here it is only presented the simulation of the one SCRAM manual and it is compared in the behavior of a nucleus with UO 2 . Additionally one carries out an analysis of stability taking into account the four corners that define the area of stability of the map flow-power and to conditions of 100% of flow and 100% of power. The module of stability is based on the pattern of Lahey and Podowsky to estimate the drops of pressure during a perturbation. It is concludes that the behavior of this nucleus is not very different to the one shown by the nuclei loaded with the fuel of UO 2 . (Author)

  3. PIV measurements of the turbulence integral length scale on cold combustion flow field of tangential firing boiler

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Wen-fei; Xie, Jing-xing; Gong, Zhi-jun; Li, Bao-wei [Inner Mongolia Univ. of Science and Technology, Baotou (China). Inner Mongolia Key Lab. for Utilization of Bayan Obo Multi-Metallic Resources: Elected State Key Lab.

    2013-07-01

    The process of the pulverized coal combustion in tangential firing boiler has prominent significance on improving boiler operation efficiency and reducing NO{sub X} emission. This paper aims at researching complex turbulent vortex coherent structure formed by the four corners jets in the burner zone, a cold experimental model of tangential firing boiler has been built. And by employing spatial correlation analysis method and PIV (Particle Image Velocimetry) technique, the law of Vortex scale distribution on the three typical horizontal layers of the model based on the turbulent Integral Length Scale (ILS) has been researched. According to the correlation analysis of ILS and the temporal average velocity, it can be seen that the turbulent vortex scale distribution in the burner zone of the model is affected by both jet velocity and the position of wind layers, and is not linear with the variation of jet velocity. The vortex scale distribution of the upper primary air is significantly different from the others. Therefore, studying the ILS of turbulent vortex integral scale is instructive to high efficiency cleaning combustion of pulverized coal in theory.

  4. Control rod

    International Nuclear Information System (INIS)

    Fukumoto, Takashi; Hirakawa, Hiromasa; Kawashima, Norio; Goto, Yasuyuki.

    1994-01-01

    Neutron absorbers are contained in a tubular member comprising, integrally a tubular portion and four corners disposed at the outer circumference of the tubular portion at every 90deg, to provide a neutron absorbing tube. A plurality of neutron absorbing tubes are arranged in parallel in the lateral direction, and adjacent corners are joined, into a blade to constitute a control rod. Such a control rod has a great structural strength, simple in the structure and relatively light in weight and can contain a great amount of neutron absorbers. Upon formation of the control rod by arranging the blades in a cross-like shape, at least a portion thereof is constituted with short neutron absorbing tubes shorter than the entire length of the blade, and gaps are formed at positions in adjacent in the axial direction. With such a constitution, there is no worry that a wing end of the blade collides against or be abraded with a fuel channel box or a fuel support. Even if fuel channels are vibrated upon scram of the reactor, such as occurrence of earthquakes, it can be inserted to the reactor easily. (N.H.)

  5. Twin lead ballistic conductor based on nanoribbon edge transport

    Science.gov (United States)

    Konôpka, Martin; Dieška, Peter

    2018-03-01

    If a device like a graphene nanoribbon (GNR) has all its four corners attached to electric current leads, the device becomes a quantum junction through which two electrical circuits can interact. We study such system theoretically for stationary currents. The 4-point energy-dependent conductance matrix of the nanostructure and the classical resistors in the circuits are parameters of the model. The two bias voltages in the circuits are the control variables of the studied system while the electrochemical potentials at the device's terminals are non-trivially dependent on the voltages. For the special case of the linear-response regime analytical formulae for the operation of the coupled quantum-classical device are derived and applied. For higher bias voltages numerical solutions are obtained. The effects of non-equilibrium Fermi levels are captured using a recursive algorithm in which self-consistency between the electrochemical potentials and the currents is reached within few iterations. The developed approach allows to study scenarios ranging from independent circuits to strongly coupled ones. For the chosen model of the GNR with highly conductive zigzag edges we determine the regime in which the single device carries two almost independent currents.

  6. Apparatus and method for mounting photovoltaic power generating systems on buildings

    Science.gov (United States)

    Russell, Miles Clayton [Lincoln, MA

    2008-10-14

    Rectangular PV modules (6) are mounted on a building roof (4) by mounting stands that are distributed in rows and columns. Each stand comprises a base plate (10) that rests on the building roof (4) and first and second brackets (12, 14) of different height attached to opposite ends of the base plate (10). Each bracket (12, 14) has dual members for supporting two different PV modules (6), and each PV module (6) has a mounting pin (84) adjacent to each of its four corners. Each module (6) is supported by attachment of two of its mounting pins (84) to different first brackets (12), whereby the modules (6) and their supporting stands are able to resist uplift forces resulting from high velocity winds without the base plates (10) being physically attached to the supporting roof structure (4). Preferably the second brackets (14) have a telescoping construction that permits their effective height to vary from less than to substantially the same as that of the first brackets (12).

  7. The Colorado Plateau V: research, environmental planning, and management for collaborative conservation

    Science.gov (United States)

    Villarreal, Miguel L.; van Riper, Carena J.; Johnson, Matthew J.; van Riper, Charles

    2012-01-01

    Roughly centered on the Four Corners region of the southwestern United States, the Colorado Plateau covers some 130,000 square miles of sparsely vegetated plateaus, mesas, canyons, arches, and cliffs in Arizona, Utah, Colorado, and New Mexico. With elevations ranging from 3,000 to 14,000 feet, the natural systems found within the plateau are dramatically varied, from desert to alpine conditions. This volume, the fifth from the University of Arizona Press and the tenth overall, focuses on adaptation of resource management and conservation to climate change and water scarcity, protecting biodiversity through restructured energy policies, ensuring wildlife habitat connectivity across barriers, building effective conservation networks, and exploring new opportunities for education and leadership in conservation science. An informative read for people interested in the conservation and natural history of the region, the book will also serve as a valuable reference for those people engaged in the management of cultural and biological resources of the Colorado Plateau, as well as scientists interested in methods and tools for land and resource management throughout the West.

  8. Expelling Slavery from the Nation: Representations of labour exploitation in Australia’s supply chain

    Directory of Open Access Journals (Sweden)

    Anna Szörényi

    2016-09-01

    Full Text Available On 4 May 2015, the Australian national broadcaster’s current affairs programme Four Corners aired an episode titled ‘Slaving Away: The dirty secrets behind Australia’s fresh food’, that provided revelations of labour exploitation of migrant workers on working holiday visas. The government reacted swiftly to these allegations with an ‘operation’ ostensibly designed to stop the exploitation. In reports of Operation Cloudburst, however, there was a shift in the media’s definition of the problem: worker exploitation became visa violations and newspapers shortly reported the resulting action taken: the ‘illegal workers’ in Australia’s food industry had been arrested. This paper tracks the competing discursive and visual representations of this case that ultimately made questions of labour rights become questions of immigration, making it plausible and acceptable that concern over exploitation of workers should be addressed by deportation of ‘illegal immigrants’. Such discursive slippage is enabled by cultural amnesia over Australia’s history of exploitation of racialised and migrant labourers, which allows ‘slavery’ to be represented as a ‘foreign’ problem that can be expelled in defence of the purity of the national domestic space.

  9. Disaster risk assessment case study: Recent drought on the Navajo Nation, USA

    Science.gov (United States)

    Hiza, Margaret; Kelley, Klara B.; Francis, Harris; Block, Debra

    2011-01-01

    The Navajo Nation is an ecologically sensitive semi-arid to arid section of the southern Colorado Plateau. In this remote part of the United States, located at the Four Corners (Arizona, New Mexico, Colorado, and Utah), traditional people live a subsistence lifestyle that is inextricably tied to, and dependent upon, landscape conditions and water supplies. Soft bedrock lithologies and sand dunes dominate the region, making it highly sensitive to fluctuations in precipitation intensity, percent vegetation cover, and local land use practices. However, this region has sparse and discontinuous meteorological monitoring records. As a complement to the scant long-term meteorological records and historical documentation, we conducted interviews with 50 Native American elders from the Navajo Nation and compiled their lifetime observations on the changes in water availability, weather, and sand or dust storms. We then used these observations to further refine our understanding of the historical trends and impacts of climate change and drought for the region. In addition to altered landscape conditions due to climatic change, drought, and varying land use practices over the last 130 years, the Navajo people have been affected by federal policies and harsh economic conditions which weaken their cultural fabric. We conclude that a long-term drying trend and decreasing snowpack, superimposed on regional drought cycles, will magnify drought impacts on the Navajo Nation and leave its people increasingly vulnerable.

  10. 24-GHz LTCC Fractal Antenna Array SoP With Integrated Fresnel Lens

    KAUST Repository

    Ghaffar, Farhan A.

    2012-09-30

    A novel 24-GHz mixed low-temperature co-fired ceramic (LTCC) tape based system-on-package (SoP) is presented, which incorporates a fractal antenna array with an integrated grooved Fresnel lens. The four-element fractal array employs a relatively low dielectric constant substrate (CT707, εr = 6.4), whereas the lens has been realized on a high-dielectric-constant superstrate (CT765, εr = 68.7 ). The two (substrate and superstrate) are integrated through four corner posts to realize the required air gap (focal distance). The fractal array alone provides a measured gain of 8.9 dBi. Simulations predict that integration of this array with the lens increases the gain by 6 dB. Measurements reveal that the design is susceptible to LTCC fabrication tolerances. In addition to high gain, the SoP provides a bandwidth of 8%. The high performance and compact size (24 × 24 × 4.8 mm3 ) of the design makes it highly suitable for emerging wireless applications such as automotive radar front end.

  11. USING REMOTE SENSING AND RPAS FOR ARCHAEOLOGY AND MONITORING IN WESTERN GREENLAND

    Directory of Open Access Journals (Sweden)

    K. Pavelka

    2016-06-01

    Full Text Available Since 2002, German low-cost scientific expeditions to Greenland have been performed. The objective was a geodetic survey and glaciology with GNSS technology – mainly the measurement of glacier profiles (height. The same glacier profiles along the route were measured during German expeditions in 2006, 2010, 2012 and 2015. The last international expedition was supplemented with RPAS (UAV measurement, the testing of small corner reflectors for Terra SAR X satellite measurement and the use of image based modelling technology for historical monuments documentation, all in specific arctic conditions. The RPAS measurement was focused on the documentation of existing valuable archaeological sites near Ilulissat city and the testing of RPAS technology for the monitoring of the face of the moving glacier. Two typical church wooden constructions were documented by simple photogrammetric technology based on image correlation. Both experiments were evaluated as successfully case projects. The last part of the experiments deals with the monitoring of a moving inland glacier using SAR technology; four corner reflectors were installed on the glacier and on a massive nearby rock. Two ascending and two descending overflights of the Terra SAR X satellite in fine resolution mode were performed. The InSAR technology give inconclusive results, but some movements were detected; small and inexpensive corner reflectors of our own production have proven suitable. Experience and expertise from the measurement such as the first outputs from the expedition are the content of the present article.

  12. The discovery and measurements of a Higgs boson.

    Science.gov (United States)

    Gianotti, F; Virdee, T S

    2015-01-13

    In July 2012, the ATLAS and CMS collaborations at CERN's Large Hadron Collider announced the discovery of a Higgs-like boson, a new heavy particle at a mass more than 130 times the mass of a proton. Since then, further data have revealed its properties to be strikingly similar to those of the Standard Model Higgs boson, a particle expected from the mechanism introduced almost 50 years ago by six theoreticians including British physicists Peter Higgs from Edinburgh University and Tom Kibble from Imperial College London. The discovery is the culmination of a truly remarkable scientific journey and undoubtedly the most significant scientific discovery of the twenty-first century so far. Its experimental confirmation turned out to be a monumental task requiring the creation of an accelerator and experiments of unprecedented capability and complexity, designed to discern the signatures that correspond to the Higgs boson. Thousands of scientists and engineers, in each of the ATLAS and CMS teams, came together from all four corners of the world to make this massive discovery possible.

  13. Design and Numerical Study of Micropump Based on Induced Electroosmotic Flow

    Directory of Open Access Journals (Sweden)

    Kai Zhang

    2018-01-01

    Full Text Available Induced charge electroosmotic flow is a new electric driving mode. Based on the Navier–Stokes equations and the Poisson–Nernst–Planck (PNP ion transport equations, the finite volume method is adopted to calculate the equations and boundary conditions of the induced charge electroosmotic flow. In this paper, the formula of the induced zeta potential of the polarized solid surface is proposed, and a UDF program suitable for the simulation of the induced charge electroosmotic is prepared according to this theory. At the same time, on the basis of this theory, a cross micropump driven by induced charge electroosmotic flow is designed, and the voltage, electric potential, charge density, and streamline of the induced electroosmotic micropump are obtained. Studies have shown that when the cross-shaped micropump is energized, in the center of the induction electrode near the formation of a dense electric double layer, there exist four symmetrical vortices at the four corners, and they push the solution towards both outlets; it can be found that the average velocity of the solution in the cross-flow microfluidic pump is nonlinear with the applied electric field, which maybe helpful for the practical application of induced electroosmotic flow in the field of micropump.

  14. Nordex sails all over the world; Nordex turbine autour du monde

    Energy Technology Data Exchange (ETDEWEB)

    Jeanson, E.

    1999-02-01

    The wind turbine manufacturers' order books are full and Nordex-Balcke Duerr is not an exception. The German-Danish company estimates being able to quadruple its sales figures with respect to those of last year, i.e. two billion French francs for 1999. The increase of Nordex activities is admittedly due to a favorable market, but it also results from the strong financial commitment of its leading shareholder, Balcke Duerr, which wants to develop Nordex activity. In this way, the production of machines is doubling this year in Denmark. The firm is meeting orders from the four corners of the world. In Egypt, China or Spain, it is delivering the 600 kW model N 43, its most popular wind turbine worldwide. The Americans have chosen the 1 MW model. In France, Nordex-Balcke Duerr is multiplying the projects, in particular with the 1,300 kW wind turbines which will soon be installed in the Aveyron, and then in Corsica. (author)

  15. Proyecto MercadoFRESCO: a multi-level, community-engaged corner store intervention in East Los Angeles and Boyle Heights.

    Science.gov (United States)

    Ortega, Alexander N; Albert, Stephanie L; Sharif, Mienah Z; Langellier, Brent A; Garcia, Rosa Elena; Glik, Deborah C; Brookmeyer, Ron; Chan-Golston, Alec M; Friedlander, Scott; Prelip, Michael L

    2015-04-01

    Urban food swamps are typically situated in low-income, minority communities and contribute to overweight and obesity. Changing the food landscape in low income and underserved communities is one strategy to combat the negative health consequences associated with the lack of access to healthy food resources and an abundance of unhealthy food venues. In this paper, we describe Proyecto MercadoFRESCO (Fresh Market Project), a corner store intervention project in East Los Angeles and Boyle Heights in California that used a multi-level approach with a broad range of community, business, and academic partners. These are two neighboring, predominantly Latino communities that have high rates of overweight and obesity. Located in these two communities are approximately 150 corner stores. The project used a community-engaged approach to select, recruit, and convert four corner stores, so that they could become healthy community assets in order to improve residents' access to and awareness of fresh and affordable fruits and vegetables in their immediate neighborhoods. We describe the study framework for the multi-level intervention, which includes having multiple stakeholders, expertise in corner store operations, community and youth engagement strategies, and social marketing campaigns. We also describe the evaluation and survey methodology to determine community and patron impact of the intervention. This paper provides a framework useful to a variety of public health stakeholders for implementing a community-engaged corner store conversion, particularly in an urban food swamp.

  16. Rack for nuclear fuel elements

    International Nuclear Information System (INIS)

    Rubinstein, H.J.; Gordon, C.B.; Robison, A.; Clark, P.M.

    1977-01-01

    Disclosed is a rack for storing spent nuclear fuel elements in which a plurality of aligned rows of upright enclosures of generally square cross-sectional areas contain vertically disposed spent fuel elements. Each fuel element is supported at the lower end thereof by a respective support that rests on the floor of the spent fuel pool for a nuclear power plant. An open rack frame is employed as an upright support for the enclosures containing the spent fuel elements. Legs at the lower corners of the frame rest on the floor of the pool to support the frame. In one exemplary embodiment, the support for the fuel element is in the form of a base on which a fuel element rests and the base is supported by legs. In another exemplary embodiment, each fuel element is supported on the pool floor by a self-adjusting support in the form of a base on which a fuel element rests and the base rests on a ball or swivel joint for self-alignment. The lower four corners of the frame are supported by legs adjustable in height for leveling the frame. Each adjustable frame leg is in the form of a base resting on the pool floor and the base supports a threaded post. The threaded post adjustably engages a threaded column on which rests the lower end of the frame. 16 claims, 14 figures

  17. Teaching with Stories as the Content and Context for Learning

    Directory of Open Access Journals (Sweden)

    Frances Vitali

    2016-02-01

    Full Text Available Undergraduate teacher education program students have the opportunity to work with diverse student populations in a local school district in the Four Corners Area in the Northwest part of New Mexico. The family oral history practicum is a way to connect theory and practice while recognizing the issue that language is not a neutral landscape. What better way to demonstrate this complementarity than through stories. The goal is to bring an awareness of respect for oral language in relationship to literate language and explore how to balance both perspectives in school culture as prospective teachers. Preservice teacher candidates become storytelling coaches and team up with third graders in semester long storytelling projects, collaborating with local elementary school teachers. Students' family stories become the content and context for teaching and learning. With a diverse classroom population of Navajo, Hispanic, Mexican, and White students, family stories are the heart and central theme of the project. Storytelling coaches learn the nuances of diversity when theory is massaged with authentic experience of students as they share what they have learned beside their young storytellers and authors.

  18. Gold-silver mining districts, alteration zones, and paleolandforms in the Miocene Bodie Hills Volcanic Field, California and Nevada

    Science.gov (United States)

    Vikre, Peter G.; John, David A.; du Bray, Edward A.; Fleck, Robert J.

    2015-09-25

    The Bodie Hills is a ~40 by ~30 kilometer volcanic field that straddles the California-Nevada state boundary between Mono Lake and the East Walker River. Three precious metal mining districts and nine alteration zones are delineated in Tertiary-Quaternary volcanic and Mesozoic granitic and metamorphic rocks that comprise the volcanic field. Cumulative production from the mining districts, Bodie, Aurora, and Masonic, is 3.4 million ounces of gold and 28 million ounces of silver. Small amounts of mercury were produced from the Potato Peak, Paramount-Bald Peak, and Cinnabar Canyon-US 395 alteration zones; a native sulfur resource in the Cinnabar Canyon-US 395 alteration zone has been identified by drilling. There are no known mineral resources in the other six alteration zones, Red Wash-East Walker River, East Brawley Peak, Sawtooth Ridge, Aurora Canyon, Four Corners, and Spring Peak. The mining districts and alteration zones formed between 13.4 and 8.1 Ma in predominantly ~15–9 Ma volcanic rocks of the Bodie Hills volcanic field. Ages of hydrothermal minerals in the districts and zones are the same as, or somewhat younger than, the ages of volcanic host rocks.

  19. Parallel-plate submicron gap formed by micromachined low-density pillars for near-field radiative heat transfer

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Kota, E-mail: kotaito@mosk.tytlabs.co.jp [Toyota Central Research and Development Laboratories, Nagakute, Aichi 480-1192 (Japan); Research Center for Advanced Science and Technology (RCAST), The University of Tokyo, Komaba, Meguro-ku, Tokyo 153-8904 (Japan); Miura, Atsushi; Iizuka, Hideo [Toyota Central Research and Development Laboratories, Nagakute, Aichi 480-1192 (Japan); Toshiyoshi, Hiroshi [Research Center for Advanced Science and Technology (RCAST), The University of Tokyo, Komaba, Meguro-ku, Tokyo 153-8904 (Japan)

    2015-02-23

    Near-field radiative heat transfer has been a subject of great interest due to the applicability to thermal management and energy conversion. In this letter, a submicron gap between a pair of diced fused quartz substrates is formed by using micromachined low-density pillars to obtain both the parallelism and small parasitic heat conduction. The gap uniformity is validated by the optical interferometry at four corners of the substrates. The heat flux across the gap is measured in a steady-state and is no greater than twice of theoretically predicted radiative heat flux, which indicates that the parasitic heat conduction is suppressed to the level of the radiative heat transfer or less. The heat conduction through the pillars is modeled, and it is found to be limited by the thermal contact resistance between the pillar top and the opposing substrate surface. The methodology to form and evaluate the gap promotes the near-field radiative heat transfer to various applications such as thermal rectification, thermal modulation, and thermophotovoltaics.

  20. Arithmetic learning with the use of graphic organiser

    Science.gov (United States)

    Sai, F. L.; Shahrill, M.; Tan, A.; Han, S. H.

    2018-01-01

    For this study, Zollman’s four corners-and-a-diamond mathematics graphic organiser embedded with Polya’s Problem Solving Model was used to investigate secondary school students’ performance in arithmetic word problems. This instructional learning tool was used to help students break down the given information into smaller units for better strategic planning. The participants were Year 7 students, comprised of 21 male and 20 female students, aged between 11-13 years old, from a co-ed secondary school in Brunei Darussalam. This study mainly adopted a quantitative approach to investigate the types of differences found in the arithmetic word problem pre- and post-tests results from the use of the learning tool. Although the findings revealed slight improvements in the overall comparisons of the students’ test results, the in-depth analysis of the students’ responses in their activity worksheets shows a different outcome. Some students were able to make good attempts in breaking down the key points into smaller information in order to solve the word problems.

  1. Model for the analysis of transitories and stability of a BWR reactor with fuel of thorium; Modelo para el analisis de transitorios y de estabilidad de un reactor BWR con combustible de torio

    Energy Technology Data Exchange (ETDEWEB)

    Nunez C, A. [CNSNS, 03020 Mexico D.F. (Mexico)]. E-mail: anunezc@cnsns.gob.mx; Espinosa P, G. [UAM-I, 09340 Mexico D.F. (Mexico); Francois L, J.L. [Fac. de Ingenieria, UNAM 62550 Jiutepec, Morelos (Mexico)

    2004-07-01

    In this work it is described the thermo hydraulic and neutronic pattern used to simulate the behavior of a nucleus of thorium-uranium under different conditions of operation. The analysed nucleus was designed with base to assemblies that operate under the cover-seed concept. The pattern was proven to conditions of stationary state and transitory state. Here it is only presented the simulation of the one SCRAM manual and it is compared in the behavior of a nucleus with UO{sub 2}. Additionally one carries out an analysis of stability taking into account the four corners that define the area of stability of the map flow-power and to conditions of 100% of flow and 100% of power. The module of stability is based on the pattern of Lahey and Podowsky to estimate the drops of pressure during a perturbation. It is concludes that the behavior of this nucleus is not very different to the one shown by the nuclei loaded with the fuel of UO{sub 2}. (Author)

  2. 24th ICM

    CERN Document Server

    Yeung, David

    2003-01-01

    Since the first Congress in Zürich in 1897, the ICM has been an eagerly­ awaited event every four years. Many of these occasions are celebrated for historie developments and seminal contributions to mathematics. 2002 marks the year of the 24th ICM, the first of the new millennium. Also historie is the first ICM Satellite Conference devoted to game theory and applications. It is one of those rare occasions, in which masters of the field are able to meet under congenial surroundings to talk and share their gathered wisdom. As is usually the case in ICM meetings, participants of the ICM Satellite Conference on Game Theory and Applications (Qingdao, August 2(02) hailed from the four corners of the world. In addition to presentations of high qual­ ity research, the program also included twelve invited plenary sessions with distinguished speakers. This volume, which gathers together selected papers read at the conference, is divided into four sections: (I) Foundations, Concepts, and Structure. (II) Equilibrium P...

  3. Baseline Glass Development for Combined Fission Products Waste Streams

    International Nuclear Information System (INIS)

    Crum, Jarrod V.; Billings, Amanda Y.; Lang, Jesse B.; Marra, James C.; Rodriguez, Carmen P.; Ryan, Joseph V.; Vienna, John D.

    2009-01-01

    Borosilicate glass was selected as the baseline technology for immobilization of the Cs/Sr/Ba/Rb (Cs), lanthanide (Ln) and transition metal fission product (TM) waste steams as part of a cost benefit analysis study.(1) Vitrification of the combined waste streams have several advantages, minimization of the number of waste forms, a proven technology, and similarity to waste forms currently accepted for repository disposal. A joint study was undertaken by Pacific Northwest National Laboratory (PNNL) and Savannah River National Laboratory (SRNL) to develop acceptable glasses for the combined Cs + Ln + TM waste streams (Option 1) and Cs + Ln combined waste streams (Option 2) generated by the AFCI UREX+ set of processes. This study is aimed to develop baseline glasses for both combined waste stream options and identify key waste components and their impact on waste loading. The elemental compositions of the four-corners study were used along with the available separations data to determine the effect of burnup, decay, and separations variability on estimated waste stream compositions.(2-5) Two different components/scenarios were identified that could limit waste loading of the combined Cs + LN + TM waste streams, where as the combined Cs + LN waste stream has no single component that is perceived to limit waste loading. Combined Cs + LN waste stream in a glass waste form will most likely be limited by heat due to the high activity of Cs and Sr isotopes.

  4. High-precision approach to localization scheme of visible light communication based on artificial neural networks and modified genetic algorithms

    Science.gov (United States)

    Guan, Weipeng; Wu, Yuxiang; Xie, Canyu; Chen, Hao; Cai, Ye; Chen, Yingcong

    2017-10-01

    An indoor positioning algorithm based on visible light communication (VLC) is presented. This algorithm is used to calculate a three-dimensional (3-D) coordinate of an indoor optical wireless environment, which includes sufficient orders of multipath reflections from reflecting surfaces of the room. Leveraging the global optimization ability of the genetic algorithm (GA), an innovative framework for 3-D position estimation based on a modified genetic algorithm is proposed. Unlike other techniques using VLC for positioning, the proposed system can achieve indoor 3-D localization without making assumptions about the height or acquiring the orientation angle of the mobile terminal. Simulation results show that an average localization error of less than 1.02 cm can be achieved. In addition, in most VLC-positioning systems, the effect of reflection is always neglected and its performance is limited by reflection, which makes the results not so accurate for a real scenario and the positioning errors at the corners are relatively larger than other places. So, we take the first-order reflection into consideration and use artificial neural network to match the model of a nonlinear channel. The studies show that under the nonlinear matching of direct and reflected channels the average positioning errors of four corners decrease from 11.94 to 0.95 cm. The employed algorithm is emerged as an effective and practical method for indoor localization and outperform other existing indoor wireless localization approaches.

  5. Transport woes threaten California production

    International Nuclear Information System (INIS)

    Anon.

    1994-01-01

    California oil producers face a loss of production this year because of constraints on pipeline and tanker transportation to Los Angeles area refineries. The potential bottleneck is occurring at a time when Outer Continental Shelf production is near capacity from Chevron Corp.'s Point Arguello project at the same time production is increasing from Exxon Corp.'s nearby Santa Ynex Unit (SYU) expansion. Both megaprojects must compete for pipeline space with onshore crude producers, notably in California's San Joaquin Valley (SJV). Recent development limiting transportation options include: An indefinite shutdown of Four Corners Pipe Line Co.'s 50,000 b/d Line No. 1, damaged by the Jan. 17 earthquake; Loss of a tanker permit by Chevron and partners for offshore Point Arguello production; Permanent shutdown of Exxon's offshore storage and treatment (OST) facility, which since 1981 has used tankers to transport about 20,000 b/d of SYU production from the Santa Barbara Channel to Los Angeles. The OST, the first commercial floating production system in the US -- placed in the Santa Barbara Channel in 1981 after a decade of precedent setting legal and political battles -- was shut down Apr. 4. The paper discusses these production concerns, available options, the OST shutdown, and the troubled history of the OST

  6. Metoclopramide unmasks potentially misleading contralateral suppression in patients undergoing adrenal vein sampling for primary aldosteronism.

    Science.gov (United States)

    Rossitto, Giacomo; Miotto, Diego; Battistel, Michele; Barbiero, Giulio; Maiolino, Giuseppe; Bisogni, Valeria; Sanga, Viola; Rossi, Gian Paolo

    2016-11-01

    As metoclopramide stimulates aldosterone secretion, we tested its usefulness in the assessment of lateralization of primary aldosteronism by adrenal vein sampling (AVS). Prospective within-patient study in consecutive patients undergoing AVS for primary aldosteronism subtyping. We compared the diagnostic accuracy of baseline and postmetoclopramide lateralization index and relative (to cortisol) aldosterone secretion indices (RASI) for each adrenal gland with aldosterone-producing adenoma (APA) determined by the four corners criteria as the reference diagnosis. We recruited 93 consecutive patients (mean age: 52 years; women 31%). Metoclopramide increased plasma aldosterone in the inferior vena cava and in both adrenal veins. The postmetoclopramide lateralization index was accurate in identifying APA, but did not increase diagnostic accuracy over baseline lateralization index, because the RASI increased similarly in both sides. Conversely, metoclopramide raised RASI to values more than 0.90 bilaterally in non-APA patients allowing accurate identification of factitious aldosterone suppression. In contrast, RASI was 0.90 or less in 48% contralateral to the tumor in APA patients. Regression analysis showed the APA patients with persistent suppression of RASI contralaterally showed a more florid primary aldosteronism phenotype. Metoclopramide does not enhance lateralization of aldosterone excess in APA, but consistently increased the value of RASI in non-APA cases, thus unmasking potentially misleading suppression of aldosterone. Postmetoclopramide RASI may therefore allow a more precise diagnosis when AVS can be achieved only unilaterally.

  7. Phyllotaxis: a framework for foam topological evolution.

    Science.gov (United States)

    Rivier, Nicolas; Sadoc, Jean-François; Charvolin, Jean

    2016-01-01

    Phyllotaxis describes the arrangement of florets, scales or leaves in composite flowers or plants (daisy, aster, sunflower, pinecone, pineapple). As a structure, it is a geometrical foam, the most homogeneous and densest covering of a large disk by Voronoi cells (the florets), constructed by a simple algorithm: Points placed regularly on a generative spiral constitute a spiral lattice, and phyllotaxis is the tiling by the Voronoi cells of the spiral lattice. Locally, neighboring cells are organized as three whorls or parastichies, labelled with successive Fibonacci numbers. The structure is encoded as the sequence of the shapes (number of sides) of the successive Voronoi cells on the generative spiral. We show that sequence and organization are independent of the position of the initial point on the generative spiral, that is invariant under disappearance (T2 of the first Voronoi cell or, conversely, under creation of a first cell, that is under growth. This independence shows how a foam is able to respond to a shear stress, notably through grain boundaries that are layers of square cells slightly truncated into heptagons, pentagons and hexagons, meeting at four-corner vertices, critical points of T1 elementary topological transformations.

  8. Real-time door detection for indoor autonomous vehicle

    Science.gov (United States)

    He, Zhihao; Zhu, Ming

    2017-07-01

    Indoor Autonomous Vehicle(IAV) is used in many indoor scenes. Such as hotels and hospitals. Door detection is a key issue to guide the IAV into rooms. In this paper, we consider door detection in the use of indoor navigation of IAV. Since real-time properties are important for real-world IAV, the detection algorithm must be fast enough. Most monocular-camera based door detection model need a perfect detection of the four line segments of the door or the four corners. But in many situations, line segments could be extended or cut off. And there could be many false detected corners. And few of them can distinguish doors from door-like objects with door-like shape effectively. We proposed a 2-D vision model of the door that is made up of line segments. The number of parts detected is used to determine the possibility of a door. Our algorithm is tested on a database of doors.1 The robustness and real-time are verified. The precision is 89.4%. Average time consumed for processing a 640x320 figure is 44.73ms.

  9. Automated mapping of mineral groups and green vegetation from Landsat Thematic Mapper imagery with an example from the San Juan Mountains, Colorado

    Science.gov (United States)

    Rockwell, Barnaby W.

    2013-01-01

    Multispectral satellite data acquired by the ASTER (Advanced Spaceborne Thermal Emission and Reflection Radiometer) and Landsat 7 Enhanced Thematic Mapper Plus (TM) sensors are being used to populate an online Geographic Information System (GIS) of the spatial occurrence of mineral groups and green vegetation across the western conterminous United States and Alaska. These geospatial data are supporting U.S. Geological Survey national-scale mineral deposit database development and other mineral resource and geoenvironmental research as a means of characterizing mineral exposures related to mined and unmined hydrothermally altered rocks and mine waste. This report introduces a new methodology for the automated analysis of Landsat TM data that has been applied to more than 180 scenes covering the western United States. A map of mineral groups and green vegetation produced using this new methodology that covers the western San Juan Mountains, Colorado, and the Four Corners Region is presented. The map is provided as a layered GeoPDF and in GIS-ready digital format. TM data analysis results from other well-studied and mineralogically characterized areas with strong hydrothermal alteration and (or) supergene weathering of near-surface sulfide minerals are also shown and compared with results derived from ASTER data analysis.

  10. Effect of Anode Change on Heat Transfer and Magneto-hydrodynamic Flow in Aluminum Reduction Cell

    Science.gov (United States)

    Wang, Qiang; Li, Baokuan; Fafard, Mario

    2016-02-01

    In order to explore the impact of anode replacement on heat transfer and magneto-hydrodynamic flow in aluminum smelting cells, a transient three-dimensional coupled mathematical model has been developed. With a steady state magnetic field, an electrical potential approach was used to obtain electromagnetic fields. Joule heating and Lorentz force, which were the source terms in the energy and momentum equations, were updated at each iteration. The phase change of molten electrolyte (bath) was modeled by an enthalpy-based technique in which the mushy zone was treated as a porous medium with porosity equal to the liquid fraction. A reasonable agreement between the test data and simulated results was achieved. Under normal conditions, the bath at the middle of the cell is hotter, while becoming colder at the four corners. Due to the heat extracted from the bath, the temperature of the new cold anode increases over time. The temperature of the bath under the new cold anode therefore quickly drops, resulting in a decrease of the electrical conductivity. More Joule effect is created. In addition, the bath under the new cold anode gradually freezes and flows more slowly. The temperature of the new anode located at the middle of the cell rises faster because of the warmer bath. It is easier to eliminate the effect of anode change when it occurs in the middle of the cell.

  11. Manifestations of Globalization and Linguistic Imperialism in English Language Teaching and Materials Preparation: Ideology in the International ELT Textbooks

    Directory of Open Access Journals (Sweden)

    Seyyed Ali Kazemi

    2017-09-01

    Full Text Available This study intended to investigate the imposition of values and ideological patterns of particular societies affecting learners' identity as a result of globalization and linguistic imperialism in the internationally distributed textbooks which are developed to meet the English language needs of international learners and are broadly used in Islamic countries like Iran. It was important to work out whether violation of standards and ideological patterns of certain societies could be detected. For that reason, critical discourse analysis (CDA with its theory and procedures, as developed by Fairclough (1989, used in conversations, illustrations and reading passages in Interchange, Four Corners, Top Notch and American English File series and three meaning dimensions– the textbooks content, the social relations of the characters in the textbooks, and their subject positions– were classified and analyzed statistically. Overall, the findings of this study represented that these ELT books are by some means unfair and inclined to signify a specific discourse type, that is, the Western culture discourse, ideological patterns, and consumer societies, which can impose the Western view and have different effects on students' identity in Islamic countries.

  12. A new zinc(II supramolecular square: Synthesis, crystal structure, thermal behavior and luminescence

    Directory of Open Access Journals (Sweden)

    Wang Xiu-Yan

    2015-01-01

    Full Text Available A new square-shaped Zn(II complex, namely, [Zn4(L4(phen4]•6H2O (1 (L = 2-hydroxynicotinate and phen = 1,10- phenanthroline, has been synthesized under hydrothermal condition. The crystal of 1 belongs to triclinic, space group P -1 with a = 10.773(2 Å, b = 12.641(3 Å, c = 13.573(3 Å, α = 107.44(3º, β = 102.66(3º, γ = 93.89(3°, C72H56N12O18Zn4, Mr = 1638.77, V = 1702.8(6 Å3 , Z = 1, Dc = 1.598 g/cm3 , S = 1.045, μ(MoKα = 1.475 mm-1 , F(000 = 836, R = 0.0472 and wR = 0.0919. In 1, four L ligands bridge four Zn(II atoms to form a square-shaped structure, where four phen ligands are respectively located on four corners of the square. The π-π stacking interactions extend the adjacent squares into a 1D supramolecular chain. The thermal behavior of 1 has been characterized. Moreover, its solid state luminescence property has been studied at room temperature.

  13. Ground truth measurements plan for the Multispectral Thermal Imager (MTI) satellite

    Energy Technology Data Exchange (ETDEWEB)

    Garrett, A.J.

    2000-01-03

    Sandia National Laboratories (SNL), Los Alamos National Laboratory (LANL), and the Savannah River Technology Center (SRTC) have developed a diverse group of algorithms for processing and analyzing the data that will be collected by the Multispectral Thermal Imager (MTI) after launch late in 1999. Each of these algorithms must be verified by comparison to independent surface and atmospheric measurements. SRTC has selected 13 sites in the continental U.S. for ground truth data collections. These sites include a high altitude cold water target (Crater Lake), cooling lakes and towers in the warm, humid southeastern US, Department of Energy (DOE) climate research sites, the NASA Stennis satellite Validation and Verification (V and V) target array, waste sites at the Savannah River Site, mining sites in the Four Corners area and dry lake beds in the southwestern US. SRTC has established mutually beneficial relationships with the organizations that manage these sites to make use of their operating and research data and to install additional instrumentation needed for MTI algorithm V and V.

  14. Geometry Effects of Capillary on the Evaporation from the Meniscus

    International Nuclear Information System (INIS)

    Choi, Choong Hyo; Jin, Song Wan; Yoo, Jung Yul

    2007-01-01

    The effect of capillary cross-section geometry on evaporation is investigated in terms of the meniscus shape, evaporation rate and evaporation-induced flow for circular, square and rectangular cross-sectional capillaries. The shapes of water and ethanol menisci are not much different from each other in square and rectangular capillaries even though the surface tension of water is much larger than that of ethanol. On the other hand, the shapes of water and ethanol menisci are very different from each other in circular capillary. The averaged evaporation fluxes in circular and rectangular capillaries are measured by tracking the meniscus position. At a given position, the averaged evaporation flux in rectangular capillaries in much larger than that in circular capillary with comparable hydraulic diameter. The flow near the evaporating meniscus is also measured using micro-PIV, so that the rotating vortex motion is observed near the evaporating ethanol and methanol menisci except for the case of methanol meniscus in rectangular capillary. This difference is considered to be due to the existence of corner menisci at the four corners

  15. Fuel assemblies for use in BWR type reactors

    International Nuclear Information System (INIS)

    Hirukawa, Koji.

    1987-01-01

    Purpose: To moderate the peak configuration of the burnup degree change curve for the infinite multiplication factor by applying an improvement to the arrangement of fuel rods. Constitution: In a fuel assembly for a BWR type reactor comprising a plurality of fuel rods and water rods arranged in a square lattice, fuel rods containing burnable poisons are arranged at four corners at the second and the third layers from the outside of the square lattice arrangement. Among them, the Cd poison effect in the burnable poison incorporated fuel rods disposed at the second layer is somewhat greater at the initial burning stage and then rapidly decreased along with burning. While on the other hand, the poison effect of the burnable poison-incorporated fuel rods at the third layer is smaller than that at the second layer at the initial burning stage and the reduction in the poison effect due to burning is somewhat more moderate. Since these fuel rods are in adjacent with each other, they interfere to each other and also provide an effect of moderating the burning of the burnable poisons. (Takahashi, M.)

  16. Enhanced MRI in carpal tunnel syndrome

    International Nuclear Information System (INIS)

    Hayakawa, Katsuhiko; Nakane, Takashi; Kobayashi, Shigeru; Asai, Takahiro; Wada, Kunio; Yoshizawa, Hidezo

    1998-01-01

    In this study, we performed contrast-enhanced MRI in patients with idiopathic carpal tunnel syndrome and examined the morphologic change in the carpal tunnel. In the transverse section of the opening of carpal tunnel where scaphoid and pisiform bones are figured out, we measured and examined 4 items, viz. the soft carpal tunnel volume, flat rate of median nerve, position of median nerve and thickness of palmer ligaments composing the base of carpal tunnel, with an image analyzer attached to the MRI apparatus. Whereas the average carpal tunnel volume in 12 hands of normal controls was 166.8 mm 2 , that in 74 hands of carpal tunnel syndrome was 207.2 mm 2 , a significant increase compared with the normal controls. The flat rate of median nerve was 46% in the controls, but that was 37.5% in the carpal tunnel syndrome, a significant flattening was noted. We connected the peaks of the scaphoid node and pisiform bone with a line and named it standard line. When we observed the position of median nerve in the carpal tunnel, the nerve in 9 of 12 hands, 75%, lay below the standard line in the controls, but the nerve in 65 of 74 hands, 87.8%, lay above the standard line in the carpal tunnel syndrome, clearly showing that the median nerve had shifted to the palmar side. Regarding these morphologic changes of the carpal tunnel, the internal pressure of the carpal tunnel is considered to be raised with swelling of the soft tissues mainly composing the inside of carpal tunnel, thus the area of cross section of carpal tunnel to be increased, the median nerve to be shifted to the palmar side and the median nerve to be compressed by the transverse carpal ligament at that time. Although we can observe these morphological changes readily in MRI images, these images show only the results of carpal tunnel syndrome after all, and do not specify the direct causes. However, we believe that these facts are important factors in the manifestation of idiopathic carpal tunnel syndrome. (author)

  17. Arthroscopic Partial Capitate Resection for Type Ia Avascular Necrosis: A Short-Term Outcome Analysis.

    Science.gov (United States)

    Shimizu, Takamasa; Omokawa, Shohei; del Piñal, Francisco; Shigematsu, Koji; Moritomo, Hisao; Tanaka, Yasuhito

    2015-12-01

    To examine short-term clinical results of arthroscopic partial resection for type Ia avascular necrosis of the capitate. Patients who underwent arthroscopic treatment for type 1a avascular necrosis of the capitate with at least 1-year follow-up were identified through a retrospective chart review. The necrotic capitate head was arthroscopically resected with removal of the lunate facet and preservation of the scaphoid and hamate facets. Wrist range of motion, grip strength, and radiographic parameters--carpal height ratio, radioscaphoid angle, and radiolunate angle-were determined before surgery and at the latest follow-up. Patients completed a visual analog scale for pain; Disabilities of the Arm, Shoulder, and Hand measure; and the Patient-Rated Wrist Evaluation score before surgery and at the latest follow-up. Five patients (1 male, 4 females) with a mean age of 34 years (range, 16-49 years) and a mean follow-up duration of 20 months (range, 12-36 months) were identified during the chart review. All were type Ia (Milliez classification). Arthroscopy revealed fibrillation or softening with cartilage detachment at the lunate facet of the capitate head and an intact articular surface at the scaphoid and hamate facet. At the latest follow-up, the mean wrist flexion-extension was 123° (vs 81° before surgery) and grip strength was 74% (vs 37% before surgery). The visual analog scale score for pain; the Disabilities of the Arm, Shoulder, and Hand score; and the Patient-Rated Wrist Evaluation score before surgery showed a significant improvement following treatment. Radiographic parameters did not significantly change at the final follow-up, although the proximal carpal row trended toward flexion. Arthroscopic partial resection of the capitate head was an acceptable treatment for type Ia avascular necrosis of the capitate. It provided adequate pain relief and improved the range of wrist motion and grip strength during short-term follow-up. Therapeutic IV. Copyright

  18. [Internal screwed plate for recent fractures of the humeral diaphysis in adults].

    Science.gov (United States)

    Dayez, J

    1999-06-01

    Can medial plating of the humerus, through an antero lateral approach, diminish incidence of iatrogenic radial palsies? We carried out a prospective study of medial plating of humeral shaft fractures through an antero lateral approach between 1988 and 1997. 41 fractures were fixed, 36 were followed up for a mean period of 5.8 years. The indications were multiple injuries (10), displaced fractures (23), and failure of conservative treatment (3). Road traffic accidents and sports injuries were the cause in 68 per cent of cases. Two fractures were open and in 9 cases there was a radial palsy. Bone graft was never used. The approach to the medial aspect of the humerus an antero lateral incision was the essential feature of the technique. After a slightly curved incision on the antero lateral aspect of the arm, the space between biceps and brachialis anterior was bluntly dissected. The assistant holded the elbow flexed in order to relax the biceps and rotated il laterally to expose the medial aspect of the bone. Splitting brachialis fibres longitudinally exposed the fracture site. It was easy to check if the radial nerve was trapped and, if not, the nerve seen during the operation. Postoperatively patients were given a simple sling and mobilised freely, including rotation. We had no intra-operative complications, no infections, no fixation failure, no post operative radial palsies and no non-unions. Results were excellent in 89 per cent of cases (full recovery of pain free range of movement). Four patient had a restriction of elbow movements of 10 degrees but without any discomfort. The mean time to union was 80 days. All radial nerve palsies recovered between 24 hours and 1 year. The plate was removed in 11 cases. Iatrogenic complications of humeral plating have led to the increased popularity of intramedullary nailing. Even if secondary radial palsies and non-unions have decreased, union of the humeral shafts is often difficult. Placing the plate into the medial

  19. Fatal injuries to teenage construction workers in the US.

    Science.gov (United States)

    Suruda, Anthony; Philips, Peter; Lillquist, Dean; Sesek, Richard

    2003-11-01

    The construction industry is second only to agriculture in the annual number of fatal injuries in workers less than 18 years of age. We examined fatal injury reports for youth and adult workers to determine risk factors for injury and applicability of existing child labor regulations. The US Occupational Safety & Health Administration (OSHA) investigation data for fatal work injuries from 1984 through 1998 were reviewed with respect to type of event, employer characteristics, and apparent violations of existing child labor laws under the Fair Labor Standards Act (FLSA). We also examined whether the employer met exemption criteria for federal enforcement of child labor or OSHA regulations. The fatality rate for teenage construction workers age 19 and younger was 12.1 per 100,000 per year, slightly less than for adult workers. Teenage workers who were fatally injured were more likely than adults to have been employed at non-union construction firms (odds ratio (OR) = 4.96, P worker. Fatalities in teenagers were more likely to occur in special construction trades such as roofing. Among fatalities in workers less than 18 years of age, approximately one-half (49%) of the 76 fatal injuries were in apparent violation of existing child labor regulations. We estimated that in 41 of the 76 cases (54%) the employer's gross annual income exceeded the $500,000 threshold for federal enforcement of child labor laws. Only 28 of 76 cases (37%) were at construction firms with 11 or more employees, which are subject to routine OSHA inspections. Fatal injuries in teenage construction workers differed from those in adults in that they were more likely to be at small, non-union firms of which a substantial proportion were exempt from federal enforcement of child labor laws and from routine OSHA inspections. Safety programs for young construction workers should include small, non-union construction firms and those in special construction trades such as roofing. We did not identify

  20. The future of robotics in hand surgery.

    Science.gov (United States)

    Liverneaux, P; Nectoux, E; Taleb, C

    2009-10-01

    Robotics has spread over many surgical fields over the last decade: orthopaedic, cardiovascular, urologic, gynaecologic surgery and various other types of surgery. There are five different types of robots: passive, semiactive and active robots, telemanipulators and simulators. Hand surgery is at a crossroad between orthopaedic surgery, plastic surgery and microsurgery; it has to deal with fixing all sorts of tissues from bone to soft tissues. To our knowledge, there is not any paper focusing on potential clinical applications in this realm, even though robotics could be helpful for hand surgery. One must point out the numerous works on bone tissue with regard to passive robots (such as fluoroscopic navigation as an ancillary for percutaneous screwing in the scaphoid bone). Telemanipulators, especially in microsurgery, can improve surgical motion by suppressing physiological tremor thanks to movement demultiplication (experimental vascular and nervous sutures previously published). To date, the robotic technology has not yet become simple-to-use, cheap and flawless but in the future, it will probably be of great technical help, and even allow remote-controlled surgery overseas.

  1. Clinical manifestations of Waardenburg syndrome in a male adolescent in Mali, West Africa.

    Science.gov (United States)

    Imperato, Pascal James; Imperato, Gavin H

    2015-02-01

    Waardenburg syndrome (WS) is a genetic disorder of which there are four distinct types. These four types are differentiated by the physical defects which they produce. Presented here is the case of a 13-year-old boy with WS Type I who was observed and physically assessed in Mali, West Africa in 1969. His physical findings included a bright blue coloring to the irises of the eyes, profound sensorineural deafness, mutism, dystopia canthorum (lateral displacement of the inner canthi of the eyes), broad nasal root, bushy eyebrows, and scaphoid deformities of the supraorbital portions of the frontal bone. Because family members were not available for interviews or physical examinations, it was not possible to determine if this patient was suffering from a congenital form of the disorder or from a spontaneous mutation. Given the patient's then location in a remote rural area of Mali where electricity was absent, it was not possible to perform additional diagnostic tests. The patient described here is the first with WS in Mali, West Africa to have been medically observed and evaluated and later documented in the medical literature. A second case of the syndrome in Mali was described in the medical literature in 2011 in an 18-month-old infant who did not have sensorineural hearing loss, but who did have a bilateral cleft lip. An historical overview of WS is presented along with details concerning the characteristics of the four types of the disorder.

  2. Radiologic evaluation of wrist arthrography

    International Nuclear Information System (INIS)

    Park, Yang Hee; Seong, Hyeun Lim; Yang, Jae Beom; Park, Chan Sup; Lee, Sang Seun

    1991-01-01

    Wrist arthrography allows direct visualization of the cartilage and synovial structure not seen in plain film. Arthrography of the wrist is valuable in evaluating patients with persistent wrist pain and limitation of motion after trauma. Wrist arthrography was performed in the evaluation of 30 patients with rheumatoid arthritis (2 cases), ganglions (12 cases), and wrist trauma (16 cases), and contrast media was injected in radiocarpal joint. The arthrographic findings were analyzed, and the results were as follows: In 16 patients with wrist trauma, 12 cases (75%) of compartment communication was seen including communication with distal radioulnar joint (44%), midcarpal joint (69%), and common carpometacarpal joint (63%). Of the total 30 patients, the pisiform-triquetral joint communicated with the radio carpal joint in 9 cases (30%). In 16 patients with trauma, the findings of post-traumatic arthritis included tendon communication (50%), irregular synovium (31%), and rupture of the joint capsule (25%). There was no lymphatic filling. Of 3 scaphoid fracture patients without bony callus formation, fibrous union was verified in one patient and nouncion in 2. O 12 patients with ganglion, communication between the ganglion and radiocarpal joint was seen in 2 cases and no communication in 10 cases

  3. Surgical Deroofing and Rubber Compression Treatment for Pseudocyst of the Auricle: Report of Two Cases

    Directory of Open Access Journals (Sweden)

    Arif Aydın

    2017-12-01

    Full Text Available Pseudocyst of the auricle is a benign condition characterized by the non-inflammatory swelling of the ear. It is usually located within the scaphoid and triangular fossa. Although minor trauma is accepted to be the most probable cause, the exact etiology remains unclear. In this article we present two cases of this rare condition in two male patients, one 22 years old presenting with unilateral and one 28 years old presenting with bilateral pseudocysts of the auricle, and summarize the differential diagnosis, treatment options, and pathogenesis. In both cases we performed a deroofing procedure followed by compression with a reshaped rubber of the syringe piston. At the end of the six-month follow-up one patient had no recurrence and had excellent cosmetic results. The other patient was evaluated on the third postoperative day and had no recurrence with satisfactory cosmetic results. Many treatment options have been reported for pseudocyst of the auricle. The lowest recurrence rates are reported with the deroofing procedure, and this technique provides cosmetically acceptable results. Many materials have been used for compression after surgery in the literature. The rubber of the syringe piston has not been used before. It is a cheap, effective, and convenient way of compression.

  4. Laterality and grip strength influence hand bone micro-architecture in modern humans, an HRpQCT study.

    Science.gov (United States)

    Reina, Nicolas; Cavaignac, Etienne; Trousdale, William H; Laffosse, Jean-Michel; Braga, José

    2017-06-01

    It is widely hypothesized that mechanical loading, specifically repetitive low-intensity tasks, influences the inner structure of cancellous bone. As such, there is likely a relationship between handedness and bone morphology. The aim of this study is to determine patterns in trabecular bone between dominant and non-dominant hands in modern humans. Seventeen healthy patients between 22 and 32 years old were included in the study. Radial carpal bones (lunate, capitate, scaphoid, trapezium, trapezoid, 1st, 2nd and 3rd metacarpals) were analyzed with high-resolution micro-computed tomography. Additionally, crush and pinch grip were recorded. Factorial analysis indicated that bone volume ratio, trabeculae number (Tb.N), bone surface to volume ratio (BS.BV), body weight, stature and crush grip were all positively correlated with principal components 1 and 2 explaining 78.7% of the variance. Volumetric and trabecular endostructural parameters (BV/TV, BS/BV or Tb.Th, Tb.N) explain the observed inter-individual variability better than anthropometric or clinical parameters. Factors analysis regressions showed correlations between these parameters and the dominant side for crush strength for the lunate (r 2 = 0.640, P modern human wrist. © 2017 Anatomical Society.

  5. X-ray and CT diagnosis of intraosseous ganglion

    International Nuclear Information System (INIS)

    Gong Xiangyang; Zhang Weimin; Yan Shigui

    2002-01-01

    Objective: To investigate the pathogenesis, clinical manifestations, imaging features, and differential diagnosis of intraosseous ganglion. Methods: Clinical and imaging features of 15 cases (5 men, 10 women; mean age 39.7 years) with intraosseous ganglia were retrospectively analyzed. There were 17 lesions, including 6 acetabular, 4 lunate, 3 proximal ends of tibia, 1 major tuberculum of humeral, 1 femoral head, 1 scaphoid, and 1 phalange. Results: ( 1 ) Common radiological features included a unilocular or multilocular cyst surrounded by a full and thin rim of sclerotic: bone in the subchondral epiphysis without any signs of degenerative joint disease. (2) Lesions were displayed as well-defined round radiolucent defect or multi-cystic changes with surrounding bony sclerosis or cystic and expansile change with irregular shape on CT scans. (3) CT showed an intraosseous ganglion communicating with adjacent joint in 1 patient. (4) CT values of the lesions were between 15 - 80 HU. (5) Gas in the cyst could be seen in 3 cases. Conclusion: Combined with patient's age, lesion distribution, clinical manifestations, and imaging features, it is possible to make a correct diagnosis of intraosseous ganglion

  6. NMR findings in patients after wrist trauma with a negative plain radiographs

    International Nuclear Information System (INIS)

    Markuszewski, Maciej; Kraus, Alexandra; Studniarek, Michał; Zawadzka, Anna

    2012-01-01

    The purpose was to assess the prevalence and location of the injuries of the carpal bones and soft tissue of the wrist on NMR in patients with negative radiographs. A total of 89 patients (9–81years) were consecutively examined after wrist trauma. Radiograms were performed in four projections: AP, PA, oblique and lateral. In 63 cases of negative radiographs and persistent clinical problem, simplified NMR (T1,T2, STIR; in coronal plane) was conducted with a 1.5 Tesla magnet. Results were evaluated by two independent observers. A positive X-ray result was stated when at least one observer suggested bone fracture. The MR images were viewed for detection of possible bone fracture, bone edema and soft tissue injuries. Cohen’s kappa coefficient was calculated to assess the quality of chosen criteria by means of agreement between both observers and both methods. As many as 26 X-ray studies were classified as positive. Substantial agreement between independent observers was found (kappa=0.63). In 17 cases out of 63 with two negative wrist radiogram, the NMR result was positive (19%). The most frequently fractured or injured bone was scaphoid (10 cases) and distal radius (5 cases). Fair agreement was found between X-ray and NMR studies (kappa=0.37) due to different diagnostic information received in both methods. Simplified NMR imaging of the wrist proved to be strongly efficient in the detection of pathological changes in injured wrists

  7. Posterior Radioscaphoid Angle as a Predictor of Wrist Degenerative Joint Disease in Patients With Scapholunate Ligament Tears.

    Science.gov (United States)

    Gondim Teixeira, Pedro Augusto; De Verbizier, Jacques; Aptel, Sabine; Wack, Maxime; Dap, François; Dautel, Gilles; Blum, Alain

    2016-01-01

    The purpose of this study is to determine whether the posterior radioscaphoid angle, a marker of posterior displacement of the scaphoid, is associated with degenerative joint disease in patients with scapholunate ligament tears. Images from 150 patients with wrist pain who underwent CT arthrography and radiography were retrospectively evaluated. Patients with and without scapholunate ligament ruptures were divided into two groups according to CT arthrography findings. The presence of degenerative changes (scapholunate advanced collapse [SLAC] wrist) was evaluated and graded on conventional radiographs. Images were evaluated by two readers independently, and an adjudicator analyzed the discordant cases. Posterior radioscaphoid angle values were correlated with CT arthrography and radiographic findings. The association between posterior radioscaphoid angle and degenerative joint disease was evaluated. Scapholunate and radiolunate angles were considered in the analysis. The posterior radioscaphoid angle was measurable in all patients, with substantial interobserver agreement (intraclass correlation coefficient, 0.75). The posterior radioscaphoid angle performed better than did the scapholunate and radiolunate angles in the differentiation of patients with and without SLAC wrist (p degenerative wrist disease, with potential prognostic implications in patients with wrist trauma and scapholunate ligament ruptures.

  8. A case series of Osteoid Osteoma: 7 cases

    Directory of Open Access Journals (Sweden)

    Farzan M

    1997-08-01

    Full Text Available Osteoid osteoma is a unique benign primary bone tumor that may present in the metaphyseal diaphyseal areas of the short tubular bones and has also been reported in the carpal bones. It occurs in the first two decades of life. The classic history is bone pain, often relieved by aspirin. The clinical appearance is local swelling and tenderness. The typical radiographic appearance is very characteristic: an eccentric area of cortical sclerosis, frequently with a radiolucent nidus. The lesion does not exceed 1 cm in diameter. The use of a bone scan may be helpful diagnostically, as are the CAT scan and tomography. Doyle et al described seven cases of osteoid osteoma with a prolonged delay in diagnosis, but reported an excellent cure rate following excision. The carpus is not unusual as a site for this tumor, especially the scaphoid. Treatment is windowing with curettage of the tumor nidus. The use of a dental drill to window the phalanx and expose the nidus is very helpful. Removal of the entire nidus is permanently curative, but if a portion of the tumor is missed, prompt recurrence of the symptoms is the rule.

  9. Fusion of different modalities of imaging the fist

    International Nuclear Information System (INIS)

    Verdenet, J.; Garbuio, P.; Runge, M.; Cardot, J.C.

    1997-01-01

    The standard radiographical pictures are not able always to bring out the fracture of one of the fist bones. In an early study it was shown that 40% of patients presenting a suspicion of fracture and in which the radio- image was normal, have had a fracture confirmed with quantification by MRI and scintigraphy. The last one does not allow to specify the localization and consequently we developed a code to fusion entirely automatically the radiologic image and the scintigraphic image using no external marker. The code has been installed on a PC and uses the Matlab environment. Starting from the histogram processing the contours are individualized on the interpolated radio- and scinti-images. For matching there are 3 freedom degrees: one of rotation and 2 of translation (in x and y axes). The internal axes of the forearm was chosen to effect the rotation and translation. The forehand thickness, identical for each modality, allows to match properly the images. We have obtained an anatomic image on which the contour and the hyper-fixating zones of the scintigraphy are added. On a set of 100 examinations we observed 38 fractures while the difference between a fracture of the scaphoid and of another fist bone is confirmed in 93% of cases

  10. Intrathoracic fracture-dislocation of the humerus - case report and literature review

    Directory of Open Access Journals (Sweden)

    Wilson Carlos Sola Junior

    Full Text Available ABSTRACT Shoulder fracture-dislocations are uncommon. Those associated with intrathoracic dislocation are very rare conditions, resulting from high-energy trauma; usually, the affected limb is in an abduction position. In Brazil, there is only one report of a teenager with displacement of the epiphysis into the chest cavity; the present is the first adult patient report of intrathoracic dislocation of the humerus. The authors present the case of a patient female, aged 56 years, who was hit by motorcycle and thrown approximately 5 meters away. She was rescued on site with thoracic, pelvic, and right upper limb trauma. Her chest was drained due to pneumothorax and multiple fractures of ribs; she was diagnosed with fracture-dislocation in four parts, with intrathoracic dislocation of the humeral head. Displaced forearm bones fracture was also diagnosed; the olecranon, scaphoid, and ischiopubic fractures were not displaced. The patient underwent a joint procedure with a cardiothoracic surgery team to remove the humeral head through thoracotomy and chest drainage; subsequently, a partial arthroplasty of the humerus was performed, with graft from the humeral head and fixation of forearm fractures. Conservative treatment was chosen for the other fractures. After three months, all fractures were healed with gradual functional improvement. The patient remained in physiotherapy and orthopedic monitoring, having been discharged from the thoracic surgery; in a severe depressive episode, the patient committed suicide after 11 months of the trauma.

  11. PREVALENCE AND TYPES OF SPORTS INJURIES PRESENTING TO EMERGENCY DEPARTMENT SUEZ CANAL UNIVERSITY HOSPITAL

    Directory of Open Access Journals (Sweden)

    Adel Hamed Elbaih

    2016-10-01

    Full Text Available Inroduction: regular physical activity is essential for the prevention of various diseases and reduces the risk of premature mortality in general and coronary heart disease, hypertension, colon cancer, obesity and diabetes mellitus in particular. Aim of this study was to assess the most common sports causing injuries and to assess the types and mechanisms of these injuries. Patients and methods: The researcher examined 250 patients attending emergency departmentl. Results: The study showed that the most common type of sports involved in injury was football .The ankle was the most common affected part in the whole body . Chest contusion and back contusion were the most common types of sports injuries in head, neck and trunk. Fracture scaphoid and fissure radius were the most common sport injuries. Ankle sprain was the most common injury. The study showed that (62.7% of the studied patients who were playing football had injuries in the lower limbs. Ankle sprain was the most common sport injury that was associated with wearing football shoes . Conclusion: Ankle sprain was the most common sport injury associated with artificial grass court . Wrist sprain was the common sport injury in the upper limbs associated with artificial grass court .

  12. Early radiological diagnostics for scapholunate dissociation (SLD); Radiologische Fruehdiagnostik der skapholunaeren Dissoziation (SLD)

    Energy Technology Data Exchange (ETDEWEB)

    Schmitt, R.; Froehner, S.; Fodor, S.; Christopoulos, G. [Herz- und Gefaessklinik GmbH, Institut fuer Diagnostische und Interventionelle Radiologie, Bad Neustadt an der Saale (Germany); Kalb, K.H. [Herz- und Gefaessklinik GmbH, Bad Neustadt an der Saale (Germany). Klinik fuer Handchirurgie

    2006-08-15

    The partial tear of the scapholunate ligament (pre-dynamic stage of SLD) as well as the complete tear (dynamic stage) does not lead to carpal malalignment. However, if the completely ruptured ligament is accompanied by lesions of the extrinsic ligaments, both the scaphoid and the lunate are malaligned already at rest (static stage of SLD). Later, osteoarthritis will develop, beginning in the radioscaphoid compartment, progressing to the midcarpal joint, and ending in a carpal collapse (osteoarthrotic stage of SLD). Dynamic SLD is detectable only in stress views and in cinematography. The high utility of MRI for directly visualizing the injured ligament is emphasized: reparation tissue is focally enhanced at the rupture site by intravenously applied contrast agent; the individual segments of the scapholunate ligament can be visualized in direct MR arthrography, therefore allowing differentiation of partial and complete ligamentous tears. (orig.) [German] Die Teilruptur des Lig. scapholunatum (praedynamisches Stadium) und die isolierte Komplettruptur (dynamisches Stadium) fuehren zu keiner karpalen Gefuegestoerung in Ruhe. Erst wenn die Komplettruptur von Laesionen der extrinsischen Bandstabilisatoren begleitet wird, stehen das Skaphoid und Lunatum bereits in Ruhe in Fehlstellung (statisches Stadium). Spaeter kommt es zur Handgelenkarthrose, zuerst radioskaphoidal, dann mediokarpal mit Ausbildung eines karpalen Kollapses (arthrotisches Stadium). Die dynamische Instabilitaet ist nur mit Stressaufnahmen und kinematographisch nachweisbar. Die MRT vermag das rupturierte Lig. scapholunatum direkt darzustellen: Intravenoes verabreichtes Kontrastmittel reichert sich fokal am Reparationsgewebe der Rupturstelle an; mit der direkten MR-Arthrogaphie koennen die Bandsegmente besser abgegrenzt und Partial- von Komplettrupturen unterschieden werden. (orig.)

  13. Trapezium excision and suture suspensionplasty (TESS) for the treatment of thumb carpometacarpal arthritis.

    Science.gov (United States)

    Putnam, Matthew D; Meyer, Nicholas J; Baker, Daniel; Brehmer, Jess; Carlson, Brent D

    2014-06-01

    Basilar thumb arthritis, or first carpometacarpal arthritis, is a common condition affecting older women and some men. It is estimated that as many as one third of postmenopausal woman are affected. Surgical treatment of this condition includes options ranging from arthrodesis to prosthetic arthroplasty. Intermediate options include complete or partial trapezial excision with or without interposition of a cushioning/stabilizing material (auto source, allo source, synthetic source). A multitude of methods appear to offer similar end results, although some methods definitely involve more surgical work and perhaps greater patient risk. Through retrospective evaluation of a cohort of patients who underwent suture suspensionplasty, we determined the postoperative effect on strength, motion, patient satisfaction, complications, and radiographic maintenance of the scaphoid-metacarpal distance. This review shows the method to be clinically effective and, by comparison with a more traditional ligament reconstruction trapezial interposition arthroplasty, the method does not require use of autograft or allograft tendon and has fewer surgical steps. Forty-four patients were included in this retrospective study. The results showed that 91% of patients were satisfied with the procedure. Pinch and grip strength remained the same preoperatively and postoperatively. A Disabilities of the Arm, Shoulder, and Hand patient-reported outcome instrument (DASH) scores averaged 30 at final follow-up. Three patients developed a late complication requiring further surgical intervention. In summary, this technique appears to be technically reproducible, requires no additional tendon material, and achieves objectively and subjectively similar results to other reported procedures used to manage first CMC Arthritis.

  14. Moroccan immigrants in the Andalusian agricultural sector

    Directory of Open Access Journals (Sweden)

    Simón Pedro Izcara Palacios

    2005-07-01

    Full Text Available In Andalucia (Spain, the absense of local labor willing to accept the wages and work conditions offered in the export farming sector, together with the growth of production of hand-harvested fruits and vegetables, has increased the farmer´s dependence upon migrant labor, principally from Morocco. Moreover, a high level of irregular labor in the agricultural sector results from the coexistence of restrictive laws with the employer´s willingness to break the law hiring cheap, flexible, non-unionized and legally defenseless labor, in order to reduce costs and increase economic benefits. At the same time, in an increasingly xenophobic atmosphere, Moroccans live in very precarious conditions which include rudimentary housing where a majority of the migrants reside in overcrowded conditions. Using qualitative methodology, this article analyzes the social situation of Moroccan migrant workers employed in agriculture in Andalucia, a region situated in the south of Spain.

  15. Ilizarov fixation.

    Science.gov (United States)

    Pemberton, C; Swanepoel, S

    1993-12-01

    Professor Gavanit Ilizarov, a Russian, was practising medicine in Siberia and although not trained as a surgeon he was becoming increasingly faced with orthopaedic problems. As he had no means of treating many of these, he devised his own system based on Kurstner wires and rings but using bicycle spokes and modified clutch rings. This was in 1951. He continued to make modifications over the years and, as the system has been introduced to the rest of the world, others, too, have added their own adaptations. There are now 42 components which go to make up the Ilizarov system. By using various combinations of these components it is possible to build a frame to treat a variety of orthopaedic problems i.e. deformities, non-unions and limb lengthening.

  16. Retrospective analysis of extra-articular distal humerus shaft fractures treated with the use of pre-contoured lateral column metaphyseal LCP by triceps-sparing posterolateral approach

    Directory of Open Access Journals (Sweden)

    Yatinder Kharbanda

    2016-11-01

    Full Text Available Abstract Management of extra-articular distal humerus fractures presents a challenge to the treating surgeon due to the complex anatomy of the distal part of the humerus and complicated fracture morphology. Although surgical treatment has shown to provide a more stable reduction and alignment and predictable return to function, it has been associated with complications like iatrogenic radial nerve palsy, infection, non-union and Implant failure. We in the present series retrospectively analysed 20 patients with extra-articular distal humerus shaft fractures surgically treated using the extra-articular distal humeral locking plate approached by the triceps-sparing posterolateral approach. The outcome was assessed using the DASH score, range of motion at the elbow and the time to union. The mean time to radiographic fracture union was 12 weeks.

  17. Retrospective analysis of extra-articular distal humerus shaft fractures treated with the use of pre-contoured lateral column metaphyseal LCP by triceps-sparing posterolateral approach.

    Science.gov (United States)

    Kharbanda, Yatinder; Tanwar, Yashwant Singh; Srivastava, Vishal; Birla, Vikas; Rajput, Ashok; Pandit, Ramsagar

    2017-04-01

    Management of extra-articular distal humerus fractures presents a challenge to the treating surgeon due to the complex anatomy of the distal part of the humerus and complicated fracture morphology. Although surgical treatment has shown to provide a more stable reduction and alignment and predictable return to function, it has been associated with complications like iatrogenic radial nerve palsy, infection, non-union and Implant failure. We in the present series retrospectively analysed 20 patients with extra-articular distal humerus shaft fractures surgically treated using the extra-articular distal humeral locking plate approached by the triceps-sparing posterolateral approach. The outcome was assessed using the DASH score, range of motion at the elbow and the time to union. The mean time to radiographic fracture union was 12 weeks.

  18. Atypical femoral neck stress fracture in a marathon runner: a case report and literature review.

    LENUS (Irish Health Repository)

    2012-02-01

    BACKGROUND: Femoral neck stress fractures are relatively rare and may present as sports-related injuries. The presentation is variable, and prompt diagnosis facilitates the earliest return to pre-morbid functional activity levels. Delayed detection may precipitate femoral non-union or avascular necrosis, resulting in long-term functional deficit. AIMS: We present the case of a basicervical femoral neck stress fracture occurring in a 23-year-old marathon runner. The pathophysiology and practical management issues related to this unusual injury pattern are discussed. CONCLUSION: The growing interest in amateur athletic activities should raise the index of suspicion for stress fractures of the femoral neck in healthy adults with atypical hip pain. Increased levels of patient education and physician awareness can reduce the incidence of long-term morbidity in cases of this unusual sports-related injury.

  19. Primary unreamed intramedullary locked nailing in open fractures of tibia

    Directory of Open Access Journals (Sweden)

    Jain Vineet

    2005-01-01

    Full Text Available Background: Fractures of tibia are among the commonest fractures sustained in road traffic accidents. They are frequently open and contaminated. Unreamed nails are considered superior to external fixator in the management of open fractures of tibia. Method: Forty patients with open fractures of tibia, grade I, II, IIIa, IIIb were included in the study. They were managed by primary unreamed intramedullary nailing with adequate soft tissue management. Results: Functional results were excellent in 26 cases, good in 10 cases and fair in 4 cases. Four cases had delayed union. Average time of union was 16.9 weeks. Conclusion: Primary unreamed intramedullary nailing offers advantage of rigid fixation, low incidence of infection, non-union, good functional results and early return to work. An adequate soft tissue management is mandatory in treatment of these fractures.

  20. Contribution of G.A. Ilizarov to bone reconstruction: historical achievements and state of the art

    Directory of Open Access Journals (Sweden)

    Alexander V. Gubin

    2016-07-01

    Full Text Available Abstract Methodological solutions of Prof. G.A. Ilizarov are the core stone of the contemporary bone lengthening and reconstruction surgery. They have been acknowledged in the orthopaedic world as one of the greatest contributions to treating bone pathologies. The Ilizarov method of transosseous compression–distraction osteosynthesis has been widely used for managing bone non-union and defects, bone infection, congenital and posttraumatic limb length discrepancies, hand and foot disorders. The optimal conditions for implementing distraction and compression osteogenesis were proven by numerous experimental studies that Prof. G.A. Ilizarov organized and supervised at a large orthopaedic research institute in Kurgan. The tension stress effect on regeneration and growth of tissues was thoroughly investigated with radiographic, histological and biochemical methods. The impact of the Ilizarov method on the progress of bone lengthening and reconstruction surgery could be called revolutionary.

  1. Exploitation by Economic Necessity

    Directory of Open Access Journals (Sweden)

    Kristian F. Braekkan

    2015-10-01

    Full Text Available This study develops and tests a model that proposes economic necessity moderates the relationship between psychological contract violations (PCVs and organizational commitment and trust in the employing organization among non-unionized manufacturing workers (N = 226. Moderated regression analyses revealed that there was a significant interaction between PCV and economic necessity in predicting both outcomes. Specifically, the findings indicated that individuals experiencing high PCV and high economic necessity did not decrease their organizational commitment like their counterparts who endorsed lower economic necessity. They did, however, experience significantly decreased trust in their employer. The findings suggest that individuals who are forced to sell their labor power and obtain what they need through the market are more likely to continue to be exploited by their employer, as they have no other options than to continue the relationship. The importance of the findings is discussed, and recommendations for future research are provided.

  2. The effect of bone marrow aspirate, bone graft and collagen composites on fixation of bone implants

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Overgaard, Søren

    2007-01-01

     Introduction: Replacement of extensive local bone loss especially in revision joint arthroplasties is a significant clinical challenge. Autogenous and allogenic cancellous bone grafts have been the gold standard in reconstructive orthopaedic surgery, but it is well known that there is morbidity...... associated with harvesting of autogenous bone graft and limitations in the quantity of bone available. Disadvantages of allograft include the risk of bacterial or viral contamination and non union as well as the potential risk of disease transmission. Alternative options are attractive and continue...... to be sought. Hydroxyapatite and collagen composites have the potential in mimicking and replacing skeletal bones. Aim: This study attempted to determine the effect of hydroxyapatite/collagen composites in the fixation of bone implants. The composites used in this study is produced by Institute of Science...

  3. Surgical treatment of synovial osteochondromatosis of the hip using a modified-Hardinge approach with a Z-shaped capsular incision

    Directory of Open Access Journals (Sweden)

    Yu Takeda

    2015-12-01

    Full Text Available Synovial osteochondromatosis of the hip is a rare condition, and the surgical treatment approach for this condition requires complete removal of loose bodies combined with synovectomy. While these, procedures are generally accepted as the optimal treatment method, this is still controversial topic. Recent studies have reported that open surgical procedures remain acceptable for synovial osteochondromatosis of the hip. These procedures include the dislocation of the femoral head, and complications such as femoral head necrosis and bursitis or great trochanter non-union due to trochanteric osteotomy have been reported. The present study reports a modified technique for surgical dislocation through a Z-shaped capsular incision without trochanteric flip osteotomy for the treatment of synovial osteochondromatosis of the hip.

  4. Results of Closed Intramedullary Nailing using Talwarkar Square Nail in Adult Forearm Fractures

    Directory of Open Access Journals (Sweden)

    Nadeem A Lil

    2012-07-01

    Full Text Available The aim of the study was to evaluate results of closed intramedullary nailing using Talwarkar square nails in adult forearm fractures. We prospectively evaluated 34 patients with both bone forearm fractures. The average time to union was 12.8 (SD +3.2 weeks with cast support for a mean of 8.2 weeks. Union was achieved in 31 out of 34 patients. Using the Grace and Eversmann rating system, 17 patients were excellent, 10 were good, and 4 had an acceptable result. Three patients had non-unions, 2 for the radius and one for the ulna. There were two cases of superficial infection, one subject had olecranon bursitis, and one case of radio-ulnar synostosis. Complication rates associated with the use of square nails were lower compared to plate osteosynthesis and locked intramedullary nails. To control rotation post- operatively, there is a need for application of an above-elbow cast after nailing.

  5. Hierarchical tailoring of strut architecture to control permeability of additive manufactured titanium implants.

    Science.gov (United States)

    Zhang, Z; Jones, D; Yue, S; Lee, P D; Jones, J R; Sutcliffe, C J; Jones, E

    2013-10-01

    Porous titanium implants are a common choice for bone augmentation. Implants for spinal fusion and repair of non-union fractures must encourage blood flow after implantation so that there is sufficient cell migration, nutrient and growth factor transport to stimulate bone ingrowth. Additive manufacturing techniques allow a large number of pore network designs. This study investigates how the design factors offered by selective laser melting technique can be used to alter the implant architecture on multiple length scales to control and even tailor the flow. Permeability is a convenient parameter that characterises flow, correlating to structure openness (interconnectivity and pore window size), tortuosity and hence flow shear rates. Using experimentally validated computational simulations, we demonstrate how additive manufacturing can be used to tailor implant properties by controlling surface roughness at a microstructual level (microns), and by altering the strut ordering and density at a mesoscopic level (millimetre). Copyright © 2013 The Authors. Published by Elsevier B.V. All rights reserved.

  6. Femoral neck pseudoarthrosis in a polio patient treated with closed reduction and cell therapy

    Directory of Open Access Journals (Sweden)

    M.A. Codesido

    2017-04-01

    Full Text Available Poliomyelitis disease affects the anterior horns cells of the spinal cord and certain motor nuclei of the brain stem. Paralysis type is flaccid and asymmetrical and result in muscular imbalance.Due to this, in case of having a hip muscles involvement, degenerative or posttraumatic, total hip arthroplasty is normally contraindicated because of the excessive risk of hip dislocation. In cases of subcapital femoral neck fractures the femoral head vascularization is a main concern, and in cases of neglected fracture with pseudoarthrosis the vascular status to the head must be investigated prior to further decisions.We report the case of a femoral neck fracture non-union after a missed femoral neck fracture in a polio affected leg treated with cannulated screws and percutaneous autologous injection of processed total nuclear cells (TNC mixed with putty demineralized bone matrix. Keywords: Pseudoarthrosis, Poliomyelitis, Cell therapy, Femoral neck

  7. Bone graft materials in fixation of orthopaedic implants in sheep

    DEFF Research Database (Denmark)

    Babiker, Hassan

    2013-01-01

    Bone graft is widely used within orthopaedic surgery especially in revision joint arthroplasty and spine fusion. The early implant fixation in the revision situation of loose joint prostheses is important for the long-term survival. Bone autograft has been considered as gold standard in many...... orthopaedic procedures, whereas allograft is the gold standard by replacement of extensive bone loss. However, the use of autograft is associated with donor site morbidity, especially chronic pain. In addition, the limited supply is a significant clinical challenge. Limitations in the use of allograft include...... the risk of bacterial contamination and disease transmission as well as non-union and poor bone quality. Other bone graft and substitutes have been considered as alternative in order to improve implant fixation. Hydroxyapatite and collagen type I composite (HA/Collagen) have the potential in mimicking...

  8. Osteosynthesis of the diaphysis of the humeral with plates - Series of cases

    International Nuclear Information System (INIS)

    Reyes Reyes, Claudia Juliana; Valencia Chamorro, Martha Patricia; Garcia Gonzalez, Luis Alejandro

    2005-01-01

    Humeral shaft fractures may be treated in various ways. When surgical treatment is preferred, both plates and intramedullary nails are available and feasible options; the latter have recently gained popularity. We present the results of a case series of humeral fractures treated by open reduction and plate fixation with DCP plates, the results are described in terms of union rate, function, satisfaction, and complications. Thirty patients were included, with ages from 18 to 74 years, with mean follow-up time of 35 months; twelve patients were treated for delayed or non-union after orthopedic treatment. There was one case of nonunion, and one of iatrogenic neurapraxia of the radial nerve. Mobility and strength were excellent. All patients reported to be satisfied with the treatment and its result. We discuss that plate fixation for humeral shaft fractures is a predictable choice, with low complication rate and high union rate

  9. Interactions between bone cells and biomaterials: An update.

    Science.gov (United States)

    Beauvais, Sabrina; Drevelle, Olivier; Jann, Jessica; Lauzon, Marc-Antoine; Foruzanmehr, Mohammadreza; Grenier, Guillaume; Roux, Sophie; Faucheux, Nathalie

    2016-06-01

    As the populations of the Western world become older, they will suffer more and more from bone defects related to osteoporosis (non-union fractures, vertebral damages), cancers (malignant osteolysis) and infections (osteomyelitis). Autografts are usually used to fill these defects, but they have several drawbacks such as morbidity at the donor site and the amount and quality of bone that can be harvested. Recent scientific milestones made in biomaterials development were shown to be promising to overcome these limitations. Cell interactions with biomaterials can be improved by adding at their surface functional groups such as adhesive peptides and/or growth factors. The development of such biomimetic materials able to control bone cell responses can only proceed if it is based on a sound understanding of bone cell behavior and regulation. This review focuses on bone physiology and the regulation of bone cell differentiation and function, and how the latest advances in biomimetic materials can be translated within promising clinical outcomes.

  10. The effects of bone marrow aspirate, bone graft, and collagen composites on fixation of titanium implants

    DEFF Research Database (Denmark)

    Babiker, Hassan; Ding, Ming; Sandri, Monica

    2012-01-01

    Replacement of extensive local bone loss especially in revision joint arthroplasty and spine fusion is a significant clinical challenge. Allograft and autograft have been considered as gold standards for bone replacement. However, there are several disadvantages such as donor site pain, bacterial...... contamination, and non union as well as the potential risk of disease transmission. Hydroxyapatite and collagen composites (HA/Collagen) have the potential in mimicking and replacing skeletal bones. This study attempted to determine the effects of newly developed HA/Collagen-composites with and without bone...... marrow aspirate (BMA) on enhancement of bone implant fixation. Method: Titanium alloy implants were inserted into bilateral femoral condyles of eight skeletally mature sheep, four implants per sheep. The implant had a circumferential gap of 2 mm. The gap was filled with: HA/Collagen; HA...

  11. Fixation of displaced subcapital femoral fractures. Compression screw fixation versus double divergent pins.

    Science.gov (United States)

    Christie, J; Howie, C R; Armour, P C

    1988-03-01

    One hundred and twenty-seven consecutive patients with displaced subcapital fractures of the femoral neck (Garden Grade III or IV) all under 80 years of age and independently mobile, were randomly allocated to fixation with either double divergent pins or a single sliding screw-plate device. The incidence of non-union and infection in the sliding screw-plate group was significantly higher, and we believe that when internal fixation is considered appropriate multiple pinning should be used. Mobility after treatment was disappointing in about half of the patients, and we feel that internal fixation can only be justified in patients who are physiologically well preserved and who maintain a high level of activity.

  12. Clinical evaluation of a new custom offset shoulder prosthesis for treatment of complex fractures of the proximal humerus

    DEFF Research Database (Denmark)

    Mehlhorn, Alexander T; Schmal, Hagen; Sudkamp, Norbert P

    2006-01-01

    ). The Constant-Murley-Score and radiological score according to Neer's classification were used for postoperative functional and radiological assessment. Following hemiarthroplasty, Group A achieved an average Constant Score of 52 and Group B of 46. The pain relief after hemiarthroplasty was about 53% in Group......Primary hemiarthroplasty of the shoulder is an accepted procedure to treat complex proximal humeral fractures. The goal of this study was to assess the functional outcome in patients treated with hemiarthroplasty using a custom offset shoulder prosthesis, either for an acute four-part fracture...... of the proximal humerus or following failed primary treatment of a complex humeral fracture. Thirty seven patients were followed up for a mean of 17 months after shoulder replacement (Group A: four-part-fractures; n = 26, Group B: posttraumatic necrosis/non-union after failed primary treatment; n = 11...

  13. Stress fractures of the foot and ankle.

    Science.gov (United States)

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

    2017-08-01

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

  14. Combined finite element and multibody musculoskeletal investigation of a fractured clavicle with reconstruction plate

    DEFF Research Database (Denmark)

    Cronskar, Marie; Rasmussen, John; Tinnsten, Mats

    2015-01-01

    This paper addresses the various treatment options for clavicle fractures by means of computational models, more precisely cases with a need for internal fixation: non-unions and certain complex fractures. The motivation for the work is that treatment can be enhanced by a better understanding...... of the loading of the clavicle and fixation device. This study aimed to develop a method for realistic simulation of stresses in the bone and fixation device in the case of a fractured clavicle. A finite element (FE) mesh of the clavicle geometry was created from computer tomography (CT) data and imported...... into the FE solver where the model was subjected to muscle forces and other boundary conditions from a multibody musculoskeletal model performing a typical activity of daily life. A reconstruction plate and screws were also imported into the model. The combination models returned stresses and displacements...

  15. Minimally-invasive treatment of high velocity intra-articular fractures of the distal tibia.

    LENUS (Irish Health Repository)

    Leonard, M

    2012-02-01

    The pilon fracture is a complex injury. The purpose of this study was to evaluate the outcome of minimally invasive techniques in management of these injuries. This was a prospective study of closed AO type C2 and C3 fractures managed by early (<36 hours) minimally invasive surgical intervention and physiotherapist led rehabilitation. Thirty patients with 32 intra-articular distal tibial fractures were treated by the senior surgeon (GK). Our aim was to record the outcome and all complications with a minimum two year follow-up. There were two superficial wound infections. One patient developed a non-union which required a formal open procedure. Another patient was symptomatic from a palpable plate inferiorly. An excellent AOFAS result was obtained in 83% (20\\/24) of the patients. Early minimally invasive reduction and fixation of complex high velocity pilon fractures gave very satisfactory results at a minimum of two years follow-up.

  16. Fracture of Fully-coated Femoral Stem after Primary Total Hip Arthroplasty for Nonunion of Intertrochanteric Fracture: A Case Report.

    Science.gov (United States)

    Chun, Young Soo; Juh, Hyung Suk; Cho, Yoon Je; Rhyu, Kee Hyung

    2015-09-01

    Femoral stem fracture is an uncommon reason for the failure of total hip arthroplasty, with only 16 cases of fully coated stem fractures reported to date. Here we report a case in which a fully coated primary femoral stem fracture occurred after conversion to total hip arthroplasty for the non-union of an intertrochanteric fracture of the femur. Metallurgic evaluation of the etiology and mechanism revealed that the fracture was initiated by fatigue-related failure and completed by ductile failure on the posterior side of the fracture. Considering the recent trend of treating an intertrochanteric fracture with hip arthroplasty, possible stem failure should be considered, since most patients will have at least one of the known risk factors for stem fracture.

  17. Partial resection of fibula in treatment of ununited tibial shaft fractures

    Directory of Open Access Journals (Sweden)

    Butt Mohd Farooq

    2006-01-01

    Full Text Available Background : In management of fracture of both tibia and fibula, intact fibula may delay union of tibial fractures. Method : Twenty five cases of ununited fractures of tibia were managed between 1997 and 2004, by partial fibulectomy done after 20 weeks after fracture and a POP cast given for 4 weeks which was changed to a PTB cast and weight bearing encouraged at the earliest. Result : All fractures united at an average time of 14 weeks (range 6 to 20 weeks after partial fibulectomy with acceptable alignment in coronal and sagittal planes. There was no neurovascular complication, limitation of joint motion or problem at the osteotomy site. Conclusion : Partial fibulectomy is a viable option in the management of tibial delayed and non-union.

  18. The use of hydroxyapatite for arthrodesis in dogs and cats: a clinical study

    International Nuclear Information System (INIS)

    Dórea Neto, F.A.; Padilha Filho, J.G.; Santos, L.A.; Oriá, A.P.; Canola, J.C.; Stefanes, S.A.; Regonato, E.

    2007-01-01

    Twenty-five arthrodeses were performed in four cats and 17 dogs using synthetic hydroxyapatite as fresh autogenous graft cancellous bone substitute. arthrodesis was performed in the carpal joint in eight cases, in the tarsal joint in 10, in the elbow joint in six, and in the knee joint in one case. the mean radiographic follow-up time was 30 days in one animal, 45 days in another animal and 60 days in the 19 remaining cases. bone union was observed in 24 arthrodeses. non-union of one elbow arthrodesis was due to failure of stabilization. restoration of limb functionality was classified as good to excellent in 22 cases. hydroxyapatite was able to promote bone growth and is suitable for using in routine surgical procedures for small animals

  19. [Intramedullary osteosynthesis of distal metacarpal fractures with curved wires].

    Science.gov (United States)

    Schlageter, M; Winkel, R; Porcher, R; Haas, H G

    1997-07-01

    When intramedullary pinning is used to treat metacarpal fractures, as recently described by Förstner (1994) and Foucher (1995), the closed reduction technique developed by Jahss (1938) is applied in the same way as for conservative fracture treatment. It is not always possible to achieve complete anatomical reduction using this closed technique. The intramedullary pinning technique, that we have applied since 1989, involves a Kirschner wire which is bent at one end. Apart from reducing the fracture, the pre-set Kirschner wire serves as a butressing internal fixator. The elastic clamping of the wire acts as an internal wire spring splint, permitting early mobilisation. We have operated on 62 metacarpal fractures using the above-mentioned technique over a period of 6 years until 1995. Anatomic reduction was realized in 50 of 62 fractures. In the follow-up of 32 fractures, we noticed four complications: one infection, two paraesthesias, and one non-union.

  20. Experimental fracture healing: evaluation using radionuclide bone imaging: concise communication

    International Nuclear Information System (INIS)

    Gumerman, L.W.; Fogel, S.R.; Goodman, M.A.; Hanley, E.N. Jr.; Kappakas, G.S.; Rutkowski, R.; Levine, G.

    1978-01-01

    Radionuclide bone imaging was performed in a rabbit model to observe the course of fracture healing and to establish criteria for distinguishing nonunion and delayed healing from normal healing. Sequential gamma-camera images (with pinhole collimator) were collected and subjected to computer analysis. Five groups were established: (a) control--immobilization; (b) control--immobilization plus periosteal stripping; (c) simple fracture--osteotomy; (d) delayed union--osteotomy plus periosteal stripping; and (e) nonunion--osteotomy, periosteal stripping and polymethyl methacrylate interposed between fracture fragments. Histographic representation of absolute count rates along rabbit tibias followed a predictable pattern in the simple-fracture and delayed-union groups. They differed only in the time of appearance of phases. The non-union group demonstrated no recognizable sequential pattern. In this experimental model, serial bone scanning the quantitative data analysis has shown potential for indicating the course of healing in fractures and for serving as a guide to treatment

  1. Functional bracing for delayed union of a femur fracture associated with Paget's disease of the bone in an Asian patient: a case report

    Directory of Open Access Journals (Sweden)

    Fukuta Masashi

    2010-05-01

    Full Text Available Abstract Paget's disease of the bone is a common metabolic bone disease in most European countries, Australia, New Zealand, and North America. Conversely, this disease is rare in Scandinavia, Asia, and Africa. In Japan, it is extremely rare, with a prevalence of 0.15/100000. Paget's disease is a localized disorder of bone remodeling. Excessive bone resorption and abnormal bone formation result in biomechanically weakened bone and predispose patients to fracture. Delayed union and non-union of fractures have been reported in patients with Paget's disease. Therefore, open reduction and internal fixation of fractures has been recommended to prevent such complications. Here we report an unusual case of a 63-year-old Asian woman with delayed union of a femur fracture secondary to Paget's disease, which was treated successfully by functional bracing.

  2. Ilizarov′s method for treatment of nonunion of diaphyseal fractures of the humerus

    Directory of Open Access Journals (Sweden)

    Kiran Manish

    2010-01-01

    Full Text Available Background: Nonunion in diaphyseal fractures of the humerus can be treated by various modalities like plating and bone grafting, exchange nailing, fibular strut grafting and Ilizarov′s method of ring fixation. To achieve union in infected nonunion in which multiple surgeries have already been done is further challenging. We conducted a prospective study wherein the outcome of the treatment of nonunion of diaphyseal fractures of the humerus by Ilizarov′s method was analyzed. Materials and Methods: Nineteen patients with diaphyseal nonunion of the humerus were treated by Ilizarov′s external fixator. These included nonunion after plating (n=11, intramedullary nailing (n=1 or conservative methods (n=7. In post-surgical infected nonunion (n=6, the implants were removed, debridement done, bone fragments were docked followed by application of ring fixator and compression. In aseptic nonunion (n=13, distraction for three weeks followed by compression was the protocol. Early shoulder and elbow physiotherapy was instituted. The apparatus was removed after clinical and radiological union and the results were assessed for bone healing and functional status. Results: Fracture union was achieved in all the 19 cases. Pin site infection was seen in 2 cases (10.52%. The bone healing results were excellent in eighteen cases (94.73% and good in one case (5.26%.The functional results were found to be excellent in fourteen cases (73.68%, good in four (21.05% and fair in one case (5.26%. Conclusion: Ilizarov′s method is an excellent option for treatment of septic and aseptic non union of diaphyseal fractures of the humerus as it addresses all the problems associated with non union of the humerus like infection, deformity and joint stiffness.

  3. Advantages of Direct Insertion of a Straight Probe Without a Guide Tube During Anterior Odontoid Screw Fixation of Odontoid Fractures.

    Science.gov (United States)

    Park, Jin Hoon; Kang, Dong-Ho; Lee, Moon Kyu; Yoo, Byoungwoo; Jung, Sang Ku; Hwang, Soo-Hyun; Kim, Jeoung Hee; Oh, Sunkyu; Lee, Eun Jung; Jeon, Sang Ryong; Roh, Sung Woo; Rhim, Seung Chul

    2016-05-01

    A retrospective cohort study. The aim of this study was to compare the anterior odontoid screw fixation (AOSF) with a guide tube or with a straight probe. AOSF associates with several complications, including malpositioning, fixation loss, and screw breakage. Screw pull-out from the C2 body is the most common complication. All consecutive patients with type II or rostral shallow type III odontoid fractures who underwent AOSFs during the study period were enrolled retrospectively. The guide-tube AOSF method followed the standard published method except C3 body and C2-3 disc annulus rimming was omitted to prevent disc injury; instead, the guide tube was anchored at the anterior inferior C2 vertebra corner. After 2 screw pull-outs, the guide-tube cohort was analyzed to identify the cause of instrument failure. Thereafter, the straight-probe method was developed. A guide tube was not used. A small pilot hole was made on the most anterior side of the inferior endplate, followed by insertion of a 2.5 mm straight probe through the C2 body. Non-union and instrument failure rates and screw-direction angles of the guide-tube and straight-probe groups were recorded. The guide-tube group (n = 13) had 2 screw pull-outs and 1 non-union. The straight-probe group (n = 8) had no complications and significantly larger screw-direction angles than the guide-tube group (60.5 ± 4.63 vs. 54.8 ± 3.82 degrees; P = 0.047). Straight-probe AOSF yielded larger direction angles without injuring bone and disc. Complications were absent. The procedure was easier than guide-tube AOSF and assured sufficient engagement, even in horizontal fracture orientation cases. 3.

  4. The use of circular external fixators in the management of lower limb trauma in Dublin: a single surgeon's 20-year experience.

    Science.gov (United States)

    O'Neill, B J; Fox, C M; Molloy, A P; O'hEireamhoin, S; Moore, D P

    2016-02-01

    It has been estimated that approximately 520,000 injury presentations are made to Irish accident and emergency departments each year. Fractures account for 20 % of these injuries. Circular external fixators (frames) have been shown to be a safe and effective method of treatment for long bone fractures where internal fixation is impossible or in-advisable. We present the outcomes of all frames applied at our institution for stabilisation of acute fractures over a 20-year period. We retrospectively reviewed a prospectively compiled database of all frames applied in our institution and identified all frames which were applied for acute lower limb trauma. We identified 68 fractures in 63 patients. There were 11 femoral fractures and 57 tibial fractures. All fractures were classified using the AO Classification system, and most fractures were Type C fractures. We used an Ilizarov frame for 53 fractures and a Taylor Spatial Frame for 15 fractures. The mean time in frame was 365 days for a femoral fracture and 230 days for a tibial fracture. There were five tibial non-unions giving an overall union rate of 93 %. Factors associated with non-union included high-energy trauma and cigarette smoking. The vast majority of lower limb fractures can be treated using 'conventional' methods. Complex fractures which are not amenable to open reduction and internal fixation or cast immobilisation can be treated in a frame with excellent results. The paucity of published reports regarding the use of frames for complex trauma reflects the under-utilisation of the technique.

  5. Lower limb stress fractures in sport: Optimising their management and outcome

    Science.gov (United States)

    Robertson, Greg A J; Wood, Alexander M

    2017-01-01

    Stress fractures in sport are becoming increasing more common, comprising up to 10% of all of sporting injuries. Around 90% of such injuries are located in the lower limb. This articles aims to define the optimal management of lower limb stress fractures in the athlete, with a view to maximise return rates and minimise return times to sport. Treatment planning of this condition is specific to the location of the injury. However, there remains a clear division of stress fractures by “high” and “low” risk. “Low risk” stress fractures are those with a low probability of fracture propagation, delayed union, or non-union, and so can be managed reliably with rest and exercise limitation. These include stress fractures of the Postero-Medial Tibial Diaphysis, Metatarsal Shafts, Distal Fibula, Medial Femoral Neck, Femoral Shaft and Calcaneus. “High risk” stress fractures, in contrast, have increased rates of fracture propagation, displacement, delayed and non-union, and so require immediate cessation of activity, with orthopaedic referral, to assess the need for surgical intervention. These include stress fractures of the Anterior Tibial Diaphysis, Fifth Metatarsal Base, Medial Malleolus, Lateral Femoral Neck, Tarsal Navicular and Great Toe Sesamoids. In order to establish the optimal methods for managing these injuries, we present and review the current evidence which guides the treatment of stress fractures in athletes. From this, we note an increased role for surgical management of certain high risk stress fractures to improve return times and rates to sport. Following this, key recommendations are provided for the management of the common stress fracture types seen in the athlete. Five case reports are also presented to illustrate the application of sport-focussed lower limb stress fracture treatment in the clinical setting. PMID:28361017

  6. Epidemiology of distal radius fractures in polytrauma patients and the influence of high traumatic energy transfer.

    Science.gov (United States)

    Ferree, Steven; van der Vliet, Quirine M J; Nawijn, Femke; Bhashyam, Abhiram R; Houwert, Roderick M; Leenen, Luke P H; Hietbrink, Falco

    2018-03-01

    For several extremity fractures differences in morphology, incidence rate and functional outcome were found when polytrauma patients were compared to patients with an isolated injury. This is not proven for distal radius fractures (DRF). Therefore, this study aimed to analyse fracture morphology in relation to energy transfer in both poly- and mono-trauma patients with a DRF. This was a retrospective cohort study. All patients aged 16 years and older with a DRF were included. Patients with an Injury Severity Score of 16 or higher were classified as polytrauma patients. Injuries were defined as high or low energy. All DRFs were classified using the AO/OTA fracture classification system. A total of 830 patients with a DRF were included, 12% were polytrauma. The incidence rate of DRF in polytrauma patients was 3.5%. Ipsilateral upper extremity injury was found in >30% of polytrauma and high-energy monotrauma patients, compared to 5% in low-energy monotrauma patients. More type C DRF were found in polytrauma and high-energy monotrauma patients versus low-energy monotrauma patients. Operative intervention rates for all types of DRF were similar for polytrauma and high-energy monotrauma patients. Non-union rates were higher in polytrauma patients. Higher energy mechanisms of injury, in polytrauma and high-energy monotrauma patients, were associated with more severe complex articular distal radius fractures and more ipsilateral upper extremity injuries. Polytrauma and high-energy monotrauma patient have a similar fracture morphology. However, polytrauma patients have in addition to more injured body regions also more non-union related interventions than high-energy monotrauma patients. Copyright © 2018 Elsevier Ltd. All rights reserved.

  7. Successful staged hip replacement in septic hip osteoarthritis in osteopetrosis: a case report

    Directory of Open Access Journals (Sweden)

    Manzi Giovanni

    2012-04-01

    Full Text Available Abstract Background Osteopetrosis is a rare, inherited, bone disorder, characterized by osteosclerosis, obliteration of the medullary cavity and calcified cartilage. The autosomal dominant form is compatible with a normal life span, although fractures often result from minimal trauma, due to the pathologic nature of bone. Osteomyelitis is common in patients with osteopetrosis because of a reduced resistance to infection, attributed to the lack of marrow vascularity and impairment of white cell function. Only one case of osteomyelitis of the proximal third of the femur has been previously reported, treated with several repeated debridements and finally with femoral head resection. Here we present for the first time a case of a staged implant of a cementless total hip prosthesis for the treatment of a septic hip in femoral neck nonunion in osteopetrosis. Case presentation A 36-years-old woman, affected by autosomal dominant osteopetrosis was referred to our department because of a septic hip arthritis associated with femoral neck septic non-union, with draining fistulas. The infection occurred early after a plate osteosynthesis for a closed perthrocanteric fracture of the femur and persisted in spite of osteosynthesis removal, surgical debridement and external fixation. In our hospital the patient underwent accurate debridement, femoral head and greater trochanter resection, preparation of the diaphyseal intramedullary canal and implant of an antibiotic-loaded cement spacer. The spacer was exchanged after one month, due to infection recurrence and four months later, a cementless total hip arthroplasty was implanted, with no clinical and laboratory signs of infection recurrence at two years follow-up. Conclusions In case of hip septic arthritis and proximal femur septic non-union, femoral head resection may not be the only option available and staged total hip arthroplasty can be considered.

  8. A clinical evaluation of alternative fixation techniques for medial malleolus fractures.

    Science.gov (United States)

    Barnes, Hayley; Cannada, Lisa K; Watson, J Tracy

    2014-09-01

    Medial malleolus fractures have traditionally been managed using partially threaded screws and/or Kirschner wire fixation. Using these conventional techniques, a non-union rate of as high as 20% has been reported. In addition too many patients complaining of prominent hardware as a source of pain post-fixation. This study was designed to assess the outcomes of medial malleolar fixation using a headless compression screw in terms of union rate, the need for hardware removal, and pain over the hardware site. Saint Louis University and Mercy Medical Center, Level 1 Trauma Centers, St. Louis, MO. After IRB approval, we used billing records to identify all patients with ankle fractures involving the medial malleolus. Medical records and radiographs were reviewed to identify patients with medial malleolar fractures treated with headless compression screw fixation. Our inclusion criteria included follow-up until full weight bearing and a healed fracture. Follow-up clinical records and radiographs were reviewed to determine union, complication rate and perception of pain over the site of medial malleolus fixation. Sixty-four ankles were fixed via headless compression screws and 44 had adequate follow-up for additional evaluation. Seven patients had isolated medial malleolar fractures, 23 patients had bimalleolar fractures, and 14 patients had trimalleolar fractures. One patient (2%) required hardware removal due to cellulitis. One patient (2%) had a delayed union, which healed without additional intervention. Ten patients (23%) reported mild discomfort to palpation over the medial malleolus. The median follow-up was 35 weeks (range: 12-208 weeks). There were no screw removals for painful hardware and no cases of non-union. Headless compression screws provide effective compression of medial malleolus fractures and result in good clinical outcomes. The headless compression screw is a beneficial alternative to the conventional methods of medial malleolus fixation. Copyright

  9. Operative treatment of the midshaft fractures of the clavicle – does delay matter?

    Directory of Open Access Journals (Sweden)

    Matej Andoljšek

    2007-11-01

    Full Text Available Background: Fractures of the clavicle are common injuries and mostly treated non-operatively. Nearly always the fracture is clinically united within three to four weeks and functional recovery should be completed within two months. Traditionally thinking has been that operative treatment is indicated exceptionaly and that delayed surgery is less successful. In retrospective comparative study authors have asked – whether delay of surgery in middle-third clavicular fractures negatively affects functional results and – whether after delayed surgery complications are more frequent.Patients and methods: Thirty-seven of 733 fractures of the clavicle were treated operatively. Among these, 11 were fresh Allman Type I fractures (early procedure, 9 delayed- or non-unions and one malunion (late procedure. All fractures were fixed with plates and screws. In none of the reconstructive procedures composite bone grafting was performed, twice spongiotic bone graft and twice morsilized calus grafts were used. DASH and Constant scores were used for outcome evaluation.Results: Twenty-one of 22 patients were evaluated (one foreign turist missed on average 21 month after surgery. Average DASH scores for early operated patients were 14.4 and for late operated 18.5; an average Quich DASH were 16.4 and 20.5 respectively. Average Constant scores were 85.6 and 76.0. Statistically differences are not important. Three patients had early complications (two from early, one from late group. Five patients had late complications (four skin paresthesias, one non-union.Conclusions: In retrospective study, functional results of surgically treated fresh Type I fractures and after reconstructive surgery for delayed-, non- and mal-union of the midshaft of the clavicle were comparable. No significant differences in complication rates were confirmed.

  10. Functional Results of Unstable (Type 2 Distal Clavicle Fractures Treated with Superior Anterior Locking Plate

    Directory of Open Access Journals (Sweden)

    Rajesh Govindasamy

    2017-11-01

    Full Text Available Background: The treatment of distal clavicle fracture is always a challenge, as it is mostly unstable and has higherrate of delayed union, malunion, non-union and associated acromioclavicular arthritis. So the management of thesefractures remains controversial. The purpose of this study is to evaluate the functional results of Type 2 distal endclavicle fractures treated with superior anterior locking plate.Methods: From June 2011 to August 2015 a retrospective study of12 male patients (mean age of 41.3 years 11 withunilateral and 1 with bilateral distal clavicle fractures treated with superior anterior locking plate was done. They wereevaluated at regular intervals with mean follow up of 14 months(12-18 months.Those with minimum one year followup were included in our study. All were evaluated for the functioning of the shoulder joint by both Oxford shoulder scoreand Quick DASH scores, rate of bone union, complications and earliest time for return to work.Results: All fractures union seen within 6-8 weeks (mean time: 7.1 weeks.All had good shoulder range of motion. Theaverage oxford shoulder and Quick DASH score were 46.2 and 6.5.There were no major complications in our studyviz. non-union, plate failure, secondary fracture. But one patient had superficial wound infection. All patients returned towork within 3 months of postoperative period.Conclusion: Displaced distal clavicle fractures treated with superior anterior locking plates achieved excellent resultsin terms of bony union with rarely any complications and demonstrate promising results with this novel technique.

  11. Lower limb stress fractures in sport: Optimising their management and outcome.

    Science.gov (United States)

    Robertson, Greg A J; Wood, Alexander M

    2017-03-18

    Stress fractures in sport are becoming increasing more common, comprising up to 10% of all of sporting injuries. Around 90% of such injuries are located in the lower limb. This articles aims to define the optimal management of lower limb stress fractures in the athlete, with a view to maximise return rates and minimise return times to sport. Treatment planning of this condition is specific to the location of the injury. However, there remains a clear division of stress fractures by "high" and "low" risk. "Low risk" stress fractures are those with a low probability of fracture propagation, delayed union, or non-union, and so can be managed reliably with rest and exercise limitation. These include stress fractures of the Postero-Medial Tibial Diaphysis, Metatarsal Shafts, Distal Fibula, Medial Femoral Neck, Femoral Shaft and Calcaneus. "High risk" stress fractures, in contrast, have increased rates of fracture propagation, displacement, delayed and non-union, and so require immediate cessation of activity, with orthopaedic referral, to assess the need for surgical intervention. These include stress fractures of the Anterior Tibial Diaphysis, Fifth Metatarsal Base, Medial Malleolus, Lateral Femoral Neck, Tarsal Navicular and Great Toe Sesamoids. In order to establish the optimal methods for managing these injuries, we present and review the current evidence which guides the treatment of stress fractures in athletes. From this, we note an increased role for surgical management of certain high risk stress fractures to improve return times and rates to sport. Following this, key recommendations are provided for the management of the common stress fracture types seen in the athlete. Five case reports are also presented to illustrate the application of sport-focussed lower limb stress fracture treatment in the clinical setting.

  12. The role of triple pelvic osteotomy in therapy of residual hip dysplasia and sequel of AVN: long-term experience.

    Science.gov (United States)

    Dungl, P; Rejholec, M; Chomiak, J; Grill, F

    2007-01-01

    Triple pelvic osteotomy was performed for sequel of DDH including AVN between 1981 and 2002 for 329 patients (351 hips, 280 females, 49 males, average age at surgery 16.5 years, range 9-41 years, follow-up 4-25 years). A small modification of Steel's technique consisting of strictly subperiostal resection of segment from both pubic and ischial bone was used. Average gain of lengthening extremity was 1.8 cm. The average CE angle was improved from 7.8 to 35.5 degrees. Clinical results were evaluated according to Merle d'Aubigne and reflected to the preoperative clinical and radiological findings. There were 146 hip joints in 128 patients (76%) with excellent results in the group of congruent hips without arthrosis. In 182 hips in 178 patients with hip joints with some deformity, limited ROM and decentration, 40% were excellent, 32% good, 23% fair and 5% unsatisfactory results were achieved. The group of decentrated hip joints in young adults in incongruency, limited ROM and sometimes severe arthrosis consisted of 23 monolateral surgeries with 39% unsatisfactory, 39% fair and 22% good results, respectively. No major neurovascular complications were seen. Non-unions were recorded in 19 patients (5.4%), including 2 triple and 2 double non-unions. Based on our long-term experience, we can conclude that triple pelvic osteotomy according to Steel in our modification is a safe method and gives regularly excellent or good results for correction of clinical and radiographic appearance of acetabular dysplasia when there is a proper indication.

  13. Multi-scale Modeling of Power Plant Plume Emissions and Comparisons with Observations

    Science.gov (United States)

    Costigan, K. R.; Lee, S.; Reisner, J.; Dubey, M. K.; Love, S. P.; Henderson, B. G.; Chylek, P.

    2011-12-01

    The Remote Sensing Verification Project (RSVP) test-bed located in the Four Corners region of Arizona, Utah, Colorado, and New Mexico offers a unique opportunity to develop new approaches for estimating emissions of CO2. Two major power plants located in this area produce very large signals of co-emitted CO2 and NO2 in this rural region. In addition to the Environmental Protection Agency (EPA) maintaining Continuous Emissions Monitoring Systems (CEMS) on each of the power plant stacks, the RSVP program has deployed an array of in-situ and remote sensing instruments, which provide both point and integrated measurements. To aid in the synthesis and interpretation of the measurements, a multi-scale atmospheric modeling approach is implemented, using two atmospheric numerical models: the Weather Research and Forecasting Model with chemistry (WRF-Chem; Grell et al., 2005) and the HIGRAD model (Reisner et al., 2003). The high fidelity HIGRAD model incorporates a multi-phase Lagrangian particle based approach to track individual chemical species of stack plumes at ultra-high resolution, using an adaptive mesh. It is particularly suited to model buoyancy effects and entrainment processes at the edges of the power plant plumes. WRF-Chem is a community model that has been applied to a number of air quality problems and offers several physical and chemical schemes that can be used to model the transport and chemical transformation of the anthropogenic plumes out of the local region. Multiple nested grids employed in this study allow the model to incorporate atmospheric variability ranging from synoptic scales to micro-scales (~200 m), while including locally developed flows influenced by the nearby complex terrain of the San Juan Mountains. The simulated local atmospheric dynamics are provided to force the HIGRAD model, which links mesoscale atmospheric variability to the small-scale simulation of the power plant plumes. We will discuss how these two models are applied and

  14. Photometric Assessment of Night Sky Quality over Chaco Culture National Historical Park

    Science.gov (United States)

    Hung, Li-Wei; Duriscoe, Dan M.; White, Jeremy M.; Meadows, Bob; Anderson, Sharolyn J.

    2018-06-01

    The US National Park Service (NPS) characterizes night sky conditions over Chaco Culture National Historical Park using measurements in the park and satellite data. The park is located near the geographic center of the San Juan Basin of northwestern New Mexico and the adjacent Four Corners state. In the park, we capture a series of night sky images in V-band using our mobile camera system on nine nights from 2001 to 2016 at four sites. We perform absolute photometric calibration and determine the image placement to obtain multiple 45-million-pixel mosaic images of the entire night sky. We also model the regional night sky conditions in and around the park based on 2016 VIIRS satellite data. The average zenith brightness is 21.5 mag/arcsec2, and the whole sky is only ~16% brighter than the natural conditions. The faintest stars visible to naked eyes have magnitude of approximately 7.0, reaching the sensitivity limit of human eyes. The main impacts to Chaco’s night sky quality are the light domes from Albuquerque, Rio Rancho, Farmington, Bloomfield, Gallup, Santa Fe, Grants, and Crown Point. A few of these light domes exceed the natural brightness of the Milky Way. Additionally, glare sources from oil and gas development sites are visible along the north and east horizons. Overall, the night sky quality at Chaco Culture National Historical Park is very good. The park preserves to a large extent the natural illumination cycles, providing a refuge for crepuscular and nocturnal species. During clear and dark nights, visitors have an opportunity to see the Milky Way from nearly horizon to horizon, complete constellations, and faint astronomical objects and natural sources of light such as the Andromeda Galaxy, zodiacal light, and airglow.

  15. Traditions of the Sun, One Model for Expanding Audience Access

    Science.gov (United States)

    Hawkins, I.; Paglierani, R.

    2006-12-01

    The Internet is a powerful tool with which to expand audience access, bringing students, teachers and the public to places and resources they might not otherwise visit or make use of. We will present Traditions of the Sun, an experiential Web site that invites exploration of the world's ancient observatories with special emphasis on Chaco Culture National Historic Park in the Four Corners region of the US and several sites in the Yucatan Peninsula in Mexico. Traditions of the Sun includes resources in English and Spanish along with a unique trilingual on-line book, "Traditions of the Sun, A Photographic Journal," containing explanatory text in Yucatec Maya as well. Traditions of the Sun offers rich opportunities for virtual visits to ancient sites used for solar observing while learning about current NASA research on the Sun and indigenous solar practices within a larger historical and cultural context. The site contains hundreds of photographs, historic images and rich multimedia to help tell the story of the Sun-Earth Connection. Visitors to the site can zoom in on the great Mayan cities of Chichen Itza, Uxmal, Dzibilchaltun, and Mayapan to learn about Mayan astronomy, history, culture, and science. They can also visit Chaco Canyon to watch sunrise over Pueblo Bonito on the summer solstice, take a virtual reality tour of the great kiva at Casa Rinconada or see panoramic vistas from Fajada Butte, an area which, for preservation purposes, is restricted to the public. Traditions of the Sun provides one model of how exploration and discovery can come to life for both formal and informal audiences via the Internet. Traditions of the Sun is a collaborative project between NASA's Sun-Earth Connection Education Forum, the National Park Service, Instituto National de Antropologia e Historia, Universidad Nacional Autonoma de Mexico, and Ideum.

  16. Analysis of Chemical Reaction Kinetics Behavior of Nitrogen Oxide During Air-staged Combustion in Pulverized Boiler

    Directory of Open Access Journals (Sweden)

    Jun-Xia Zhang

    2016-03-01

    Full Text Available Because the air-staged combustion technology is one of the key technologies with low investment running costs and high emission reduction efficiency for the pulverized boiler, it is important to reveal the chemical reaction kinetics mechanism for developing various technologies of nitrogen oxide reduction emissions. At the present work, a three-dimensional mesh model of the large-scale four corner tangentially fired boiler furnace is established with the GAMBIT pre-processing of the FLUENT software. The partial turbulent premixed and diffusion flame was simulated for the air-staged combustion processing. Parameters distributions for the air-staged and no the air-staged were obtained, including in-furnace flow field, temperature field and nitrogen oxide concentration field. The results show that the air-staged has more regular velocity field, higher velocity of flue gas, higher turbulence intensity and more uniform temperature of flue gas. In addition, a lower negative pressure zone and lower O2 concentration zone is formed in the main combustion zone, which is conducive to the NO of fuel type reduced to N2, enhanced the effect of NOx reduction. Copyright © 2016 BCREC GROUP. All rights reserved Received: 5th November 2015; Revised: 14th January 2016; Accepted: 16th January 2016  How to Cite: Zhang, J.X., Zhang, J.F. (2016. Analysis of Chemical Reaction Kinetics Behavior of Nitrogen Oxide During Air-staged Combustion in Pulverized Boiler. Bulletin of Chemical Reaction Engineering & Catalysis, 11 (1: 100-108. (doi:10.9767/bcrec.11.1.431.100-108 Permalink/DOI: http://dx.doi.org/10.9767/bcrec.11.1.431.100-108

  17. Effects of burn location and investigator on burn depth in a porcine model.

    Science.gov (United States)

    Singer, Adam J; Toussaint, Jimmy; Chung, Won Taek; Thode, Henry C; McClain, Steve; Raut, Vivek

    2016-02-01

    In order to be useful, animal models should be reproducible and consistent regardless of sampling bias, investigator creating burn, and burn location. We determined the variability in burn depth based on biopsy location, burn location and investigator in a porcine model of partial thickness burns. 24 partial thickness burns (2.5 cm by 2.5 cm each) were created on the backs of 2 anesthetized pigs by 2 investigators (one experienced, one inexperienced) using a previously validated model. In one of the pigs, the necrotic epidermis covering each burn was removed. Five full thickness 4mm punch biopsies were obtained 1h after injury from the four corners and center of the burns and stained with Hematoxylin and Eosin and Masson's trichrome for determination of burn depth by a board certified dermatopathologist blinded to burn location and investigator. Comparisons of burn depth by biopsy location, burn location and investigator were performed with t-tests and ANOVA as appropriate. The mean (SD) depth of injury to blood vessels (the main determinant of burn progression) in debrided and non-debrided pigs pooled together was 1.8 (0.3)mm, which included 75% of the dermal depth. Non-debrided burns were 0.24 mm deeper than debrided burns (Plocations, in debrided burns. Additionally, there were also no statistical differences in burn depths from midline to lateral in either of these burn types. Burn depth was similar for both investigators and among biopsy locations. Burn depth was greater for caudal locations in non-debrided burns and overall non-debrided burns were deeper than debrided burns. However, burn depth did not differ based on investigator, biopsy site, and medial-lateral location. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  18. Restoration of degraded drylands through exclosures enhancing woody species diversity and soil nutrients in the highlands of Tigray, Northern Ethiopia

    Directory of Open Access Journals (Sweden)

    Kide M. Gebremedihin

    2018-02-01

    Full Text Available Exclusion of grazing animals and tree plantations were among the methods used for the rehabilitation of degraded lands in tropical semiarid areas. Exclosures can foster secondary forest succession by improving soil conditions, attracting seed-dispersal agents and modifying microclimate for understory growth. This paper compares the woody species diversity and soil chemical properties under exclosure with increasing age and grazing land at different slope positions. The study has been conducted in northern Ethiopia from 12 exclosure sites paired each with adjacent grazing land with four treatments replicated three times. In the entire study 216 plots were examined of which 108 were in exclosures and 108 in communal grazing lands.There were four age classes and three slope positions in each of the landuses. Vegetation data were collected using plots measuring 100 m2. Soils for physicochemical properties were collected from the four corners and center of 5 × 5m plots which was inside the 10 × 10m plot. A total of 61 woody plant species belonging to 41 families were recorded. Diversity and species richness were higher in the exclosures than in grazing lands. Among exclosures these parameters were higher in exclosures older than 30 years and at the foot of the slope. Grazing lands, the youngest exclosures and upper elevation gradient recorded lower values. Chemical soil properties were significantly higher in the exclosures, among them in the oldest exclosures and at foot elevation (except for P than these were in the grazing land, the youngest exclosures and upper parts of slopes respectively. Exclosures are instrumental to improve the woody species diversity and soil chemical properties in the drylands.

  19. Application of an image intensifier to the study on hadrons in air shower, 4

    International Nuclear Information System (INIS)

    Tsushima, Itsuro; Kawasumi, Norio; Hashimoto, Katsumi; Machida, Masaharu

    1975-01-01

    As the apparatus for observing cosmic ray air shower, the particle detection apparatus combining spark chamber, scintillator and photomultiplier tube is frequently used, but the exact detection of particle number is impossible with it when particle density is large. The authors have carried out the experiment to measure nuclear active particles in air shower and to grasp the central part of air shower as energy flow by utilizing an image intensifier tube. On the roof of building S, a laboratory was built, and a core detector of 2 m x 2 m area, 13 AS detectors of 0.25 m 2 and an AS detector of 1 m 2 were installed. The gate of the II was opened by utilizing coincidence pulses, and the position and amount of scintillation in the core detector was taken into a camera through the II. The time of observation was 289 hours, and the time of II operation was 113 hours. Total number of air shower recorded was 218 cases, and the centers of 120 cases among them were determined in the AS detectors at four corners. The centers of 39 cases were within the area of the core detector. In the coincident counting of air shower and burst carried out in the present experiment, the total delay time from the arrival of air shower to the gate pulse actuating the II was 1.6 sec. The core of air shower of about 10 6 size and 1.3 age was caught by this method. The problems for future are the determination of core position for the air shower of smaller size, and the meaning of spot images of II. (Kako, I.)

  20. Linear stability of a fuel channel uniformly heated considering retrofeeding by vacuum. Theoretical study

    International Nuclear Information System (INIS)

    Gonzalez M, V.; Salinas H, J.G.; Espinosa P, G.

    2000-01-01

    The Technology, Regulation and Services Management of the National Commission of Nuclear Safety and Safeguards in coordinated form with the IPH Department of the Metropolitan Autonomous-Iztapalapa University, developed the present project to study the linear stability in a fuel channel uniformly heated with effects of retrofeeding by vacuums. In this study the methodology used in the analysis of linear stability of the nuclear reactor unit 1 at Laguna Verde power plant is described which represented by an average channel uniformly heated. The conceptual model consists of two cells which represent the two regions in which is divided the channel according to the cooling is in one and two phases, considering the boiling length dependent in the time. It is used the homogeneous flux models for describing the thermohydraulic behavior of the cooling in the two phases region. The neutron processes with the punctual model of the neutron kinetics with a group of retarded neutrons precursors are described. It is studied the behavior of the system in the frequency domain with the transfer functions obtained and it is characterized in four operation states corresponding to the four corners of the low stability zone in the map power-flow Laguna Verde power plant. For these operation states the characteristic frequency is determined and the corresponding Nyquist diagrams are obtained. The results show that the system stability depends on the power-flow relation and that the operations which implicate a reduction of this relation improve the stability of the system (reducing the power introducing control bars with constant cooling flow or increase cooling flow with bars pattern established). The obtained results with effects of retrofeeding by vacuums show that the value of the characteristic frequency is modified very little with respect to the model without retrofeeding, therefore the thermohydraulic processes seem to determine the response of the stability of the system

  1. Edificio de «La Caixa» Madrid – España

    Directory of Open Access Journals (Sweden)

    Bosch Aymerich, José M.

    1980-10-01

    Full Text Available This eight-storey building, for «La Caixa», occupies a city block on the downtown avenue of Paseo de la Castellana in Madrid. The lower floors have cants on their four corners, which fade away gradually giving the building a more original note. All of the floors are developed about a central core, and the lower floors are to be used for «La Caixa» needs. The foundations were carried out on the basis of reinforced concrete piles. Metal pillars were used for the structure, and the flooring system was on the basis of a continuous reinforced slab. The exterior of the building was executed in the form of an aluminium curtain wall, with finishing touches in a U shape which break up the glazed surface.

    Este edificio de ocho plantas, destinado a «La Caixa», ocupa una manzana en el céntrico Paseo de la Castellana de Madrid. Las plantas Inferiores presentan chaflanes en sus cuatro esquinas, los cuales van desapareciendo progresivamente ganando así el edificio en originalidad. Todas las plantas, de las cuales las inferiores están destinadas al servicio de «La Caixa», se desarrollan en torno a un núcleo central. La cimentación se realizó a base de pilotes de hormigón armado. Para la estructura se emplearan pilares metálicos y el sistema de forjado a base de una losa continua armada. Se adoptó para las fachadas la solución de un muro cortina de aluminio, con remates en forma de U que cortan la superficie acristalada.

  2. The Colorado Plateau II: biophysical, socioeconomic, and cultural research

    Science.gov (United States)

    Mattson, David J.; van Riper, Charles

    2005-01-01

    The publication of The Colorado Plateau: Cultural, Biological, and Physical Research in 2004 marked a timely summation of current research in the Four Corners states. This new volume, derived from the seventh Biennial Conference on the Colorado Plateau in 2003, complements the previous book by focusing on the integration of science into resource management issues. The 32 chapters range in content from measuring human impacts on cultural resources, through grazing and the wildland-urban interface issues, to parameters of climate change on the Plateau. The book also introduces economic perspectives by considering shifting patterns and regional disparities in the Colorado Plateau economy. A series of chapters on mountain lions explores the human-wildland interface. These chapters deal with the entire spectrum of challenges associated with managing this large mammal species in Arizona and on the Colorado Plateau, conveying a wealth of timely information of interest to wildlife managers and enthusiasts. Another provocative set of chapters on biophysical resources explores the management of forest restoration, from the micro scale all the way up to large-scale GIS analyses of ponderosa pine ecosystems on the Colorado Plateau. Given recent concerns for forest health in the wake of fires, severe drought, and bark-beetle infestation, these chapters will prove enlightening for forest service, park service, and land management professionals at both the federal and state level, as well as general readers interested in how forest management practices will ultimately affect their recreation activities. With broad coverage that touches on topics as diverse as movement patterns of rattlesnakes, calculating watersheds, and rescuing looted rockshelters, this volume stands as a compendium of cutting-edge research on the Colorado Plateau that offers a wealth of insights for many scholars.

  3. Bridging the gap between tribal risk perceptions and scientific decision-making for uranium legacy sites located in Native American communities

    Science.gov (United States)

    Joseph, C.; Waugh, W.; Glenn, E.; Chief, K.

    2017-12-01

    There are approximately 15,000 abandoned uranium mines (AUM) in the western United States, of which 500 AUMs are located in the Colorado Plateau Four-Corners region. Uranium mill tailings, referred to as legacy waste, compromise the largest volume of any category of radioactive waste in the nation. Today, the Department of Energy Legacy Management is responsible for long-term stewardship and maintenance of inactive uranium processing sites that have been remediated to prevent further migration and exposure of tailings to the environment and surrounding communities. In collaboration with the DOE-LM, I am investigating the impact of climate change and community adaptation on the long-term performance of disposal cell covers for uranium mill tailings located in Native American communities, as well as how these communities have adapted to and perceive these areas. I am interested in how abiotic engineered cell covers may be candidate sites for future conversion to vegetated evapotranspirative caps for arid to semi-arid climates. The objectives are to: 1) assess above-ground tissue of plants encroaching engineered cell covers for concentrations of uranium, radium, selenium, molybdenum, thorium, arsenic, lead, and manganese and compare them to control sites; 2) determine if above-cell plant tissue is accumulating to toxic levels that may create an exposure pathway, 3) identify climate scenarios for site locations and determine how short-and long-scale climate projections will influence spatial and temporal plant distribution for specific woody species; and 4) evaluate the risk perceptions of Hopi villages located five miles downstream of one site location. To date, risk perception and stakeholder outreach to the Hopi communities has been absent. This study will help inform how land use, water use, and sustenance practices may contribute to environmental health disparities for one of the few tribes that has maintained physical continuity within their ancestral homeland.

  4. Hybrid nodal methods in the solution of the diffusion equations in X Y geometry; Metodos nodales hibridos en la solucion de las ecuaciones de difusion en geometria XY

    Energy Technology Data Exchange (ETDEWEB)

    Hernandez M, N. [CFE, Carretera Cardel-Nautla Km. 43.5, 91680 Veracruz (Mexico); Alonso V, G.; Valle G, E. del [IPN-ESFM, 07738 Mexico D.F. (Mexico)]. e-mail: nhmiranda@mexico.com

    2003-07-01

    In 1979, Hennart and collaborators applied several schemes of classic finite element in the numerical solution of the diffusion equations in X Y geometry and stationary state. Almost two decades then, in 1996, himself and other collaborators carried out a similar work but using nodal schemes type finite element. Continuing in this last direction, in this work a group it is described a set of several Hybrid Nodal schemes denominated (NH) as well as their application to solve the diffusion equations in multigroup in stationary state and X Y geometry. The term hybrid nodal it means that such schemes interpolate not only Legendre moments of face and of cell but also the values of the scalar flow of neutrons in the four corners of each cell or element of the spatial discretization of the domain of interest. All the schemes here considered are polynomials like they were it their predecessors. Particularly, its have developed and applied eight different hybrid nodal schemes that its are very nearby related with those developed by Hennart and collaborators in the past. It is treated of schemes in those that nevertheless that decreases the number of interpolation parameters it is conserved the accurate in relation to the bi-quadratic and bi-cubic schemes. Of these eight, three were described and applied in a previous work. It is the bi-lineal classic scheme as well as the hybrid nodal schemes, bi-quadratic and bi-cubic for that here only are described the other 5 hybrid nodal schemes although they are provided numerical results for several test problems with all them. (Author)

  5. Measurement of action forces and posture to determine the lumbar load of healthcare workers during care activities with patient transfers.

    Science.gov (United States)

    Theilmeier, Andreas; Jordan, Claus; Luttmann, Alwin; Jäger, Matthias

    2010-11-01

    Moving patients or other care activities with manual patient handling is characterized by high mechanical load on the lumbar spine of healthcare workers (HCWs). During the patient transfer activity, the caregivers exert lifting, pulling, and pushing forces varying over time with respect to amplitude and direction. Furthermore, the caregivers distinctly change their posture and frequently obtain postures asymmetrical to the median sagittal plane, including lateral bending and turning the trunk. This paper describes a procedure to determine lumbar load during patient transfer supported by measurement techniques and an exemplary application; this methodology represents the basis of a complex research project, the third 'Dortmund Lumbar Load Study (DOLLY 3)'. Lumbar load was determined by simulation calculations using a comprehensive biomechanical model ('The Dortmunder'). As the main influencing factors, the hand forces of the caregiver exerted during typical patient transfers and the posture and movements of the HCW were recorded in laboratory studies. The action forces were determined three-dimensionally with the help of a newly developed 'measuring bed', two different 'measuring chairs', a 'measuring bathtub', and a 'measuring floor'. To capture the forces during transfers in or at the bed, a common hospital bed was equipped with an additional framework, which is attached to the bedstead and connected to the bedspring frame via three-axial force sensors at the four corners. The other measuring systems were constructed similarly. Body movements were recorded using three-dimensional optoelectronic recording tools and video recordings. The posture and force data served as input data for the quantification of various lumbar-load indicators.

  6. Seasonal Patterns of Dry Deposition at a High-Elevation Site in the Colorado Rocky Mountains

    Science.gov (United States)

    Oldani, Kaley M.; Mladenov, Natalie; Williams, Mark W.; Campbell, Cari M.; Lipson, David A.

    2017-10-01

    In the Colorado Rocky Mountains, high-elevation barren soils are deficient in carbon (C) and phosphorus (P) and enriched in nitrogen (N). The seasonal variability of dry deposition and its contributions to alpine elemental budgets is critical to understanding how dry deposition influences biogeochemical cycling in high-elevation environments. In this 2 year study, we evaluated dry and wet deposition inputs to the Niwot Ridge Long Term Ecological Research (NWT LTER) site in the Colorado Rocky Mountains. The total organic C flux in wet + dry (including soluble and particulate C) deposition was >30 kg C ha-1 yr-1 and represents a substantial input for this C-limited environment. Our side-by-side comparison of dry deposition collectors with and without marble insert indicated that the insert improved retention of dry deposition by 28%. Annual average dry deposition fluxes of water-soluble organic carbon (4.25 kg C ha-1 yr-1) and other water-soluble constituents, including ammonium (0.16 kg NH4+ha-1 yr-1), nitrate (1.99 kg NO3- ha-1 yr-1), phosphate (0.08 kg PO43- ha-1 yr-1), and sulfate (1.20 kg SO42- ha-1 yr-1), were comparable to those in wet deposition, with highest values measured in the summer. Backward trajectory analyses implicate air masses passing through the arid west and Four Corners, USA, as dominant source areas for dry deposition, especially in spring months. Synchronous temporal patterns of deposition observed at the NWT LTER site and a distant Rocky Mountain National Park Clean Air Status and Trends Network site indicate that seasonal dry deposition patterns are regional phenomena with important implications for the larger Rocky Mountain region.

  7. A new CANDU-600 containment structure

    International Nuclear Information System (INIS)

    Serban, V.; Bobei, M.; Gheorghiu, M.; Popescu, M.; Stanciu, M.; Dinica, D.; Alexandru, C.

    1994-01-01

    This paper is presenting a structure made of reinforced concrete with rectangular cross-section, box-divided, prefabricated and modulled on a bay 6.5 m wide and 4.5 m high, and provided with a steel liner. The building has an overall basement in which the steel liner is embedded and which is supporting the building walls. The inner structure is common to the containment as well and it is carried out for each room (generally 6.5 m by 6.5 m) having intermediar floors at the necessary elevations. The containment dimensions, on horizontal plane are 6 x 6.5 m by 5 x 6.5 m and the total height of the side walls is 30.5 m. The containment is closed in A-C direction by a prefabricated semi-cylinder which is supported by the side walls and 5 intermediate arches. The fuel transfer deck structure is common to the inner structure and the containment structure. The Calandria vault is a separate individual structure located above E1. 100. For CANDU-600 main equipment the same arrangement was maintained, some unsignificant modifications being made, for example, the access areas located in the four corners of the building as well as the location of some auxiliary systems. The paper is also including a set of 1:200 scale drawings, comments on the construction manner and the results of the building structural analysis. The suggested solution is evidencing economical benefits facilities in the operation and construction of the plant and it is specially recommended for areas with high seismic events. (author)

  8. Deposition and early hydrologic evolution of Westwater Canyon wet alluvial-fan system

    International Nuclear Information System (INIS)

    Galloway, W.E.

    1980-01-01

    The Westwater Canyon Member is one of several large, low-gradient alluvial fans that compose the Morrison Formation in the Four Corners area. Morrison fans were deposited by major laterally migrating streams entering a broad basin bounded by highlands to the west and south. The Westwater Canyon sand framework consists of a downfan succession of 1) proximal braided channel, 2) straight bed-load channel, 3) sinuous mixed-load channel, and 4) distributary mixed-load-channel sand bodies. Regional sand distribution and facies patterns are highly digitate and radiate from a point source located northwest of Gallup, New Mexico. Early ground-water flow evolution within the Westwater Canyon fan aquifer system can be inferred by analogy with Quaternary wet-fan deposits and by the interpreted paragenetic sequence of diagenetic features present. Syndepositional flow was controlled by the downfan hydrodynamic gradient and the high horizontal and vertical transmissivity of the sand-rich fan aquifer. Dissolution and transport of soluble humate would be likely in earliest ground water, which was abundant, fresh, and slightly alkaline. With increasing confinement of the aquifer below less permeable tuffaceous Brushy Basin deposits and release of soluble constituents from volcanic ash, flow patterns stabilized, and relatively more saline, uranium-rich ground water permeated the aquifer. Uranium mineralization occurred during this early postdepositional, semiconfined flow phase. Development of overlying Dakota swamps suggests a shallow water table indicative of regional dischare or stagnation. In either event, only limited downward flux of acidic water is recorded by local, bleached, kaolinized zones where the Westwater Canyon directly underlies the Dakota swamps. Subsequent ground-water flow phases have further obscured primary alteration patterns and caused local oxidation and redistribution of uranium

  9. Monitoring Ground Subsidence in Hong Kong via Spaceborne Radar: Experiments and Validation

    Directory of Open Access Journals (Sweden)

    Yuxiao Qin

    2015-08-01

    Full Text Available The persistent scatterers interferometry (PSI technique is gradually becoming known for its capability of providing up to millimeter accuracy of measurement on ground displacement. Nevertheless, there is still quite a good amount of doubt regarding its correctness or accuracy. In this paper, we carried out an experiment corroborating the capability of the PSI technique with the help of a traditional survey method in the urban area of Hong Kong, China. Seventy three TerraSAR-X (TSX and TanDEM-X (TDX images spanning over four years are used for the data process. There are three aims of this study. The first is to generate a displacement map of urban Hong Kong and to check for spots with possible ground movements. This information will be provided to the local surveyors so that they can check these specific locations. The second is to validate if the accuracy of the PSI technique can indeed reach the millimeter level in this real application scenario. For validating the accuracy of PSI, four corner reflectors (CR were installed at a construction site on reclaimed land in Hong Kong. They were manually moved up or down by a few to tens of millimeters, and the value derived from the PSI analysis was compared to the true value. The experiment, carried out in unideal conditions, nevertheless proved undoubtedly that millimeter accuracy can be achieved by the PSI technique. The last is to evaluate the advantages and limitations of the PSI technique. Overall, the PSI technique can be extremely useful if used in collaboration with other techniques, so that the advantages can be highlighted and the drawbacks avoided.

  10. "Half a Century of Evolution of Neonatology: A Witness's Story" : Dr. K. C. Chaudhuri Lifetime Achievement Award Oration Delivered at AIIMS, New Delhi on 7th September 2014.

    Science.gov (United States)

    Vidyasagar, Dharmapuri

    2015-12-01

    Lifetime achievement awards are awarded to recognize contributions during the career of an individual, rather than for a single or multiple contributions of a person in his/her field of specialty. I am highly honored being the recipient of the Dr. K. C. Chaudhuri Lifetime Achiement Award Oration. The award for me is significant for several reasons: First being associated with legendary figure such as Dr. Chaudhuri, secondly being recognized by my fellow Indian colleagues. Finally, it also marks half a century of my experience in development of subspecialty of neonatology in US. Some fifty and odd years ago, as an young novice from India I joined the mainstream of this evolution, thanks to my professors and mentors in US and thanks to America, the land of opportunity. During this odyssey, I met many great men and women of science and intellect, saw great scientific discoveries, many innovations, combined with social changes that led to significant reduction of neonatal mortality rates in the industrialized Western countries. I also saw the "Globalization" of "Modern Neonatology" in which I participated with vigor; thus, improving the newborn care in four corners of the world. I am proud that I had the opportunity to contribute a little to growth of neonatology in US and outside the US. This is the story of my professional life. The message of my life story for the younger generation is : Dream big, never give up your dreams. Hardwork, maintaining your integrity, and honesty are the three precepts that will define your character and you will be rewarded in the long run.

  11. Hybrid nodal methods in the solution of the diffusion equations in X Y geometry

    International Nuclear Information System (INIS)

    Hernandez M, N.; Alonso V, G.; Valle G, E. del

    2003-01-01

    In 1979, Hennart and collaborators applied several schemes of classic finite element in the numerical solution of the diffusion equations in X Y geometry and stationary state. Almost two decades then, in 1996, himself and other collaborators carried out a similar work but using nodal schemes type finite element. Continuing in this last direction, in this work a group it is described a set of several Hybrid Nodal schemes denominated (NH) as well as their application to solve the diffusion equations in multigroup in stationary state and X Y geometry. The term hybrid nodal it means that such schemes interpolate not only Legendre moments of face and of cell but also the values of the scalar flow of neutrons in the four corners of each cell or element of the spatial discretization of the domain of interest. All the schemes here considered are polynomials like they were it their predecessors. Particularly, its have developed and applied eight different hybrid nodal schemes that its are very nearby related with those developed by Hennart and collaborators in the past. It is treated of schemes in those that nevertheless that decreases the number of interpolation parameters it is conserved the accurate in relation to the bi-quadratic and bi-cubic schemes. Of these eight, three were described and applied in a previous work. It is the bi-lineal classic scheme as well as the hybrid nodal schemes, bi-quadratic and bi-cubic for that here only are described the other 5 hybrid nodal schemes although they are provided numerical results for several test problems with all them. (Author)

  12. Historical deposition and fluxes of mercury in Narraguinnep Reservoir, southwestern Colorado, USA

    International Nuclear Information System (INIS)

    Gray, John E.; Fey, David L.; Holmes, Charles W.; Lasorsa, Brenda K.

    2005-01-01

    Narraguinnep Reservoir has been identified as containing fish with elevated Hg concentrations and has been posted with an advisory recommending against consumption of fish. There are presently no point sources of significant Hg contamination to this reservoir or its supply waters. To evaluate potential historical Hg sources and deposition of Hg to Narraguinnep Reservoir, the authors measured Hg concentrations in sediment cores collected from this reservoir. The cores were dated by the 137 Cs method and these dates were further refined by relating water supply basin hydrological records with core sedimentology. Rates of historical Hg flux were calculated (ng/cm 2 /a) based on the Hg concentrations in the cores, sediment bulk densities, and sedimentation rates. The flux of Hg found in Narraguinnep Reservoir increased by approximately a factor of 2 after about 1970. The 3 most likely sources of Hg to Narraguinnep Reservoir are surrounding bedrocks, upstream inactive Au-Ag mines, and several coal-fired electric power plants in the Four Corners region. Patterns of Hg flux do not support dominant Hg derivation from surrounding bedrocks or upstream mining sources. There are 14 coal-fired power plants within 320 km of Narraguinnep Reservoir that produce over 80 x 10 6 MWH of power and about 1640 kg-Hg/a are released through stack emissions, contributing significant Hg to the surrounding environment. Two of the largest power plants, located within 80 km of the reservoir, emit about 950 kg-Hg/a. Spatial and temporal patterns of Hg fluxes for sediment cores collected from Narraguinnep Reservoir suggest that the most likely source of Hg to this reservoir is from atmospheric emissions from the coal-fired electric power plants, the largest of which began operation in this region in the late-1960s and early 1970s

  13. Direct numerical simulation of free and forced square jets

    International Nuclear Information System (INIS)

    Gohil, Trushar B.; Saha, Arun K.; Muralidhar, K.

    2015-01-01

    Highlights: • Free square jet at Re = 500–2000 is studied using DNS. • Forced square jet at Re = 1000 subjected to varicose perturbation is also investigated at various forcing frequencies. • Vortex interactions within the jet and jet spreading are affected both for free and forced jets. • Perturbation at higher frequency shows axis-switching. - Abstract: Direct numerical simulation (DNS) of incompressible, spatially developing square jets in the Reynolds number range of 500–2000 is reported. The three-dimensional unsteady Navier–Stokes equations are solved using high order spatial and temporal discretization. The objective of the present work is to understand the evolution of free and forced square jets by examining the formation of large-scale structures. Coherent structures and related interactions of free jets suggest control strategies that can be used to achieve enhanced spreading and mixing of the jet with the surrounding fluid. The critical Reynolds number for the onset on unsteadiness in an unperturbed free square jet is found to be 875–900 while it reduces to the range 500–525 in the presence of small-scale perturbations. Disturbances applied at the flow inlet cause saturation of KH-instability and early transition to turbulence. Forced jet calculations have been carried out using varicose perturbation with amplitude of 15%, while frequency is independently varied. Simulations show that the initial development of the square jet is influenced by the four corners leading to the appearance hairpin structures along with the formation of vortex rings. Farther downstream, adjacent vortices strongly interact leading to their rapid breakup. Excitation frequencies in the range 0.4–0.6 cause axis-switching of the jet cross-section. Results show that square jets achieve greater spreading but are less controllable in comparison to the circular ones

  14. Efficacy of patient skin dose reduction by a compensating filter through of irradiation field overlaps on the area during percutaneous coronary intervention

    International Nuclear Information System (INIS)

    Yamasaki, Hiroyuki; Yamaguchi, Sadao; Yamamoto, Naomi; Miyagawa, Takashi; Hirose, Etsuko; Takenaka, Tatsuaki; Nakahara, Makoto

    2011-01-01

    Our study was involved with entrance surface dose reduction and irradiation field by the filter use of PCI, and insertion in place of an effective compensating filter to maximize entrance surface dose reduction, which we verified. The radiation dosimetry put a 6 cc ion chamber on the back side of the thorax phantom, and changed the filter of the four corners (a: upper left, b: upper right, c: lower right, d: lower left) of the monitor confirmed with fluoroscopy [(0) no filter, (1) one filter, (2) two filters]. The angle of C arm was assumed to be eight directions and 0 degrees adopted by this hospital. It was compared with a corrective rate of which one was no filter. Next, the presence of filter and irradiation field overlaps on the area in monitor in the angle of C arm was verified by this hospital's classic example. As for corrective rate, (1) becomes 0.41 and (2) become 0.25 at fluoroscopy, (1) becomes 0.26 and (2) become 0.16 at exposure. Irradiation field overlaps on the area (+) compensating filter (-) was many with d of right anterior oblique (RAO)/cranial (CAU), a of RAO and c of CAU at left coronary angiography (CAG), c of left anterior oblique (LAO) at right CAG, b of LAO/cranial (CRA) (left CAG), b of CRA (right CAG) and a and d of RAO (right CAG) at both CAG. Irradiation field overlaps on the area (+) compensating filter (+) was many with b of CRA at left CAG, a of LAO/CRA at right CAG, b of CRA (left CAG) and b of RAO (right CAG) at both CAG. When the compensating filter is used the entrance surface dose reduction effect was great. If automatic exposure control protects the part of irradiation field overlaps on the area in the range without operating excessively, the radiological risk can be reduced, and it is conceivable as useful clinical setting. (author)

  15. Benchmarking the Geant4 full system simulation of an associated alpha-particle detector for use in a D-T neutron generator.

    Science.gov (United States)

    Zhang, Xiaodong; Hayward, Jason P; Cates, Joshua W; Hausladen, Paul A; Laubach, Mitchell A; Sparger, Johnathan E; Donnald, Samuel B

    2012-08-01

    The position-sensitive alpha-particle detector used to provide the starting time and initial direction of D-T neutrons in a fast-neutron imaging system was simulated with a Geant4-based Monte Carlo program. The whole detector system, which consists of a YAP:Ce scintillator, a fiber-optic faceplate, a light guide, and a position-sensitive photo-multiplier tube (PSPMT), was modeled, starting with incident D-T alphas. The scintillation photons, whose starting time follows the distribution of a scintillation decay curve, were produced and emitted uniformly into a solid angle of 4π along the track segments of the alpha and its secondaries. Through tracking all photons and taking into account the quantum efficiency of the photocathode, the number of photoelectrons and their time and position distributions were obtained. Using a four-corner data reconstruction formula, the flood images of the alpha detector with and without optical grease between the YAP scintillator and the fiber-optic faceplate were obtained, which show agreement with the experimental results. The reconstructed position uncertainties of incident alpha particles for both cases are 1.198 mm and 0.998 mm respectively across the sensitive area of the detector. Simulation results also show that comparing with other faceplates composed of 500 μm, 300 μm, and 100 μm fibers, the 10-μm-fiber faceplate is the best choice to build the detector for better position performance. In addition, the study of the background originating inside the D-T generator suggests that for 500-μm-thick YAP:Ce coated with 1-μm-thick aluminum, and very good signal-to-noise ratio can be expected through application of a simple threshold. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Linear stability of a fuel channel uniformly heated considering retrofeeding by vacuum. Theoretical study; Estabilidad lineal de un canal combustible uniformemente calentado considerando retroalimentacion por vacios

    Energy Technology Data Exchange (ETDEWEB)

    Gonzalez M, V. [Comision Nacional de Seguridad Nuclear y Salvaguardias, 03000 Mexico D.F. (Mexico); Salinas H, J.G.; Espinosa P, G. [Universidad Autonoma Metropolitana-Iztapalapa, 09000 Mexico D.F. (Mexico)

    2000-07-01

    The Technology, Regulation and Services Management of the National Commission of Nuclear Safety and Safeguards in coordinated form with the IPH Department of the Metropolitan Autonomous-Iztapalapa University, developed the present project to study the linear stability in a fuel channel uniformly heated with effects of retrofeeding by vacuums. In this study the methodology used in the analysis of linear stability of the nuclear reactor unit 1 at Laguna Verde power plant is described which represented by an average channel uniformly heated. The conceptual model consists of two cells which represent the two regions in which is divided the channel according to the cooling is in one and two phases, considering the boiling length dependent in the time. It is used the homogeneous flux models for describing the thermohydraulic behavior of the cooling in the two phases region. The neutron processes with the punctual model of the neutron kinetics with a group of retarded neutrons precursors are described. It is studied the behavior of the system in the frequency domain with the transfer functions obtained and it is characterized in four operation states corresponding to the four corners of the low stability zone in the map power-flow Laguna Verde power plant. For these operation states the characteristic frequency is determined and the corresponding Nyquist diagrams are obtained. The results show that the system stability depends on the power-flow relation and that the operations which implicate a reduction of this relation improve the stability of the system (reducing the power introducing control bars with constant cooling flow or increase cooling flow with bars pattern established). The obtained results with effects of retrofeeding by vacuums show that the value of the characteristic frequency is modified very little with respect to the model without retrofeeding, therefore the thermohydraulic processes seem to determine the response of the stability of the system

  17. Textural and mineralogical characteristics of microbial fossils associated with modern and ancient iron (oxyhydr)oxides: terrestrial analogue for sediments in Gale Crater.

    Science.gov (United States)

    Potter-McIntyre, Sally L; Chan, Marjorie A; McPherson, Brian J

    2014-01-01

    Iron (oxyhydr)oxide microbial mats in modern to ∼100 ka tufa terraces are present in a cold spring system along Ten Mile Graben, southeastern Utah, USA. Mats exhibit morphological, chemical, and textural biosignatures and show diagenetic changes that occur over millennial scales. The Jurassic Brushy Basin Member of the Morrison Formation in the Four Corners region of the USA also exhibits comparable microbial fossils and iron (oxyhydr)oxide biosignatures in the lacustrine unit. Both the modern spring system and Brushy Basin Member represent alkaline, saline, groundwater-fed systems and preserve diatoms and other similar algal forms with cellular elaboration. Two distinct suites of elements (1. C, Fe, As and 2. C, S, Se, P) are associated with microbial fossils in modern and ancient iron (oxyhydr)oxides and may be potential markers for biosignatures. The presence of ferrihydrite in ∼100 ka fossil microbial mats and Jurassic rocks suggests that this thermodynamically unstable mineral may also be a potential biomarker. One of the most extensive sedimentary records on Mars is exposed in Gale Crater and consists of non-acidic clays and sulfates possibly of lacustrine origin. These terrestrial iron (oxyhydr)oxide examples are a valuable analogue because of similar iron- and clay-rich host rock compositions and will help (1) understand diagenetic processes in a non-acidic, saline lacustrine environment such as the sedimentary rocks in Gale Crater, (2) document specific biomediated textures, (3) demonstrate how biomediated textures might persist or respond to diagenesis over time, and (4) provide a ground truth library of textures to explore and compare in extraterrestrial iron (oxyhydr)oxides, where future explorations hope to detect past evidence of life.

  18. Camera Coverage Estimation Based on Multistage Grid Subdivision

    Directory of Open Access Journals (Sweden)

    Meizhen Wang

    2017-04-01

    Full Text Available Visual coverage is one of the most important quality indexes for depicting the usability of an individual camera or camera network. It is the basis for camera network deployment, placement, coverage-enhancement, planning, etc. Precision and efficiency are critical influences on applications, especially those involving several cameras. This paper proposes a new method to efficiently estimate superior camera coverage. First, the geographic area that is covered by the camera and its minimum bounding rectangle (MBR without considering obstacles is computed using the camera parameters. Second, the MBR is divided into grids using the initial grid size. The status of the four corners of each grid is estimated by a line of sight (LOS algorithm. If the camera, considering obstacles, covers a corner, the status is represented by 1, otherwise by 0. Consequently, the status of a grid can be represented by a code that is a combination of 0s or 1s. If the code is not homogeneous (not four 0s or four 1s, the grid will be divided into four sub-grids until the sub-grids are divided into a specific maximum level or their codes are homogeneous. Finally, after performing the process above, total camera coverage is estimated according to the size and status of all grids. Experimental results illustrate that the proposed method’s accuracy is determined by the method that divided the coverage area into the smallest grids at the maximum level, while its efficacy is closer to the method that divided the coverage area into the initial grids. It considers both efficiency and accuracy. The initial grid size and maximum level are two critical influences on the proposed method, which can be determined by weighing efficiency and accuracy.

  19. Attributing Methane and Carbon Dioxide Emissions from Anthropogenic and Natural Sources Using AVIRIS-NG

    Science.gov (United States)

    Thorpe, A. K.; Frankenberg, C.; Thompson, D. R.; Duren, R. M.; Aubrey, A. D.; Bue, B. D.; Green, R. O.; Gerilowski, K.; Krings, T.; Borchardt, J.; Kort, E. A.; Sweeney, C.; Conley, S. A.; Roberts, D. A.; Dennison, P. E.; Ayasse, A.

    2016-12-01

    Imaging spectrometers like the next generation Airborne Visible/Infrared Imaging Spectrometer (AVIRIS-NG) can map large regions with the high spatial resolution necessary to resolve methane (CH4) and carbon dioxide (CO2) emissions. This capability is aided by real time detection and geolocation of gas plumes, permitting unambiguous identification of individual emission source locations and communication to ground teams for rapid follow up. We present results from AVIRIS-NG flight campaigns in the Four Corners region (Colorado and New Mexico) and the San Joaquin Valley (California). Over three hundred plumes were observed, reflecting emissions from anthropogenic and natural sources. Examples of plumes will be shown for a number of sources, including CH4 from well completions, gas processing plants, tanks, pipeline leaks, natural seeps, and CO2 from power plants. Despite these promising results, an imaging spectrometer built exclusively for quantitative mapping of gas plumes would have improved sensitivity compared to AVIRIS-NG. For example, an instrument providing a 1 nm spectral sampling (2,000-2,400 micron) would permit mapping CH4, CO2, H2O, CO, and N2O from more diffuse sources using both airborne and orbital platforms. The ability to identify emission sources offers the potential to constrain regional greenhouse gas budgets and improve partitioning between anthropogenic and natural emission sources. Because the CH4 lifetime is only about 9 years and CH4 has a Global Warming Potential 86 times that of CO2 for a 20 year time interval, mitigating these emissions is a particularly cost-effective approach to reduce overall atmospheric radiative forcing. Fig. 1. True color image subset with superimposed gas plumes showing concentrations in ppmm. Left: AVIRIS-NG observed CH4 plumes from natural gas processing plant extending over 500 m downwind of multiple emissions sources. Right: Multiple CO2 plumes observed from coal-fired power plant.

  20. Airborne DOAS retrievals of methane, carbon dioxide, and water vapor concentrations at high spatial resolution: application to AVIRIS-NG

    Directory of Open Access Journals (Sweden)

    A. K. Thorpe

    2017-10-01

    Full Text Available At local scales, emissions of methane and carbon dioxide are highly uncertain. Localized sources of both trace gases can create strong local gradients in its columnar abundance, which can be discerned using absorption spectroscopy at high spatial resolution. In a previous study, more than 250 methane plumes were observed in the San Juan Basin near Four Corners during April 2015 using the next-generation Airborne Visible/Infrared Imaging Spectrometer (AVIRIS-NG and a linearized matched filter. For the first time, we apply the iterative maximum a posteriori differential optical absorption spectroscopy (IMAP-DOAS method to AVIRIS-NG data and generate gas concentration maps for methane, carbon dioxide, and water vapor plumes. This demonstrates a comprehensive greenhouse gas monitoring capability that targets methane and carbon dioxide, the two dominant anthropogenic climate-forcing agents. Water vapor results indicate the ability of these retrievals to distinguish between methane and water vapor despite spectral interference in the shortwave infrared. We focus on selected cases from anthropogenic and natural sources, including emissions from mine ventilation shafts, a gas processing plant, tank, pipeline leak, and natural seep. In addition, carbon dioxide emissions were mapped from the flue-gas stacks of two coal-fired power plants and a water vapor plume was observed from the combined sources of cooling towers and cooling ponds. Observed plumes were consistent with known and suspected emission sources verified by the true color AVIRIS-NG scenes and higher-resolution Google Earth imagery. Real-time detection and geolocation of methane plumes by AVIRIS-NG provided unambiguous identification of individual emission source locations and communication to a ground team for rapid follow-up. This permitted verification of a number of methane emission sources using a thermal camera, including a tank and buried natural gas pipeline.

  1. Airborne DOAS retrievals of methane, carbon dioxide, and water vapor concentrations at high spatial resolution: application to AVIRIS-NG

    Science.gov (United States)

    Thorpe, Andrew K.; Frankenberg, Christian; Thompson, David R.; Duren, Riley M.; Aubrey, Andrew D.; Bue, Brian D.; Green, Robert O.; Gerilowski, Konstantin; Krings, Thomas; Borchardt, Jakob; Kort, Eric A.; Sweeney, Colm; Conley, Stephen; Roberts, Dar A.; Dennison, Philip E.

    2017-10-01

    At local scales, emissions of methane and carbon dioxide are highly uncertain. Localized sources of both trace gases can create strong local gradients in its columnar abundance, which can be discerned using absorption spectroscopy at high spatial resolution. In a previous study, more than 250 methane plumes were observed in the San Juan Basin near Four Corners during April 2015 using the next-generation Airborne Visible/Infrared Imaging Spectrometer (AVIRIS-NG) and a linearized matched filter. For the first time, we apply the iterative maximum a posteriori differential optical absorption spectroscopy (IMAP-DOAS) method to AVIRIS-NG data and generate gas concentration maps for methane, carbon dioxide, and water vapor plumes. This demonstrates a comprehensive greenhouse gas monitoring capability that targets methane and carbon dioxide, the two dominant anthropogenic climate-forcing agents. Water vapor results indicate the ability of these retrievals to distinguish between methane and water vapor despite spectral interference in the shortwave infrared. We focus on selected cases from anthropogenic and natural sources, including emissions from mine ventilation shafts, a gas processing plant, tank, pipeline leak, and natural seep. In addition, carbon dioxide emissions were mapped from the flue-gas stacks of two coal-fired power plants and a water vapor plume was observed from the combined sources of cooling towers and cooling ponds. Observed plumes were consistent with known and suspected emission sources verified by the true color AVIRIS-NG scenes and higher-resolution Google Earth imagery. Real-time detection and geolocation of methane plumes by AVIRIS-NG provided unambiguous identification of individual emission source locations and communication to a ground team for rapid follow-up. This permitted verification of a number of methane emission sources using a thermal camera, including a tank and buried natural gas pipeline.

  2. New 2D adaptive mesh refinement algorithm based on conservative finite-differences with staggered grid

    Science.gov (United States)

    Gerya, T.; Duretz, T.; May, D. A.

    2012-04-01

    We present new 2D adaptive mesh refinement (AMR) algorithm based on stress-conservative finite-differences formulated for non-uniform rectangular staggered grid. The refinement approach is based on a repetitive cell splitting organized via a quad-tree construction (every parent cell is split into 4 daughter cells of equal size). Irrespective of the level of resolution every cell has 5 staggered nodes (2 horizontal velocities, 2 vertical velocities and 1 pressure) for which respective governing equations, boundary conditions and interpolation equations are formulated. The connectivity of the grid is achieved via cross-indexing of grid cells and basic nodal points located in their corners: four corner nodes are indexed for every cell and up to 4 surrounding cells are indexed for every node. The accuracy of the approach depends critically on the formulation of the stencil used at the "hanging" velocity nodes located at the boundaries between different levels of resolution. Most accurate results are obtained for the scheme based on the volume flux balance across the resolution boundary combined with stress-based interpolation of velocity orthogonal to the boundary. We tested this new approach with a number of 2D variable viscosity analytical solutions. Our tests demonstrate that the adaptive staggered grid formulation has convergence properties similar to those obtained in case of a standard, non-adaptive staggered grid formulation. This convergence is also achieved when resolution boundary crosses sharp viscosity contrast interfaces. The convergence rates measured are found to be insensitive to scenarios when the transition in grid resolution crosses sharp viscosity contrast interfaces. We compared various grid refinement strategies based on distribution of different field variables such as viscosity, density and velocity. According to these tests the refinement allows for significant (0.5-1 order of magnitude) increase in the computational accuracy at the same

  3. Scaling up the diversity-resilience relationship with trait databases and remote sensing data: the recovery of productivity after wildfire.

    Science.gov (United States)

    Spasojevic, Marko J; Bahlai, Christie A; Bradley, Bethany A; Butterfield, Bradley J; Tuanmu, Mao-Ning; Sistla, Seeta; Wiederholt, Ruscena; Suding, Katharine N

    2016-04-01

    Understanding the mechanisms underlying ecosystem resilience - why some systems have an irreversible response to disturbances while others recover - is critical for conserving biodiversity and ecosystem function in the face of global change. Despite the widespread acceptance of a positive relationship between biodiversity and resilience, empirical evidence for this relationship remains fairly limited in scope and localized in scale. Assessing resilience at the large landscape and regional scales most relevant to land management and conservation practices has been limited by the ability to measure both diversity and resilience over large spatial scales. Here, we combined tools used in large-scale studies of biodiversity (remote sensing and trait databases) with theoretical advances developed from small-scale experiments to ask whether the functional diversity within a range of woodland and forest ecosystems influences the recovery of productivity after wildfires across the four-corner region of the United States. We additionally asked how environmental variation (topography, macroclimate) across this geographic region influences such resilience, either directly or indirectly via changes in functional diversity. Using path analysis, we found that functional diversity in regeneration traits (fire tolerance, fire resistance, resprout ability) was a stronger predictor of the recovery of productivity after wildfire than the functional diversity of seed mass or species richness. Moreover, slope, elevation, and aspect either directly or indirectly influenced the recovery of productivity, likely via their effect on microclimate, while macroclimate had no direct or indirect effects. Our study provides some of the first direct empirical evidence for functional diversity increasing resilience at large spatial scales. Our approach highlights the power of combining theory based on local-scale studies with tools used in studies at large spatial scales and trait databases to

  4. The first 3D malonate bridged copper [Cu(O2C–CH2–CO2H)2·2H2O]: Structure, properties and electronic structure

    International Nuclear Information System (INIS)

    Seguatni, A.; Fakhfakh, M.; Smiri, L.S.; Gressier, P.; Boucher, F.; Jouini, N.

    2012-01-01

    A new inorganic-organic compound [Cu(O 2 C–CH 2 –CO 2 H) 2 ·2H 2 O] ([Cumal]) was hydrothermally synthesized and characterized by IR spectroscopy, thermal analysis and single crystal X-ray diffraction. [Cumal] is the first three-dimensional compound existing in the system Cu(II)–malonic acid–H 2 O. Its framework is built up through carboxyl bridged copper where CuO 6 octahedra are elongated with an almost D 4h symmetry (4+2) due to the Jahn–Teller effect. The magnetic properties were studied by measuring its magnetic susceptibility in the temperature range of 2–300 K indicating the existence of weak ferromagnetic interactions. The electronic structure of [Cumal] was calculated within the density functional theory (DFT) framework. Structural features are well reproduced using DFT structural optimizations and the optical spectra, calculated within the dielectric formalism, explain very well the light blue colour of the compound. It is shown that a GGA+U approach with a U eff value of about 6 eV is necessary for a better correlation with the experiment. - Graphical abstract: [Cu(O 2 C–CH 2 –CO 2 H) 2 ·2H 2 O]: the first 3D hybrid organic–inorganic compound built up carboxyl groups. The network presents a diamond-like structure achieved via carboxyl. Highlights: ► A new organic–inorganic material with an unprecedented topology is synthesized. ► Crystallographic structure is determined using single crystal X-ray diffraction. ► Electronic structure is obtained from DFT, GGA+U calculation. ► Framework can be described as formed from CuC 4 tetrahedron sharing four corners. ► This structure can be classified as an extended diamond structure.

  5. Experimental and theoretical studies of d-dot

    International Nuclear Information System (INIS)

    Ishida, Takekazu; Fujii, Masaki; Abe, Taiji; Yamamoto, Masuo; Miki, Shigehito; Kawamata, Shuichi; Satoh, Kazuo; Yotsuya, Tsutomu; Kato, Masaru; Machida, Masahiko; Koyama, Tomio; Terashima, Takahito; Tsukui, Shigeki; Adachi, Motoaki

    2006-01-01

    We propose the idea of d-dot, where a d-wave superconducting dot is embedded in s-wave matrix. Spontaneous half vortices should appear in the four corners of the d-dot [M. Kato, M. Ako, M. Machida, T. Koyama, T. Ishida, Physica C 412-414 (2004) 352; M. Ako, M. Kato, M. Machida, T. Koyama, T. Ishida, Physica C 412-414 (2004) 544; M. Fujii, T. Abe, H. Yoshikawa, S. Miki, S. Kawamata, K. Satoh, T. Yotsuya, M. Kato, M. Machida, T. Koyama, T. Terashima, S. Tsukui, M. Adachi, T. Ishida, Physica C 426-431 (2005) 104]. Symmetric geometry and the fourfold symmetry of the d-dot would be suitable as a building block for constructing the novel physical systems. The phase dynamics of a closed 0-π junction, which can be realized in a small d x 2 -y 2 -dot, is mapped on a quantum two-level system when the system size is small enough. Using two-component Ginzburg-Landau equation, we study the physical properties of d-dots systematically. We prepare epitaxial YBa 2 Cu 3 O 7 (YBCO) films of thickness 100nm on SrTiO 3 substrates using a laser ablation apparatus. The d-dot is fabricated by a photolithography, electron beam lithography EB and an electron cyclotron resonance (ECR) etching, a focused ion beam microscope, and a lift-off technique. Local vortex profile is investigated using a SQUID microscope when d-dot is cooled in zero field

  6. Impact of climate change and El Niño episodes on droughts in sub-Saharan Africa

    Science.gov (United States)

    Gizaw, Mesgana Seyoum; Gan, Thian Yew

    2017-07-01

    Various drought prone regions of sub-Saharan Africa (SSAF) have been affected by severe droughts in recent decades and centuries, which had caused catastrophic humanitarian crisis. In this study, the Palmer Drought Severity Index was used to analyse changes in drought characteristics of SSAF during 1971-2000 and the Representative Concentration Pathways (RCP4.5 and RCP8.5) climate projections of selected GCMs (Global Climate Models) for the 2041-2070 (2050s) and 2071-2100 (2080s) periods. The results show that most areas in South Africa (SA) and West Africa (WA) will shift to a drier climate in the 2050 and 2080s. However, some areas in Greater Horn of Africa (GHA) are expected to be relatively wetter in the 2050 and 2080s whereas very little change is projected in the average drought severity of Central Africa (CA). The frequency of short (6-12 months) and long (above 12 months) drought events also increased on average by 5 %. However, a 1-6 % decrease in the average duration of long drought periods was projected during the 2050 and 2080s likely due to the increase in the intensity and frequency of extreme precipitation events in SSAF. An increase in the frequency of El Niño episodes under a warmer twentyfirst century climate is also expected to increase the drought prone regions of WA, SA and particularly GHA while CA still remains virtually unaffected. Overall, the results suggest that SSAF will experience a drier climate in the 2050 and 2080s with an increase in drought prone areas in the four corners of the sub-continent.

  7. Bright field electron microscopy of biological specimens

    International Nuclear Information System (INIS)

    Johansen, B.V.

    1976-01-01

    A preirradiation procedure is described which preserves negatively stained morphological features in bright field electron micrographs to a resolution of about 1.2 nm. Prior to microscopy the pre-irradiation dose (1.6 x 10 -3 C cm -2 ) is given at low electron optical magnification at five different areas on the grid (the centre plus four 'corners'). This pre-irradiation can be measured either with a Faraday cage or through controlled exposure-developing conditions. Uranyl formate stained T2 bacteriophages and stacked disk aggregates of Tobacco Mosaic Virus (TMV) protein served as test objects. A comparative study was performed on specimens using either the pre-irradiation procedure or direct irradiation by the 'minimum beam exposure' technique. Changes in the electron diffraction pattern of the stain-protein complex and the disappearance of certain morphological features in the specimens were both used in order to compare the pre-irradiation method with the direct exposure technique. After identical electron exposures the pre-irradiation approach gave a far better preservation of specimen morphology. Consequently this procedure gives the microscopist more time to select and focus appropriate areas for imaging before deteriorations take place. The investigation also suggested that microscopy should be carried out between 60,000 and 100,000 times magnification. Within this magnification range, it is possible to take advantage of the phase contrast transfer characteristics of the objective lens while the electron load on the object is kept at a moderate level. Using the pre-irradiation procedure special features of the T2 bacteriophage morphology could be established. (author)

  8. Agility performance in athletes of different sport specializations

    Directory of Open Access Journals (Sweden)

    Erika Zemková

    2014-09-01

    Full Text Available Background: Data on agility skills in different populations using pre-planned, change of direction speed tests have previously been reported. However, there are no available data on the agility times of athletes specializing in different sports obtained from Reactive agility tests. Objective: The study compares agility time in groups of athletes of different sports where agility is one of the limiting factors of performance. Methods: Altogether 282 athletes of 14 sport specializations performed the Agility test. Their task was to touch, as fast as possible, with either the left or the right foot, one of four mats located outside each of the four corners of a 0.8 m square. The mats had to be touched in accordance with the location of a stimulus in one of the corners of a screen. The test consisted of 60 visual stimuli with random generation of their location on the screen and a time of generation of 500 to 2,500 ms. The result was a sum of the 32 best agility times. Results: The Agility test has been found to be sensitive in distinguishing groups of athletes of different sport specializations. Table tennis players, badminton players, fencers, tae-kwon-do competitors and karate competitors showed the best agility times (< 350 ms, followed by ice-hockey, tennis, soccer, volleyball, basketball, and hockeyball players (350-400 ms, then aikidoists (400-450 ms, and finally judoists and wrestlers (450-500 ms. Conclusions: The best agility times are in athletes of racquet sports, followed by competitors of combat sports with reactions to visual stimuli, then players of ball sports, and finally competitors of combat sports with reactions to tactile stimuli. Since this is the first study testing agility skills using the Reactive agility test in athletes of different sport specializations, data obtained can be used for comparison of athletes within particular sports.

  9. Groundwater Flow Model of the General Separations Area Using PORFLOW

    International Nuclear Information System (INIS)

    FLACH, GREGORY

    2004-01-01

    The E Area PA (McDowell-Boyer et al. 2000) includes a steady-state simulation of groundwater flow in the General Separations Area as a prerequisite for saturated zone contaminant transport analyses. The groundwater flow simulations are based on the FACT code (Hamm and Aleman2000). The FACT-based GSA model was selected during preparation of the original PA to take advantage of an existing model developed for environmental restoration applications at the SRS (Flach and Harris 1997, 1999; Flach 1999). The existing GSA/FACT model was then slightly modified for PA use, as described in the PA document. FACT is a finite-element code utilizing deformed brick elements. Material properties are defined at element centers, and state variables such as hydraulic head are located at element vertices. The PORFLOW code (Analytic and Computational Research, Inc. 2000) was selected for performing saturated zone transport simulations of source zone radionuclides and their progeny. PORFLOW utilizes control volume discretization and the nodal point integration method, with all properties and state variables being defined at the center of an interior grid cell. The groundwater flow calculation includes translating the Darcy velocity field computed by FACT into a form compatible for input to PORFLOW. The FACT velocity field is defined at element vertices, whereas PORFLOW requires flux across cell faces. For the present PA, PORFLOW cell face flux is computed in a two-step process. An initial face flux is computed from FACT as an average of the normal components of Darcy velocity at the four corners. The derived flux field approximately conserves mass, but not rigorously. Thus, the flux field is subsequently perturbed to force rigorous mass conservation on a cell-by-cell basis. The undocumented process used is non-unique and can introduce significant artifacts into the final flux field

  10. Store-directed price promotions and communications strategies improve healthier food supply and demand: impact results from a randomized controlled, Baltimore City store-intervention trial.

    Science.gov (United States)

    Budd, Nadine; Jeffries, Jayne K; Jones-Smith, Jessica; Kharmats, Anna; McDermott, Ann Yelmokas; Gittelsohn, Joel

    2017-12-01

    Small food store interventions show promise to increase healthy food access in under-resourced areas. However, none have tested the impact of price discounts on healthy food supply and demand. We tested the impact of store-directed price discounts and communications strategies, separately and combined, on the stocking, sales and prices of healthier foods and on storeowner psychosocial factors. Factorial design randomized controlled trial. Twenty-four corner stores in low-income neighbourhoods of Baltimore City, MD, USA. Stores were randomized to pricing intervention, communications intervention, combined pricing and communications intervention, or control. Stores that received the pricing intervention were given a 10-30 % price discount by wholesalers on selected healthier food items during the 6-month trial. Communications stores received visual and interactive materials to promote healthy items, including signage, taste tests and refrigerators. All interventions showed significantly increased stock of promoted foods v. There was a significant treatment effect for daily unit sales of healthy snacks (β=6·4, 95 % CI 0·9, 11·9) and prices of healthy staple foods (β=-0·49, 95 % CI -0·90, -0·03) for the combined group v. control, but not for other intervention groups. There were no significant intervention effects on storeowner psychosocial factors. All interventions led to increased stock of healthier foods. The combined intervention was effective in increasing sales of healthier snacks, even though discounts on snacks were not passed to the consumer. Experimental research in small stores is needed to understand the mechanisms by which store-directed price promotions can increase healthy food supply and demand.

  11. The Quality of Cost-Utility Analyses in Orthopedic Trauma.

    Science.gov (United States)

    Nwachukwu, Benedict U; Schairer, William W; O'Dea, Evan; McCormick, Frank; Lane, Joseph M

    2015-08-01

    As health care in the United States transitions toward a value-based model, there is increasing interest in applying cost-effectiveness analysis within orthopedic surgery. Orthopedic trauma care has traditionally underemphasized economic analysis. The goals of this review were to identify US-based cost-utility analysis in orthopedic trauma, to assess the quality of the available evidence, and to identify cost-effective strategies within orthopedic trauma. Based on a review of 971 abstracts, 8 US-based cost-utility analyses evaluating operative strategies in orthopedic trauma were identified. Study findings were recorded, and the Quality of Health Economic Studies (QHES) instrument was used to grade the overall quality. Of the 8 studies included in this review, 4 studies evaluated hip and femur fractures, 3 studies analyzed upper extremity fractures, and 1 study assessed open tibial fracture management. Cost-effective interventions identified in this review include total hip arthroplasty (over hemiarthroplasty) for femoral neck fractures in the active elderly, open reduction and internal fixation (over nonoperative management) for distal radius and scaphoid fractures, limb salvage (over amputation) for complex open tibial fractures, and systems-based interventions to prevent delay in hip fracture surgery. The mean QHES score of the studies was 79.25 (range, 67-89). Overall, there is a paucity of cost-utility analyses in orthopedic trauma; however, the available evidence suggests that certain operative interventions can be cost-effective. The quality of these studies, however, is fair, based on QHES grading. More attention should be paid to evaluating the cost-effectiveness of operative intervention in orthopedic trauma. Copyright 2015, SLACK Incorporated.

  12. Automatic generation of statistical pose and shape models for articulated joints.

    Science.gov (United States)

    Xin Chen; Graham, Jim; Hutchinson, Charles; Muir, Lindsay

    2014-02-01

    Statistical analysis of motion patterns of body joints is potentially useful for detecting and quantifying pathologies. However, building a statistical motion model across different subjects remains a challenging task, especially for a complex joint like the wrist. We present a novel framework for simultaneous registration and segmentation of multiple 3-D (CT or MR) volumes of different subjects at various articulated positions. The framework starts with a pose model generated from 3-D volumes captured at different articulated positions of a single subject (template). This initial pose model is used to register the template volume to image volumes from new subjects. During this process, the Grow-Cut algorithm is used in an iterative refinement of the segmentation of the bone along with the pose parameters. As each new subject is registered and segmented, the pose model is updated, improving the accuracy of successive registrations. We applied the algorithm to CT images of the wrist from 25 subjects, each at five different wrist positions and demonstrated that it performed robustly and accurately. More importantly, the resulting segmentations allowed a statistical pose model of the carpal bones to be generated automatically without interaction. The evaluation results show that our proposed framework achieved accurate registration with an average mean target registration error of 0.34 ±0.27 mm. The automatic segmentation results also show high consistency with the ground truth obtained semi-automatically. Furthermore, we demonstrated the capability of the resulting statistical pose and shape models by using them to generate a measurement tool for scaphoid-lunate dissociation diagnosis, which achieved 90% sensitivity and specificity.

  13. Anatomist and the pioneer of radiology Étienne Destot--95th anniversary of his death.

    Science.gov (United States)

    Báča, Václav; Kachlík, David; Báčová, Tereza; Bartoška, Radek; Marvan, Jiří; Douša, Pavel; Secrest, Thomas; Džupa, Valér

    2014-04-01

    Destot was a leading pioneer in radiology, a pupil of Ollier, an anatomist, and researcher who followed in the experimental medicine tradition of Claude Bérnard. This work is an extensive, in depth, look at the life and work of Étienne Destot. On February 5, 1896, he began performing X-ray examinations, less than two months after Roentgen's discovery! His pioneering work described a space bordered by the hamate, capitate, triquetrum, and lunate; this space is now known as Destot's space. Tanton stated that Destot was the first to reveal the mechanism of fractures of the posterior margin of the distal tibia and to emphasize their clinical relevance; in honor of this contribution, Tanton named such a fracture the “fracture of Destot.” Moreover, Destot is credited with being the first physician to use the term “pilon” in the orthopedic literature. He first described fractures of the scaphoid in 1905. He also described superficial hematomas, Destot's sign, located above the inguinal ligament or in the scrotum or thigh. Such hematomas are indicative of pelvic fractures. Destot is credited with inventing or improving many pieces of medical equipment (e.g., Lambotte's screw plates, anastomotic boutons for the digestive tube, monopolar endocavital radiological tubes). He was also active in developing technical aspects of equipment (e.g., radioscopic examination of the heart, a prototype of the mobile radiological laboratory). Étienne Destot is best known as a radiologist; however, his influence extends well beyond this field. He was an anatomist and surgeon, the founder of radiology in Lyon, prosector, physician, electrician, researcher, and artist.

  14. The Prevalence of Unanticipated Hamate Hook Abnormalities in Computed Tomography Scans: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Silke A. Spit

    2017-05-01

    Full Text Available Background:It is possible that some hamate hook fractures are not diagnosed or treated, thereby affecting the study of their natural history. Study of the prevalence of incidental hamate hook fractures, nonunions, and other abnormalities on computed tomography (CT ordered for another reason could document a subset of undiagnosed and untreated hamate hook fractures which might change our understanding about the natural history.Methods: Reports of 2489 hand, wrist, and forearm CT scans for hamate hook abnormalities were searched. We excluded 19 patients with anticipated hamate fractures and 1 patient that had a hamate hook excision. Twenty-eight patients had an unanticipated hamate hook abnormality.Results: There was a significant difference in the prevalence of incidental hamate hook abnormalities by sex but not by age. Among the 28 unexpected hamate hook abnormalities, there were 16 fractures of the base (12 acute, 1 nonunion, and 3 of uncertain age, 5 acute oblique fractures, and 7 tip abnormalities/ossicles. The patient with an incidental nonunion had a CT scan for wrist pain and was diagnosed with gout.All fractures involved a direct blow to the hand (distal radius or scaphoid fracture, or crush injury. The 7 patients with a hamate tip abnormality had a CT scan for a distal radius or metacarpal fracture, crush injury or wrist pain. Five acute fractures were treated operatively with excision and the other 23 fractures were treated nonoperatively.Conclusion: Hamate fractures can be diagnosed incidental to other hand and wrist problems on CT.

  15. A novel method to replicate the kinematics of the carpus using a six degree-of-freedom robot.

    Science.gov (United States)

    Fraysse, François; Costi, John J; Stanley, Richard M; Ding, Boyin; McGuire, Duncan; Eng, Kevin; Bain, Gregory I; Thewlis, Dominic

    2014-03-21

    Understanding the kinematics of the carpus is essential to the understanding and treatment of wrist pathologies. However, many of the previous techniques presented are limited by non-functional motion or the interpolation of points from static images at different postures. We present a method that has the capability of replicating the kinematics of the wrist during activities of daily living using a unique mechanical testing system. To quantify the kinematics of the carpal bones, we used bone pin-mounted markers and optical motion capture methods. In this paper, we present a hammering motion as an example of an activity of daily living. However, the method can be applied to a wide variety of movements. Our method showed good accuracy (1.0-2.6°) of in vivo movement reproduction in our ex vivo model. Most carpal motion during wrist flexion-extension occurs at the radiocarpal level while in ulnar deviation the motion is more equally shared between radiocarpal and midcarpal joints, and in radial deviation the motion happens mainly at the midcarpal joint. For all rotations, there was more rotation of the midcarpal row relative to the lunate than relative to the scaphoid or triquetrum. For the functional motion studied (hammering), there was more midcarpal motion in wrist extension compared to pure wrist extension while radioulnar deviation patterns were similar to those observed in pure wrist radioulnar deviation. Finally, it was found that for the amplitudes studied the amount of carpal rotations was proportional to global wrist rotations. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Surgeon-Based 3D Printing for Microvascular Bone Flaps.

    Science.gov (United States)

    Taylor, Erin M; Iorio, Matthew L

    2017-07-01

    Background  Three-dimensional (3D) printing has developed as a revolutionary technology with the capacity to design accurate physical models in preoperative planning. We present our experience in surgeon-based design of 3D models, using home 3D software and printing technology for use as an adjunct in vascularized bone transfer. Methods  Home 3D printing techniques were used in the design and execution of vascularized bone flap transfers to the upper extremity. Open source imaging software was used to convert preoperative computed tomography scans and create 3D models. These were printed in the surgeon's office as 3D models for the planned reconstruction. Vascularized bone flaps were designed intraoperatively based on the 3D printed models. Results  Three-dimensional models were created for intraoperative use in vascularized bone flaps, including (1) medial femoral trochlea (MFT) flap for scaphoid avascular necrosis and nonunion, (2) MFT flap for lunate avascular necrosis and nonunion, (3) medial femoral condyle (MFC) flap for wrist arthrodesis, and (4) free fibula osteocutaneous flap for distal radius septic nonunion. Templates based on the 3D models allowed for the precise and rapid contouring of well-vascularized bone flaps in situ, prior to ligating the donor pedicle. Conclusions  Surgeon-based 3D printing is a feasible, innovative technology that allows for the precise and rapid contouring of models that can be created in various configurations for pre- and intraoperative planning. The technology is easy to use, convenient, and highly economical as compared with traditional send-out manufacturing. Surgeon-based 3D printing is a useful adjunct in vascularized bone transfer. Level of Evidence  Level IV. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  17. Digital Tomosynthesis to Evaluate Fracture Healing: Prospective Comparison With Radiography and CT.

    Science.gov (United States)

    Ha, Alice S; Lee, Amie Y; Hippe, Daniel S; Chou, Shinn-Huey S; Chew, Felix S

    2015-07-01

    Radiography, currently the standard for postoperative fracture imaging, is limited by overlapping bone and hardware. Tomosynthesis has the benefit of level-by-level imaging without the disadvantages of metal artifacts, increased radiation, and higher costs of CT, the current problem-solving tool. The purpose of this study was to compare tomosynthesis with radiography for evaluating fracture healing. In a prospective study, patients within 1 year of wrist hardware fixation underwent radiography, tomosynthesis, and CT, and the images were interpreted by three readers. The diagnostic accuracy of radiology and tomosynthesis was assessed with ROC curves, and interreader agreement was assessed with Cohen kappa. Fracture scores were correlated with Disabilities of the Arm, Shoulder, and Hand (DASH) and pain scores. The study participants were 49 patients with 51 fractures. The most common fracture sites were distal radius (43%), scaphoid (18%), and metacarpals (18%). Rates of cortex obscuration by hardware were 2% for CT, 8% for tomosynthesis, and 15% for radiography (p tomosynthesis than with radiography (AUC, 0.84 vs 0.76, p = 0.01). Inter-reader agreement was moderate for both radiography and tomosynthesis (κ = 0.44 vs 0.55, p = 0.051). There was no significant correlation between fracture scores and DASH scores. There was significant correlation between reported pain levels and both tomosynthesis (r = 0.28, p = 0.03) and CT (r = 0.29, p = 0.04) fracture scores. Tomosynthesis provides diagnostic information superior to that of ra diography in postoperative evaluation of wrist fractures with lower cost and radiation than CT and should be considered in fracture follow-up imaging of other bones.

  18. Abductor pollicis longus tendon interposition for arthrosis of the first carpo-metacarpal joint. Long-term results.

    Science.gov (United States)

    Lied, Line; Bjørnstad, Kari; Woje, Ann K N; Finsen, Vilhjalmur

    2016-02-01

    We performed an interposition arthroplasty using the abductor pollicis longus tendon for arthrosis in the basal joint of the thumb that needed surgery from 1995 to 2010. In 2001 47 patients (55 thumbs) were reviewed after 3.5 (1-5) years. The pain relief was excellent in 32 thumbs, and 25 patients improved their ability to perform daily tasks. Mobility was well preserved. Key pinch and grip strengths averaged 78% and 89%, respectively, of those in unaffected hands. We have now re-examined all 33 available patients (36 thumbs) 11-14 years after surgery. Fourty one of the originally examined patients were still alive. Seven were too ill to attend a follow-up and one refused. The remainder were examined in a fashion as similar as possible to that at the original review. The patients' subjective estimations of pain during the last week and satisfaction with the cosmetic and general results were recorded on visual analogue scales. The patients' ability to perform various activities of daily living were recorded and they completed the Disability of the arm, shoulder and hand (DASH) questionnaire. The mobility of the wrist and abduction of the thumb of the operated hands were recorded with a goniometer. Grip and pinch strength were measured and new radiographs were obtained. Key pinch strength had increased significantly over the last 10 years. The mobility was still good, except for thumb abduction, which had decreased with time. The median DASH score had fallen from 28 to 20 between the two reviews. There was insignificant further median loss of distance between the scaphoid and the metacarpal since the earlier review. The good results of this procedure found soon after surgery are maintained long-term.

  19. Long-term results of bone-retinaculum-bone autograft for scapholunate instability.

    Science.gov (United States)

    Soong, Maximillian; Merrell, Gregory A; Ortmann, Fred; Weiss, Arnold-Peter C

    2013-03-01

    To report long-term follow-up of scapholunate interosseous ligament reconstruction with bone-retinaculum-bone autograft in patients with dynamic scapholunate instability. Of the 14 patients from the previously reported cohort who had bone-retinaculum-bone autograft for dynamic instability, 6 returned for clinical examination and radiographs, 3 were reached by telephone, and 2 were lost to follow-up. The remaining 3 had salvage procedures (2 total wrist arthrodeses and 1 proximal row carpectomy) between the prior report and the current study and thus reached an endpoint, at 2 to 4 years. For the 6 who returned, outcome measurements included scapholunate angle and gap, radiographic evidence of secondary arthritis, wrist extension and flexion, grip strength, and Mayo wrist score. Follow-up averaged 11.9 years (range, 10.7-14.1 y). Clinical and radiographic outcomes deteriorated moderately from the prior report. Mayo wrist score averaged 83. There were 3 failures, resulting in 1 proximal row carpectomy and 2 total wrist arthrodeses. Findings at repeat surgery in the failed group included an intact graft without any apparent abnormalities, a partially ruptured graft (after a subsequent re-injury), and a completely resorbed graft. Bone-retinaculum-bone autograft reconstruction is a viable treatment option for dynamic scapholunate instability in which the scaphoid and lunate can be reduced. Results may deteriorate but are similar to those reported previously from other techniques. Problems with graft strength or stiffness may necessitate further surgery. Copyright © 2013 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  20. Preoperative CT planning of screw length in arthroscopic Latarjet.

    Science.gov (United States)

    Hardy, Alexandre; Gerometta, Antoine; Granger, Benjamin; Massein, Audrey; Casabianca, Laurent; Pascal-Moussellard, Hugues; Loriaut, Philippe

    2018-01-01

    The Latarjet procedure has shown its efficiency for the treatment of anterior shoulder dislocation. The success of this technique depends on the correct positioning and fusion of the bone block. The length of the screws that fix the bone block can be a problem. They can increase the risk of non-union if too short or be the cause of nerve lesion or soft tissue discomfort if too long. Suprascapular nerve injuries have been reported during shoulder stabilisation surgery up to 6 % of the case. Bone block non-union depending on the series is found around 20 % of the cases. The purpose of this study was to evaluate the efficiency of this CT preoperative planning to predict optimal screws length. The clinical importance of this study lies in the observation that it is the first study to evaluate the efficiency of CT planning to predict screw length. Inclusion criteria were patients with chronic anterior instability of the shoulder with an ISIS superior to 4. Exclusion criteria were patients with multidirectional instability or any previous surgery on this shoulder. Thirty patients were included prospectively, 11 of them went threw a CT planning, before their arthroscopic Latarjet. Optimal length of both screws was calculated, adding the size of the coracoid at 5 and 15 mm from the tip to the glenoid. Thirty-two-mm screws were used for patients without planning. On a post-operative CT scan with 3D reconstruction, the distance between the screw tip and the posterior cortex was measured. A one-sample Wilcoxon test was used to compare the distance from the tip of the screw to an acceptable positioning of ±2 mm from the posterior cortex. In the group without planning, screw 1 tended to differ from the acceptable positioning: mean 3.44 mm ± 3.13, med 2.9 mm, q1; q3 [0.6; 4.75] p = 0.1118, and screw 2 differed significantly from the acceptable position: mean 4.83 mm ± 4.11, med 3.7 mm, q1; q3 [1.7; 5.45] p = 0.0045. In the group with planning, position of

  1. The long-term functional outcome of type II odontoid fractures managed non-operatively.

    LENUS (Irish Health Repository)

    Butler, J S

    2010-10-01

    Odontoid fractures currently account for 9-15% of all adult cervical spine fractures, with type II fractures accounting for the majority of these injuries. Despite recent advances in internal fixation techniques, the management of type II fractures still remains controversial with advocates still supporting non-rigid immobilization as the definitive treatment of these injuries. At the NSIU, over an 11-year period between 1 July 1996 and 30 June 2006, 66 patients (n = 66) were treated by external immobilization for type II odontoid fractures. The medical records, radiographs and CT scans of all patients identified were reviewed. Clinical follow-up evaluation was performed using the Cervical Spine Outcomes Questionnaire (CSOQ). The objectives of this study were to evaluate the long-term functional outcome of patients suffering isolated type II odontoid fractures managed non-operatively and to correlate patient age and device type with clinical and functional outcome. Of the 66 patients, there were 42 males and 24 females (M:F = 1.75:1) managed non-operatively for type II odontoid fractures. The mean follow-up time was 66 months. Advancing age was highly correlated with poorer long-term functional outcomes when assessing neck pain (r = 0.19, P = 0.1219), shoulder and arm pain (r = 0.41, P = 0.0007), physical symptoms (r = 0.25, P = 0.472), functional disability (r = 0.24, P = 0.0476) and psychological distress (r = 0.41, P = 0.0007). Patients >65 years displayed a higher rate of pseudoarthrosis (21.43 vs. 1.92%) and established non-union (7.14 vs. 0%) than patients <65 years. The non-operative management of type II odontoid fractures is an effective and satisfactory method of treating type II odontoid fractures, particularly those of a stable nature. However, patients of advancing age have been demonstrated to have significantly poorer functional outcomes in the long term. This may be linked to higher rates of non-union.

  2. [Use of the induced membrane technique for the treatment of bone defects in the hand or wrist, in emergency].

    Science.gov (United States)

    Flamans, B; Pauchot, J; Petite, H; Blanchet, N; Rochet, S; Garbuio, P; Tropet, Y; Obert, L

    2010-10-01

    A prospective study is reported concerning 11 cases of bone defect of the hand and wrist treated by the induced membrane technique. Ten men and one woman with an average age of 49 yrs (17-72) sustained a high-energy trauma with severe mutilation of digit and hand but with intact pulp. Eight cases of open finger fractures with composite loss of substance and three cases of bone and joint infection (thumb, wrist, fifth finger) were included. All cases were treated by the induced membrane technique which consists in stable fixation, flap if necessary, and in filling the bone defect by a cement methyl methacrylate polymere (PMMA) spacer. A secondary procedure at two months is needed where the cement is removed and the void is filled by cancellous bone. The key point of this induced membrane technique is to respect the foreign body membrane which formed around the cement spacer creating a biologic chamber. Bone union was evaluated prospectively by X-ray and CT scan by a surgeon not involved in the treatment. Failure was defined as non-union at one year, or uncontrolled sepsis at one month. Two cases failed to achieve bone union. No septic complications occurred and all septic cases were controlled. In nine cases, bone union was achieved within four months (three to 12). Evidence of osteoid formation was determined by a bone biopsy in one case. Masquelet first reported 35 cases of large tibial non-union defects treated by the induced membrane technique. The cement spacer promotes foreign body membrane induction constituting a biological chamber. Works on animal models reported by Pellissier and Viateau demonstrated membrane properties: secretion of growths factors (VEGF, TGF beta1, BMP2) and osteoinductive cellular activity. The induced membrane seems to mimic a neoperiosteum. This technique is useful in emergency or septic conditions where bone defects cannot be treated by shortening. It avoids microsurgery and is limited by availability of cancellous bone. Copyright

  3. Salvage procedures in lower-extremity trauma in a child with hereditary motor and sensory neuropathy type I: a case report

    Directory of Open Access Journals (Sweden)

    Gothner Martin

    2012-09-01

    Full Text Available Abstract Introduction Fractures of the lower extremity are a common type of childhood injury and many can be treated without surgery. Dislocated and open fractures are an indication for fracture stabilization via either intramedullary nailing or, in the case of complicated fractures, external fixation. But if complications are likely because of diseases and disabilities (for example, a neuropathy that can complicate the post-operative procedure and rehabilitation, what options does one have? Case presentation We report a nine-year-old Caucasian girl who had hereditary motor and sensory neuropathy type I and who was admitted with a grade I open tibia fracture after a fall from a small height. Plain radiographs showed a dislocated tibia and fibula fracture. An open reduction with internal fixation with a compression plate osteosynthesis was performed, and soft tissue debridement combined with an external fixateur was undertaken. Three months later, she was re-admitted with localized swelling and signs of a local soft tissue infection in the middle of her tibia. Plain radiographs showed a non-union of the tibia fracture, and microbiological analysis confirmed a wound infection with cefuroxime-sensitive Staphylococcus aureus. Because of the non-union, the osteosynthesis was replaced with an Ilizarov external fixateur, and appropriate antibiotic therapy was initiated. Four months after the initial accident, the fracture was consolidated and we removed the external fixateur. Conclusions If there is a pre-existing neuropathy and if disease makes it difficult for a child to follow all post-operative instructions, salvage procedures should be kept in mind in case of complications. There are multiple therapeutic options, including osteosynthesis, intramedullary nailing systems, cast therapy, or an external fixateur like the Ilizarov or Taylor spatial frame system. The initial use of an external fixateur such as an Ilizarov or Taylor spatial frame in

  4. Displaced midshaft fractures of the clavicle: non-operative treatment versus plate fixation (Sleutel-TRIAL. A multicentre randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Vos Dagmar I

    2011-08-01

    Full Text Available Abstract Background The traditional view that the vast majority of midshaft clavicular fractures heal with good functional outcomes following non-operative treatment may be no longer valid for all midshaft clavicular fractures. Recent studies have presented a relatively high incidence of non-union and identified speciic limitations of the shoulder function in subgroups of patients with these injuries. Aim A prospective, multicentre randomised controlled trial (RCT will be conducted in 21 hospitals in the Netherlands, comparing fracture consolidation and shoulder function after either non-operative treatment with a sling or a plate fixation. Methods/design A total of 350 patients will be included, between 18 and 60 years of age, with a dislocated midshaft clavicular fracture. The primary outcome is the incidence of non-union, which will be determined with standardised X-rays (Antero-Posterior and 30 degrees caudocephalad view. Secondary outcome will be the functional outcome, measured using the Constant Score. Strength of the shoulder muscles will be measured with a handheld dynamometer (MicroFET2. Furthermore, the health-related Quality of Life score (ShortForm-36 and the Disabilities of Arm, Shoulder and Hand (DASH Outcome Measure will be monitored as subjective parameters. Data on complications, bone union, cosmetic aspects and use of painkillers will be collected with follow-up questionnaires. The follow-up time will be two years. All patients will be monitored at regular intervals over the subsequent twelve months (two and six weeks, three months and one year. After two years an interview by telephone and a written survey will be performed to evaluate the two-year functional and mechanical outcomes. All data will be analysed on an intention-to-treat basis, using univariate and multivariate analyses. Discussion This trial will provide level-1 evidence for the comparison of consolidation and functional outcome between two standardised

  5. The first 3D malonate bridged copper [Cu(O{sub 2}C-CH{sub 2}-CO{sub 2}H){sub 2}{center_dot}2H{sub 2}O]: Structure, properties and electronic structure

    Energy Technology Data Exchange (ETDEWEB)

    Seguatni, A., E-mail: seguatni@gmail.com [LBPC-INSERM U 698, Institut Galilee, Universite Paris XIII, 99, avenue J. B. Clement 93430, Villetaneuse (France); Fakhfakh, M. [Unite de recherche UR 12-30, Synthese et Structure de Materiaux Inorganiques, Faculte des Sciences de Bizerte, 7021 Zarzouna (Tunisia); Departement de Chimie, Universite du Quebec a Montreal, C.P. 8888, Succ. Centre-ville, Montreal, Que., H3C 3P8 (Canada); Smiri, L.S. [Unite de recherche UR 12-30, Synthese et Structure de Materiaux Inorganiques, Faculte des Sciences de Bizerte, 7021 Zarzouna (Tunisia); Gressier, P.; Boucher, F. [Institut des Materiaux Jean Rouxel, Universite de Nantes, CNRS, 2 rue de la Houssiniere, BP 32229, 44322 Nantes Cedex 3 (France); Jouini, N. [Departement de Chimie, Universite du Quebec a Montreal, C.P. 8888, Succ. Centre-ville, Montreal, Que., H3C 3P8 (Canada)

    2012-03-15

    A new inorganic-organic compound [Cu(O{sub 2}C-CH{sub 2}-CO{sub 2}H){sub 2}{center_dot}2H{sub 2}O] ([Cumal]) was hydrothermally synthesized and characterized by IR spectroscopy, thermal analysis and single crystal X-ray diffraction. [Cumal] is the first three-dimensional compound existing in the system Cu(II)-malonic acid-H{sub 2}O. Its framework is built up through carboxyl bridged copper where CuO{sub 6} octahedra are elongated with an almost D{sub 4h} symmetry (4+2) due to the Jahn-Teller effect. The magnetic properties were studied by measuring its magnetic susceptibility in the temperature range of 2-300 K indicating the existence of weak ferromagnetic interactions. The electronic structure of [Cumal] was calculated within the density functional theory (DFT) framework. Structural features are well reproduced using DFT structural optimizations and the optical spectra, calculated within the dielectric formalism, explain very well the light blue colour of the compound. It is shown that a GGA+U approach with a U{sub eff} value of about 6 eV is necessary for a better correlation with the experiment. - Graphical abstract: [Cu(O{sub 2}C-CH{sub 2}-CO{sub 2}H){sub 2}{center_dot}2H{sub 2}O]: the first 3D hybrid organic-inorganic compound built up carboxyl groups. The network presents a diamond-like structure achieved via carboxyl. Highlights: Black-Right-Pointing-Pointer A new organic-inorganic material with an unprecedented topology is synthesized. Black-Right-Pointing-Pointer Crystallographic structure is determined using single crystal X-ray diffraction. Black-Right-Pointing-Pointer Electronic structure is obtained from DFT, GGA+U calculation. Black-Right-Pointing-Pointer Framework can be described as formed from CuC{sub 4} tetrahedron sharing four corners. Black-Right-Pointing-Pointer This structure can be classified as an extended diamond structure.

  6. A Synchrotron Mössbauer Spectroscopy Study of a Hydrated Iron-Sulfate at High Pressures

    Science.gov (United States)

    Perez, T. M.; Finkelstein, G. J.; Solomatova, N. V.; Jackson, J. M.

    2017-12-01

    Szomolnokite is a monohydrated ferrous iron sulfate mineral, FeSO4*H2O, where the ferrous iron atoms are in octahedral coordination with four corners shared with SO4 and two with H2O. While somewhat rare on Earth, szomolnokite has been detected on the surface of Mars along with several other hydrated sulfates and suggested to occur near the surface of Venus [1,2]. It is not clear if these sulfates are a result of reactions occurring at depth driven by changes in the behavior of iron in the sulfate. To date, only a few high-pressure studies have been conducted on hydrated iron sulfates using Mössbauer spectroscopy. Our study represents a first step towards understanding of the electronic environment of iron in a monohydrated sulfate at pressure. Using a hydrostatic helium pressure-transmitting medium, the pressure dependence of iron's site-specific behavior in a synthetic szomolnokite powdered sample was explored up to about 100 GPa with time-resolved synchrotron Mössbauer spectroscopy at the Advanced Photon Source of Argonne National Laboratory. At 1 bar, the Mössbauer spectrum is well described by three Fe2+-like sites, consistent with conventional Mössbauer spectra reported in Dyar et al. [3]. At pressures up to 20 GPa, changes in the hyperfine parameters are most likely due to a structural phase transition. Above this pressure, a fourth site is required to explain the time-spectra. Changes in the electronic configuration of iron, such as those due to a phase transition and/or a spin crossover, will affect the material's compressibility and transport properties. We will compare our high-pressure trends with those of other iron-bearing phases and discuss the relative influence on the dynamics of terrestrial planetary interiors. 1. Bishop et al. (2014) What Lurks in the Martian Rocks and Soil? Investigations of Sulfates, Phosphates, and Perchlorates. Spectral and thermal properties of perchlorate salts and implications for Mars. Am. Min. 99(8-9), 1580

  7. Correcting bias in the rational polynomial coefficients of satellite imagery using thin-plate smoothing splines

    Science.gov (United States)

    Shen, Xiang; Liu, Bin; Li, Qing-Quan

    2017-03-01

    The Rational Function Model (RFM) has proven to be a viable alternative to the rigorous sensor models used for geo-processing of high-resolution satellite imagery. Because of various errors in the satellite ephemeris and instrument calibration, the Rational Polynomial Coefficients (RPCs) supplied by image vendors are often not sufficiently accurate, and there is therefore a clear need to correct the systematic biases in order to meet the requirements of high-precision topographic mapping. In this paper, we propose a new RPC bias-correction method using the thin-plate spline modeling technique. Benefiting from its excellent performance and high flexibility in data fitting, the thin-plate spline model has the potential to remove complex distortions in vendor-provided RPCs, such as the errors caused by short-period orbital perturbations. The performance of the new method was evaluated by using Ziyuan-3 satellite images and was compared against the recently developed least-squares collocation approach, as well as the classical affine-transformation and quadratic-polynomial based methods. The results show that the accuracies of the thin-plate spline and the least-squares collocation approaches were better than the other two methods, which indicates that strong non-rigid deformations exist in the test data because they cannot be adequately modeled by simple polynomial-based methods. The performance of the thin-plate spline method was close to that of the least-squares collocation approach when only a few Ground Control Points (GCPs) were used, and it improved more rapidly with an increase in the number of redundant observations. In the test scenario using 21 GCPs (some of them located at the four corners of the scene), the correction residuals of the thin-plate spline method were about 36%, 37%, and 19% smaller than those of the affine transformation method, the quadratic polynomial method, and the least-squares collocation algorithm, respectively, which demonstrates

  8. PCBs and PCDD/Fs in soil from informal e-waste recycling sites and open dumpsites in India: Levels, congener profiles and health risk assessment.

    Science.gov (United States)

    Chakraborty, Paromita; Selvaraj, Sakthivel; Nakamura, Masafumi; Prithiviraj, Balasubramanian; Cincinelli, Alessandra; Bang, John J

    2018-04-15

    Growth of informal electronic waste (e-waste) recycling sector is an emerging problem for India. The presence of halogenated compounds in e-wastes may result in the formation of persistent organic pollutants like polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) during recycling processes. We therefore investigated PCBs and PCDD/Fs in surface soils explicitly from the informal e-waste recycling sites and nearby open dumpsites of major metropolitan cities from four corners of India, viz., New Delhi (North), Kolkata (East), Mumbai (West) and Chennai (South). In the informal e-waste recycling sites, the range of Σ 26 PCBs (0.4-488ng/g) and ƩPCDD/Fs (1.0-10.6ng/g) were higher than Ʃ 26 PCBs (0.3-21ng/g) and ƩPCDD/Fs (0.15-7.3ng/g) from open dumpsites. In the e-waste sites, ƩPCDDs were found with increasing trend from ƩTetraCDD to OctaCDD, whereas ƩPCDFs showed a reverse trend. The dominance of PCDF congeners and maximum toxicity equivalents (TEQ) for both PCDDs (17pg TEQ/g) and PCDFs (82pg TEQ/g) at Mandoli in New Delhi has been related to intensive precious metal recovery process using acid bath. Among dumpsites, highest TEQ for PCDD/Fs was observed at Kodangaiyur dumpsite of Chennai (CN DS -02, 45pg TEQ/g). Positive Matrix Factorization (PMF) model identified distinct congener pattern based on the functional activities, such as e-waste dismantling, shredding, precious metal recovery and open burning in dumpsites. E-waste metal recovery factor was loaded with 86-91% of PCB-77, -105, -114, -118 and 30% of PCB-126, possibly associated with the burning of wires during the copper extraction process. Almost 70% of the Ʃ 26 PCB concentrations was comprised of the dioxin-like PCB congeners with a maximum concentration of 437ng/g at New Moore market in Chennai, followed by Wire Lane (102ng/g), in Mumbai. We speculate that PCB-126 might have resulted from combustion of plastic materials in e-waste stream and dumped waste

  9. Robot-assisted automatic ultrasound calibration.

    Science.gov (United States)

    Aalamifar, Fereshteh; Cheng, Alexis; Kim, Younsu; Hu, Xiao; Zhang, Haichong K; Guo, Xiaoyu; Boctor, Emad M

    2016-10-01

    Ultrasound (US) calibration is the process of determining the unknown transformation from a coordinate frame such as the robot's tooltip to the US image frame and is a necessary task for any robotic or tracked US system. US calibration requires submillimeter-range accuracy for most applications, but it is a time-consuming and repetitive task. We provide a new framework for automatic US calibration with robot assistance and without the need for temporal calibration. US calibration based on active echo (AE) phantom was previously proposed, and its superiority over conventional cross-wire phantom-based calibration was shown. In this work, we use AE to guide the robotic arm motion through the process of data collection; we combine the capability of the AE point to localize itself in the frame of the US image with the automatic motion of the robotic arm to provide a framework for calibrating the arm to the US image automatically. We demonstrated the efficacy of the automated method compared to the manual method through experiments. To highlight the necessity of frequent ultrasound calibration, it is demonstrated that the calibration precision changed from 1.67 to 3.20 mm if the data collection is not repeated after a dismounting/mounting of the probe holder. In a large data set experiment, similar reconstruction precision of automatic and manual data collection was observed, while the time was reduced by 58 %. In addition, we compared ten automatic calibrations with ten manual ones, each performed in 15 min, and showed that all the automatic ones could converge in the case of setting the initial matrix as identity, while this was not achieved by manual data sets. Given the same initial matrix, the repeatability of the automatic was [0.46, 0.34, 0.80, 0.47] versus [0.42, 0.51, 0.98, 1.15] mm in the manual case for the US image four corners. The submillimeter accuracy requirement of US calibration makes frequent data collections unavoidable. We proposed an automated

  10. Bedrock aquifers of eastern San Juan County, Utah

    Science.gov (United States)

    Avery, Charles

    1986-01-01

    This study is one of a series of studies appraising the waterbearing properties of the Navajo Sandstone and associated formations in southern Utah.  The study area is about 4,600 square miles, extending from the Utah-Arizona State line northward to the San Juan-Grand County line and westward from the Utah-Colorado State line to the longitude of about 109°50'.Some of the water-yielding formations are grouped into aquifer systems. The C aquifer is comprised of the DeChelly Sandstone Member of the Cutler Formation.  The P aquifer is comprised of the Cedar Mesa Member of the Cutler Formation and the undifferentiated Cutler Formation. The N aquifer is comprised of the sedimentary section that includes the Wingate Sandstone, Kayenta Formation, Navajo Sandstone, Carmel Formation, and Entrada sandstone.  The M aquifer is comprised of the Bluff Sandstone Member and other sandstone units of the Morrison Formation.  The D aquifer is comprised of the Burro Canyon Formation and Dakota Sandstone.  Discharge from the ground-water reservoir to the San Juan River between gaging stations at Four Corners and Mexican Hat is about 66 cubic feet per second.The N aquifer is the main aquifer in the study area. Recharge by infiltration of precipitation is estimated to be 25,000 acre-feet per year.  A major ground-water divide exists under the broad area east of Monticello.  The thickness of the N aquifer, where the sedimentary section is fully preserved and saturated, generally is 750 to 1,250 feet.   Hydraulic conductivity values obtained from aquifer tests range from 0.02 to 0.34 foot per day.  The total volume of water in transient storage is about 11 million acre-feet. Well discharge somewhat exceeded 2,340 acre-feet during 1981.  Discharge to the San Juan River from the N aquifer is estimated to be 6.9 cubic feet per second. Water quality ranges from a calcium bicarbonate to sodium chloride type water

  11. Dorsal capsulodesis associated with arthoscopy-assisted scapholunate ligament reconstruction using a palmaris longus tendon graft

    Directory of Open Access Journals (Sweden)

    Victor Bignatto Carvalho

    Full Text Available ABSTRACT OBJECTIVES: To measure the quality of life, the time to work return, and clinical, functional, and radiographic parameters of patients treated with dorsal capsulodesis associated with scapholunate (SL reconstruction, assisted by arthroscopy. METHODS: From January 2015 to September 2016, 14 adult patients with SL dissociation underwent surgical treatment with the SL reconstruction procedure assisted by arthroscopy, using the new technique proposed in this study. All patients were assessed by the occupational therapy department at regular intervals after surgery and performed the same sequence of rehabilitation. The parameters analyzed were: range of motion (ROM, Disability of the Arm, Shoulder, and Hand (DASH, visual analog scale (VAS, and radiographic analysis to visualize the pre- and postoperative SL gap and the pre- and postoperative dorsal intercalated segment instability (DISI deformity the. The complications and the time to return to work activities were described. RESULTS: The follow-up time was 12 months (3-17. The ROM averaged 321° (96.9% of the normal side. VAS was 1.79/10 (1-6. DASH was 6.50/100 (1-30. The time to work return work was 4.42 months (2-17. As for complications, one patient developed SLAC, and underwent four-corner fusion one year after ligament reconstruction. Currently, he has experienced pain relief, with a functional range of motion of the wrist, and has not yet returned to professional activities. The preoperative SL gap was 4.29 mm (2-7; in the postoperative period, it was 1.79 mm (1-4. The DISI deformity was present in ten patients with SL angle > 70° (preoperative and it was corrected after surgery, in all patients. SLAC stage I was identified in a patient. Arthroscopy was performed in all cases. The SL instability was classified as Geissler grade III in four cases and as grade IV in ten cases. CONCLUSION: The new approach (dorsal capsulodesis associated with SL reconstruction, assisted by arthroscopy

  12. Studying Legacy Uranium Contamination On Navajo, Laguna, and Isleta Lands In Collaboration With Native American Undergraduate Researchers

    Science.gov (United States)

    Cadol, D. D.; Frey, B.; Chee, C.

    2017-12-01

    Personally relevant research experiences at key points in a student's education are potentially powerful influences on their long-term career path. With this in mind, New Mexico EPSCoR created the STEM Advancement Program (STEMAP) to provide a summer research experience for students from the non-graduate-degree granting institutions in New Mexico. Recruitment focused on underrepresented minorities, primarily Native American and Hispanic students, who applied to work with one of six research components. Our research component focused on understanding the fate and transport of environmental uranium in the Four Corners region. The geosciences are especially amenable to providing meaningful research experiences, particularly for groups that have a strong cultural connection with the land. Uranium mining activities were extensive on several reservations in the 1950s to 1980s, and many of the sites have not been remediated. The impact of mining likely contributed to the high interest among Native American (especially Navajo) STEMAP applicants in this research topic. In four years of summer research we mentored four Native American students (two male and two female) and one white non-Hispanic female. Following their work in our research group, one student extended her research, three graduated, and one transferred to a research institution. This success likely reflects a combination of recruitment efforts, which built on community connections, as well as efforts to provide personal mentoring and to create an inclusive environment. The work of these students has advanced our understanding of fluvial transport of uranium from inactive mining districts, an important pathway given the role of these streams in providing water for agriculture and aggregate for construction. Findings demonstrate an affinity of uranium to sorb to fine-grained sediment, meaning standing water in stock ponds is of particular concern. The students also studied uranium-bearing dust generated from

  13. Use of Solid Waste (Foundry Slag) Mortar and Bamboo Reinforcement in Seismic Analysis for Single Storey Masonry Building

    Science.gov (United States)

    Ahmad, S.; Husain, A.; Ghani, F.; Alam, M. N.

    2013-11-01

    were observed up to the table force of 4.25 kN (1,300 rpm), whereas for fixed base failure started at 800 rpm.To strengthen the fixed base model, bamboo reinforcement were used for economical point of view. Another model of same dimension with same mortar ratio was fabricated on the shake table with bamboo reinforcement as plinth band and lintel band. In addition another four round bamboo bars of 3 mm diameter were placed at each of the four corners of the model. The building model was tested and found very encouraging and surprising results. The model failure started at 1,600 rpm, which means that this model is surviving the double force in comparison with the non-bamboo reinforcement.

  14. Aspects on caring in pediatric nuclear medicine

    International Nuclear Information System (INIS)

    Ljung, B.M.L.

    2002-01-01

    During nuclear medicine examinations, the child is exposed to more or less distressful and/or painful procedures. Many children find it difficult to understand why they have to go through a specific examination. In addition, the surrounding is unfamiliar with heavy technical equipment. The first experience is crucial for the child's future attitudes towards hospitals in general and diagnostic procedures in particular. Apart from having child-focused personnel, there are many ways to improve the situation, and I will focus on four corner-stones. 1. Information; 2. Pain relief; 3. Diversion; 4. Sedation. 1. Information should be addressed directly to the child as well as to the parents. Today, children use the computer already from an early age, and we have initiated the use of Internet as a medium for child-adapted information. With texts, photos and multimedia on an interactive site we are able to reach also quite young children as well as children with difficulties to understand only written parts. Pain relief for vein puncture should always be considered. We use the topical anaesthetic EMLA cream in newborns (> 2.800 g) as well as in teenagers. Trained staff is another condition for high success rate in performing vein punctures, and continuous education vouches for that. 3. Diversion (distraction) is a general term for directing the child's attention from the procedures or to make time pass faster. Age adapted diversions should be readily available for every child. Apart from soap bubbles, toys, books, music and videos there are other possibilities, such as 'Guided imagery', a way of day-dreaming initiated by personnel trained in this method. 4. Sedation should be used when other options are not sufficient. For conscious sedation we use midazolam, administered either iv, intranasal, rectally or orally. The nurses/technologists handle the routines. In nuclear medicine, 4-5 % of the children, mostly between 1-3 years old, are sedated either for fear of vein

  15. Diagenetic Iron Cycling in Ancient Alkaline Saline Lacustrine Sedimentary Rocks: A Case Study on the Jurassic Brushy Basin Member of the Morrison Formation, Colorado Plateau, USA

    Science.gov (United States)

    Potter-McIntyre, S. L.; Chan, M. A.; McPherson, B. J. O. L.

    2014-12-01

    The upper part of the Brushy Basin Member in the Four Corners region of the U.S. was deposited in an ephemeral alkaline saline lake system with copious input of volcanic ash. The variegated shale formation provides a setting for the study of early diagenetic iron cycling that records the action of alkaline saline fluid chemistries reacting with volcaniclastic sediments in the presence of microbes. A bull's-eye pattern of authigenic minerals with increasing alteration towards the basinal center similar to modern alkaline saline lakes provides evidence for an extreme paleoenvironmental interpretation. The purpose of this research is to document specific factors, such as reactive sediments, microbial influences, and grain size that affect concretion formation and iron cycling in an ancient extreme environment. Three broad diagenetic facies are interpreted by color and associated bioturbation features: red, green and intermediate. Diagenetic facies reflect meter-scale paleotopography: red facies represent shallow water to subaerial, oxidizing conditions; green facies reflect saturated conditions and reducing pore water chemistry shortly after deposition, and intermediate facies represent a combination of the previous two conditions. Evidence of biotic influence is abundant and trace fossils exhibit patterns associated with the diagenetic facies. Red diagenetic facies typically contain burrows and root traces and green diagenetic facies exhibit restricted biotic diversity typically limited to algal molds (vugs). Microbial fossils are well-preserved and are in close proximity to specific iron mineral textures suggesting biotic influence on the crystal morphology. Three categories of concretions are characterized based on mineralogy: carbonate, iron (oxyhydr)oxide and phosphate concretions. Concretion mineralogy and size vary within an outcrop and even within a stratigraphic horizon such that more than one main category is typically present in an outcrop. Variation in

  16. Dose calibrations of itensifying screens and neutral density filters for use on pulsed x-ray sources

    International Nuclear Information System (INIS)

    Gersten, M.; Rauch, J.E.; Shannon, J.

    1983-01-01

    We calibrated three intensifying screens: Kodak Lanex Regular, Kodak X-Omatic Regular, and Kodak X-Omatic Fine, with relative speeds of 400, 100, and 15 for exposures to a 85 keV bremsstrahling spectrum when used in conjunction with Ortho G film. We also calibrated three neutral density filters: 0.6, 1, and 2 OD. When the screens are used in conjunction with the neutral density filters, 12 configurations can be obtained, with a total dynamic range of 2700. The film/screen/filter pack calibrations were performed in support of the bremsstrahlung experiments on Maxwell Laboratories BLACKJACK 5' pulse generator; the film/screen/filter packs are used to record pinhole photographs, one of the major diagnostics in the program. Because of reciprocity failure associated with the exposure of photographic film by visible light, an intense pulsed X-ray source was needed for the calibration. We used Maxwell Laboratories modular bremsstrahlung source, MBS. In the mode used (mean electron energy 213 + or - 6 keV, peak diode voltage 264 + or - 8 keV, and peak diode current 368 + or - 24 kA), a source strength of 47 + or - 2 J was obtained in a 30 + or - 1.2 ns FWHM pulse. In this mode, 41 + or - 4 percent of the fluence was above 67 keV. In this experiment, the machine operating parameters were held constant and the flux on the film/screen/filter pack was varied between 1.5 x 10 -3 - 5.6 x 10 -8 J/cm 2 . This was achieved by varying the distance between the film/screen/filter pack and the source and-by aperturing the source. The fil/screen/filter pack used for the calibration had three horizontal strips of screen pairs, overlayed with three vertical strips of neutral density filter pairs. One vertical section was left unfiltered. In this configuration 12 exposures are obtained simulatenously. The dose was measured with four TLD's placed inside the film/screen/filter pack at four corners

  17. Compensating wage differentials and the impact of health insurance in the public sector on wages and hours.

    Science.gov (United States)

    Qin, Paige; Chernew, Michael

    2014-12-01

    This paper examines the trade-off between wages and employer spending on health insurance for public sector workers, and the relationship between coverage and hours worked. Our primary approach compares trends in wages and hours for public employees with and without state/local government provided health insurance using individual-level micro-data from the 1992-2011 CPS. To adjust for differences between insured and uninsured public sector employees, we create a matched sample based on an employee's propensity to receive health insurance. We assess the relationship between state contribution to the health plan premium, state-level healthcare spending, and the wages and hours of state and local government employees. We find modest reductions in wages are associated with having employer-sponsored health insurance (ESHI), although this effect is not precisely measured. The reduction in wages associated with having ESHI is larger among non-unionized workers. Further, we find little evidence that provision of health insurance increases hours worked. Copyright © 2014 Elsevier B.V. All rights reserved.

  18. Gamma nail in the treatment of closed trochanteric fractures. Results and indications of 121 cases.

    Science.gov (United States)

    Kempf, I; Grosse, A; Taglang, G; Favreul, E

    2014-02-01

    The Gamma Nail is the latest advance in the treatment of trochanteric fractures based on intramedullary nailing principles during closed procedures. Its design is based on Küntscher's Y-nail and locking intramedullary (IM) nails. This paper reports the results from the first-ever series of 121 patients operated between 1988 and 1990. They were followed until bone union was achieved. The mean patient age was 75 years. Most patients were in poor general health and had unstable fractures. Anatomical preoperative reduction was achieved in 72% of cases. Fixation was good in 66% of cases and acceptable in 27% of cases. Intra-operative complications consisted of nine fractures without consequences. Of the treated patients, 83.4% resumed weight-bearing during the first week. There was one case of deep infection that resolved with treatment. The mortality rate was 12.3% at three months. We noted 7 alunions in varus, 3 in valgus, 2 in external rotation and 1 in internal rotation. There were no cases of non-union. In six cases, the screw had cut out of the femoral head. The drawbacks associated with surgical treatment methods for trochanteric fractures also apply to the Gamma nail. Nevertheless, one of its primary advantages is the possibility of using a closed procedure. When compared to Ender nailing, knee pain is absent and weight-bearing can be achieved in all patients, no matter the fracture type. Copyright © 2014. Published by Elsevier Masson SAS.

  19. Proximal femoral fractures: Principles of management and review of literature

    Science.gov (United States)

    Mittal, Ravi; Banerjee, Sumit

    2012-01-01

    Purpose The purpose of this study was to review the principles involved in the management of proximal femoral fractures as reported in the literature. Methods: A medical literature search in the MEDLINE (PubMed) and Cochrane database was undertaken to review strategies and principles in proximal femoral fracture treatment. Randomized control trials and meta analysis were given preference while case reports/small series were rejected. Results and conclusions: Early anatomical reduction and surgical fixation remains the best option to reduce the risk of complications like non-union and avascular necrosis in treating fracture neck femurs. Cancellous screws continue to be the preferred treatment for fixation of neck femur fractures in younger population until the benefit of using sliding hip screws is validated by large multicentric studies. In the geriatric age group, early prosthetic replacement brings down the mortality and morbidity associated with neck femur fractures. Sliding hip screw (DHS) is the best available option for stable inter trochanteric fractures. The use of intramedullary nails e.g. PFN is beneficial in treating inter trochanteric fractures with comminution and loss of lateral buttress. Intramedullary implants have been proven to have increased success rates in subtrochanteric fractures and should be preferred over extramedullary plate fixation systems. PMID:25983451

  20. Outcomes of bilateral sacroiliac joint fusions and the importance of understanding potential coexisting lumbosacral pathology that might also require surgical treatment.

    Science.gov (United States)

    Dall, Bruce E; Eden, Sonia V

    2015-06-01

    Only one study in the literature describes performing a bilateral sacroiliac joint fusion, and the results were poor. Many patients needing a bilateral sacroiliac joint fusion frequently have had previous lumbosacral surgeries and present with lumbosacral pain as well. This study reviews our results in consecutive patients having had a bilateral sacroiliac joint fusion over a five-year period. Fifteen patients had bilateral sacroiliac joint fusions with 13 having concurrent lumbosacral fusions. The modified posterior midline fascial splitting approach, first described by Belanger was utilized. Patients were followed for an average of 30.3 months. There were no infections, neurovascular injuries, lasting morbidity or deaths. One non-union of a sacroiliac joint (7%) occurred, which after revision was satisfactory. There was a statistically significant drop in pain (p=0.01488) using the VAS, and patient satisfaction rates were 86%. With all those patients saying they would have the surgery again for the same result. There was no significant increase in functionality. Patients needing bilateral sacroiliac joint fusions frequently fall into the "failed back" category, and it is important to evaluate both the sacroiliac joints and the lumbosacral spine for potential pain generators. This study shows that by treating all the pain generators in both areas there were significant decreases in pain, low complications, low re-operation rates, and high patient satisfaction scores. Overall functionality, however, was not positively affected.