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Sample records for olecranon epiphyseal fracture

  1. Treatment of proximal ulna and olecranon fractures by dorsal plating

    NARCIS (Netherlands)

    Kloen, Peter; Buijze, Geert A.

    2009-01-01

    OBJECTIVE : Anatomic reconstruction of proximal ulna and olecranon fractures allowing early mobilization and prevention of ulnohumeral arthritis. INDICATIONS : Comminuted olecranon or proximal ulna fractures (including Monteggia fractures), olecranon fractures extending distally from the coronoid

  2. Biomechanical Evaluation of Standard Versus Extended Proximal Fixation Olecranon Plates for Fixation of Olecranon Fractures.

    Science.gov (United States)

    Boden, Allison L; Daly, Charles A; Dalwadi, Poonam P; Boden, Stephanie A; Hutton, William C; Muppavarapu, Raghuveer C; Gottschalk, Michael B

    2018-01-01

    Small olecranon fractures present a significant challenge for fixation, which has resulted in development of plates with proximal extension. Olecranon-specific plates with proximal extensions are widely thought to offer superior fixation of small proximal fragments but have distinct disadvantages: larger dissection, increased hardware prominence, and the increased possibility of impingement. Previous biomechanical studies of olecranon fracture fixation have compared methods of fracture fixation, but to date there have been no studies defining olecranon plate fixation strength for standard versus extended olecranon plates. The purpose of this study is to evaluate the biomechanical utility of the extended plate for treatment of olecranon fractures. Sixteen matched pairs of fresh-frozen human cadaveric elbows were used. Of the 16, 8 matched pairs received a transverse osteotomy including 25% and 8 including 50% of the articular surface on the proximal fragment. One elbow from each pair was randomly assigned to a standard-length plate, and the other elbow in the pair received the extended-length plate, for fixation of the fracture. The ulnae were cyclically loaded and subsequently loaded to failure, with ultimate load, number of cycles, and gap formation recorded. There was no statistically significant difference between the standard and extended fixation plates in simple transverse fractures at either 25% or 50% from the proximal most portion of the articular surface of the olecranon. Standard fixation plates are sufficient for the fixation of small transverse fractures, but caution should be utilized particularly with comminution and nontransverse fracture patterns.

  3. Racing prognosis of horses following surgically repaired olecranon fractures

    Science.gov (United States)

    Rodgerson, Dwayne H.; Hunt, Robert J.; Spirito, Michael A.; Thorpe, Paul E.; Tessman, Ron K.

    2006-01-01

    Abstract Olecranon fracture is a common orthopedic problem in juvenile horses. Prognosis for complete fracture healing when various methods of internal fixation are used is good; however, the impact of olecranon fracture stabilization on the likelihood that foals will start on a racecourse is unknown. Medical records of foals undergoing internal fixation for an olecranon fracture were reviewed. The dam’s foaling records were obtained and lifetime racing records were then retrieved for both the affected foals and 1 of their siblings. Twenty-two of 24 repaired fractures healed completely, subsequently, 16 of the foals started in at least 1 race. Statistical calculations suggest that when compared with their siblings, the occurrence of olecranon factures requiring internal fixation in juvenile racehorses will not significantly reduce the likelihood that they will race; however, the siblings had significantly more lifetime race starts and higher career earnings. PMID:16604980

  4. Current techniques for management of transverse displaced olecranon fractures

    NARCIS (Netherlands)

    den Hamer, A.; Heusinkveld, M.H.G.; Traa, W.; Oomen, P.; Oliva, F.; Del Buono, A.; Maffulli, N.

    2015-01-01

    BACKGROUND: displaced transverse fractures of the olecranon are the most common fractures occurring in the elbow in adults that requires operative intervention. METHODS: a literature search was performed on PubMed, Web of Science, Science Direct/Scopus, Google Scholar and Google using the keywords

  5. variability in olecranon ao fracture fixation: a radiological study

    African Journals Online (AJOL)

    ABSTRACT. Background: Tension Band Wire(TBW) fixation of olecranon fracture is a commonly used technique by ... There are many classification systems of this injury of which the Mayo is ... backing out by as much as three times in comparison with those ..... “K” wire. A blinded randomized control outcome based clinical.

  6. Chondromalacia of trochlear notch after healing of olecranon stress fracture: a case report.

    Science.gov (United States)

    Lu, Cheng-Chang; Chen, Shen-Kai; Wang, Chih-Wei; Chou, Pei-Hsi

    2006-05-01

    Chondromalacia of the trochlear notch and stress fracture of olecranon are uncommon injuries in the throwing athletes. We report an 18-year-old high school pitcher who had persistent postero-lateral elbow pain after a healed olecranon stress fracture of the right elbow. Diagnostic arthroscopy revealed chondromalacia of the trochlear notch. After treatment with arthroscopic drilling and abrasion chondroplasty, he returned to competitive pitching 1 year later postsurgery. This rare association between chondromalacia and stress fracture of the olecranon has not been reported previously in the literatures. Chondromalacia of the trochlear notch should be included as a differential diagnosis in evaluating athletes with persistent elbow pain after healed olecranon stress fractures.

  7. Minimally invasive tension band wiring technique for olecranon fractures.

    Science.gov (United States)

    Takada, Naoya; Kato, Kenji; Fukuta, Makoto; Wada, Ikuo; Otsuka, Takanobu

    2013-12-01

    Some types of implants, such as plates, screws, wires, and nails, have been used for open reduction and internal fixation of olecranon fractures. A ≥ 10 cm longitudinal incision is used for open reduction and internal fixation of olecranon fractures. According to previous studies, tension band wiring is a popular method that gives good results. However, back out of the wires after the surgery is one of the main postoperative complications. Moreover, if the Kirschner wires are inserted through the anterior ulnar cortex, they may impinge on the radial neck, supinator muscle, or biceps tendon. Herein, we describe the minimally invasive tension band wiring technique using Ring-Pin. This technique can be performed through a 2 cm incision. Small skin incisions are advantageous from an esthetic viewpoint. Ring-Pin was fixed by using a dedicated cable wire that does not back out unless the cable wire breaks or slips out of the dedicated metallic clamp. As the pins are placed in intramedullary canal, this technique does not lead to postoperative complications that may occur after transcortical fixation by conventional tension band wiring. Minimally invasive tension band wiring is one of the useful options for the treatment of olecranon fractures with some advantages.

  8. Surgical interventions for treating fractures of the olecranon in adults.

    Science.gov (United States)

    Matar, Hosam E; Ali, Amjid A; Buckley, Simon; Garlick, Nicholas I; Atkinson, Henry D

    2014-11-26

    Fractures of the olecranon (the bony tip of the elbow) account for approximately 1% of all upper extremity fractures. Surgical intervention is often required to restore elbow function. Two key methods of surgery are tension band wire fixation and plate fixation. To assess the effects (benefits and harms) of different surgical interventions in the treatment of olecranon fractures in adults. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register (22 September 2014), the Cochrane Central Register of Controlled Trials (CENTRAL, 2014, Issue 8), MEDLINE (1946 to September week 2 2014), EMBASE (1980 to 19 September 2014), trial registers, conference proceedings and reference lists of articles. Randomised controlled trials (RCT) and quasi-RCTs that compared different surgical interventions for the treatment of olecranon fractures in adults. Two review authors independently performed study selection, risk of bias assessment and data extraction. The primary outcomes of this review were function, pain and adverse events. We included six small trials involving 244 adults with olecranon fractures. Of these, four were RCTs and two were quasi-RCTs; both of were at high risk of selection bias. All six trials were at high risk of performance bias, reflecting lack of blinding, and four trials were at high risk of detection bias. The quality of the evidence for most outcomes was generally very low because of limitations in study design and implementation, and either imprecision of the results or inadequate outcome measures. Thus, we are very uncertain about the estimates of effect.One trial (41 participants) comparing plate fixation with standard tension band wiring provided very low quality evidence at 16 to 86 weeks' follow-up of a better clinical outcome after plate fixation (good outcome (little pain or loss of elbow motion): 19/22 versus 9/19, risk ratio (RR) 1.82 favouring plate fixation, 95% confidence interval (CI) 1.10 to 3.01). There was very low

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

    Science.gov (United States)

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

    1994-01-01

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

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

    DEFF Research Database (Denmark)

    Lauritzen, J B; Lund, B

    1993-01-01

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

  11. Repair of olecranon fractures using fiberWire without metallic implants: report of two cases

    Directory of Open Access Journals (Sweden)

    Okawa Atsushi

    2010-10-01

    Full Text Available Abstract Olecranon fractures are a common injury in fractures. The tension band technique for olecranon fractures yields good clinical outcomes; however, it is associated with significant complications. In many patients, implants irritate overlying soft tissues and cause pain. This is mostly due to protrusion of the proximal ends of the K-wires or by the twisted knots of the metal wire tension band. Below we described 2 cases of olecranon fractures treated with a unique technique using FiberWire without any metallic implants. Technically, the fragment was reduced, and two K-wires were inserted from the dorsal cortex of the distal segment to the tip of the olecranon. K-wire was exchanged for a suture retriever, and 2 strands of FiberWire were retrieved twice. Each of the two FiberWires was manually tensioned and knotted on the posterior surface of the olecranon. Bony unions could be achieved, and patients had no complaint of pain and skin irritation. There was only a small loss of flexion and extension in comparison with that of the contralateral side, and the patient did not feel inconvenienced in his daily life. Using the method described, difficulty due to K-wire or other metallic implants was avoided.

  12. Repair of olecranon fractures using fiberWire without metallic implants: report of two cases.

    Science.gov (United States)

    Nimura, Akimoto; Nakagawa, Teruhiko; Wakabayashi, Yoshiaki; Sekiya, Ichiro; Okawa, Atsushi; Muneta, Takeshi

    2010-10-12

    Olecranon fractures are a common injury in fractures. The tension band technique for olecranon fractures yields good clinical outcomes; however, it is associated with significant complications. In many patients, implants irritate overlying soft tissues and cause pain. This is mostly due to protrusion of the proximal ends of the K-wires or by the twisted knots of the metal wire tension band. Below we described 2 cases of olecranon fractures treated with a unique technique using FiberWire without any metallic implants. Technically, the fragment was reduced, and two K-wires were inserted from the dorsal cortex of the distal segment to the tip of the olecranon. K-wire was exchanged for a suture retriever, and 2 strands of FiberWire were retrieved twice. Each of the two FiberWires was manually tensioned and knotted on the posterior surface of the olecranon. Bony unions could be achieved, and patients had no complaint of pain and skin irritation. There was only a small loss of flexion and extension in comparison with that of the contralateral side, and the patient did not feel inconvenienced in his daily life. Using the method described, difficulty due to K-wire or other metallic implants was avoided.

  13. Randomized prospective study of olecranon fracture fixation: cable pin system versus tension band wiring.

    Science.gov (United States)

    Liu, Q-H; Fu, Z-G; Zhou, J-L; Lu, T; Liu, T; Shan, L; Liu, Y; Bai, L

    2012-01-01

    This prospective, randomized study compared the effectiveness of the cable pin system (CPS) versus tension band wiring (TBW) for olecranon fracture fixation. Patients with acute transverse or slight oblique olecranon fractures were randomly divided into two groups: one fixed by CPS and the other by TBW. Clinical outcome data were collected and analysed following a mean duration of 21 months. The mean ± SD fracture healing time was significantly shorter in the CPS group (n = 30; 9.73 ± 2.02 weeks) compared with the TBW group (n = 32; 11.13 ± 2.21 weeks). One patient in the CPS group and seven patients in the TBW group experienced postoperative complications; this difference was statistically significant. The mean ± SD Mayo Elbow Performance Score in the CPS group was significantly higher (88.67 ± 6.42) than that in the TBW group (80.78 ± 11.99). Logistic regression analysis showed an association between fixation method and fracture healing time, complications and elbow function. Internal fixation by CPS is an effective method for olecranon fracture and is associated with a shorter healing time, fewer complications and better function than TBW.

  14. Posttraumatic Proximal Radioulnar Synostosis after Closed Reduction for a Radial Neck and Olecranon Fracture

    Directory of Open Access Journals (Sweden)

    Patrick R. Keller

    2018-01-01

    Full Text Available Posttraumatic proximal radioulnar synostosis (PPRUS is a severe complication of radial head and neck fractures known to occur after severe injury or operative fixation. Cases of PPRUS occurring after minimally displaced, nonoperatively treated radial neck injuries are, by contrast, extremely rare. Here, we present a pediatric case of PPRUS that developed after a nonoperatively treated minimally displaced radial neck fracture with concomitant olecranon fracture. While more cases are needed to establish the association between this pattern of injury and PPRUS, we recommend that when encountering patients with a minimally displaced radial neck fracture and a concomitant elbow injury, the rare possibility of developing proximal radioulnar synostosis should be considered.

  15. Unusual stress fracture in an adolescent baseball pitcher affecting the trochlear groove of the olecranon

    International Nuclear Information System (INIS)

    Blake, Joseph J.; Block, John J.; Kan, J.H.; Hannah, Gene A.

    2008-01-01

    Stress fractures of the proximal ulna are known to occur in throwing athletes. Most cases extend to involve the olecranon, and cases limited to the trochlear groove are rare. In this report we present a 17-year-old elite baseball pitcher with a stress fracture of the trochlear groove of the proximal ulna. Diagnosis was made by demonstration of characteristic signal changes on MRI of the elbow. The fracture occurred at the cortical notch, also known as the pseudodefect of the trochlear groove. This case suggests that the cortical notch serves as an area of weakness predisposing pitchers to development of a stress fracture. (orig.)

  16. [Case-control study on cable-pin system in the treatment of olecranon fractures].

    Science.gov (United States)

    Ma, Hu-Jing; Shan, Lei; Zhou, Jun-Lin; Liu, Qing-He; Lu, Tie; Sun, Song

    2012-05-01

    To prospectively evaluate the clinical result of Cable-Pin system in the treatment of olecranon fractures and compare with tension band wiring (TBW) method. From March 2008 to June 2010,65 patients with olecranon fractures were divided into two groups: 32 patients in Cable-Pin group were treated with Cable-Pin system, including 18 males and 14 females, ranging in age from 21 to 69 years, with an average of (53.69 +/- 13.42) years; 33 patients in TBW group were treated with Kirschner tension bend, including 20 males and 13 females, ranging in age from 20 to 70 years, with an average of (53.18 +/- 13.36) years. The incision length, operation time, the amounts of hemoglobin after operation, fracture healing time, complications and HSS elbow scores were recorded and analyzed statistically. The follow-up period ranged from 12 to 24 months, with an average period of 18.4 months. There were statistical differences (PCable-Pin group. There was no statistical differences (P>0.05) in the length of incision (t= 0.416, P=0.679), operation time (t=0.816, P=0.417) and the postoperative amounts of hemoglobin (t=-0.553, P=0.294) between two groups. Cable-Pin system is an easy and reliable method for the treatment of olecranon fractures with less complications and better functions than TBW.

  17. Outcomes of the distal intraarticular humeral fractures treated by olecranon osteotomy

    Directory of Open Access Journals (Sweden)

    Erhan Yılmaz

    2009-01-01

    Full Text Available Objectives: To evaluate the management and outcome of intraarticular fractures of the distal humerus treated by open reduction and internal fixation using the olecranon osteotomy technique. Materials and methods: Twenty-one patients with in-traarticular fractures of the distal humerus were treated by open reduction and internal fixation. The mean age of the patients was 41.6 years and the mean follow-up pe-riod was 25.3 months. All fractures were type C accord-ing to the AO/ASIF fracture classification system. Chev-ron type olecranon osteotomy was performed within 12-24 h after the injury in all cases but 4 of them. Physical and radiological examination of patients with the appro-priate range checks were made.Results: All fractures united within average duration of 3.2 months. Excellent or good results were found in pa-tients less than 50 years-old, in women, when passing time from injury to surgery was within 12 hours and when early mobilization was achieved. The complica-tions were seen as 2 (9.6% transient neuropraxia of the ulnar nerve, 2 (9.6% failure of fixation, 1 (4.8% het-erotopic ossification and 1 (4.8% olecranon non-union. Fracture type (C1 and time from occurrence of injury to surgery (<12 hours are the main prognostic factors for achieving the excellent/ good functional results.Conclusions: The critical factors for a successful out-come of intraarticular fractures of the distal humerus in-cluded meticulous surgical technique, stable internal fix-ation, surgical experimentation and early controlled postoperative mobilization.

  18. Treatment of stress fracture of the olecranon in throwing athletes with internal fixation through a small incision

    Directory of Open Access Journals (Sweden)

    Fujioka Hiroyuki

    2012-12-01

    Full Text Available Abstract The present study is a report of retrospective case series of stress fracture of the olecranon. Six patients presented posterior elbow pain in throwing in baseball and softball, but fracture was not diagnosed in radiographs. We detected stress fracture of the olecranon using computed tomographic (CT scan and treated the patient with internal fixation with a headless cannulated double threaded screw through a small skin incision. All patients returned to competitive level without elbow complaints after the operation. When throwing athletes present with unusual posterior elbow pain and no significant findings on radiographs, a CT scan examination should be performed. We recommend surgical treatment of internal fixation with a screw through a small skin incision, as a good option for stress fracture of the olecranon in order to allow early return to sports activity in competitive athletes.

  19. Occult posterolateral rotatory dislocation of the elbow with olecranon fracture in a child: a case report

    Directory of Open Access Journals (Sweden)

    Fujimori Takahito

    2012-09-01

    Full Text Available Abstract Introduction Acute posterolateral rotator elbow dislocation in a child is rare and can be easily misdiagnosed due to immaturity of the epiphysis. This is the first case of occult posterolateral rotator elbow dislocation in combination with an olecranon fracture. We report our experience with this case, which was not diagnosed correctly by plain radiographs. Case presentation An 11-year-old Asian boy suffered severe pain and swelling of his right elbow after his outstretched arm hit a car dashboard in a motor vehicle accident. Plain radiographs showed only a minimally displaced olecranon fracture and a tiny lateral epicondylar avulsion fracture. However, stress radiographs under general anesthesia revealed severe posterolateral rotatory instability. During surgery, we found that the cartilaginous lateral epicondylar apophysis was much larger than the epicondylar fragment on the radiographs. After the lateral epicondylar osteochondral fragment and lateral collateral ligament complex were fixed, the instability disappeared. Conclusion Our experience with this case shows that it is important to check for instability with pediatric elbow fractures, because a tiny avulsion fracture was able to cause severe posterolateral rotatory instability in a child.

  20. 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.

  1. Stabilization of Olecranon Fractures by Tension Band Wiring or Plate Osteosynthesis: A Retrospective Study of 41 Cases.

    Science.gov (United States)

    Fournet, Alexandre; Boursier, Jean-François; Corbeau, Solène; Decambron, Adeline; Viateau, Véronique; Fayolle, Pascal; Bedu, Anne-Sophie; Leperlier, Dimitri; Manassero, Mathieu

    2018-01-01

     This article aimed to describe olecranon fracture in dogs and cats and their stabilization with tension band wiring or plate osteosynthesis, and to evaluate complications associated with each technique.  Medical records of cats and dogs that had been surgically treated for olecranon fractures with either tension band wiring or plate osteosynthesis were retrospectively reviewed. The surgical technique, complications and long-term outcomes were assessed.  Forty-one olecranon fractures were included. Fractures were articular, comminuted and open in 90, 31 and 27% of cases, respectively. Tension band wiring and plate osteosynthesis were performed in 22 and 19 fractures, respectively. Complications occurred more commonly after tension band wiring (74%) compared with plate osteosynthesis (27%) ( p  = 0.002) and these were probably related to it being used in comminuted fractures ( p  = 0.01) or to errors in technique. Minor complications included Kirschner wires migration ( n  = 5), pain ( n  = 3), osteomyelitis ( n  = 3), skin breakdown ( n  = 3) and seroma ( n  = 1). Implant failure requiring further fixation ( n  = 4) was observed only in the tension band wiring group. Other major complications included skin wound debridement and closure ( n  = 1) and chronic lameness requiring implant removal ( n  = 7). Long-term functional outcomes were excellent regardless of the technique used.  Plate osteosynthesis should be performed for olecranon fracture repair if technically feasible. Schattauer GmbH Stuttgart.

  2. [ARTHROSCOPIC TREATMENT OF ANTERIOR CRUCIATE LIGAMENT TIBIAL EMINENCE AVULSION FRACTURE IN ADOLESCENTS WITH EPIPHYSEAL UNCLOSURE].

    Science.gov (United States)

    Liu, Yang; Sun, Xuebin; Zhang, Keyuan; Li, Gang; Ni, Jiati

    2015-06-01

    To evaluate the clinical results of arthroscopic treatment of anterior cruciate ligament (ACL) tibial eminence avulsion fractures in adolescents with epiphyseal unclosure. Between January 2011 and October 2013, 35 knees with ACL tibial eminence avulsion fractures (35 patients with epiphyseal unclosure) were arthroscopically treated with suture fixation. There were 25 males and 10 females, aged 8-16 years (mean, 14.7 years). The causes included sports injury in 24 cases, traffic accident injury in 9 cases, and daily life injury in 2 cases. According to Meyers-McKeever classification criteria, there were 27 cases of type II and 8 cases of type III. Five cases had meniscus injury. The preoperative the International Knee Documentation Committee (IKDC) score was 48.7 ± 3.2, and Lysholm score was 51.2 ± 4.5. The time from injury to operation was 2-16 days (mean, 5 days). Primary healing of incision was obtained in all patients. The mean follow-up time was 22.4 months (range, 12-32 months). Anatomical reduction was achieved in 28 cases and satisfactory reduction in 7 cases. X-ray films showed all fractures healing at last follow-up. There was no limb shortening deformity, varus knee, or valgus knee. Lachman test results were all negative. The other knees had normal range of motion except 1 knee with limited flexion, whose range of motion returned to 0-120° after treatment. At last follow-up, the IKDC score was significantly improved to 93.2 ± 4.1 (t = -53.442, P = 0.000), and the Lysholm score was significantly increased to 96.2 ± 2.5 (t = -56.242, P = 0.000). The arthroscopic fixation technique has satisfactory results for the reduction and fixation of ACL tibial eminence avulsion fracture in the adolescents with epiphyseal unclosure because of little trauma and quick recovery.

  3. Surgical Management of Proximal Interphalangeal Joint Repetitive Stress Epiphyseal Fracture Nonunion in Elite Sport Climbers.

    Science.gov (United States)

    El-Sheikh, Yasser; Lutter, Chris; Schoeffl, Isabelle; Schoeffl, Volker; Flohe, Sascha

    2017-11-14

    Repetitive stress fracture of the middle phalanx epiphysis is an injury specific to elite adolescent sport climbers. As sport climbing becomes increasingly popular in younger age groups, an increased number of these injuries have been reported in recent years. To date, treatment of these fractures has been nonsurgical, with strict rest and physiotherapy prescribed until fracture union. However, when these patients present in a delayed fashion with an established nonunion, nonsurgical treatment may fail, leading to disabling chronic pain and/or digital deformity in some cases. In this article, we present 2 cases of surgical treatment for finger middle phalanx repetitive stress epiphyseal fracture nonunion, using a percutaneous spot drilling epiphysiodesis technique. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  4. Treatment of type 2 and 4 olecranon fractures with locking compression plate (LCP) osteosynthesis in horses: a prospective study (2002-2008)

    OpenAIRE

    Jackson, M; Kummer, M; Auer, J; Hagen, R; Fürst, A

    2011-01-01

    This prospective study describes a series of 18 olecranon fractures in 16 horses that were treated with locking compression plates (LCP). Twelve of the 18 fractures were simple (type 2), whereas six were comminuted (type 4). Six fractures were open and 12 were closed. Each horse underwent LCP osteosynthesis consisting of open reduction and application of one or two LCP. Complete fracture healing was achieved in 13 horses. Three horses had to be euthanatized: two because of severe infection an...

  5. Treatment of type 2 and 4 olecranon fractures with locking compression plate osteosynthesis in horses: a prospective study (2002-2008).

    Science.gov (United States)

    Jackson, M; Kummer, M; Auer, J; Hagen, R; Fuerst, A

    2011-01-01

    This prospective study describes a series of 18 olecranon fractures in 16 horses that were treated with locking compression plates (LCP). Twelve of the 18 fractures were simple (type 2), whereas six were comminuted (type 4). Six fractures were open and 12 were closed. Each horse underwent LCP osteosynthesis consisting of open reduction and application of one or two LCP. Complete fracture healing was achieved in 13 horses. Three horses had to be euthanatized: two because of severe infection and one because of a comminuted radial fracture 11 days after fixation of the olecranon fracture. Complications encountered after discharge of the horses from the Equine Hospital at the Vetsuisse Faculty (University of Zurich) included implant infection (n=2) and lameness (n=3), which were successfully treated with implant removal. Despite being easier to use, LCP osteosynthesis resulted in a clinical outcome similar to DCP osteosynthesis.

  6. The anterior tilt angle of the proximal tibia epiphyseal plate: A significant radiological finding in young children with trampoline fractures

    Energy Technology Data Exchange (ETDEWEB)

    Stranzinger, Enno, E-mail: enno.stranzinger@insel.ch [University Hospital Bern, Inselspital, Department of Diagnostic, Interventional and Pediatric Radiology, CH-3010 Bern (Switzerland); Leidolt, Lars, E-mail: lars.leidolt@insel.ch [University Hospital Bern, Inselspital, Department of Diagnostic, Interventional and Pediatric Radiology, CH-3010 Bern (Switzerland); Eich, Georg, E-mail: georg.eich@ksa.ch [Cantonal Hospital Aarau, Pediatric Radiology, Tellstrasse, CH-5001 Aarau (Switzerland); Klimek, Peter Michael, E-mail: peter.klimek@ksa.ch [Cantonal Hospital Aarau, Pediatric Surgery, Tellstrasse, CH-5001 Aarau (Switzerland)

    2014-08-15

    Objective: Evaluation of the anterior tilt angle of the proximal tibia epiphyseal plate in young children, which suffered a trampoline fracture in comparison with a normal population. Materials and methods: 62 children (31 females, 31 males) between 2 and 5 years of age (average 2 years 11 months, standard deviation 11 months) with radiographs in two views of the tibia were included in this retrospective study. 25 children with proximal tibia fractures were injured with a history of jumping on a trampoline. All other causes for tibia fractures were excluded. A normal age-mapped control cohort of 37 children was compared. These children had neither evidence of a trampoline related injury nor a fracture of the tibia. The anterior tilt angle of the epiphyseal plate of the tibia was defined as an angle between the proximal tibia physis and the distal tibia physis on a lateral view. Two radiologists evaluated all radiographs for fractures and measured the anterior tilt angle in consensus. An unpaired Student's t-test was used for statistical analysis (SPSS). Original reports were reviewed and compared with the radiological findings and follow-up radiographs. Results: In the normal control group, the average anterior tilt angle measured −3.2°, SD ± 2.8°. The children with trampoline fractures showed an anterior tilt of +4.4°, SD ± 2.9°. The difference was statistically significant, P < 0.0001. In 6 patients (24% of all patients with confirmed fractures) the original report missed to diagnose the proximal tibial fracture. Conclusion: Young children between 2 and 5 years of age are at risk for proximal tibia fractures while jumping on a trampoline. These fractures may be very subtle and difficult to detect on initial radiographs. Measurement of the anterior tilt angle of the proximal tibia epiphyseal plate on lateral radiographs is supportive for interpreting correctly trampoline fractures.

  7. The anterior tilt angle of the proximal tibia epiphyseal plate: A significant radiological finding in young children with trampoline fractures

    International Nuclear Information System (INIS)

    Stranzinger, Enno; Leidolt, Lars; Eich, Georg; Klimek, Peter Michael

    2014-01-01

    Objective: Evaluation of the anterior tilt angle of the proximal tibia epiphyseal plate in young children, which suffered a trampoline fracture in comparison with a normal population. Materials and methods: 62 children (31 females, 31 males) between 2 and 5 years of age (average 2 years 11 months, standard deviation 11 months) with radiographs in two views of the tibia were included in this retrospective study. 25 children with proximal tibia fractures were injured with a history of jumping on a trampoline. All other causes for tibia fractures were excluded. A normal age-mapped control cohort of 37 children was compared. These children had neither evidence of a trampoline related injury nor a fracture of the tibia. The anterior tilt angle of the epiphyseal plate of the tibia was defined as an angle between the proximal tibia physis and the distal tibia physis on a lateral view. Two radiologists evaluated all radiographs for fractures and measured the anterior tilt angle in consensus. An unpaired Student's t-test was used for statistical analysis (SPSS). Original reports were reviewed and compared with the radiological findings and follow-up radiographs. Results: In the normal control group, the average anterior tilt angle measured −3.2°, SD ± 2.8°. The children with trampoline fractures showed an anterior tilt of +4.4°, SD ± 2.9°. The difference was statistically significant, P < 0.0001. In 6 patients (24% of all patients with confirmed fractures) the original report missed to diagnose the proximal tibial fracture. Conclusion: Young children between 2 and 5 years of age are at risk for proximal tibia fractures while jumping on a trampoline. These fractures may be very subtle and difficult to detect on initial radiographs. Measurement of the anterior tilt angle of the proximal tibia epiphyseal plate on lateral radiographs is supportive for interpreting correctly trampoline fractures

  8. The anterior tilt angle of the proximal tibia epiphyseal plate: a significant radiological finding in young children with trampoline fractures.

    Science.gov (United States)

    Stranzinger, Enno; Leidolt, Lars; Eich, Georg; Klimek, Peter Michael

    2014-08-01

    Evaluation of the anterior tilt angle of the proximal tibia epiphyseal plate in young children, which suffered a trampoline fracture in comparison with a normal population. 62 children (31 females, 31 males) between 2 and 5 years of age (average 2 years 11 months, standard deviation 11 months) with radiographs in two views of the tibia were included in this retrospective study. 25 children with proximal tibia fractures were injured with a history of jumping on a trampoline. All other causes for tibia fractures were excluded. A normal age-mapped control cohort of 37 children was compared. These children had neither evidence of a trampoline related injury nor a fracture of the tibia. The anterior tilt angle of the epiphyseal plate of the tibia was defined as an angle between the proximal tibia physis and the distal tibia physis on a lateral view. Two radiologists evaluated all radiographs for fractures and measured the anterior tilt angle in consensus. An unpaired Student's t-test was used for statistical analysis (SPSS). Original reports were reviewed and compared with the radiological findings and follow-up radiographs. In the normal control group, the average anterior tilt angle measured -3.2°, SD ± 2.8°. The children with trampoline fractures showed an anterior tilt of +4.4°, SD ± 2.9°. The difference was statistically significant, Ptrampoline. These fractures may be very subtle and difficult to detect on initial radiographs. Measurement of the anterior tilt angle of the proximal tibia epiphyseal plate on lateral radiographs is supportive for interpreting correctly trampoline fractures. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Olecranon bursitis.

    Science.gov (United States)

    Reilly, Danielle; Kamineni, Srinath

    2016-01-01

    Bursitis is a common medical condition, and of all the bursae in the body, the olecranon bursa is one of the most frequently affected. Bursitis at this location can be acute or chronic in timing and septic or aseptic. Distinguishing between septic and aseptic bursitis can be difficult, and the current literature is not clear on the optimum length or route of antibiotic treatment for septic cases. The current literature was reviewed to clarify these points. The reported data for olecranon bursitis were compiled from the current literature. The most common physical examination findings were tenderness (88% septic, 36% aseptic), erythema/cellulitis (83% septic, 27% aseptic), warmth (84% septic, 56% aseptic), report of trauma or evidence of a skin lesion (50% septic, 25% aseptic), and fever (38% septic, 0% aseptic). General laboratory data ranges were also summarized. Distinguishing between septic and aseptic olecranon bursitis can be difficult because the physical and laboratory data overlap. Evidence for the optimum length and route of antibiotic treatment for septic cases also differs. In this review we have presented the current data of offending bacteria, frequency of key physical examination findings, ranges of reported laboratory data, and treatment practices so that clinicians might have a better guide for treatment. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  10. A case report of the management and the outcome of a complete epiphyseal separation and dislocation with left anterior column fracture of the acetabulum

    Directory of Open Access Journals (Sweden)

    Jesús Palencia

    2016-01-01

    Conclusion: Epiphyseal fracture with dislocation of the femoral head is rare among children and adolescents, especially when associated with an acetabular fracture. AVN in such cases can develop, and it represents a challenge to orthopedic surgeons due to the poor prognosis and the future functional limitations of the joint.

  11. [Application of three-dimensional printing in the operation of distal tibia fracture involving epiphyseal plate injury for teenagers].

    Science.gov (United States)

    Zhao, Jingxin; Ma, Yachang; Han, Dong; Jin, Yu

    2017-10-01

    To investigate the application value of three-dimensional (3-D) printing technology in the operation of distal tibia fracture involving epiphyseal plate injury for teenagers. The retrospective analysis was conducted on the clinical data of 16 cases of children patients with distal tibia fracture involving epiphyseal plate injury undergoing the operation by using of 3-D printing technology between January 2014 and December 2015. There were 12 males and 4 females with an age of 9-14 years (mean, 12.8 years). The causes of injury included traffic accident injury in 9 cases, heavy pound injury in 3 cases, and sport injury in 4 cases. The time from injury to operation was 3-92 hours (mean, 25.8 hours). According to Salter-Harris typing standard, the typing for epiphyseal injury was classified as type Ⅱ in 11 cases, type Ⅲ in 4 cases, and type Ⅳ in 1 case. The thin slice CT scan on the affected limb was performed before operation, and the Mimics14.0 medical software was applied for the design and the 1∶1 fracture model was printed by the 3-D printer; the stimulation of operative reduction was made in the fracture model, and bone plate, Kirschner wire, and hollow screw with the appropriate size were chosen, then the complete operative approach and method were designed and the internal fixator regimen was chosen, then the practical operation was performed based on the preoperative design regimen. The operation time was 40-68 minutes (mean, 59.1 minutes); the intraoperative blood loss was 5-102 mL (mean, 35 mL); the intraoperative fluoroscopy times was 2-6 times (mean, 2.8 times). All the patiens were followed up 12-24 months (mean, 15 months). The fracture of 15 cases reached anatomic reduction, and 1 cases had no anatomic reduction with the displaced end less than 1 mm. All the fractures reached bony union with the healing time of 2-4 months (mean, 2.6 months). There was no deep vein thrombosis, premature epiphyseal closure and oblique, or uneven ankle surface

  12. Societal costs in displaced transverse olecranon fractures: using decision analysis tools to find the most cost-effective strategy between tension band wiring and locked plating.

    Science.gov (United States)

    Francis, Tittu; Washington, Travis; Srivastava, Karan; Moutzouros, Vasilios; Makhni, Eric C; Hakeos, William

    2017-11-01

    Tension band wiring (TBW) and locked plating are common treatment options for Mayo IIA olecranon fractures. Clinical trials have shown excellent functional outcomes with both techniques. Although TBW implants are significantly less expensive than a locked olecranon plate, TBW often requires an additional operation for implant removal. To choose the most cost-effective treatment strategy, surgeons must understand how implant costs and return to the operating room influence the most cost-effective strategy. This cost-effective analysis study explored the optimal treatment strategies by using decision analysis tools. An expected-value decision tree was constructed to estimate costs based on the 2 implant choices. Values for critical variables, such as implant removal rate, were obtained from the literature. A Monte Carlo simulation consisting of 100,000 trials was used to incorporate variability in medical costs and implant removal rates. Sensitivity analysis and strategy tables were used to show how different variables influence the most cost-effective strategy. TBW was the most cost-effective strategy, with a cost savings of approximately $1300. TBW was also the dominant strategy by being the most cost-effective solution in 63% of the Monte Carlo trials. Sensitivity analysis identified implant costs for plate fixation and surgical costs for implant removal as the most sensitive parameters influencing the cost-effective strategy. Strategy tables showed the most cost-effective solution as 2 parameters vary simultaneously. TBW is the most cost-effective strategy in treating Mayo IIA olecranon fractures despite a higher rate of return to the operating room. Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  13. Isolated olecranon fractures in children affected by osteogenesis imperfecta type I treated with single screw or tension band wiring system: Outcomes and pitfalls in relation to bone mineral density.

    Science.gov (United States)

    Persiani, Pietro; Ranaldi, Filippo M; Graci, Jole; De Cristo, Claudia; Zambrano, Anna; D'Eufemia, Patrizia; Martini, Lorena; Villani, Ciro

    2017-05-01

    The purpose of this study is to compare the results of 2 techniques, tension band wiring (TBW) and fixation with screws, in olecranon fractures in children affected with osteogenesis imperfecta (OI) type I. Between 2010 and 2014, 21 olecranon fractures in 18 children with OI (average age: 12 years old) were treated surgically. Ten patients were treated with the screw fixation and 11 with TBW. A total of 65% of olecranon fractures occurred as a result of a spontaneous avulsion of the olecranon during the contraction of the triceps muscle. The average follow-up was 36 months. Among the children treated with 1 screw, 5 patients needed a surgical revision with TBW due to a mobilization of the screw. In this group, the satisfactory results were 50%. In patients treated with TBW, the satisfactory results were 100% of the cases. The average Z-score, the last one recorded in the patients before the trauma, was -2.53 in patients treated with screw fixation and -2.04 in those treated with TBW. TBW represents the safest surgical treatment for patients suffering from OI type I, as it helps to prevent the rigidity of the elbow through an earlier recovery of the range of motion, and there was no loosening of the implant. In analyzing the average Z-score before any fracture, the fixation with screws has an increased risk of failure in combination with low bone mineral density.

  14. Traumatic olecranon bursitis

    International Nuclear Information System (INIS)

    Saini, M.; Canoso, J.J.

    1982-01-01

    The affected elbow of 28 patients with traumatic olecranon bursitis was radiographically compared with the homologous elbow of 28 matched controls. Olecranon spurs, amorphous calcium deposits, or both, were present in 16 patients and 4 controls (p<0.01). Air was injected in the bursa in 12 additional patients. Nodules in the bursal floor were noted in 10, and the bursa was partially septated in 8. Olecranon spurs, present in 6 patients, corresponded to the insertion of the triceps tendon. With elbow flexion the bursa flattened and lengthened while the olecranon process glided distally beneath the bursal floor. (Auth.)

  15. Surgical Repair of an Olecranon Fracture in a Horse / Reparação Cirúrgica de Fratura de Olécrano em Eqüino

    Directory of Open Access Journals (Sweden)

    Josmari Pirolo

    2010-04-01

    Full Text Available Olecranon fractures are frequently encountered in horses especially in foals. External trauma due to kicks or falls is the most common cause of the fracture. Treatment modalities of olecranon fractures including prolonged stall rest and surgical reconstruction of the different types of fractures have been proposed with different outcomes. This article describes a successful surgical reconstruction of an olecranon fracture in an adult horse repaired with a dynamic compression plate. The horse regained complete soundness and performed his job normally for additional 7 years. Information regarding the history, clinical signs, diagnosis, surgical treatment and long-term prognosis is discussed and compared with the current literature.As fraturas de olécrano ocorrem freqüentemente em eqüinos, especialmente em potros jovens. A causa mais comum da fratura relaciona-se ao trauma externo originado, principalmente, por coices ou quedas. Modalidades distintas de tratamento incluindo o repouso prolongado ou a reparação cirúrgica dos variados tipos de fratura têm sido executadas com diferentes resultados. Este trabalho tem por objetivo a descrição de um caso de fratura de olécrano em um eqüino adulto reparada cirurgicamente por meio de placa e parafusos ortopédicos. O animal apresentou recuperação plena da função locomotora desempenhando normalmente suas funções por mais 7 anos. Informações relativas ao histórico, sinais clínicos, diagnóstico, tratamento cirúrgico e prognóstico são discutidas e comparadas com a literatura.

  16. Medial epiphyseal fracture-detachment of the sternoclavicular joint with posterior displacement in a judo athlete - equivalent of posterior sternoclavicular dislocation

    Directory of Open Access Journals (Sweden)

    Rui Pimenta

    2013-04-01

    Full Text Available Posterior sternoclavicular dislocation is a rare traumatic injury that presents a potential risk of injury to mediastinal structures. The diagnosis is fundamentally clinical and treatment is done on an emergency basis. The authors report the clinical case of a young judo athlete with post-traumatic medial epiphyseal fracture-detachment, with posterior displacement (lesion equivalent to posterior sternoclavicular dislocation at pediatric ages. He underwent open reduction and ligament repair by means of a mini-anchor.The radiological and clinical outcome was excellent, and the athlete returned to his sports activity without limitations. We discuss the particular features of this pathological condition, along with the different therapeutic approaches and their complications

  17. Epiphysical clefts

    International Nuclear Information System (INIS)

    Brent Harrison, R.; Keats, T.E.

    1980-01-01

    Defects or clefts may be seen in the growing epiphysis and are usually observed just before puberty. The basal epiphysis of the proximal phalanx of the great toe is the most common site but similar defects have been observed in a numer of other epiphyseso At least some of these defects develop within a single normal appearing epiphysis and are not associated with signs or symptoms suggestive of fracture. The mechanism of formation of these defects is not clear. The defects probably close spontaneously some-time around late puberty. (orig.) [de

  18. Birth injuries to the epiphyseal cartilage

    International Nuclear Information System (INIS)

    Ekengren, K.; Bergdahl, S.; Ekstroem, G.

    1978-01-01

    A birth injury in the vicinity of a joint might lead to a fracture through the epiphyseal cartilage. The criteria for diagnosing such a fracture at radiography are considered and the continued remodelling of the bone demonstrated. The history of 2 cases with late diagnosis and serious long-term sequelae are described, in order to emphasize the necessity of early radiography. (Auth.)

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

    Science.gov (United States)

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

    2016-04-01

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

  20. Bilateral Olecranon Tophaceous Gout Bursitis

    Directory of Open Access Journals (Sweden)

    Güzelali Özdemir

    2017-01-01

    Full Text Available In this case, we present a patient with the diagnosis of bilateral olecranon tophaceous gout. After the surgical treatment, there was no limitation of range of motion or wound problem at 6th month control.

  1. Epiphyseal injuries of the distal tibia. Does MRI provide useful additional information?

    International Nuclear Information System (INIS)

    Iwinska-Zelder, J.; Schmidt, S.; Ishaque, N.; Klose, K.J.; Hoppe, M.; Schmitt, J.; Gotzen, L.

    1999-01-01

    Plain film radiography often underestimates the extent of injury in children with epiphyseal fracture. Especially Salter-Harris V fractures (crush fracture of the epiphyseal plate) are often primarily not detected. MRI of the ankle was performed in 10 children aged 9-17 (mean 14) years with suspected epiphyseal injury using 1.0-T Magnetom Expert. The fractures were classified according to the Salter-Harris-Rang-Odgen classification and compared with the results of plain radiography. In one case MRI could exclude epiphyseal injury; in four cases the MRI findings changed the therapeutic management. The visualisation of the fracture in three orthogonal planes and the possibility of detection of cartilage and ligamentous injury in MR imaging makes this method superior to conventional radiography and CT. With respect to radiation exposure MRI instead of CT should be used for the diagnosis of epiphyseal injuries in children. (orig.) [de

  2. Olecranon bursitis: a systematic overview

    Science.gov (United States)

    Hay, Bruce A; Bolt, Alexander M; Hay, Stuart M

    2014-01-01

    Background Olecranon bursitis is a common condition where the bursal cavity, superficial to the olecranon, becomes inflamed. This can occur either with or without infection and has been given pseudonyms relating to the repeated minor trauma from external pressure that often predisposes. As a result of the multiple aetiologies, olecranon bursitis can present to any medical specialty with reasonable frequency and, although many therapies are described, a single, evidence-based and standardized treatment pathway is not well described. Methods We summarize the key points within the literature and subsequently propose an evidence-based treatment pathway. Results Relevant evidence is presented from appropriate publications to add rational to existing decision-making processes, together with personal experience and suggested operative bursectomy techniques from an established upper limb surgeon. The common and significant aetiologies are summarized and, in particular, red flag symptoms are highlighted by way of warning to the unsuspecting investigator. Conclusions The conclusion is provided in diagrammatic form, providing a suggested treatment pathway from history and examination through to operative intervention. PMID:27582935

  3. An unusual case of olecranon tuberculosis.

    Science.gov (United States)

    Megas, Panagiotis; Karageorgos, Athanasios; Gliatis, Ioannis; Marangos, Markos

    2008-08-01

    A 67-year-old woman presented with erythema and swelling over her left elbow. She felt pain during palpation of the olecranon, while the range of elbow motion was slightly reduced (02 in circle-302 in circle-1302 in circle). She had been treated conservatively elsewhere for 3 months with nonsteroidal anti-inflammatory drugs and splint immobilization. Radiographs and computed tomography showed an osteolytic area over the olecranon with cortex disruption. She underwent open biopsy of the olecranon, and the histologic features were compatible with tuberculosis. Erythrocyte sedimentation rate was elevated and she had a positive Mantoux test (14 mm). She mentioned no history of pulmonary disease and had a normal chest radiograph. She received antituberculous treatment (isoniazid, rifambin, and pyrazinamide) for 2 months without obvious improvement. She underwent surgical debridement of the olecranon while she continued antituberculous treatment for 12 months, discontinuing pyrazinamide after the third month. After the completion of antituberculous treatment, the patient was pain-free, without local signs of infection and with improved range of motion (02 in circle-202 in circle-1452 in circle). Early diagnosis and treatment of olecranon tuberculosis is of great value, and the prognosis is good when there is no spread in the elbow joint.

  4. Tension band wiring of the olecranon: is it really a dynamic principle of osteosynthesis?

    Science.gov (United States)

    Brink, P R G; Windolf, M; de Boer, P; Brianza, S; Braunstein, V; Schwieger, K

    2013-04-01

    The tension band principle as applied to transverse olecranon fractures fixed by tension band wiring is based on the premise that distraction forces on the outer cortex of the ulna during elbow flexion are converted to compression forces on the articular surface of the olecranon at the fracture site. In view of some clinical outcomes, where hardware failure and secondary dislocations occur, the question arises if the dynamic compression theory is correct. Compressive forces during active flexion and extension after tension band wiring of a transverse osteotomy of the olecranon were measured in 6 fresh frozen human cadaveric models using a pressure-sensor in the osteotomy gap. We could collect 30 measurements during active flexion and 30 during active extension. Active flexion did not cause any compressive forces in the osteotomy gap. Extension with the humerus in an upright position and the elbow actively extended causes some compression (0.37-0.51 MPa) at the articular surface comparing with active flexion (0.2 MPa) due to gravity forces. Posterior, there was no significant pressure difference observed (0.41-0.45 versus 0.36-0.32 MPa) between active flexion and extension. The tension band wiring principle only exists during active extension in a range of 30-120° of flexion of the elbow. Postoperative exercise programs should be modified in order to prevent loss of compression at the fracture site of transverse olecranon fractures, treated with tension band wiring when the elbow is mobilised. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Polydimethylsiloxane pressure sensors for force analysis in tension band wiring of the olecranon.

    Science.gov (United States)

    Zens, Martin; Goldschmidtboeing, Frank; Wagner, Ferdinand; Reising, Kilian; Südkamp, Norbert P; Woias, Peter

    2016-11-14

    Several different surgical techniques are used in the treatment of olecranon fractures. Tension band wiring is one of the most preferred options by surgeons worldwide. The concept of this technique is to transform a tensile force into a compression force that adjoins two surfaces of a fractured bone. Currently, little is known about the resulting compression force within a fracture. Sensor devices are needed that directly transduce the compression force into a measurement quality. This allows the comparison of different surgical techniques. Ideally the sensor devices ought to be placed in the gap between the fractured segments. The design, development and characterization of miniaturized pressure sensors fabricated entirely from polydimethylsiloxane (PDMS) for a placement within a fracture is presented. The pressure sensors presented in this work are tested, calibrated and used in an experimental in vitro study. The pressure sensors are highly sensitive with an accuracy of approximately 3 kPa. A flexible fabrication process for various possible applications is described. The first in vitro study shows that using a single-twist or double-twist technique in tension band wiring of the olecranon has no significant effect on the resulting compression forces. The in vitro study shows the feasibility of the proposed measurement technique and the results of a first exemplary study.

  6. Treatment of olecranon bursitis: a systematic review.

    Science.gov (United States)

    Sayegh, Eli T; Strauch, Robert J

    2014-11-01

    The optimal management of olecranon bursitis is ill-defined. The purposes of this review were to systematically evaluate clinical outcomes for aseptic versus septic bursitis, compare surgical versus nonsurgical management, and examine the roles of corticosteroid injection and aspiration in aseptic bursitis. The English-language literature was searched using PubMed, Cumulative Index to Nursing and Allied Health Literature, Physiotherapy Evidence Database, Allied and Complementary Medicine, and Cochrane Central Register of Controlled Trials. Analyses were performed for clinical resolution and complications after treatment of aseptic and/or septic olecranon bursitis. Twenty-nine studies containing 1278 patients were included. Compared with septic bursitis, aseptic bursitis was associated with a significantly higher overall complication rate (p = 0.0108). Surgical management was less likely to clinically resolve septic or aseptic bursitis (p = 0.0476), and demonstrated higher rates of overall complications (p = 0.0117), persistent drainage (p = 0.0194), and bursal infection (p = 0.0060) than nonsurgical management. Corticosteroid injection for aseptic bursitis was associated with increased overall complications (p = 0.0458) and skin atrophy (p = 0.0261). Aspiration did not increase the risk of bursal infection for aseptic bursitis. Based primarily on level IV evidence, nonsurgical management of olecranon bursitis is significantly more effective and safer than surgical management. The clinical course of aseptic bursitis appears to be more complicated than that of septic bursitis. Corticosteroid injection is associated with significant risks without improving the outcome of aseptic bursitis. Therapeutic IV.

  7. The scintigraphic diagnosis and follow-up of injuries to the epiphyseal plates

    International Nuclear Information System (INIS)

    Walter, E.; Feine, U.; Anger, K.; Schweizer, P.; Neugebauer, W.; Tuebingen Univ.; Tuebingen Univ.

    1980-01-01

    Injuries to the epiphysel plates without involvement of the epiphyses or metaphyses, such as crush fractures or pure epiphysiolysis may be difficult to diagnose radiologically. Thirteen bone scans after damage to the growth plate have been performed on eight children. These indicate that these scans are able to diagnose lesions of the epiphyseal plates at an early stage and with certainty. The scintigrams also provide information concerning the healing process of the plate; they indicate when healing has been completed and when the extremity can be used for weight-bearing again. Radiation exposure of the children during scintigraphy with sub(99m)Tc-polyphosphate is within acceptable limits. (orig.) [de

  8. CT evaluation of primary epiphyseal bone abscesses

    Energy Technology Data Exchange (ETDEWEB)

    Azouz, E.M. (Dept. of Radiology, McGill Univ., Montreal Children' s Hospital, PQ (Canada)); Greenspan, A. (Dept. of Radiology, California Univ., Davis School of Medicine, Sacramento, CA (United States)); Marton, D. (Dept. of Radiology, Montreal Univ., Hopital Ste Justine, PQ (Canada))

    1993-01-01

    We reviewed the clinical, radiographic, and computed tomographic (CT) findings in eight children with a histologically proven diagnosis of epiphyseal or apophyseal osteomyelitis. In all cases the femur was involved: in five the osteomyelitis was localized in the femoral condyle, in two it was in the greater trochanter, and in one it was in the femoral head epiphysis. In four of the six cases of epiphyseal involvement there was associated joint effusion or septic arthritis. CT examination may demonstrate a serpentine tract, a sequestrum, cortical destruction or adjacent soft tissue swelling and can differentiate osteomyelitis from other epiphyseal lucent lesions, particularly chondroblastoma and osteoid osteoma. Early diagnosis helps avoid delays in initiating antibiotic or surgical treatment caused by the unusual (epiphyseal or apophyseal) location of the bone abscess. (orig./GD)

  9. Rare giant cell tumor involvement of the olecranon bone

    Directory of Open Access Journals (Sweden)

    Chen Yang

    2014-01-01

    Full Text Available Giant cell tumor (GCT of bone is a relatively common benign bone lesion and is usually located in long bones, but involvement of the olecranon is extremely rare. Here, we present a case of solitary GCT of bone in the olecranon that was confirmed by preoperative needle biopsy and postoperative histological examination. The treatment included intralesional curettage, allogeneic bone grafting, and plating. At 26 months follow-up, the patient had no local recurrence.

  10. Diagnosis and management of olecranon bursitis.

    Science.gov (United States)

    Del Buono, Angelo; Franceschi, Francesco; Palumbo, Alessio; Denaro, Vincenzo; Maffulli, Nicola

    2012-10-01

    We aim to review the current knowledge on diagnosis, clinical features and main management modalities of olecranon bursitis. We underline that the first treatment line is conservative, including ice, rest, anti-inflammatory and analgesic drugs and, occasionally, bursal fluid aspiration. In unresponsive patients, although open excisional procedures allow to completely remove the pathological bursal tissue, arthroscopy is increasingly being considered as a suitable new modality of management. These minimally invasive procedures, although not free from complications, avoid the wound problems often occurring following open excision. Copyright © 2012 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

  11. Longitudinal tibial epiphyseal bracket in Nievergelt syndrome

    International Nuclear Information System (INIS)

    Burnstein, M.I.; De Smet, A.A.; Breed, A.L.; Thomas, J.R.; Hafez, G.R.

    1989-01-01

    A patient is described with lower extremity mesomelic dwarfism associated with bilateral congenital elbow, hip, and knee dislocations. Rhomboid-shaped tibiae and delayed ossification of the primary fibular ossification centers were demonstrated at birth. Plain films and magnetic resonance imaging revealed that the tibial deformities were due to the presence of longitudinal epiphyseal brackets. These brackets were observed at surgery and confirmed histologically. Recognition of the longitudinal epiphyseal bracket and its relationship to the tibial deformities seen in this patient with Nievergelt syndrome is important for planning surgical treatment. (orig.)

  12. Longitudinal tibial epiphyseal bracket in Nievergelt syndrome

    Energy Technology Data Exchange (ETDEWEB)

    Burnstein, M.I.; De Smet, A.A.; Breed, A.L.; Thomas, J.R.; Hafez, G.R.

    1989-04-01

    A patient is described with lower extremity mesomelic dwarfism associated with bilateral congenital elbow, hip, and knee dislocations. Rhomboid-shaped tibiae and delayed ossification of the primary fibular ossification centers were demonstrated at birth. Plain films and magnetic resonance imaging revealed that the tibial deformities were due to the presence of longitudinal epiphyseal brackets. These brackets were observed at surgery and confirmed histologically. Recognition of the longitudinal epiphyseal bracket and its relationship to the tibial deformities seen in this patient with Nievergelt syndrome is important for planning surgical treatment. (orig.).

  13. Solitary lucent epiphyseal lesions in children

    Energy Technology Data Exchange (ETDEWEB)

    Gardner, D.J.; Azouz, E.M.

    1988-10-01

    We evaluated retrospectively the varying radiographic appearances of 15 solitary lucent epiphyseal lesions occurring in children. Imaging modalities used included plain films, conventional tomography, nuclear scintigraphy, and computed tomography. 40% of the lesions (6) were due to osteomyelitis. The remaining lesions included tuberculosis (1), foreign body granuloma (1), chondroblastoma (2), chondromyoxid fibroma (1), enchondroma (1), osteoid osteoma (2), and eosinophilic granuloma (1). Although the radiographic appearances of such lesions may be particularly characteristic, pathologic correlation is frequently necessary. The high incidence of osteomyelitis in our cases emphasizes its importance as a cause for a lucent epiphyseal lesion.

  14. Candida glabrata olecranon bursitis treated with bursectomy and intravenous caspofungin.

    Science.gov (United States)

    Skedros, John G; Keenan, Kendra E; Trachtenberg, Joel D

    2013-01-01

    Orthopedic surgeons are becoming more involved in the care of patients with septic arthritis and bursitis caused by yeast species. This case report involves a middle-aged immunocompromised female who developed a Candida glabrata septic olecranon bursitis that developed after she received a corticosteroid injection in the olecranon bursa for presumed aseptic bursitis. Candida (Torulopsis) glabrata is the second most frequently isolated Candida species from the bloodstream in the United States. Increased use of fluconazole and other azole antifungal agents as a prophylactic treatment for recurrent Candida albicans infections in immunocompromised individuals is one reason why there appears to be increased resistance of C. glabrata and other nonalbicans Candida (NAC) species to fluconazole. In this patient, this infection was treated with surgery (bursectomy) and intravenous caspofungin, an echinocandin. This rare infectious etiology coupled with this intravenous antifungal treatment makes this case novel among cases of olecranon bursitis caused by yeasts.

  15. Epiphyseal osteochondroma of the anterior cruciate ligament.

    Science.gov (United States)

    Chekofsky, K M; Scott, W N; Fielding, J W

    1979-01-01

    An 8-year-old Black boy complained of pain, swelling, and a decreased range of motion in the knee. One arthrotomy operation was reported to show a normal knee joint. Six months later, a second arthrotomy demonstrated an osteochondroma growing from the epiphysis into the anterior cruciate ligament. Epiphyseal osteochondroma should be added to the working differential diagnosis on children with effusion and decrease of knee motion.

  16. Bilateral olecranon bursitis – A rare clinical presentation of gout

    Directory of Open Access Journals (Sweden)

    Betul Sargın

    2018-04-01

    Full Text Available Background: Gout is the most common form of crystal arthropathy. Monoarthritis affecting the first metatarsophalangeal joint is the common initial presentation. Bilateral olecranon bursitis is a rare presentation of gout. Aim of the work: To describe the clinical features of bilateral olecranon bursitis as an initial presentation of gout. Case report: A 62-year old male patient presented to the rheumatology clinic , Adnan Menderes University with sudden bilateral elbow pain and swelling for three months . Swellings gradually increased to the size of a golf ball with minimal restriction in the elbow extension (170°. He didn’t have arthritis in the elbows. The patient had medical history of heart failure and chronic obstructive pulmonary disease and medications received included acetylsalicylic acid and diuretics. Blood tests revealed elevated serum uric acid (12.6 mg/dL, with normal renal function tests, erythrocyte sedimentation rate (ESR 43 mm/h and C-reactive protein (CRP 8.8 mg/L. Rheumatoid factor and hepatitis markers were negative. Diagnostic bursal aspiration excluded septic bursitis and under polarized microscopy monosodium urate (MSU crystals were identified with typical negative birefringence. A diagnosis of gout was established. ESR and CRP were normalized after diclofenac potassium (100 mg and colchicine (1.5 mg. Allopurinol 300 mg was added when his joint pain was relieved. Conclusion: This is the first gout case initially presenting with bilateral olecranon bursitis. Bursal fluid analysis is important in such atypical presentation to look for MSU crystals and establish a diagnosis. Keywords: Olecranon bursitis, Gout, Crystal arthropathy, Monosodium urate

  17. Neglected distal humeral epiphyseal injury - Two Case Reports ...

    African Journals Online (AJOL)

    We present two cases of neglected distal humeral epiphyseal injury in children that resulted in cubitus varus deformity in one case. Full range of movements was achieved in both cases after proper management. Keywords: Neglected epiphyseal injury; Cubitus varus; Diagnosis; Treatment Internet Journal of Medical Update ...

  18. Multiple Epiphyseal Dysplasia: A Clinical and Molecular Genetic Study

    NARCIS (Netherlands)

    J.B.A. van Mourik (Jan)

    1998-01-01

    textabstractMultiple epiphyseal dysplasia (MED) is one of the most common osteochondrodysplasias [Wynne-Davies and Gormley 1985]. During childhood and adolescence it affects the epiphyses of the tubular bones, resulting in axial deformities and shorter limbs.·Later in life MED can lead to

  19. Osteoradionecrosis of the olecranon: treatment by radial forearm flap

    International Nuclear Information System (INIS)

    Thornton, J.W.; Stevenson, T.R.; VanderKolk, C.A.

    1987-01-01

    Osteoradionecrosis of the olecranon is an unusual pathologic entity, treated best by debridement and wound closure using vascularized tissue. Local skin is often unavailable for flap design and transposition. The radial forearm flap can be isolated on a proximal vascular pedicle and transposed to cover the wound. In the case presented, healing was brisk and complete, allowing early elbow mobilization. Although the donor site is not easily concealed, no functional impairment results from flap elevation and all full-thickness wounds are confined to the involved extremity

  20. Trevor Disease (Hemimelic Epiphyseal Displasia): 12‑year Follow ...

    African Journals Online (AJOL)

    Trevor disease or hemimelic epiphyseal dysplasia is a rare skeletal developmental disorder characterized ... It was impossible to remove and model the anomalous tissue ... imaging (MRI) images ‑ gross deformation of the talus head and neck.

  1. Correlative roentgenography and morphology of the longitudinal epiphyseal bracket

    International Nuclear Information System (INIS)

    Ogden, J.A.; Light, T.R.; Conlogue, G.J.; Yale Univ., New Haven, CT

    1981-01-01

    Detailed examination of a complete chondro-osseous specimen from a patient with duplication of the first ray of the foot revealed the involved metatarsal had a trapezoid-shaped, diaphyseal-metaphyseal osseous unit that was longitudinally bracketed along the lateral side by a functioning physis, epiphysis, and secondary (epiphyseal) ossification center. The physis extended as an arc from the medial proximal side toward and along the lateral side and then back to the medial side distally. The medial side of the diaphysis had a normal periosteum. The longitudinal epiphyseal ossification bracket was a composite of initially separate proximal and distal secondary ossification centers that had progressively extended toward each other and finally coalesced along the laterally placed epiphyseal cartilage. We have termed this deformity the 'longitudinal epiphyseal bracket' (LEB). The macroscopic and microscopic anatomy relevant to initial diagnosis and evaluation of sequential roentgenographic changes will be considered. (orig.)

  2. Epiphyseal injuries of the distal tibia. Does MRI provide useful additional information?; Epiphysenfugenverletzungen der distalen Tibia. Sinnvolle Mehrinformation durch die MRT?

    Energy Technology Data Exchange (ETDEWEB)

    Iwinska-Zelder, J.; Schmidt, S.; Ishaque, N.; Klose, K.J.; Hoppe, M. [Marburg Univ. (Germany). Abt. fuer Strahlendiagnostik; Schmitt, J.; Gotzen, L. [Marburg Univ. (Germany). Medizinisches Zentrum fuer Operative Medizin

    1999-01-01

    Plain film radiography often underestimates the extent of injury in children with epiphyseal fracture. Especially Salter-Harris V fractures (crush fracture of the epiphyseal plate) are often primarily not detected. MRI of the ankle was performed in 10 children aged 9-17 (mean 14) years with suspected epiphyseal injury using 1.0-T Magnetom Expert. The fractures were classified according to the Salter-Harris-Rang-Odgen classification and compared with the results of plain radiography. In one case MRI could exclude epiphyseal injury; in four cases the MRI findings changed the therapeutic management. The visualisation of the fracture in three orthogonal planes and the possibility of detection of cartilage and ligamentous injury in MR imaging makes this method superior to conventional radiography and CT. With respect to radiation exposure MRI instead of CT should be used for the diagnosis of epiphyseal injuries in children. (orig.) [Deutsch] Die konventionelle Roentgendiagnostik unterschaetzt haeufig das Ausmass der kindlichen Extremitaetenfrakturen mit Epiphysenbeteiligung (Typ Salter-Harris). Insbesondere werden die Kompressionsfrakturen der Wachstumsfuge (Salter-Harris V) primaer haeufig nicht erkannt. Prospektiv wurden 10 Kinder im Alter von 9-17 Jahren (Durchschnittsalter = 14 J.) mit Verdacht auf eine epiphysaere Fraktur der distalen Tibia magnetresonanztomographisch (1.0-Tesla Magnetom Expert), untersucht. Die MRT-Ergebnisse wurden auf der Basis der Klassifikation nach Salter-Harris-Rang-Odgen mit den konventionellen Roentgenbildern verglichen. In einem Fall, bei einem 15jaehrigen Patienten, gelang durch die MRT der Ausschluss einer epiphysaeren Verletzung. In 7 Faellen fuehrte der MRT-Einsatz zu einer Aenderung der Klassifikation nach Salter-Harris. Hieraus resultierte bei 4 Patienten ein Therapiewechsel. Da Frakturen, die sie begleitenden Knorpellaesionen und ligamentaere Verletzungen multiplanar dargestellt werden koennen, weist die MRT deutliche Vorteile

  3. Chemotherapy decreases epiphyseal strength and increases bone fracture risk

    NARCIS (Netherlands)

    Van Leeuwen, BL; Verkerke, GJ; Hartel, RM; Sluiter, WJ; Kamps, WA; Jansen, HWB; Hoekstra, HJ

    To establish the effect of three frequently used chemotherapeutic agents in childhood cancer on the skeleton, growing male Wistar rats were studied. Treatment with doxorubicin, methotrexate, and cisplatin reduces the proximal tibial growth plate shear strength because of a decreased surface area and

  4. [Current treatment concepts for olecranon and prepatellar bursitis in Austria].

    Science.gov (United States)

    Baumbach, S F; Michel, M; Wyen, H; Buschmann, C T; Kdolsky, R; Kanz, K-G

    2013-04-01

    The limited evidence available on the diagnosis and treatment of olecranon and prepatellar bursitis indicates nationally varying treatment approaches. Therefore the aim of this study was to survey the current treatment concepts of olecranon and prepatellar bursitis in Austria. An online questionnaire comprising of demographic data, questions regarding diagnostics and differentiation between septic bursitis (SB) and non-septic bursitis (NSB) as well as two case reports for therapy appraisal were sent to members of the Austrian Society of Orthopaedics and Orthopaedic Surgery (ÖGO) and the Austrian Society of Traumatology (ÖGU). The overall response rates were 46 % (ÖGU)/12 % (ÖGO). Differentiation between SB and NSB was predominantly based on medical history/clinical presentation (ÖGU: 100 %/ÖGO: 84 %) and blood sampling (ÖGU: 82 %/ÖGO: 77 %). 64/36 % of surveyed members of ÖGO/OGU performed a bursal aspiration. 95/55 % of Austrian ÖGU opinion leaders favoured a surgical treatment approach in cases of SB/NSB. Conversely, ÖGO members rather favoured a conservative treatment approach (28/27 %). Significant differences were found between ÖGO and ÖGU, with the latter favouring a surgical treatment approach in cases of SB and NSB. However, the international literature argues for a conservative treatment approach. Further high quality research is needed to establish an evidence-based treatment approach. Georg Thieme Verlag KG Stuttgart · New York.

  5. First report of Nocardia asiatica olecranon bursitis in an immunocompetent traveler returning to Austria.

    Science.gov (United States)

    Leitner, Eva; Valentin, Thomas; Hoenigl, Martin; Lanz, Philipp; Flick, Holger; Zollner-Schwetz, Ines; Grisold, Andrea J; Feierl, Gebhard; Krause, Robert

    2013-07-01

    Nocardia spp. are rarely isolated in extrapulmonary clinical specimens. We describe the first case of olecranon bursitis caused by Nocardia asiatica. The patient, a traveler returning from Thailand, was successfully treated with linezolid.

  6. Paecilomyces lilacinus septic olecranon bursitis in an immunocompetent host.

    Science.gov (United States)

    Schweitzer, Karl M; Richard, Marc J; Leversedge, Fraser J; Ruch, David S

    2012-05-01

    Paecilomyces lilacinus is a filamentous fungus that is a rare cause of infection in immunocompromised human hosts. We present a case of lilacinus septic olecranon bursitis in an otherwise healthy 78-year-old male. This patient's case was complicated by wound breakdown after bursectomy and appropriate anti-fungal treatment, requiring a local soft tissue rearrangement. This case demonstrates the need for appropriate and timely medical and surgical treatment in infections involving lilacinus, which are not isolated solely to systemically immunocompromised and medically-ill patient populations. In cases where the patient is systemically immumocompromised or has been rendered locally immunocompromised, it is essential to obtain a full culture work-up, including fungi.

  7. Neglected Distal Humeral Epiphyseal Injury - Two Case Reports

    Directory of Open Access Journals (Sweden)

    Dr. Pankaj Kumar

    2008-07-01

    Full Text Available Distal humeral epiphyseal separation is an uncommon injury in children, which can be missed or misdiagnosed at initial presentation. Awareness of this injury and appropriate radiological assessment helps in proper management. Neglected cases because of inappropriate diagnosis can result in cubitus varus deformity. Full range of movements of elbow can be achieved if properly diagnosed and managed. We present two cases of neglected distal humeral epiphyseal injury in children that resulted in cubitus varus deformity in one case. Full range of movements was achieved in both cases after proper management.

  8. Localised form of spondylo-epiphyseal dysplasia congenita

    International Nuclear Information System (INIS)

    Hoeffel, J.C.; Mohy, R.; Collignon, P.; Moog, G.

    1988-01-01

    We report an unusual case of spondylo-epiphyseal dysplasia congenita which affected only the hips and the thoraco-lumbar spine. The epiphysis of the long bones are normal apart from the hips. Our child has a bilateral epiphyseal dysplasia of both proximal femoral epiphysis discovered incidentally at 11 months and confirmed later on at 8 years, associated with abnormalities of the superior margin of the vertebral bodies from T11 to L2. Very few similar cases have been reported anteriorly. (orig.) [de

  9. Pediatric elbow fractures: a new angle on an old topic

    Energy Technology Data Exchange (ETDEWEB)

    Emery, Kathleen H.; Anton, Christopher G. [Cincinnati Children' s Hospital Medical Center, Department of Radiology, Cincinnati, OH (United States); Zingula, Shannon N. [Mayo Clinic, Department of Radiology, Rochester, MN (United States); Salisbury, Shelia R. [Cincinnati Children' s Hospital Medical Center, Biostatistics and Epidemiology, Cincinnati, OH (United States); Tamai, Junichi [Cincinnati Children' s Hospital Medical Center, Department of Pediatric Orthopedics, Cincinnati, OH (United States)

    2016-01-15

    The three most common elbow fractures classically reported in pediatric orthopedic literature are supracondylar (50-70%), lateral condylar (17-34%), and medial epicondylar fractures (10%), with fractures of the proximal radius (including but not limited to fractures of the radial neck) being relatively uncommon (5-10%). Our experience at a large children's hospital suggests a different distribution. Our goals were (1) to ascertain the frequency of different elbow fracture types in a large pediatric population, and (2) to determine which fracture types were occult on initial radiographs but detected on follow-up. Review of medical records identified 462 children, median age 6 years and interquartile range for age of 4-8 years (range 0.8-18 years), who were diagnosed with elbow fractures at our institution over a 10-month period. Initial and follow-up radiographs were reviewed in blinded fashion independently by two experienced pediatric musculoskeletal radiologists to identify fracture types on initial and follow-up radiographs. The most common fractures included supracondylar (n = 258, 56%), radial neck (n = 80, 17%), and lateral condylar (n = 69, 15%). Additional fractures were seen on follow-up exams in 32 children. Of these, 25 had a different fracture type than was identified on initial radiographs. The most common follow-up fractures were olecranon (n = 23, 72%), coronoid process (n = 4, 13%) and supracondylar (n = 3, 9%). Olecranon fractures were significantly more common on follow-up radiographs than they were on initial radiographs (n = 33, 7%; P <.0001). Twenty-six children had more than one fracture type on the initial radiograph. The most common fracture combinations were radial neck with olecranon (n = 9) and supracondylar with lateral condylar (n = 9). Supracondylar fractures are the most frequent elbow fracture seen initially, followed by radial neck, lateral condylar, and olecranon fractures in a distribution different from what has been

  10. Multiple epiphyseal dysplasia complicated by severe osteochondritis dissecans of the knee. Incidence in two families

    Energy Technology Data Exchange (ETDEWEB)

    Versteylen, R.J.; Zwemmer, A.; Lorie, C.A.M.; Schuur, K.H.

    1988-09-01

    Two families are described which appear to contain examples of multiple epiphyseal dysplasia. In both families a striking incidence of severe osteochondritis of the knees was encountered. It is suggested that this was caused by the fragmented and maldeveloped epiphyses characteristic of epiphyseal dysplasia.

  11. Epiphyseal involvement in unicameral bone cysts

    International Nuclear Information System (INIS)

    Capanna, R.; Ruggieri, P.; Biagini, R.; Horn, J. van

    1986-01-01

    Twelve patients are reported in whom a unicameral bone cyst was found to involve the epiphysis or apophysis across an open growth plate. Nine patients showed pathologic fracture. In four patients a growth disturbance was found. A varying amount of varus angulation was present in most cases. No patient had functional impairment. (orig.)

  12. Epiphyseal involvement in unicameral bone cysts

    Energy Technology Data Exchange (ETDEWEB)

    Capanna, R.; Ruggieri, P.; Biagini, R.; Horn, J. van

    1986-08-01

    Twelve patients are reported in whom a unicameral bone cyst was found to involve the epiphysis or apophysis across an open growth plate. Nine patients showed pathologic fracture. In four patients a growth disturbance was found. A varying amount of varus angulation was present in most cases. No patient had functional impairment.

  13. Spondylo-epiphyseal dysplacea tarda (a case report.

    Directory of Open Access Journals (Sweden)

    Pathare A

    1991-04-01

    Full Text Available A rare case of disproportionate short stature suggestive of spondylo-epiphyseal dysplasia tarda is reported and relevant literature reviewed. It is emphasized that its radiological features show a marked similarity to ochronotic spine, with which it is therefore commonly mistaken. An indeterminate pigment was observed in the liver biopsy in this case with connective tissue disorder.

  14. Avascular necrosis of the hip in multiple epiphyseal dysplasia

    International Nuclear Information System (INIS)

    Mackenzie, W.G.; Bassett, G.S.; Mandell, G.A.; Scott, C.I. Jr.

    1989-01-01

    We observed radiographic changes of avascular necrosis (AVN) of the capital femoral epiphysis in 9 hips of 11 patients with multiple epiphyseal dysplasia (MED). Plain roentgenography, bone scintigraphy, and magnetic resonance imaging (MRI) studies all revealed characteristic asymmetric changes in the presence of AVN superimposed on dysplastic femoral heads

  15. Sokoto Journal of Veterinary Sciences Epiphyseal plate closure of ...

    African Journals Online (AJOL)

    ADEYEYE

    Nigeria. 2. Department of Veterinary Surgery and Radiology, Faculty of Veterinary Medicine, Usmanu Danfodiyo University. Sokoto, Nigeria ... from three different small ruminant farms with birth record within Sokoto metropolis,. Nigeria. They were ... animals, one of which is the use of epiphyseal plate closure (Choi et al., ...

  16. Mycobacterium avium intracellulare complex causing olecranon bursitis and prosthetic joint infection in an immunocompromised host

    Directory of Open Access Journals (Sweden)

    Eugene M. Tan

    2016-01-01

    Full Text Available Case: A 73-year-old immunocompromised male presented with recurrent left elbow swelling due to Mycobacterium avium intracellulare complex (MAC olecranon bursitis. 3 years after completing MAC treatment, he underwent right total knee arthroplasty (TKA. 1 year later, he developed TKA pain and swelling and was diagnosed with MAC prosthetic joint infection (PJI. He underwent TKA resection, reimplantation, and 12 months of anti-MAC therapy. This patient is the seventh case report of MAC olecranon bursitis and the third case report of MAC PJI. He is the only report of both MAC olecranon bursitis and PJI occurring in the same patient. Informed consent: This patient was informed and agreed to the publication of this material.

  17. Long-term follow-up of corticosteroid injection for traumatic olecranon bursitis.

    Science.gov (United States)

    Weinstein, P S; Canoso, J J; Wohlgethan, J R

    1984-01-01

    Forty-seven patients with traumatic olecranon bursitis were evaluated after a mean follow-up of 31 months (range 6 to 62 months). Twenty-two patients treated with bursal aspiration had delayed recovery and no complications of therapy. Twenty-five patients treated with intrabursal injection of 20 mg of triamcinolone hexacetonide had rapid recovery, usually within one week, but suffered complications such as infection (3 cases), skin atrophy (5 cases), and chronic local pain (7 cases). Since spontaneous resolution can be expected, a conservative approach is suggested in the treatment of traumatic olecranon bursitis. Images PMID:6696516

  18. Group B streptococcal meningitis in an adult: A possible complication of olecranon bursitis

    Directory of Open Access Journals (Sweden)

    Manuela Colosimo

    2014-01-01

    Full Text Available Background: We report a man with septic olecranon bursitis who had an early development of meningitis. Case Summary: A 74-year-old man presented to the emergency room with malaise, headache, mental confusion, a fever unsuccessfully treated with oral NSAIDs and ice, and with a 10-day history of pain and swelling in his right elbow. Clinical and laboratory evaluation excluded other causes and microbiological evaluation documented a S. agalactiae infection. Antibiotic treatment induced a rapid improvement, without the development of side effects. Conclusion: This is the first report on olecranon bursitis and concomitant meningitis related to S. agalactiae infection.

  19. Premature epiphyseal fusion and extramedullary hematopoiesis in thalassemia

    International Nuclear Information System (INIS)

    Colavita, N.; Orazi, C.; Danza, S.M.; Falappa, P.G.; Fabbri, R.

    1987-01-01

    The main skeletal abnormalities in β-thalassemia are widening of medullary spaces, rarefaction of bone trabeculae, thinning of cortical bone, and perpendicular periosteal spiculation. Premature epiphyseal fusion (PEF) and extramedullary hematopoiesis (EH) are found, though more rarely. The incidence of PEF and EH in 64 patients affected by β-thalassemia is reported. The different incidence of such complications in thalassemia major and intermedia is reported, and a possible correlation with transfusion regimen is also considered. (orig.)

  20. Multiple epiphyseal dysplasia: radiographic abnormalities correlated with genotype

    Energy Technology Data Exchange (ETDEWEB)

    Unger, S.L. [Ahmanson Department of Pediatrics, Steven Spielberg Pediatric Research Center, Los Angeles, CA (United States); Briggs, M.D.; Holden, P. [Wellcome Trust Centre for Cell-Matrix Research, University of Manchester (United Kingdom); Zabel, B. [Children' s Hospital, Univ. of Mainz (Germany); Ala-Kokko, L.; Paassilta, P.; Lohiniva, J. [Dept. of Medical Biochemistry, Univ. of Oulu (Finland); Rimoin, D.L. [Ahmanson Department of Pediatrics, Steven Spielberg Pediatric Research Center, Los Angeles, CA (United States); Department of Pediatrics, UCLA School of Medicine, Los Angeles, CA (United States); Lachman, R.S. [Ahmanson Department of Pediatrics, Steven Spielberg Pediatric Research Center, Los Angeles, CA (United States); Department of Pediatrics, UCLA School of Medicine, Los Angeles, CA (United States); Department of Radiology, UCLA School of Medicine, Los Angeles, CA (United States); Cohn, D.H. [Ahmanson Department of Pediatrics, Steven Spielberg Pediatric Research Center, Los Angeles, CA (United States); Department of Human Genetics, UCLA School of Medicine, Los Angeles, CA (United States)

    2001-01-01

    Multiple epiphyseal dysplasia (MED) is an osteochondrodysplasia characterized clinically by mild short stature and early-onset degenerative joint disease and radiographically by epiphyseal hypoplasia/dysplasia. MED is genetically heterogeneous, with autosomal dominant cases resulting from mutations in at least three genes: the cartilage oligomeric matrix protein (COMP) gene (EDM1) and the COL9A2 (EDM2) and COL9A3 (EDM3) genes of type IX procollagen. We present here a comparison of the radiographic phenotypes of MED patients with type IX collagen gene mutations and those with COMP gene mutations. We reviewed radiographs from two patients with MED produced by COMP mutations, two families with COL9A2 mutations, and one family with a mutation in COL9A3. The data demonstrated that the patients with type IX collagen defects had more severe joint involvement at the knees and relative hip sparing, while the patients with COMP mutations had significant involvement at the capital femoral epiphyses and irregular acetabuli. This pattern of joint involvement was consistent regardless of overall degree of severity of the phenotype. (orig.)

  1. Septic and non-septic olecranon bursitis in the accident and emergency department--an approach to management.

    Science.gov (United States)

    Stell, I M

    1996-01-01

    Olecranon bursitis is relatively common. One third of episodes are septic. Most of the remainder are non-septic, with occasional rheumatological causes. Trauma can cause both septic and non-septic olecranon bursitis. Clinical features are helpful in separating septic from non-septic olecranon bursitis, but there may be local erythema in both. Aspiration should be carried out in all cases, and if the presence of infection is still in doubt, microscopy, Gram staining, and culture of the aspirate will resolve the issue. Septic olecranon bursitis should be treated by aspiration, which may need to be repeated, and a long course of antibiotics. Some cases will need admission, and a few will need surgical treatment. Non-septic olecranon bursitis can be managed with aspiration alone. Non-steroidal anti-inflammatory drugs probably hasten symptomatic improvement. Intrabursal corticosteroids produce a rapid resolution but concern remains over their long term local effects. Recovery from septic olecranon bursitis can take months. PMID:8894865

  2. Epiphyseal plate closure of radio-ulna bone in red Sokoto goat ...

    African Journals Online (AJOL)

    They were classified into different age groups and subgroups, from 1-144 weeks. The radiographs of their forearms were taken and the proximal and distal epiphyseal plate lengths of both radius and ulna bones were measured. The radiographic images of the bones showed that the proximal and distal epiphyseal plates of ...

  3. Radiological features of bilateral hereditary micro-epiphyseal dysplasia - a distinct entity in the skeletal dysplasias

    NARCIS (Netherlands)

    Morstert, AK; Dijkstra, PF; van Horn, [No Value; Jansen, BRH; Heutink, P; Lindhout, D

    Aim: To prove that bilateral hereditary micro-epiphyseal dysplasia (BHMED), first described by Elsbach in 1959 [1], is a distinct disorder radiologically as well as clinically, compared with multiple epiphyseal dysplasia (MED). Material and Methods: We used the data of the revised pedigree with 84

  4. Histology of Epiphyseal Plate of Adolescent Rat Stimulated by Laserpuncture

    Science.gov (United States)

    Handayani, Selfi; Ramelan, Ari H.; Purwanto, Bambang; Saputra, Koosnadi; Tamtomo, Didik G.

    2017-11-01

    Epiphyseal plate was used for determining longitudinal bone growth. Laserpuncture was believed to stimulate height growth. We used 40 male Wistar rats which aged three weeks old and weighed more than 40 g as subjects. They randomly divided into group A or B and each group evenly divided into four subgroups which were a negative control and others applied with laser on GV20, ST 36 or combination of GV 20+ST 36 respectively. These acupoints were then stimulated using the laser. After treatment, mice were sacrificed, then tibias were taken for histology preparation processes. By light microscope, epiphyseal plate (EP) height (µm) and chondrocytes hypertrophy (CH) height were measured at six equidistant points, and the values were averaged to obtain a final result for each section. Collected data were analyzed using ANOVA test, and the significant value was set up p< 0.05. The mean of EC and CH were lower than control, but mean of ratio EP/CH were higher than control. However, ANOVA showed that there did not differ significantly (p=0.36).

  5. Olecranon Bursitis Caused by Candida parapsilosis in a Patient with Rheumatoid Arthritis

    Directory of Open Access Journals (Sweden)

    Carla F. Gamarra-Hilburn

    2016-01-01

    Full Text Available Septic bursitis is usually caused by bacterial organisms. However, infectious bursitis caused by fungi is very rare. Herein, we present a 68-year-old woman with long-standing rheumatoid arthritis who developed pain, erythema, and swelling of the right olecranon bursa. Aspiration of the olecranon bursa showed a white blood cell count of 3.1×103/μL (41% neutrophils, 30% lymphocytes, and 29% monocytes. Fluid culture was positive for Candida parapsilosis. She was treated with caspofungin 50 mg intravenously daily for 13 days followed by fluconazole 200 mg orally daily for one week. She responded well to this treatment but had recurrent swelling of the bursa. Bursectomy was recommended but she declined this option. This case, together with other reports, suggests that the awareness of uncommon pathogens, their presentation, and predisposing risk factors are important to establish an early diagnosis and prevent long-term complications.

  6. Surgical treatment and histopathology of different forms of olecranon and presternal bursitis in cattle and buffalo

    Science.gov (United States)

    Fathy, Ahmed

    2006-01-01

    Thirty seven cases of bursitis presented to our Veterinary Teaching Hospital from 2001 to 2005. There were 10 adult female buffalos with olecranon bursitis (one had bilateral bursitis) and 26 calves (7 cattle and 19 buffalos, 16 males and 10 females) with presternal bursitis. There were 10 out of 11 cases of olecranon bursitis and 21 out of 26 cases of presternal bursitis with different forms (cystic, proliferative and fibrous) that were removed surgically. The remaining 6 cases, cystic bursitis (olecranon = 1, presternal = 5), were treated by aspiration of their contents and injection of 4% iodine tincture intrabursally. Only 2 cases recovered, 3 cases progressed to fibrosis and required further surgical treatment 2 to 3 weeks later, and 1 case continued to have a cystic lesion. Histopathological examination of tissue specimens from different forms of bursitis revealed that the acquired bursae were generally lined with synovial-like membrane formed from 2-3 cellular layers that covered the connective tissue capsule. The connective tissue capsule differed from one type to another and consisted of fibrous tissues containing numerous small blood vessels, blood capillaries, lymphatics and nerves. There was also evidence for inflammation within the capsule represented by congestion of blood vessels and the presence of perivascular inflammatory cells, mostly mononuclear. In conclusion, surgical treatment was successful and effective for treatment of olecranon and presternal bursitis particularly for the chronic proliferative and fibrous form in cattle and buffalo. The histological structure of the acquired bursae was relatively similar consisting of a synovial-like membrane and a connective tissue capsule with varying degrees of the inflammatory process. PMID:16871025

  7. The effect of above average weight gains on the incidence of radiographic bone aberrations and epiphysitis in growing horses

    International Nuclear Information System (INIS)

    Thompson, K.N.; Jackson, S.G.; Rooney, J.R.

    1988-01-01

    The relationship between body weight gain and the onset of bone aberrations (e.g. epiphysitis) is described. A model was derived which described the increase in transverse epiphyseal width, and the major factor found to affect epiphyseal width was average daily gain in body weight. In addition, a radiographic examination of the epiphyseal areas showed a larger number of bone aberrations in groups gaining weight at an above-average rate. Thus, a rapid increase in body weight can be suggested as a significant factor in the onset of epiphysitis

  8. Multiparametric MRI of Epiphyseal Cartilage Necrosis (Osteochondrosis with Histological Validation in a Goat Model.

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    Luning Wang

    Full Text Available To evaluate multiple MRI parameters in a surgical model of osteochondrosis (OC in goats.Focal ischemic lesions of two different sizes were induced in the epiphyseal cartilage of the medial femoral condyles of goats at 4 days of age by surgical transection of cartilage canal blood vessels. Goats were euthanized and specimens harvested 3, 4, 5, 6, 9 and 10 weeks post-op. Ex vivo MRI scans were conducted at 9.4 Tesla for mapping the T1, T2, T1ρ, adiabatic T1ρ and TRAFF relaxation times of articular cartilage, unaffected epiphyseal cartilage, and epiphyseal cartilage within the area of the induced lesion. After MRI scans, safranin O staining was conducted to validate areas of ischemic necrosis induced in the medial femoral condyles of six goats, and to allow comparison of MRI findings with the semi-quantitative proteoglycan assessment in corresponding safranin O-stained histological sections.All relaxation time constants differentiated normal epiphyseal cartilage from lesions of ischemic cartilage necrosis, and the histological staining results confirmed the proteoglycan (PG loss in the areas of ischemia. In the scanned specimens, all of the measured relaxation time constants were higher in the articular than in the normal epiphyseal cartilage, consistently allowing differentiation between these two tissues.Multiparametric MRI provided a sensitive approach to discriminate between necrotic and viable epiphyseal cartilage and between articular and epiphyseal cartilage, which may be useful for diagnosing and monitoring OC lesions and, potentially, for assessing effectiveness of treatment interventions.

  9. Multiple Epiphyseal Dysplasia (MED: A Rare Type of Skeletal Dysplasia

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    Mohammad Imnul Islam

    2012-06-01

    Full Text Available Multiple epiphyseal dysplasia (MED is a congenital disorder of skeletal development that primarily affects the ends of long bones, causing progressive joint and bone inflammation and short stature. Mutations in several genes are responsible for pathogenesis of this disease. We are reporting a case of MED who presented with the complaints of multiple swelling of the joints which was associated with pain during movement for last seven years. The patient had flexion deformity of all the affected joints along with restriction of movement. These were associated with kyphosis, pectus carnitum, knock-knee and short stature. Radiological findings were suggestive of MED. Counseling was done with the parents regarding the etiology, progression and outcome of the disease.DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.11025 BSMMU J 2012; 5(1:57-60 

  10. Morphology and physiology of the epiphyseal growth plate.

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    Robert Klepacz

    2009-05-01

    Full Text Available The epiphyseal growth plate develops from the cartilaginous-orientated mesenchymal cells that express SOX family genes. This multilayer structure is formed by the proliferation and hypertrophy of cells that synthesize the extracellular matrix composed of collagen (mainly type II, IX, X, XI and proteoglycans (aggrecan, decorin, annexin II, V and VI. The resting zone is responsible for protein synthesis and maintaining a germinal structure. In the proliferative zone, cells rapidly duplicate. The subsequent morphological changes take place in the transformation zone, divided into the upper and lower hypertrophic layers. In the degenerative zone, the mineralization process becomes intensive due to increased release of alkaline phosphate, calcium and matrix vesicles by terminally differentiated chondrocytes and some other factors e.g., metaphyseal ingrowth vessels. At this level, as well as in the primary and secondary spongiosa zones, chondrocytes undergo apoptosis and are physiologically eliminated. Unlike adult cartilage, in fetal and early formed growth plates, unusual forms such as authophagal bodies, paralysis and dark chondrocytes were also observed. Their ultrastructure differs greatly from apoptotic and normal cartilage cells. Chondrocyte proliferation and differentiation are regulated by various endocrine, paracrine, and autocrine agents such as growth, thyroid and sex hormones, beta-catenin, bone morphogenetic proteins, insulin-like growth factor, iodothyronine deiodinase, leptin, nitric oxide, transforming growth factor beta and vitamin D metabolites. However, the most significant factor is parathyroid hormone-related protein (PTHrP which is synthesized in the perichondrium by terminally differentiated chondrocytes. Secondary to activation of PTH/PTHrP receptors, PTHrP stimulates cell proliferation by G protein activation and delays their transformation into prehypertrophic and hypertrophic chondrocytes. When proliferation is completed

  11. A different trauma, a different fracture

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    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

  12. A Rare Case of Epiphyseal Chondromyxoid Fibroma of the Proximal Tibia

    International Nuclear Information System (INIS)

    Choi, Yun Sun; Kim, Byoung Suck; Lee, Seok Hoon; Song, Baek Yong; Park, Yong Koo

    2011-01-01

    Chondromyxoid fibroma is an uncommon benign cartilaginous tumor of the bone. It occurs most frequently in the metaphysis of long tubular bones, and an epiphyseal location is exceedingly rare. We present here an unusual case of a chondromyxoid fibroma that occurred in the epiphysis of the proximal tibia with an open growth plate. MR imaging findings of this tumor, which has, to the best of our knowledge, never been described in an epiphyseal location, makes the present case unique.

  13. RADIOLOGICAL ASSESSMENT OF AGE FROM EPIPHYSEAL FUSION AT THE KNEE JOINT

    OpenAIRE

    Ebeye, Oladunni Abimbola; Eboh, Dennis Erhisenebe; Onyia, Nwabueze Stephen

    2016-01-01

    Objectives: Age determination is needed in administration of justice, employment, marriage, forensic investigation and identification. This cross-sectional study aimed to investigate the relationship between stages of epiphyseal union at the knee joint and chronological age.Methods: Anterior posterior and lateral knee radiographs of 100 males and 110 females aged 9–19 years were examined. Epiphyseal union was divided into five specific stages in the femur, tibia and fibula. Fusion was scored ...

  14. Polyostotic Fibrous Dysplasia with Epiphyseal Involvement in Long Bones: A Case Report

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    Tomoaki Fukui

    2013-01-01

    Full Text Available Fibrous dysplasia (FD is an uncommon, but well-known benign skeletal disorder. In cases affecting long bones, FD is commonly recognized to locate in the diaphyses or the metaphyses and to spare the epiphyses. In this paper, we present a rare case of polyostotic FD in a 13-year-old girl with unilateral multiple epiphyseal lesions arising in the femur, the tibia, and the fibula with the growth plates.

  15. Ultrasound-Guided 50% Ethyl Alcohol Injection for Patients With Malleolar and Olecranon Bursitis: A Prospective Pilot Study

    Science.gov (United States)

    Hong, Ji Seong; Lee, Jin Hyung

    2016-01-01

    Objective To evaluate the feasibility and effect of ultrasound-guided ethyl alcohol injection on malleolar and olecranon synovial proliferative bursitis. Methods Twenty-four patients received ultrasound-guided 50% diluted ethyl alcohol injection at the site of synovial proliferative bursitis after aspiration of the free fluid. Results Swelling and symptoms significantly decreased in 13 of the 24 patients without any complications. Eleven patients had partial improvement in swelling and symptoms. Conclusion Ultrasound-guided alcohol injection could be an alternative therapeutic option before surgery in patients with chronic intractable malleolar and olecranon synovial proliferative bursitis. PMID:27152282

  16. [Treatment of septic olecranon and patellar bursitis by excision and vacuum-assisted closure therapy].

    Science.gov (United States)

    Walter, G; Kemmerer, M; Hoffmann, R

    2013-08-01

    Treatment of septic olecranon and patellar bursitis differs considerably and is currently under discussion. We therefore performed a retrospective study of our patients with septic bursitis in the past 5 years. Between March 2007 and February 2012 we treated 79 patients with septic olecranon (n = 43) and patellar (n = 36) bursitis surgically: 61-males, 18 females, age 51 (range: 11-91) years. Four patients had not been treated before, 25 had suffered recurrences after 1-10 previous procedures, and 9 patients had not improved after conservative therapy. 34 patients presented with traumatic rupture or fistula of their bursae. In all cases we performed a radical bursectomy and vacuum-assisted therapy for 4 to 5 days. In addition, patients received systemic antibiotics. We phoned all patients and were successful in 57 cases (72 %). We questioned these patients for range of movement, limitations at work, pain, sensibility disorder, satisfaction with the result and further surgical procedures. In all cases we took tissue specimens for cultures, in 48 preparations histological examination was performed. Microbiological and histological results are discussed in detail. 40 patients were free of complaints, 15 complained of mild pain, 54 of 57 had unlimited range of motion. Minor discomforts at desk work were reported by 5 of 43 patients, 12 out of 36 patient reported discomfort when performing on their knees. There was no recurrence in the period of investigation. We recommend our treatment concept for septic olecranon and patellar bursitis because patient satisfaction is high and recurrences are reliably avoided. The soft tissue is spared, so that plastic covering procedures are seldom necessary. Georg Thieme Verlag KG Stuttgart · New York.

  17. A computed microtomography method for understanding epiphyseal growth plate fusion

    Science.gov (United States)

    Staines, Katherine A.; Madi, Kamel; Javaheri, Behzad; Lee, Peter D.; Pitsillides, Andrew A.

    2017-12-01

    The epiphyseal growth plate is a developmental region responsible for linear bone growth, in which chondrocytes undertake a tightly regulated series of biological processes. Concomitant with the cessation of growth and sexual maturation, the human growth plate undergoes progressive narrowing, and ultimately disappears. Despite the crucial role of this growth plate fusion ‘bridging’ event, the precise mechanisms by which it is governed are complex and yet to be established. Progress is likely hindered by the current methods for growth plate visualisation; these are invasive and largely rely on histological procedures. Here we describe our non-invasive method utilising synchrotron x-ray computed microtomography for the examination of growth plate bridging, which ultimately leads to its closure coincident with termination of further longitudinal bone growth. We then apply this method to a dataset obtained from a benchtop microcomputed tomography scanner to highlight its potential for wide usage. Furthermore, we conduct finite element modelling at the micron-scale to reveal the effects of growth plate bridging on local tissue mechanics. Employment of these 3D analyses of growth plate bone bridging is likely to advance our understanding of the physiological mechanisms that control growth plate fusion.

  18. Bilateral femoral head dysplasia and osteochondritis. Multiple epiphyseal dysplasia tarda, spondylo-epiphyseal dysplasia tarda, and bilateral Legg-Perthes disease

    Energy Technology Data Exchange (ETDEWEB)

    Andersen, P.E. Jr.; Schantz, K.; Bollerslev, J.; Justesen, P.

    Multiple epiphyseal dysplasia tarda (MEDT) and spondylo-epiphyseal dysplasisa tarda (SEDT) are genetically transmitted conditions affecting the hips, which may resemble bilateral Legg-Perthes disease (LPD). Misdiagnoses are not uncommon, with serious implications for treatment, prognosis and genetic counseling. An epidemiologic study of MEDT and SEDT in a well-defined population of 453 921 persons in Denmark was performed. A population prevalence of 0.7 per 100 000 inhabitants with SEDT and 4.0 per 100 000 inhabitants with MEDT was found. Distinguishing features between MEDT, SEDT and bilateral LPD based on radiologic findings in the hips, other joints, and spine were ascertained. Bilateral LPD is always asymmetric, exhibits patches of increased density in the epiphyses and often metaphyseal cyst-like changes. No spinal lesion or affection of other joints is present, and the acetabula are normal. In MEDT and SEDT the capital femoral epiphyses are symmetrically flattened, fragmented and uniformly slightly sclerotic. Generalised platyspondyly is a constant finding in SEDT.

  19. Ultrasound characteristics of gouty tophi in the olecranon bursa and evaluation of their reproducibility

    International Nuclear Information System (INIS)

    Fernandes, Eloy A.; Lopes, Matheus G.; Mitraud, Sônia A.V.; Ferrari, Antonio J.L.; Fernandes, Artur R.C.

    2012-01-01

    Objectives: To describe the ultrasound characteristics of gouty tophi in the olecranon bursa and to evaluate their reproducibility. Methods: A prospective study of the ultrasound features of 35 sites of tophi nodulations in the elbows of 31 men (mean 54.6 years). The findings were evaluated dynamically following pre-established standards. The static images were evaluated by another radiologist and were reviewed by the first examiner. Results: The most frequent characteristics of tophi are: hyperechogenicity (91.7%), poorly defined contours (88.6%), multiple grouped nodules (85.6%) and heterogeneity (68.6%). Intra-observer agreement is almost perfect for echogenicity (K = 1.0), moderate for the involvement of the olecranon bursa (K = 0.47) and fair for other characteristics. Inter-observer agreement is substantial for the echogenicity (K = 0.65), fair for the echotexture (K = 0.27) and the presence of a perilesional hypoechoic halo (K = 0.34) and slight for other characteristics. Conclusions: The most frequent characteristic of tophi is hyperechogenicity. The intra-observer and inter-observer concordance for echogenicity are almost perfect and substantial, respectively. Knowledge of characteristics of the tophi in the elbow and their intra and inter-observer reproducibility may assist in establishing parameters for monitoring treatment and setting up criteria for differential diagnosis of processes involving the olecraneon bursa.

  20. [Efficacies of arthroscopic debridement and olecranon fossa plasty in the treatment of osteoarthritis and posterior elbow impingement].

    Science.gov (United States)

    Liu, Yu-jie; Wang, Jun-liang; Li, Hai-feng; Qi, Wei; Wang, Ning

    2012-07-17

    To evaluate the efficacies of arthroscopic debridement and removal of osteophyma for olecroanon and olecranon fossa plasty for posterior impingement of elbow joint. Between 1999 and 2008, a total of 21 cases were diagnosed with osteoarthritis and posterior elbow impingement. There were 15 males and 6 females. And there were 16 right and 15 left cases. They included volleyball players (n = 7), tennis players (n = 7), golf enthusiasts (n = 4) and fencers (n = 3). The average duration of onset-operation was 3.5 years (range: 2.5 - 8). Arthroscopic exploration revealed synovial hyperplasia hypertrophy, cartilage degeneration and olecranon fossa hyperplasia with deformed olecranon fossa. Debridement and plasty were performed. Loose bodies were removed from elbow joint in 6 patients. Partial resection of posterior olecranon tip was performed and osteophytes or fibrous tissue removed in this area. Dynamic observation showed no posterior elbow impingement. Postoperative follow-up was conducted in 19 cases and 2 cases became lost to follow-up. The average follow-up period was 25.3 months (range: 18 - 42). All patients were evaluated preoperatively and postoperatively with the Hospital for Special Surgery Elbow Assessment Scale. The outcomes were excellent (n = 12), good (n = 7) and fair (n = 2). Postoperative patients elbow swelling and pain relieve, sports and life function returns to normal, elbow flexion and rotating mobility obviously improved. With the elbow radiological films to measure the range of motion, the average range of motion was 90.5° preoperatively and improved to 130° postoperatively. There was significant improvement in all cases. Posterior elbow impingement is caused by hyperextension trauma and elbow overuse during specific sporting activities. Arthroscopic debridement and olecroanon or olecranon fossa plasty demonstrates excellent results for posterior impingement of elbow joint.

  1. Stress Fracture and Nonunion of Coronoid Process in a Gymnast

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    T. Hetling

    2016-01-01

    Full Text Available Background. Gymnasts have high mechanical loading forces of up to 14 times body weight. Overuse lesions are typical in wrists and stress fractures in the olecranon, while isolated fractures of the coronoid process are uncommon. We present a case of retraumatized nonunion stress fracture of the ulnar coronoid process. Case Description. A 19-year-old gymnast presented with elbow pain after training. Imaging confirmed an old fracture of the coronoid process. We describe a 6-month multiphase return to competition rehabilitation program, which allowed him to compete pain-freely. Literature Review. Acute and overuse injuries in gymnasts are known but no nonunion of the coronoid process has been described before. Only one case of stress fracture of coronoid process in a gymnast was reported. Purpose and Clinical Relevance. We could successfully and conservatively return to sport a reactivated nonunion of a stress fracture of the coronoid process.

  2. Cartilaginous epiphyses in extant archosaurs and their implications for reconstructing limb function in dinosaurs.

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    Casey M Holliday

    2010-09-01

    Full Text Available Extinct archosaurs, including many non-avian dinosaurs, exhibit relatively simply shaped condylar regions in their appendicular bones, suggesting potentially large amounts of unpreserved epiphyseal (articular cartilage. This "lost anatomy" is often underappreciated such that the ends of bones are typically considered to be the joint surfaces, potentially having a major impact on functional interpretation. Extant alligators and birds were used to establish an objective basis for inferences about cartilaginous articular structures in such extinct archosaur clades as non-avian dinosaurs. Limb elements of alligators, ostriches, and other birds were dissected, disarticulated, and defleshed. Lengths and condylar shapes of elements with intact epiphyses were measured. Limbs were subsequently completely skeletonized and the measurements repeated. Removal of cartilaginous condylar regions resulted in statistically significant changes in element length and condylar breadth. Moreover, there was marked loss of those cartilaginous structures responsible for joint architecture and congruence. Compared to alligators, birds showed less dramatic, but still significant changes. Condylar morphologies of dinosaur limb bones suggest that most non-coelurosaurian clades possessed large cartilaginous epiphyses that relied on the maintenance of vascular channels that are otherwise eliminated early in ontogeny in smaller-bodied tetrapods. A sensitivity analysis using cartilage correction factors (CCFs obtained from extant taxa indicates that whereas the presence of cartilaginous epiphyses only moderately increases estimates of dinosaur height and speed, it has important implications for our ability to infer joint morphology, posture, and the complicated functional movements in the limbs of many extinct archosaurs. Evidence suggests that the sizes of sauropod epiphyseal cartilages surpassed those of alligators, which account for at least 10% of hindlimb length. These data

  3. Cartilaginous epiphyses in extant archosaurs and their implications for reconstructing limb function in dinosaurs.

    Science.gov (United States)

    Holliday, Casey M; Ridgely, Ryan C; Sedlmayr, Jayc C; Witmer, Lawrence M

    2010-09-30

    Extinct archosaurs, including many non-avian dinosaurs, exhibit relatively simply shaped condylar regions in their appendicular bones, suggesting potentially large amounts of unpreserved epiphyseal (articular) cartilage. This "lost anatomy" is often underappreciated such that the ends of bones are typically considered to be the joint surfaces, potentially having a major impact on functional interpretation. Extant alligators and birds were used to establish an objective basis for inferences about cartilaginous articular structures in such extinct archosaur clades as non-avian dinosaurs. Limb elements of alligators, ostriches, and other birds were dissected, disarticulated, and defleshed. Lengths and condylar shapes of elements with intact epiphyses were measured. Limbs were subsequently completely skeletonized and the measurements repeated. Removal of cartilaginous condylar regions resulted in statistically significant changes in element length and condylar breadth. Moreover, there was marked loss of those cartilaginous structures responsible for joint architecture and congruence. Compared to alligators, birds showed less dramatic, but still significant changes. Condylar morphologies of dinosaur limb bones suggest that most non-coelurosaurian clades possessed large cartilaginous epiphyses that relied on the maintenance of vascular channels that are otherwise eliminated early in ontogeny in smaller-bodied tetrapods. A sensitivity analysis using cartilage correction factors (CCFs) obtained from extant taxa indicates that whereas the presence of cartilaginous epiphyses only moderately increases estimates of dinosaur height and speed, it has important implications for our ability to infer joint morphology, posture, and the complicated functional movements in the limbs of many extinct archosaurs. Evidence suggests that the sizes of sauropod epiphyseal cartilages surpassed those of alligators, which account for at least 10% of hindlimb length. These data suggest that

  4. Proximal Tibial Epiphysis Fracture in a 13-Year-Old Male Athlete

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    Ioannis M. Stavrakakis

    2017-01-01

    Full Text Available Fractures of the proximal epiphysis of the tibia are rare, representing 0.5 to 3.0% of all epiphyseal injuries. These injuries can damage the popliteal vessels and their bifurcation, affecting the blood supply of the lower limb, as well as the nerves below the knee. Epiphyseal growth arrest is also a potential complication, leading to various angular deformities. We present a case of a 13-year-old male athlete with a posteriorly displaced Salter-Harris type II fracture of the proximal epiphysis of the left tibia who was treated conservatively with closed reduction and cast immobilization.

  5. Prepatellar and olecranon bursitis: literature review and development of a treatment algorithm.

    Science.gov (United States)

    Baumbach, Sebastian F; Lobo, Christopher M; Badyine, Ilias; Mutschler, Wolf; Kanz, Karl-Georg

    2014-03-01

    Olecranon bursitis and prepatellar bursitis are common entities, with a minimum annual incidence of 10/100,000, predominantly affecting male patients (80 %) aged 40-60 years. Approximately 1/3 of cases are septic (SB) and 2/3 of cases are non-septic (NSB), with substantial variations in treatment regimens internationally. The aim of the study was the development of a literature review-based treatment algorithm for prepatellar and olecranon bursitis. Following a systematic review of Pubmed, the Cochrane Library, textbooks of emergency medicine and surgery, and a manual reference search, 52 relevant papers were identified. The initial differentiation between SB and NSB was based on clinical presentation, bursal aspirate, and blood sampling analysis. Physical findings suggesting SB were fever >37.8 °C, prebursal temperature difference greater 2.2 °C, and skin lesions. Relevant findings for bursal aspirate were purulent aspirate, fluid-to-serum glucose ratio 3,000 cells/μl, polymorphonuclear cells >50 %, positive Gram staining, and positive culture. General treatment measures for SB and NSB consist of bursal aspiration, NSAIDs, and PRICE. For patients with confirmed NSB and high athletic or occupational demands, intrabursal steroid injection may be performed. In the case of SB, antibiotic therapy should be initiated. Surgical treatment, i.e., incision, drainage, or bursectomy, should be restricted to severe, refractory, or chronic/recurrent cases. The available evidence did not support the central European concept of immediate bursectomy in cases of SB. A conservative treatment regimen should be pursued, following bursal aspirate-based differentiation between SB and NSB.

  6. The Evaluation of Epiphyseal Plate Histological Changes in Osteopetrotic op/op Mice.

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    Aligholi Sobhani

    2003-09-01

    Full Text Available This study was designed for evaluation of epiphyseal plate histological changes of femur bones in osteopetrotic op/op mice.In this study 5 osteopetrotic op/op mice which were purchased from the commercial source were used.The animals were killed by overdose of chloroform and their femur bones were extracted. The bones were fixed in 10% formaldehyde and decalcified by HCl (0.6N, and routine histological processing were performed. The sections were stained by H&E methods and studied by conventional light microscopy. The results showed that, proliferative zone (PZ and especially hypertrophic zone (HZ were much thickened. In the ossification zone, trabecular bones were irregular and atypical osteoblast cells were observed. The osteoclast cells were not attached to trabecular bones. The bone marrow cavity was restricted and bone marrow cells were poor and scattered. Findings of the present investigation are similar to those reported about epiphyseal plate in osteosclerotic (OC mice in which epiphyseal plate especially hypertrophic zone was thickened and chondrocytes were not substituted for osteoblasts in calcified cartilage area. Also, osteoclast cells had been inactive or absent in OC mice. For prevention of other complication due to the epiphyseal plate changes in new borne, suitable and punctually treatment protocols such as prescription of Macrophage Colony Stimulating-Factor (MCS-F could be useful.

  7. Bilateral hereditary micro-epiphyseal dysplasia : clinical and genetic analysis of a Dutch family

    NARCIS (Netherlands)

    Mostert, Adrianus Klazinus

    2003-01-01

    This thesis is based upon a study of a Dutch family with a unique skeletal dysplasia first described by Elsbach in 1959. Because of the presence of microepiphyses, he called this disorder bilateral hereditary micro-epiphyseal dysplasia (BHMED) and distinguished it from more common multiple

  8. Intramuscular myxoid lipoma in the proximal forearm presenting as an olecranon mass with superficial radial nerve palsy: a case report

    Directory of Open Access Journals (Sweden)

    Hildebrand Kevin A

    2011-07-01

    Full Text Available Abstract Background Extremity lipomas may occur in any location, including the proximal forearm. We describe a case of a patient with an intramuscular lipoma presenting as an unusual posterior elbow mass. Case presentation We discuss the case of a 57-year-old Caucasian man who presented with a tender, posterior elbow mass initially diagnosed as chronic olecranon bursitis. A minor sensory disturbance in the distribution of the superficial radial nerve was initially thought to be unrelated, but was likely caused by mass effect from the lipoma. No pre-operative advanced imaging was obtained because the diagnosis was felt to have already been made. At the time of surgery, a fatty mass originating in the volar forearm muscles was found to have breached the dorsal forearm fascia and displaced the olecranon bursa. Tissue diagnosis was made by histopathology as a myxoid lipoma with no aggressive features. Post-operative recovery was uneventful. Conclusion We present a case of an unusual elbow mass presenting with symptoms consistent with chronic olecranon bursitis, a relatively common condition. The only unexplained pre-operative finding was the non-specific finding of a transient superficial radial nerve deficit. We remind clinicians to be cautious when diagnosing soft tissue masses in the extremities when unexplained physical findings are present.

  9. Poly-epiphyseal overgrowth: description of a previously unreported skeletal dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Pazzaglia, Ugo E.; Bonaspetti, Giovanni [University of Brescia, Orthopaedic Clinic, Brescia (Italy); Beluffi, Giampiero [Fondazione IRCCS Policlinico San Matteo, Department of Paediatric Radiology, Pavia (Italy); Marchi, Antonietta; Bozzola, Mauro; Savasta, Salvatore [Fondazione IRCCS Policlinico San Matteo, Paediatric Clinic, University of Pavia, Pavia (Italy)

    2007-10-15

    A skeletal dysplasia with previously unreported features is presented. Its evolution was characterized by growth abnormalities of bones without involvement of other organs. Advanced bone age, increased stature and irregular epiphyseal ossification with stippling of the main long bones were documented. Physeal overgrowth was massive in the left proximal humerus and femur. Furthermore, the hip joint appeared fused with an abundant mass of pathological calcific tissue extending from the femur to the ilium. Pathological epiphyses were characterized by anarchic cartilaginous proliferation with multiple ossification centres, while lamellar bone apposition and remodelling were normal. The observed bone changes were different from those in any previously reported syndrome, metabolic defect or bone dysplasia. However, they clearly indicated a defect of endochondral ossification with some resemblance to phenotypes observed in dysplasia epiphysealis hemimelica. (orig.)

  10. Poly-epiphyseal overgrowth: description of a previously unreported skeletal dysplasia

    International Nuclear Information System (INIS)

    Pazzaglia, Ugo E.; Bonaspetti, Giovanni; Beluffi, Giampiero; Marchi, Antonietta; Bozzola, Mauro; Savasta, Salvatore

    2007-01-01

    A skeletal dysplasia with previously unreported features is presented. Its evolution was characterized by growth abnormalities of bones without involvement of other organs. Advanced bone age, increased stature and irregular epiphyseal ossification with stippling of the main long bones were documented. Physeal overgrowth was massive in the left proximal humerus and femur. Furthermore, the hip joint appeared fused with an abundant mass of pathological calcific tissue extending from the femur to the ilium. Pathological epiphyses were characterized by anarchic cartilaginous proliferation with multiple ossification centres, while lamellar bone apposition and remodelling were normal. The observed bone changes were different from those in any previously reported syndrome, metabolic defect or bone dysplasia. However, they clearly indicated a defect of endochondral ossification with some resemblance to phenotypes observed in dysplasia epiphysealis hemimelica. (orig.)

  11. Traumatic Foot Fractures in Hard Working Donkeys

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    M.A. Semieka

    2012-10-01

    Full Text Available The present study was carried out on 45 hard working donkeys suffering from different types of traumatic foot fractures. These animals were selected from the clinical cases admitted to the Veterinary Teaching Hospital, Assiut University during the period of 2007-2010. Based on history, clinical signs and radiographic examination, various types of traumatic foot fractures were diagnosed and recorded. These fractures were affect metacarpal bones (N. =16, metatarsal bones (N. =9, proximal phalanx (N. = 13, middle phalanx (N. = 3, distal phalanx (N. = 2 and proximal sesamoid bones (N. = 2. It could be concluded that fractures of the large metacarpal bones are the most common types followed by fractures of the proximal phalanx of the thoracic limb then fractures of the metatarsal bones. Fractures of the middle phalanx, distal phalanx and proximal sesamoid bone are less common in donkeys. Single fractures of the metacarpal and metatarsal bones are more common than comminuted one, in addition diaphyseal fractures of these bones are more common than metaphyseal or epiphyseal fractures. In the proximal phalanx, comminuted fractures are more common than single fractures.

  12. Medial joint space widening of the ankle in displaced Tillaux and Triplane fractures in children.

    Science.gov (United States)

    Gourineni, Prasad; Gupta, Asheesh

    2011-10-01

    Tillaux and Triplane fractures occur in children predominantly from external rotation mechanism. We hypothesized that in displaced fractures, the talus would shift laterally along with the distal fibula and the distal tibial epiphyseal fragment increasing the medial joint space. Consecutive cases evaluated retrospectively. Level I and Level II centers. Twenty-two skeletally immature patients with 14 displaced Triplane fractures and eight displaced Tillaux fractures were evaluated for medial joint space widening. Measurement of fracture displacement and medial joint space widening before and after intervention. Thirteen Triplane and six Tillaux fractures (86%) showed medial space widening of 1 to 9 mm and equal to the amount of fracture displacement. Reduction of the fracture reduced the medial space to normal. There were no known complications. Medial space widening of the ankle may be a sign of ankle fracture displacement. Anatomic reduction of the fracture reduces the medial space and may improve the results in Tillaux and Triplane fractures.

  13. The normal development of proximal humeral epiphyseal ossification center in the first 2 years of life

    International Nuclear Information System (INIS)

    Kim, Seung Cheol

    1998-01-01

    The purpose of this study is to ascertain the normal maturation of proximal epiphyseal ossification centers by monthly age during the first years of life. The distribution of age was 0 to 24 months. Six hundred and seventy-five infants were male and 436 were female; their ages were measured in months, and there was no evidence of developmental problems. Proximal humeral epiphyseal ossification centers were evaluated from chest radiographs ; if not visualized, they were graded as 0, and otherwise, as follows : grade 1 : visualized with poor margin or a diameter of less than 1/4 of metaphyseal width; grade 2: visualized with good margin or a diameter of more than 1/4 of metaphyseal width; in grade 3 and 4, two ossification centers were visualized. Grade 3 indicated that one ossification center had the morphology of grade 2. Grade 5 indicated that two ossification centers were fused. We then assessed the relationship between the development of an ossification center and monthly age. A proximal humeral epiphyseal ossification center shows regular maturational features according to monthly age. 6 refs., 2 tabs., 5 figs

  14. One- vs 2-Stage Bursectomy for Septic Olecranon and Prepatellar Bursitis: A Prospective Randomized Trial.

    Science.gov (United States)

    Uçkay, Ilker; von Dach, Elodie; Perez, Cédric; Agostinho, Americo; Garnerin, Philippe; Lipsky, Benjamin A; Hoffmeyer, Pierre; Pittet, Didier

    2017-07-01

    To assess the optimal surgical approach and costs for patients hospitalized with septic bursitis. From May 1, 2011, through December 24, 2014, hospitalized patients with septic bursitis at University of Geneva Hospitals were randomized (1:1) to receive 1- vs 2-stage bursectomy. All the patients received postsurgical oral antibiotic drug therapy for 7 days. Of 164 enrolled patients, 130 had bursitis of the elbow and 34 of the patella. The surgical approach used was 1-stage in 79 patients and 2-stage in 85. Overall, there were 22 treatment failures: 8 of 79 patients (10%) in the 1-stage arm and 14 of 85 (16%) in the 2-stage arm (Pearson χ 2 test; P=.23). Recurrent infection was caused by the same pathogen in 7 patients (4%) and by a different pathogen in 5 (3%). Outcomes were better in the 1- vs 2-stage arm for wound dehiscence for elbow bursitis (1 of 66 vs 9 of 64; Fisher exact test P=.03), median length of hospital stay (4.5 vs 6.0 days), nurses' workload (605 vs 1055 points), and total costs (Sw₣6881 vs Sw₣11,178; all Pbursitis requiring hospital admission, bursectomy with primary closure, together with antibiotic drug therapy for 7 days, was safe, effective, and resource saving. Using a 2-stage approach may be associated with a higher rate of wound dehiscence for olecranon bursitis than the 1-stage approach. Clinicaltrials.gov Identifier: NCT01406652. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  15. Intra-epiphyseal stress injury of the proximal tibial epiphysis: Preliminary experience of magnetic resonance imaging findings

    Energy Technology Data Exchange (ETDEWEB)

    Tony, G., E-mail: drgtony@gmail.com [Stafford General Hospital, Weston Road, Stafford, Staffordshire ST16 3SA (United Kingdom); Charran, A., E-mail: amandacharran@yahoo.com [Hillingdon Hospital, Pield Heath Rd, Uxbridge, Middlesex UB8 3NN (United Kingdom); Tins, B., E-mail: bernhard.tins@rjah.nhs.uk [Department of Diagnostic Imaging, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG (United Kingdom); Lalam, R., E-mail: radhesh.lalam@rjah.nhs.uk [Department of Diagnostic Imaging, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG (United Kingdom); Tyrrell, P.N.M., E-mail: prudencia.tyrrell@rjah.nhs.uk [Department of Diagnostic Imaging, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG (United Kingdom); Singh, J., E-mail: jaspreet.singh@rjah.nhs.uk [Department of Diagnostic Imaging, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG (United Kingdom); Cool, P., E-mail: paul.cool@rjah.nhs.uk [Orthopaedic Oncology, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG (United Kingdom); Kiely, N., E-mail: nigel.kiely@rjah.nhs.uk [Paediatric Orthopaedics, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG (United Kingdom); Cassar-Pullicino, V.N., E-mail: Victor.Pullicino@rjah.nhs.uk [Department of Diagnostic Imaging, Robert Jones and Agnes Hunt, Orthopaedic Hospital, Oswestry, Shropshire SY10 7 AG (United Kingdom)

    2014-11-15

    Highlights: • Purely intra-epiphyseal stress injuries of the proximal tibial epiphysis are described for the first time. • The variation in the MRI findings of these injuries depending on the stage of maturation is demonstrated. • We postulate a patho-mechanism to explain the variations in site and appearance of stress injuries in this region. - Abstract: Stress induced injuries affecting the physeal plate or cortical bone in children and adolescents, especially young athletes, have been well described. However, there are no reports in the current English language literature of stress injury affecting the incompletely ossified epiphyseal cartilage. We present four cases of stress related change to the proximal tibial epiphysis (PTE) along with their respective magnetic resonance imaging (MRI) appearances ranging from subtle oedema signal to a pseudo-tumour like appearance within the epiphyseal cartilage. The site and pattern of intra-epiphyseal injury is determined by the type of tissue that is affected, the maturity of the skeleton and the type of forces that are transmitted through the tissue. We demonstrate how an awareness of the morphological spectrum of MRI appearances in intra-epiphyseal stress injury and the ability to identify concomitant signs of stress in other nearby structures can help reduce misdiagnosis, avoid invasive diagnostic procedures like bone biopsy and reassure patients and their families.

  16. Intra-epiphyseal stress injury of the proximal tibial epiphysis: Preliminary experience of magnetic resonance imaging findings

    International Nuclear Information System (INIS)

    Tony, G.; Charran, A.; Tins, B.; Lalam, R.; Tyrrell, P.N.M.; Singh, J.; Cool, P.; Kiely, N.; Cassar-Pullicino, V.N.

    2014-01-01

    Highlights: • Purely intra-epiphyseal stress injuries of the proximal tibial epiphysis are described for the first time. • The variation in the MRI findings of these injuries depending on the stage of maturation is demonstrated. • We postulate a patho-mechanism to explain the variations in site and appearance of stress injuries in this region. - Abstract: Stress induced injuries affecting the physeal plate or cortical bone in children and adolescents, especially young athletes, have been well described. However, there are no reports in the current English language literature of stress injury affecting the incompletely ossified epiphyseal cartilage. We present four cases of stress related change to the proximal tibial epiphysis (PTE) along with their respective magnetic resonance imaging (MRI) appearances ranging from subtle oedema signal to a pseudo-tumour like appearance within the epiphyseal cartilage. The site and pattern of intra-epiphyseal injury is determined by the type of tissue that is affected, the maturity of the skeleton and the type of forces that are transmitted through the tissue. We demonstrate how an awareness of the morphological spectrum of MRI appearances in intra-epiphyseal stress injury and the ability to identify concomitant signs of stress in other nearby structures can help reduce misdiagnosis, avoid invasive diagnostic procedures like bone biopsy and reassure patients and their families

  17. Hoverboards: spectrum of injury and association with an uncommon fracture

    Energy Technology Data Exchange (ETDEWEB)

    Schapiro, Andrew H.; Lall, Neil U.; Anton, Christopher G.; Trout, Andrew T. [Cincinnati Children' s Hospital Medical Center, Department of Radiology and Medical Imaging, Cincinnati, OH (United States)

    2017-04-15

    Self-balancing electric scooters, commonly known as hoverboards, are a new and popular consumer item with recognized fall hazards. The spectrum of injuries associated with hoverboard use has not been studied. The purpose of this study is to determine the spectrum of radiologically apparent injuries associated with hoverboard use. We retrospectively reviewed all imaging studies interpreted at our institution for hoverboard-related injuries during an 8-month period. We recorded patient demographics and injury characteristics. Thirty-two of the 47 pediatric patients imaged for hoverboard-related injury had radiologically detectable injuries, all fractures. Fifty percent of these 32 patients were female and 50% were male, with a mean age of 12.4 years. There were 42 fractures total, all involving the appendicular skeleton, with 74% in the upper extremities and 26% in the lower extremities. Thirty-eight percent of the fractures involved the physis. A distinct injury pattern was seen in three patients who sustained open distal phalanx juxta-epiphyseal fractures. Most of the fractures sustained during hoverboard use are commonly seen in everyday pediatric radiology practice, with an overall pattern paralleling that reported in association with skateboard use. However an otherwise uncommon fracture, the distal phalanx juxta-epiphyseal fracture, was identified in association with hoverboard use, and this finding has important treatment implications including need for irrigation and debridement, antibiotic therapy, and potential surgical fixation. (orig.)

  18. Hoverboards: spectrum of injury and association with an uncommon fracture

    International Nuclear Information System (INIS)

    Schapiro, Andrew H.; Lall, Neil U.; Anton, Christopher G.; Trout, Andrew T.

    2017-01-01

    Self-balancing electric scooters, commonly known as hoverboards, are a new and popular consumer item with recognized fall hazards. The spectrum of injuries associated with hoverboard use has not been studied. The purpose of this study is to determine the spectrum of radiologically apparent injuries associated with hoverboard use. We retrospectively reviewed all imaging studies interpreted at our institution for hoverboard-related injuries during an 8-month period. We recorded patient demographics and injury characteristics. Thirty-two of the 47 pediatric patients imaged for hoverboard-related injury had radiologically detectable injuries, all fractures. Fifty percent of these 32 patients were female and 50% were male, with a mean age of 12.4 years. There were 42 fractures total, all involving the appendicular skeleton, with 74% in the upper extremities and 26% in the lower extremities. Thirty-eight percent of the fractures involved the physis. A distinct injury pattern was seen in three patients who sustained open distal phalanx juxta-epiphyseal fractures. Most of the fractures sustained during hoverboard use are commonly seen in everyday pediatric radiology practice, with an overall pattern paralleling that reported in association with skateboard use. However an otherwise uncommon fracture, the distal phalanx juxta-epiphyseal fracture, was identified in association with hoverboard use, and this finding has important treatment implications including need for irrigation and debridement, antibiotic therapy, and potential surgical fixation. (orig.)

  19. Radiological features of bilateral hereditary micro-epiphyseal dysplasia - a distinct entity in the skeletal dysplasias

    Energy Technology Data Exchange (ETDEWEB)

    Mostert, A.K. [Isala Clinics, Location Weezenlanden, Dept. of Orthopaedic Surgery, Zwolle (Netherlands); Dijkstra, P.F. [Jan van Breemen Inst., Dept. of Radiology, Amsterdam (Netherlands); Horn, J.R. van [Univ. Hospital Groningen, Dept. of Orthopaedic Surgery, Groningen (Netherlands); Jansen, B.R.H. [Reinier de Graaf Hospital, Dept. of Orthopaedic Surgery, Delft (Netherlands); Heutink, P. [Erasmus MCRotterdam, Dept. of Clinical Genetics, Rotterdam (Netherlands); Lindhout, D. [Univ. Medical Centre Utrecht, Dept. of Medical Genetics, Utrecht (Netherlands)

    2002-07-01

    Aim: To prove that bilateral hereditary micro-epiphyseal dysplasia (BHMED), first described by Elsbach in 1959, is a distinct disorder radiologically as well as clinically, compared with multiple epiphyseal dysplasia (MED). Material and Methods: We used the data of the revised pedigree with 84 family members, performed a medical history, physical examination and made a radiological evaluation for defining a clinical and radiological phenotype of BHMED family members. We used blood samples for genetic analysis. Results: Although there is a clear clinical picture of the dysplasia, the radiological signs are more reliable for making the diagnosis. Especially the typical deformity of the hip and knee joint are diagnostic for BHMED. By linkage analysis we excluded linkage with the three known MED-loci (EDM1, EDM2 and EDM3). Conclusion: BHMED is indeed an entity that is distinct from common multiple epiphyseal dysplasia (MED), clinically, as well as radiologically and genetically. (orig.) [German] Ziel: Es sollte dargelegt werden, dass sich eine vererbliche, laterale Mikro-Epiphysendysplasie (BHMED), Erstbeschreibung durch Elsbach 1959, klinisch, radiologisch und genetisch von einer mutiplen Epiphysendysplasie (MED) unterscheidet. Material und Methode: Anhand der Daten eines ueberarbeiteten Stammbaumes mit 84 Familienmitgliedern wurde der medizinische Werdegang rekonstruiert. Es erfolgte eine physische Untersuchung der Familienmitglieder. Schliesslich wurde eine radiologische Auswertung durchgefuehrt, um einen klinischen und radiologischen Phaenotyp der von BHMED betroffenen Familienmitglieder zu definieren. Fuer eine genetische Analyse wurden Blutproben entnommen. Ergebnisse: Obwohl es ein deutliches klinisches Bild einer Dysplasie gibt, sind die radiologischen Kennzeichen fuer die Diagnose zuverlaessiger. Insbesondere die typische Deformation der Huefte und des Kniegelenks ist diagnostisch fuer BHMED. Durch Linkage-Analyse konnte eine Verbindung zu den drei bekannten

  20. Olecranon Bursitis in a Military Population: Epidemiology and Evidence for Prolonged Morbidity in Combat Recruits.

    Science.gov (United States)

    Schermann, Haggai; Karakis, Isabella; Dolkart, Oleg; Maman, Eran; Kadar, Assaf; Chechik, Ofir

    2017-09-01

    Olecranon bursitis (OB) is a benign but disturbing condition that may adversely affect a military recruit's combat preparedness. This study was designed to assess incidence, risk factors, and associated medical burden of OB in the Israel Defense Forces. This is a retrospective study drawing on medical records of all Israel Defense Forces soldiers diagnosed as having OB between 2005 and 2015. OB was classified as septic and noninfectious. Crude incidence rates and duty-specific incidence rates were calculated. Medical burden was defined by the number of physician visits, referrals to orthopedic specialist consultations, duration of symptoms, and duration of pharmaceutical treatment. Demographic and occupational information (age, sex, height, weight, socioeconomic status, country of origin, type of military service, time of presentation to medical services) was used to identify risk factors for septic bursitis and longer duration of symptoms. Statistical analysis was performed in R statistical software. Risk factors were evaluated using the Chi-square test for categorical variables and Pearson correlation coefficients were used for continuous variables. The study was approved by the Israeli Defense Force IRB. A total of 2,692 soldiers were diagnosed with OB during the study period. The crude annual incidence rate of OB was 29/100,000 person-years (PY). Combat duty had an incidence of 97/100,000 PY, and noncombat duties had an incidence of 12/10,000 PY (p Origin from the former USSR was associated with a higher duration of symptoms (p = 0.012). Type of military service was the principal risk factor for OB, as indicated by a higher incidence of the disorder among combat compared to noncombat units, possibly the result of field training without protective gear and repetitive trauma to elbows. The greater number of diagnoses of OB during summer and autumn, when training is more intensive, support that explanation. Sex did not affect incidence of OB in administrative

  1. Hypervitaminosis A-induced premature closure of epiphyses (physeal obliteration) in humans and calves (hyena disease): a historical review of the human and veterinary literature

    International Nuclear Information System (INIS)

    Rothenberg, Alexis B.; Berdon, Walter E.; Woodard, J.C.; Cowles, Robert A.

    2007-01-01

    Vitamin A toxicity in the infant, which now occurs rarely from dietary overdosage, was recognized in the 1940s as painful periostitis with rare progression to premature closure of the lower limb epiphyses. Decades later, most cases of vitamin A-induced premature epiphyseal closure (physeal obliteration) occur in pediatric dermatologic patients given vitamin A analogues. This phenomenon resembles a strange disease discovered in more recent years in calves with closed epiphyses of the hind limbs, known as hyena disease. This was a mystery until proved to be caused by vitamin A toxicity from enriched grain that causes the calves to have short hind limbs that resemble those of a hyena and gait disturbance. This historical review links the human and veterinary literature in terms of vitamin A-induced epiphyseal closure using a case report format of a 16-month-old human infant with closed knee epiphyses and gait disturbance that is reminiscent of hyena disease seen in calves. (orig.)

  2. Modified epiphyseal index for MRI in Legg-Calve-Perthes disease (LCPD)

    Energy Technology Data Exchange (ETDEWEB)

    Kumasaka, Y; Watanabe, H; Higashihara, T; Kishimoto, H [Kansai Rosai Hospital, Hyogo (Japan). Dept. of Radiology; Harada, K; Sakurai, K; Kozuka, T [Osaka Univ. (Japan). Dept. of Radiology

    1991-04-01

    On radiographs flattening of the femoral head is evaluated by the Epiphyseal Index (EI). Using the ability of MRI to show articular cartilage and the physis clearly, we wish to propose the use of Epiphyseal Index for MRI (EIM) and demonstrate the value in LCPD. Fifteen patients were examined using 1.5 T MR scanner and T1-weighted coronal images were obtained. EIM was calculated as a ratio of height and width of cartilaginous contour surrounding epiphysis, and was compared between normal and the three radiographic stages. EIM of normal hips were ranged from 0.39 to 0.60 and had a tendency to decrease with increasing age. All cases of Stage 1 (avascular necrosis) were within the normal range (n=4, mean=0.51, SD=0.045). EIM of Stage 2 (fragmentation, n=15, mean=0.31, SD=0.055) were smaller than that of Stage 1. Stage 2 and 3 (residual, n=12, mean=0.31, SD=0.077) could not be distinguished by EIM. EIM was useful to show the flattening of epiphysis with growth and very important for differenciation between Stage 1 and 2 LCPD. (orig.).

  3. Efficiency of Human Epiphyseal Chondrocytes with Differential Replication Numbers for Cellular Therapy Products

    Directory of Open Access Journals (Sweden)

    Michiyo Nasu

    2016-01-01

    Full Text Available The cell-based therapy for cartilage or bone requires a large number of cells; serial passages of chondrocytes are, therefore, needed. However, fates of expanded chondrocytes from extra fingers remain unclarified. The chondrocytes from human epiphyses morphologically changed from small polygonal cells to bipolar elongated spindle cells and to large polygonal cells with degeneration at early passages. Gene of type II collagen was expressed in the cells only at a primary culture (Passage 0 and Passage 1 (P1 cells. The nodules by implantation of P0 to P8 cells were composed of cartilage and perichondrium. The cartilage consisted of chondrocytes with round nuclei and type II collagen-positive matrix, and the perichondrium consisted of spindle cells with type I collage-positive matrix. The cartilage and perichondrium developed to bone with marrow cavity through enchondral ossification. Chondrogenesis and osteogenesis by epiphyseal chondrocytes depended on replication number in culture. It is noteworthy to take population doubling level in correlation with pharmaceutical efficacy into consideration when we use chondrocytes for cell-based therapies.

  4. Fracture Mechanics

    International Nuclear Information System (INIS)

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

    1992-08-01

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

  5. Elbow dislocation with intra-articular fracture: the results of operative treatment without repair of the medial collateral ligament.

    Science.gov (United States)

    Forthman, Christopher; Henket, Marjolijn; Ring, David C

    2007-10-01

    To determine the effectiveness of a protocol for the treatment of fracture-dislocations of the elbow based on the concept that, if dislocation of the elbow with associated fractures can be made to resemble a simple elbow dislocation by repairing or reconstructing the fractured structures, repair of the medial collateral ligament (MCL) will not be necessary. Over a 5-year period, a single surgeon operated on 34 patients with a posterior dislocation of the elbow associated with one or more intra-articular fractures. The mean age of these 19 men and 15 women was 48 years. Associated fractures included the capitellum, trochlea, and lateral epicondyle in 3 patients; the olecranon in 1 patient; and the radial head in 30 patients (with concomitant fracture of the coronoid process-the so-called "terrible triad" of the elbow-in 22 patients, and concomitant fracture of the coronoid and olecranon in 1 patient). Operative treatment consisted of open reduction internal fixation (ORIF) or prosthetic replacement of all fractures and reattachment of the origin of the lateral collateral ligament (LCL) complex to the lateral epicondyle. The MCL was not repaired. Two patients (1 with a terrible triad injury and 1 with fracture of the capitellum and trochlea) had postoperative instability related to noncompliance, had reconstructive procedures, and were considered failures. An average of 32 months after injury, the remaining 32 patients regained an average of 120 degrees ulnohumeral motion and 142 degrees forearm rotation. Twenty-five of 34 patients (74%) had good or excellent results according to the system of Broberg and Morrey. Patients with terrible triad injuries had an average of 117 degrees ulnohumeral motion and 137 degrees forearm rotation, and 17 of 22 patients (77%) had good or excellent results. MCL repair is unnecessary in the treatment of dislocation of the elbow with associated intra-articular fractures, provided that the articular fractures and the LCL are repaired or

  6. A Randomized Trial Among Compression Plus Nonsteroidal Antiinflammatory Drugs, Aspiration, and Aspiration With Steroid Injection for Nonseptic Olecranon Bursitis.

    Science.gov (United States)

    Kim, Joon Yub; Chung, Seok Won; Kim, Joo Hak; Jung, Jae Hong; Sung, Gwang Young; Oh, Kyung-Soo; Lee, Jong Soo

    2016-03-01

    Olecranon bursitis might be a minor problem in the outpatient clinic but relatively be common to occur. However, there are few well-designed studies comparing approaches to treatment. (1) Which treatment (compression bandaging with nonsteroidal antiinflammatory drugs [NSAIDs], aspiration, or aspiration with steroid injections) is associated with the highest likelihood of resolution of nonseptic olecranon bursitis? (2) Which treatment is associated with earliest resolution of symptoms? (3) What factors are associated with treatment failure by 4 weeks? We enrolled 133 patients from two centers; after applying prespecified exclusions (septic bursitis or concomitant inflammatory arthritis, intraarticular elbow pathology, recent aspiration or steroid injection done elsewhere, and refusal to participate), 90 patients were randomly allocated to receive compression bandaging with NSAIDs (C), aspiration (A), or aspiration with steroid injection (AS) groups (30 patients in each). The groups were similar at baseline in terms of age and gender. Seven patients (four from Group A and three from Group AS) were lost to followup. All patients were followed up weekly for 4 weeks, and the same treatment procedure was repeated if the bursitis recurred with any substantial fluid collection. At 4 weeks, the state of resolution and pain visual analog scale (VAS) were evaluated. Failed resolution was defined as presence of persistent olecranon bursal fluid collection at Week 4 after the initiation of the treatment; on the contrary, if bursal fluid collection was clinically reduced or completely disappeared by the end of Week 4, the treatment was considered successful. We compared the proportion of resolution by Week 4 and the median times to resolution among the treatment groups. In addition, we evaluated whether the resolution affected pain VAS and what factors were associated with the resolution. There were no differences in the proportion of patients whose bursitis resolved by Week 4

  7. Homozygous mutations in IHH cause acrocapitofemoral dysplasia, an autosomal recessive disorder with cone- shaped epiphyses in hands and hips

    NARCIS (Netherlands)

    Hellemans, J; Coucke, PJ; Giedion, A; De Paepe, A; Kramer, P; Beemer, F; Mortier, GR

    Acrocapitofemoral dysplasia is a recently delineated autosomal recessive skeletal dysplasia, characterized clinically by short stature with short limbs and radiographically by cone-shaped epiphyses, mainly in hands and hips. Genome-wide homozygosity mapping in two consanguineous families linked the

  8. Epiphyseal involvement in Erdheim-Chester disease: radiographic and scintigraphic findings in a case with lytic lesions

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz-Hernandez, G.; Tajahuerce-Romera, G.M.; Latorre-Ibanez, M.D.; Lara-Pomares, A. [Servicio de Medicina Nuclear, Hospital Provincial de Castellon (Spain); Vila-Fayos, V. [Servicio de Reumatologia, Hospital Comarcal de Vinaroz (Spain)

    2000-08-01

    We reported a symmetric increase of activity in lower links secondary to Erdheim-Chester disease and demonstrated by bone scans and radiographs. An inusual scintigraphic and radiographic appearance with epiphyseal involvement and lytic lesions is described. Differential diagnosis of bone scan and radiographic findings is discussed. (orig.)

  9. Spondylo-meta-epiphyseal dysplasia, short limbs, abnormal calcification type: a new case with severe neurological involvement

    Energy Technology Data Exchange (ETDEWEB)

    Fano, V.; Lejarraga, H. [Hospital Garrahan, Buenos Aires (Argentina). Service of Growth and Development; Barreiro, C. [Hospital Garrahan, Buenos Aires (Argentina). Service of Genetics

    2001-01-01

    A case of an affected girl with spondylo-meta-epiphyseal dysplasia (SMED) is reported. The disease was detected at birth as a congenital dysplasia with generalized lesions. At 10 months of age, abnormal calcifications appeared in both wrists. The patient evolved with severe growth retardation and multiple neurological and respiratory complications, followed by death at 21 months of age. (orig.)

  10. Failed vascularized proximal fibular epiphyseal transfer for hip reconstruction following infection in children.

    Science.gov (United States)

    Debarge, Romain; Chotel, Franck; Gazarian, Aram; Viola, Jérémy; Berard, Jérôme

    2009-08-01

    Treatment of the sequellae of hip infection with epiphyseal destruction in children has had limited success to date. The aim of this study was to report mid-term results after hip epiphyseal reconstruction using a proximal vascularized fibular graft in three children presenting with massive epiphyseal destruction of the proximal femur following infection. Three children suffered from hip articular destruction type IVB according to the Choi classification after neonatal septic arthritis. The mean age at reconstruction was 4.3 years (range 3-6 years). The Hunka et al. criteria were used to evaluate the functional results, and the clinical evaluation was based on the Musculo-Skeletal Tumor Society (MSTS) score. Growth and fusion of the graft and hip morphology were evaluated on simple X-rays and by magnetic resonance imaging (MRI). A ratio between cephalic diameter and inter-acetabular gap was defined on the MRI scan as the "acetabular filling index". No intraoperative complication was reported. With a mean follow-up of 4.8 years (3-6 years), the MSTS score was 22.7/30 (range 20-26), while the average lower limb length discrepancy was 3 cm. Patient 1 required a secondary derotation osteotomy of the femur because of abnormal external rotation and a bad result due to the unexplained occurrence of a painful and stiff hip joint. A secondary distal transfer of the greater trochanter was performed in patient 2, and good results based on Hunka et al.'s criteria were achieved. The X-rays of patients 1 and 2 showed signs of bone growth and a major remodeling process; the MRI filling indices were 83 and 67%, respectively. Patient 3 developed an early slipped capital (fibular) epiphysis 1 month postoperatively, which was treated by percutaneous pinning; this early complication led to a bad result with full resorption of the graft. In contrast to its success in upper limb reconstruction, in this series of three patients with hip articular destruction, articular reconstruction

  11. Case report 355: Delayed closure of the right olecranon epiphysis in a right-handed, tournament-class tennis player (post-traumatic)

    Energy Technology Data Exchange (ETDEWEB)

    Retrum, R.K.; Wepfer, J.F.; Olen, D.W.; Laney, W.H.

    1986-02-01

    In summary, two cases of delayed union of the ossification center of the ulnar olecranon in the dominant elbow of competitive sibling male tennis players are reported. Pain in the elbow, exaggerated by the serving motion, was the presenting complaint in each patient, and painful, limited, terminal extension of the forearm was the major finding in both patients on physical examination. Radiological studied on the two brothers were virtually identical. In two previously reported cases in the literature, the patients were treated by operative intervention, whereas both young men reported in this manuscript, were treated non-surgically, with subsequent spontaneous fusion of the ossification center of the olecranon in each patient. Thus, such conservative therapy may very well be the treatment of choice. (orig./SHA).

  12. Case report 355: Delayed closure of the right olecranon epiphysis in a right-handed, tournament-class tennis player (post-traumatic)

    International Nuclear Information System (INIS)

    Retrum, R.K.; Wepfer, J.F.; Olen, D.W.; Laney, W.H.

    1986-01-01

    In summary, two cases of delayed union of the ossification center of the ulnar olecranon in the dominant elbow of competitive sibling male tennis players are reported. Pain in the elbow, exaggerated by the serving motion, was the presenting complaint in each patient, and painful, limited, terminal extension of the forearm was the major finding in both patients on physical examination. Radiological studied on the two brothers were virtually identical. In two previously reported cases in the literature, the patients were treated by operative intervention, whereas both young men reported in this manuscript, were treated non-surgically, with subsequent spontaneous fusion of the ossification center of the olecranon in each patient. Thus, such conservative therapy may very well be the treatment of choice. (orig./SHA)

  13. Epiphyseal osteochondromas with autosomal dominant inheritance and multiple parosteal bone proliferations

    International Nuclear Information System (INIS)

    Fahmy, Mohamed A.L.; Pandey, Tarun

    2008-01-01

    The familial cases of dysplasia epiphysealis hemimelica (DEH), or Trevor's disease, are thought to represent dominant carpotarsal osteochondromatosis (DCO). Only three families affected by DCO have been reported so far in the literature. We report a fourth family: a 10-year-old girl, her father, and his cousin. Unlike the other reported cases of DCO this family had no carpal or upper limb epiphyseal osteochondromas and many of the other reported associations. The only consistent associated finding in our cases was the presence of multiple parosteal osteochondromatous proliferations. The findings of our cases are, therefore, unique in many ways. These cases may represent a variant of dominant carpotarsal osteochondromatosis or may represent a new entity. (orig.)

  14. Epiphyseal osteochondromas with autosomal dominant inheritance and multiple parosteal bone proliferations

    Energy Technology Data Exchange (ETDEWEB)

    Fahmy, Mohamed A.L. [Razi Orthopedic Hospital, Consultant Orthopedic Surgeon, P.O. Box 4235, Safat (Kuwait); Pandey, Tarun [University of Arkansas for Medical Sciences (UAMS), Department of Radiology, Little Rock, AR (United States)

    2008-01-15

    The familial cases of dysplasia epiphysealis hemimelica (DEH), or Trevor's disease, are thought to represent dominant carpotarsal osteochondromatosis (DCO). Only three families affected by DCO have been reported so far in the literature. We report a fourth family: a 10-year-old girl, her father, and his cousin. Unlike the other reported cases of DCO this family had no carpal or upper limb epiphyseal osteochondromas and many of the other reported associations. The only consistent associated finding in our cases was the presence of multiple parosteal osteochondromatous proliferations. The findings of our cases are, therefore, unique in many ways. These cases may represent a variant of dominant carpotarsal osteochondromatosis or may represent a new entity. (orig.)

  15. Skeletal scintigraphic appearance of an auto-transplanted osteoarticular plug: epiphyseal transplant

    International Nuclear Information System (INIS)

    Morrison, Stuart C.; O'Donnell, James; Makley, John T.

    2003-01-01

    Nuclear medicine bone scan is an essential diagnostic imaging tool both for the diagnosis and staging of bone tumors and in the follow-up of these patients. It is very important that we be able to discriminate between normal variants, changes related to altered physical stress, and recurrent disease in order to interpret the bone scan meaningfully. We wish to report the appearance of the isotope bone scan, technetium 99m-labeled methylene diphosphonate ( 99m Tc-MDP), associated with an auto-transplanted osteoarticular plug (epiphyseal transplant) performed following limb amputation. This reconstructive surgery can give a potentially misleading appearance on the nuclear medicine bone scan if one is unfamiliar with this surgical technique. (orig.)

  16. Skeletal scintigraphic appearance of an auto-transplanted osteoarticular plug: epiphyseal transplant

    Energy Technology Data Exchange (ETDEWEB)

    Morrison, Stuart C.; O' Donnell, James [University Hospitals Cleveland, Department of Radiology-Hb6, Department of Radiology-Hb6, 9500 Euclid Avenue, OH 44195, Cleveland (United States); Makley, John T. [University Hospitals Cleveland, Department of Orthopedic Surgery, The Cleveland Clinic Children' s Hospital, 9500 Euclid Avenue, OH 44195, Cleveland (United States)

    2003-07-01

    Nuclear medicine bone scan is an essential diagnostic imaging tool both for the diagnosis and staging of bone tumors and in the follow-up of these patients. It is very important that we be able to discriminate between normal variants, changes related to altered physical stress, and recurrent disease in order to interpret the bone scan meaningfully. We wish to report the appearance of the isotope bone scan, technetium 99m-labeled methylene diphosphonate ({sup 99m}Tc-MDP), associated with an auto-transplanted osteoarticular plug (epiphyseal transplant) performed following limb amputation. This reconstructive surgery can give a potentially misleading appearance on the nuclear medicine bone scan if one is unfamiliar with this surgical technique. (orig.)

  17. Epiphyseal dysplasia of the hip. Diagnosis and differential diagnosis with MRI. Epiphysaere Dysplasie des Hueftgelenks, Diagnostik und Differentialdiagnostik mit der MRT

    Energy Technology Data Exchange (ETDEWEB)

    Grimm, J. (Univ. Mainz, Orthopaedische Klinik und Poliklinik (Germany)); Just, M. (Univ. Mainz, Klinik mit Poliklinik fuer Radiologie (Germany))

    1992-07-01

    Sixteen hip joints of eight patients with multiple epiphyseal dysplasia were examined by clinical investigation, plain films and by magnetic resonance imaging (MRI), using T[sub 1]- and T[sub 2]-weighted images and gradient echoes. MRI is useful in demonstrating the congruity of the joint, in the changes of the epiphyseal signal intensities and the epiphyseal line. Individual changes of the signal intensity patterns on T[sub 1]- and T[sub 2]-weighted scans are described. Although MRI exhibits a variety of patterns in different patients, a clearcut differentiation from Legg-Calve-Perthes' disease is possible. (orig.).

  18. Olecranon orientation as an indicator of elbow joint angle in the stance phase, and estimation of forelimb posture in extinct quadruped animals.

    Science.gov (United States)

    Fujiwara, Shin-Ichi

    2009-09-01

    Reconstruction of limb posture is a challenging task in assessing functional morphology and biomechanics of extinct tetrapods, mainly because of the wide range of motions possible at each limb joint and because of our poor knowledge of the relationship between posture and musculoskeletal structure, even in the extant taxa. This is especially true for extinct mammals such as the desmostylian taxa Desmostylus and Paleoparadoxia. This study presents a procedure that how the elbow joint angles of extinct quadruped mammals can be inferred from osteological characteristics. A survey of 67 dried skeletons and 113 step cycles of 32 extant genera, representing 25 families and 13 orders, showed that the olecranon of the ulna and the shaft of the humerus were oriented approximately perpendicular to each other during the stance phase. At this angle, the major extensor muscles maximize their torque at the elbow joint. Based on this survey, I suggest that olecranon orientation can be used for inferring the elbow joint angles of quadruped mammals with prominent olecranons, regardless of taxon, body size, and locomotor guild. By estimating the elbow joint angle, it is inferred that Desmostylus would have had more upright forelimbs than Paleoparadoxia, because their elbow joint angles during the stance phase were approximately 165 degrees and 130 degrees , respectively. Difference in elbow joint angles between these two genera suggests possible differences in stance and gait of these two mammals. Copyright 2009 Wiley-Liss, Inc.

  19. Simultaneous bilateral tibial tubercle avulsion fracture in a male teenager: case report and literature review.

    Science.gov (United States)

    Nicolini, Alexandre P; Carvalho, Rogerio T; Ferretti, Mario; Cohen, Moises

    2018-01-01

    Tibial tuberosity avulsion fractures are injuries accounting for less than 3% of all epiphyseal and 1% of all physeal injuries in adolescents. Bilateral injuries are very rare, with only 19 cases described in the literature. These types of fractures occur commonly in male teenagers during sport activities and are often associated with other orthopaedic disorders. We report the case of a male teenager with simultaneous bilateral tibial tubercle fractures, describe the evolution and treatment of this injury and review the literature on this subject. Case report.

  20. Selective arteriography in femoral head fractures

    Energy Technology Data Exchange (ETDEWEB)

    Mannella, P; Galeotti, R; Borrelli, M; Benea, G; Massari, L; Chiarelli, G M

    1986-01-01

    The choice between conservative and radical operation in case of femoral neck fractures is very important because it is the determining factor for a successfull therapy. In case of epiphysial necrosis, an endoprosthesis as well as an osteosynthesis will be carried out. Selective arteriography of the medical circumflex artery represents the most reliable study to establish, immediately after the fractures, the possible presence of a post-traumatic ischemic necrosis. Angiography, as a reliable diagnostic tool, has to be carried out in the most selective way and needs the image subtraction technique. The authors report their preliminary results on the reliability of angiography in the femoral epiphyseal ischemic necrosis diagnosed by comparing the results of angiography with the wood light test carried out on the surgically removed femoral head. 18 refs.

  1. Mixing implants of differing metallic composition in the treatment of upper-extremity fractures.

    Science.gov (United States)

    Acevedo, Daniel; Loy, Bo Nasmyth; Loy, Bo Nasymuth; Lee, Brian; Omid, Reza; Itamura, John

    2013-09-01

    Mixing implants with differing metallic compositions has been avoided for fear of galvanic corrosion and subsequent failure of the implants and of bone healing. The purpose of this study was to evaluate upper-extremity fractures treated with open reduction and internal fixation with metallic implants that differed in metallic composition placed on the same bone. The authors studied the effects of using both stainless steel and titanium implants on fracture healing, implant failure, and other complications associated with this method of fixation. Their hypothesis was that combining these metals on the same bone would not cause clinically significant nonunions or undo clinical effects from galvanic corrosion. A retrospective review was performed of 17 patients with upper-extremity fractures fixed with metal implants of differing metallic compositions. The primary endpoint was fracture union. Eight clavicles, 2 proximal humeri, 3 distal humeri, 3 olecranons, and 1 glenoid fracture with an average follow-up 10 months were reviewed. All fractures healed. One patient experienced screw backout, which did not affect healing. This study implies that mixing implants with differing metallic compositions on the same bone for the treatment of fractures does not adversely affect bone healing. No evidence existed of corrosion or an increase in complications with this method of treatment. Contrary to prior belief, small modular hand stainless steel plates can be used to assist in reduction of smaller fracture fragments in combination with anatomic titanium plates to obtain anatomic reduction of the fracture without adversely affecting healing. Copyright 2013, SLACK Incorporated.

  2. The proportion of distal fibula Salter-Harris type I epiphyseal fracture in the paediatric population with acute ankle injury

    DEFF Research Database (Denmark)

    Hofsli, Mikael; Torfing, Trine; Al-Aubaidi, Zaid

    2016-01-01

    Ankle injuries are common among the paediatric population. There are few prospective studies utilizing MRI to diagnose a clinically suspected Salter-Harris type I of the distal fibula (SH1FDF). The aim of this study was to examine the proportion of clinically suspected SH1FDF in children. All...

  3. MED, COMP, multilayered and NEIN: an overview of multiple epiphyseal dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Lachman, Ralph S. [International Skeletal Dysplasia Registry, UCLA School of Medicine, Radiological Services, Department of Pediatrics, Los Angeles, CA (United States); International Skeletal Dysplasia Registry, Los Angeles, CA (United States); Krakow, Deborah; Cohn, Daniel H.; Rimoin, David L. [International Skeletal Dysplasia Registry, UCLA School of Medicine, Radiological Services, Department of Pediatrics, Los Angeles, CA (United States)

    2005-02-01

    This overview covers the group of disorders that presents radiographically as multiple epiphyseal dysplasia (MED). The disorders include ''classic MED'' (Ribbing and Fairbank types): MED that is caused by mutations in the cartilage oligomeric matrix protein (COMP), type IX collagen, and matrilin 3 genes (MATN3); and MED with multilayered patella, brachydactyly, and clubbed feet resultant from mutations in gene defect diastrophic dysplasia (DTDST). The recently identified gene/molecular abnormalities in these disorders have made more exact identification possible in many cases, although clinical testing is not always available. However, there are specific radiographic findings that allow the accurate diagnosis to be made, thus potentially guiding which molecular defect(s) should be investigated. The modes of inheritance of these distinct MED conditions are not identical. When a specific diagnosis is made, proper genetic counseling as well as prognostication, management issues and complications can be delineated to the patient and family. This review will include the mechanics of diagnostic and molecular triage for these disorders. (orig.)

  4. Editorial Commentary: The All-Epiphyseal Anterior Cruciate Ligament Distal Femoral Approach: Sockets or Tunnels?

    Science.gov (United States)

    Cordasco, Frank A

    2018-05-01

    I believe that the distal femoral approach for anterior cruciate ligament reconstruction in the skeletally immature athlete with 3 to 6 years of remaining growth is best performed with an all-inside, all-epiphyseal technique using sockets rather than an outside-in approach creating tunnels. A shorter socket rather than a longer tunnel exposes a smaller surface area of the lateral distal femoral physis to potential compromise and resultant valgus malalignment. In addition, exiting the lateral femoral aspect of the epiphysis with a full-diameter tunnel as compared with a smaller diameter drill hole used to prepare a socket places the posterior articular cartilage, the lateral collateral ligament and anterolateral ligament footprints, and the popliteus tendon insertion at risk. My preference for sockets is also related to my belief that they provide a superior biologic milieu for graft incorporation compared with a full-length tunnel with the attendant violation of the lateral femoral cortex of the epiphysis. Copyright © 2018 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  5. Tratamiento funcional de fracturas desplazadas de olecranon en pacientes mayores de 70 años. [Functional treatment of displaced olecranon fractures in patients older than 70 years old.

    Directory of Open Access Journals (Sweden)

    Gerardo Gallucci

    2015-06-01

    Full Text Available Objetivo Reportar los resultados clínicos y radiológicos del tratamiento funcional de fracturas desplazadas de olécranon en pacientes >70 años. Material y Métodos Se evaluaron 28 pacientes >70 años con fracturas desplazadas de olécranon. El tratamiento consistió en la inmovilización inicial con una valva de yeso (promedio 5 días y, luego, movilización activa según tolerancia. No se indicó rehabilitación kinesiológica. Ningún paciente fue perdido en el seguimiento. El grupo estaba formado por 27 mujeres y un hombre. La edad promedio era de 82 años. Según la clasificación de la Clínica Mayo, 18 fracturas eran de tipo IIA y 10, de tipo IIB. El seguimiento promedio fue de 14 meses. Resultados La flexo-extensión fue de 142°-15°. La fuerza muscular fue de M5 en 17 pacientes y de M4 en 9. La fuerza de puño fue un 93% del lado contralateral. El dolor según la escala visual analógica fue de 1. La satisfacción con el tratamiento según esta escala fue de 9. Según el puntaje de la Clínica Mayo, 22 pacientes tuvieron resultados excelentes y 6, buenos. El puntaje DASH promedio fue de 15. Veinticuatro pacientes evolucionaron hacia la seudoartrosis. El gap articular final fue, en promedio, de 16 mm. El gap a nivel de la cortical posterior final fue, en promedio de 22 mm. Conclusión El tratamiento no quirúrgico de las fracturas desplazadas de olécranon en pacientes mayores ofrece un nú- mero elevado de buenos resultados funcionales con alto grado de satisfacción. Palabras clave: Fractura de olécranon. Fractura de codo. Tratamiento funcional.

  6. 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.

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

    Directory of Open Access Journals (Sweden)

    Thomas Gausepohl

    2017-02-01

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

  8. 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.

  9. Sudden multiple fractures in a patient with sarcoidosis in multiple organs.

    Science.gov (United States)

    Sada, Mitsuru; Saraya, Takeshi; Ishii, Haruyuki; Goto, Hajime

    2014-04-07

    A 30-year-old man who incidentally fractured his right olecranon and other multiple phalanges was admitted to our hospital. He had a 2-year history of uveitis and bilateral hilar lymphadenopathy (BHL), and pulmonary sarcoidosis was diagnosed from transbronchial lung biopsy. Right elbow arthrodesis was performed, and biopsied specimens showed non-caseating epithelioid cell granuloma, suggesting osseous sarcoidosis. He was discharged uneventfully without further treatment, but BHL had progressed with the appearance of lung parenchymal lesions 3 months later. At that time, involvement of other organs was also noted on Gallium-67 scintigraphy, showing accumulations in BHL, axillary and inguinal lymph nodes, enlarged liver and spleen and subcutaneous areas. After initiation of steroid therapy, multiple organ involvement improved, and no further bone involvement has been recognised to date. Osseous sarcoidosis complicated by bone fracture is an extremely rare presentation, but should be considered in patients with sarcoidosis, especially when multiple organs are involved.

  10. Isometric Scaling in Developing Long Bones Is Achieved by an Optimal Epiphyseal Growth Balance.

    Science.gov (United States)

    Stern, Tomer; Aviram, Rona; Rot, Chagai; Galili, Tal; Sharir, Amnon; Kalish Achrai, Noga; Keller, Yosi; Shahar, Ron; Zelzer, Elazar

    2015-08-01

    individual epiphyseal plates.

  11. Deletion of IFT80 Impairs Epiphyseal and Articular Cartilage Formation Due to Disruption of Chondrocyte Differentiation

    Science.gov (United States)

    Yuan, Xue; Yang, Shuying

    2015-01-01

    Intraflagellar transport proteins (IFT) play important roles in cilia formation and organ development. Partial loss of IFT80 function leads Jeune asphyxiating thoracic dystrophy (JATD) or short-rib polydactyly (SRP) syndrome type III, displaying narrow thoracic cavity and multiple cartilage anomalies. However, it is unknown how IFT80 regulates cartilage formation. To define the role and mechanism of IFT80 in chondrocyte function and cartilage formation, we generated a Col2α1; IFT80f/f mouse model by crossing IFT80f/f mice with inducible Col2α1-CreER mice, and deleted IFT80 in chondrocyte lineage by injection of tamoxifen into the mice in embryonic or postnatal stage. Loss of IFT80 in the embryonic stage resulted in short limbs at birth. Histological studies showed that IFT80-deficient mice have shortened cartilage with marked changes in cellular morphology and organization in the resting, proliferative, pre-hypertrophic, and hypertrophic zones. Moreover, deletion of IFT80 in the postnatal stage led to mouse stunted growth with shortened growth plate but thickened articular cartilage. Defects of ciliogenesis were found in the cartilage of IFT80-deficient mice and primary IFT80-deficient chondrocytes. Further study showed that chondrogenic differentiation was significantly inhibited in IFT80-deficient mice due to reduced hedgehog (Hh) signaling and increased Wnt signaling activities. These findings demonstrate that loss of IFT80 blocks chondrocyte differentiation by disruption of ciliogenesis and alteration of Hh and Wnt signaling transduction, which in turn alters epiphyseal and articular cartilage formation. PMID:26098911

  12. Primary subacute epiphyseal osteomyelitis caused by Mycobacterium species in young children: a modern diagnostic approach.

    Science.gov (United States)

    El Houmami, N; Minodier, P; Bouvier, C; Seligmann, H; Jouve, J-L; Raoult, D; Fournier, P-E

    2017-05-01

    Primary epiphyseal subacute osteomyelitis (PESAO) caused by Mycobacterium species in young children is poorly recognized. We aimed to define the spectrum of this uncommon condition and to propose a novel diagnostic approach. We performed a systematic review of the literature on the PubMed website by selecting all reports of isolated infantile PESAO caused by Mycobacterium species since 1975. We identified 350 citations, of which 174 were assessed for eligibility based on title and abstract. The full text of 81 eligible citations was screened, and relevant data of 15 children under 4 years of age with mycobacterial PESAO were extracted. These data were pooled with those from our Institution. Data from 16 children were reviewed. The median age was 16 ± 7 months and the male:female ratio 1.7. The knee was the most common infection site (94%). The diagnosis of mycobacterial disease was delayed in all cases (range, 2 weeks to 6 months), and initially presumed by histology in 15 children (94%). Microbiologically proven diagnosis was confirmed by bone cultures in 8 of the 15 children (53%), and by specific PCR in 2 of the 3 culture-negative bone specimens (67%). Three children experienced long-term orthopedic complications despite surgical drainage and prolonged antimycobacterial regimens. All recently reported cases came from high-burden tuberculosis areas. Mycobacterium species contribute to the burden of infantile PESAO in endemic tuberculosis areas and may cause growth disturbances. We argue in favor of the early recognition of mycobacterial disease by specific molecular assays in children with infantile PESAO living in high-burden areas.

  13. Isometric Scaling in Developing Long Bones Is Achieved by an Optimal Epiphyseal Growth Balance

    Science.gov (United States)

    Stern, Tomer; Aviram, Rona; Rot, Chagai; Galili, Tal; Sharir, Amnon; Kalish Achrai, Noga; Keller, Yosi; Shahar, Ron; Zelzer, Elazar

    2015-01-01

    individual epiphyseal plates. PMID:26241802

  14. 'Trampoline fracture' of the proximal tibia in children: report of 3 cases and review of literature.

    Science.gov (United States)

    Bruyeer, E; Geusens, E; Catry, F; Vanstraelen, L; Vanhoenacker, F

    2012-01-01

    We present three cases of fracture of the proximal tibia in young children who were jumping on a trampoline. The typical radiological findings and the underlying mechanism of trauma are discussed. The key radiological features are: a transverse hairline fracture of the upper tibia often accompanied by a buckle fracture of the lateral or medial tibial cortex, buckling of the anterior upper tibial cortex and anterior tilting of the epiphyseal plate. New types of injuries related to specific recreational activities are recognized. It is often helpful to associate a typical injury with a particular activity. Trampoline related injuries have increased dramatically over the last years. The most common lesions are fractures and ligamentous injuries, in particular a transverse fracture of the proximal tibia. However the radiological findings can be very subtle and easily overlooked. It is therefore important to be aware of the typical history and radiological findings.

  15. Classification of fractures in the area of the ankle joint for practical surgical conceras

    International Nuclear Information System (INIS)

    Gay, B.

    1983-01-01

    For practical surgical concerns we require radiological diagnosis of all injuries, indication for conservative or operative therapy and prognostic evidence in order to classify fractures of the ankle joint. Due to the fact that joint stability is ensured by the fibula and syndesmosis, we prefer classification according to Weber. Fracture types A, B and C are classified according to radiological findings, the pertinent concomitant injuries introduced and differentiated from the special forms of the ''interligamentary fracture'' and ''flake fractures''. Due to the frequency of injury in children of the distal, tibial epiphyseal cartilage we select classification according to Aitken for practical purposes, which differentiates basically between separation and fracture of the epiphysis and makes for prognosis about disturbances in growth. Delimited from ''crush injury'' the Aitken classification is compared to other conventional forms of classification in tabular form. (orig.) [de

  16. Iron supplementation during pregnancy and its effects on epiphyseal growth plate of newborn rat: a histological study

    International Nuclear Information System (INIS)

    Umbreen, F.; Qamar, K.; Rehman, S.

    2017-01-01

    To study the effect of iron supplementation during pregnancy on epiphyseal growth plate of Sprague dawley rat pups. Study Design: Laboratory based randomized control trial. Place and Duration of Study: This study was conducted at Department of Anatomy, Army Medical College Rawalpindi in collaboration with National Institute of Health (NIH) Islamabad, from Mar 2016 to Nov 2016. Material and Methods: Eight female and two male Sprague Dawley rats, 3-4 months old were selected and divided into two groups and kept for breeding. Pregnant rats were divided into two groups. Four pregnant rats in each group. Group A1was control group and group B1 was experimental group. Iron supplementation was given once daily throughout pregnancy till the time of delivery. Iron was given to the experimental group in syrup form (Sytron syrup containing iron as sodium feredetate). Each 5ml of sytron syrup contains 27.5mg of elemental iron content1. The dose was mixed in water given to the animal. Maternal body weight (wt.) was recorded at the start and the end of experiment. As the rat pups were born, they were weighed and euthanized. Right femur of each rat pup was removed for the epiphyseal plate analysis. It was processed, embedded and stained with Hematoxylin and Eosin, Perl's stain for histological study. Hypertrophy and proliferative zone length were histologically and statistically analyzed. Results: Height of hypertrophy and proliferative zone was measured. Mean values of the heights of two zones were taken. Heights of hypertrophy and proliferative zones were considerably decreased in group B1 as compared to groups A1. Conclusion: Indiscriminate iron supplementation to the rats throughout pregnancy without checking serum iron levels can disturb the longitudinal growth of epiphyseal plate of femur. The height of the hypertrophy zone and proliferative zone was significantly reduced in iron supplementation group as compared to the control group. (author)

  17. Bone maturation in children exposed in utero to the atomic bomb. [Closure of epiphyseal centers in hands and wrists

    Energy Technology Data Exchange (ETDEWEB)

    Russell, W J; Keehn, R J; Ihno, Y; Hattori, F; Kogure, T; Imamura, K

    1972-01-20

    Five hundred and fifty-six subjects exposed while in utero to the Hiroshima and Nagasaki A-bombs, and comparison subjects were observed by posteroanterior hand and wrist roentgenograms for epiphyseal closure. There were delays in closure of 6-7 and 8-9 months for males and females respectively, as compared for Japanese and American children. These findings did not correlate with the A-bomb exposure doses of the mothers of these children. Brachymesophalangia occurred in 11% of males and 19% of females in Hiroshima. Possible contributory factors to the relative delay in maturation are discussed. (auth)

  18. Infectious olecranon and patellar bursitis: short-course adjuvant antibiotic therapy is not a risk factor for recurrence in adult hospitalized patients.

    Science.gov (United States)

    Perez, Cédric; Huttner, Angela; Assal, Mathieu; Bernard, Louis; Lew, Daniel; Hoffmeyer, Pierre; Uçkay, Ilker

    2010-05-01

    No evidence-based recommendations exist for the management of infectious bursitis. We examined epidemiology and risk factors for recurrence of septic bursitis. Specifically, we compared outcome in patients receiving bursectomy plus short-course adjuvant antibiotic therapy (7 days). Retrospective study of adult patients with infectious olecranon and patellar bursitis requiring hospitalization at Geneva University Hospital from January 1996 to March 2009. We identified 343 episodes of infectious bursitis (237 olecranon and 106 patellar). Staphylococcus aureus predominated among the 256 cases with an identifiable pathogen (85%). Three hundred and twelve cases (91%) were treated surgically; 142 (41%) with one-stage bursectomy and closure and 146 with two-stage bursectomy. All received antibiotics for a median duration of 13 days with a median intravenous component of 3 days. Cure was achieved in 293 (85%) episodes. Total duration of antibiotic therapy [odds ratio (OR) 0.9; 95% confidence interval (95% CI) 0.8-1.1] showed no association with cure. In multivariate analysis, only immunosuppression was linked to recurrence (OR 5.6; 95% CI 1.9-18.4). Compared with 14 days of antibiotic treatment (OR 0.9; 95% CI 0.1-10.7) was equivalent, as was the intravenous component (OR 1.1; 95% CI 1.0-1.3). In severe infectious bursitis requiring hospitalization, adjuvant antibiotic therapy might be limited to 7 days in non-immunosuppressed patients.

  19. Arthroscopic decompression and notchplasty for long-standing anterior cruciate ligament impingement in a patient with multiple epiphyseal dysplasia: a case report

    Directory of Open Access Journals (Sweden)

    Trehan RK

    2008-05-01

    Full Text Available Abstract Introduction Multiple epiphyseal dysplasia is a genetically and clinically heterogeneous osteochondroplasia with symmetrical involvement. It is characterized by joint pain in childhood and early adulthood with early onset of osteoarthritis, mainly affecting the hips. Case presentation We report the case of a 20-year-old man of Asian origin with multiple epiphyseal dysplasia presenting with bilateral knee pain, stiffness and instability found to be caused by bilateral anterior cruciate ligament impingement on abnormal medial femoral condyles. Bilateral staged arthroscopic notchplasty was performed successfully, resulting in subjective relief of pain, and improved range of movement and stability. Conclusion Care should be taken not to exclude a diagnosis of multiple epiphyseal dysplasia when few of the characteristic radiographic features are evident but clinical suspicion is high. This case highlights the scope for subjective symptomatic improvement following a minimum of surgical intervention. We recommend limiting early intervention to managing symptomatic features rather than radiographic abnormalities alone.

  20. An unusual form of spondyloepiphyseal dysplasia, with advanced carpal and spinal end-plate ossification mimicking COMP-mutation-like multiple epiphyseal dysplasia

    Energy Technology Data Exchange (ETDEWEB)

    Pazzaglia, Ugo E.; Zarattini, Guido [University of Brescia Medical School, Department of Orthopaedics and Traumatology, Brescia (Italy); Beluffi, Giampiero [Fondazione IRCCS Policlinico S. Matteo, Section of Paediatric Radiology, Department of Radiodiagnosis, Pavia (Italy)

    2008-07-15

    We present a child with irregular ossification of tubular bone epiphyses, short bones, and spine. The radiographic evolution of bones undergoing endochondral ossification was followed from the age of 1 year 9 months to 6 years. The unusual features demonstrated in this child made classification difficult: pseudoachondroplasia was excluded because no mutations of the COMP gene were found. Considering the evolution of the radiographic appearances, the most likely diagnosis would seem to be an unusual form of spondyloepiphyseal dysplasia, mimicking some aspects of multiple epiphyseal dysplasia. Endochondral ossification was diffusely altered with a mixture of epiphyseal ossification delay associated with acceleration and early fusion. This case was a unique presentation within the family, suggesting a mutation in the affected child. (orig.)

  1. An unusual form of spondyloepiphyseal dysplasia, with advanced carpal and spinal end-plate ossification mimicking COMP-mutation-like multiple epiphyseal dysplasia

    International Nuclear Information System (INIS)

    Pazzaglia, Ugo E.; Zarattini, Guido; Beluffi, Giampiero

    2008-01-01

    We present a child with irregular ossification of tubular bone epiphyses, short bones, and spine. The radiographic evolution of bones undergoing endochondral ossification was followed from the age of 1 year 9 months to 6 years. The unusual features demonstrated in this child made classification difficult: pseudoachondroplasia was excluded because no mutations of the COMP gene were found. Considering the evolution of the radiographic appearances, the most likely diagnosis would seem to be an unusual form of spondyloepiphyseal dysplasia, mimicking some aspects of multiple epiphyseal dysplasia. Endochondral ossification was diffusely altered with a mixture of epiphyseal ossification delay associated with acceleration and early fusion. This case was a unique presentation within the family, suggesting a mutation in the affected child. (orig.)

  2. Metaphyseal osteomyelitis in children: how often does MRI-documented joint effusion or epiphyseal extension of edema indicate coexisting septic arthritis?

    International Nuclear Information System (INIS)

    Schallert, Erica K.; Kan, J.H.; Monsalve, Johanna; Zhang, Wei; Bisset, George S.; Rosenfeld, Scott

    2015-01-01

    Joint effusions identified by MRI may accompany osteomyelitis and determining whether the joint effusion is septic or reactive has important implications on patient care. Determine the incidence of epiphyseal marrow edema, joint effusions, perisynovial edema and epiphyseal non-enhancement in the setting of pediatric metaphyseal osteomyelitis and whether this may be used to predict coexisting septic arthritis. Following IRB approval, we retrospectively evaluated children who underwent MRI and orthopedic surgical consultation for suspected musculoskeletal infection between January 2011 and September 2013. Criteria for inclusion in the study were microbiologically/pathologically proven infection, MRI prior to surgical intervention, long bone involvement and age 0-18 years. MRI exams were independently reviewed by two faculty pediatric radiologists to confirm the presence of appendicular metaphyseal osteomyelitis, to evaluate extent of edema, to determine subjective presence of a joint effusion and to assess perisynovial edema and epiphyseal non-enhancement. Any discrepant readings were reviewed in consensus. Charts and operative notes were reviewed to confirm the diagnosis of osteomyelitis and septic arthritis. One hundred and three joints with metaphyseal osteomyelitis were identified (mean age: 7.1 years; M:F 1.3:1), of whom 53% (55/103) had joint effusions, and of those, 75% (41/55) had surgically confirmed septic arthritis. The incidence of coexisting septic arthritis was 40% in the setting of epiphyseal edema, 74% in epiphyseal edema and effusion, 75% with perisynovial edema, 76% with epiphyseal non-enhancement and 77% when all four variables were present. Of these, the only statistically significant variable, however, was the presence of a joint effusion with a P-value of <0.0001 via Fisher exact test. Statistical significance for coexisting septic arthritis was also encountered when cases were subdivided into intra-articular vs. extra-articular metaphyses (P

  3. Metaphyseal osteomyelitis in children: how often does MRI-documented joint effusion or epiphyseal extension of edema indicate coexisting septic arthritis?

    Energy Technology Data Exchange (ETDEWEB)

    Schallert, Erica K.; Kan, J.H.; Monsalve, Johanna; Zhang, Wei; Bisset, George S. [Texas Children' s Hospital, Department of Pediatric Radiology, Houston, TX (United States); Rosenfeld, Scott [Texas Children' s Hospital, Department of Pediatric Orthopedic Surgery, Houston, TX (United States)

    2015-08-15

    Joint effusions identified by MRI may accompany osteomyelitis and determining whether the joint effusion is septic or reactive has important implications on patient care. Determine the incidence of epiphyseal marrow edema, joint effusions, perisynovial edema and epiphyseal non-enhancement in the setting of pediatric metaphyseal osteomyelitis and whether this may be used to predict coexisting septic arthritis. Following IRB approval, we retrospectively evaluated children who underwent MRI and orthopedic surgical consultation for suspected musculoskeletal infection between January 2011 and September 2013. Criteria for inclusion in the study were microbiologically/pathologically proven infection, MRI prior to surgical intervention, long bone involvement and age 0-18 years. MRI exams were independently reviewed by two faculty pediatric radiologists to confirm the presence of appendicular metaphyseal osteomyelitis, to evaluate extent of edema, to determine subjective presence of a joint effusion and to assess perisynovial edema and epiphyseal non-enhancement. Any discrepant readings were reviewed in consensus. Charts and operative notes were reviewed to confirm the diagnosis of osteomyelitis and septic arthritis. One hundred and three joints with metaphyseal osteomyelitis were identified (mean age: 7.1 years; M:F 1.3:1), of whom 53% (55/103) had joint effusions, and of those, 75% (41/55) had surgically confirmed septic arthritis. The incidence of coexisting septic arthritis was 40% in the setting of epiphyseal edema, 74% in epiphyseal edema and effusion, 75% with perisynovial edema, 76% with epiphyseal non-enhancement and 77% when all four variables were present. Of these, the only statistically significant variable, however, was the presence of a joint effusion with a P-value of <0.0001 via Fisher exact test. Statistical significance for coexisting septic arthritis was also encountered when cases were subdivided into intra-articular vs. extra-articular metaphyses (P

  4. Epiphyseal maturity indicators at the knee and their relationship to chronological age: results of an Irish population study.

    LENUS (Irish Health Repository)

    O'Connor, Jean E

    2013-09-01

    Skeletal maturation is divisible to three main components; the time of appearance of an ossification center, its change in morphology and time of fusion to a primary ossification center. With regard to the knee, the intermediate period between appearance and fusion of the ossification centers extends over a period of greater than 10 years. This study aims to investigate radiographically the age at which morphological changes of the epiphyses at the knee occur in a modern Irish population. Radiographs of 221 subjects (137 males; 84 females) aged 9-19 years were examined. Seven nonmetric indicators of maturity were assessed using criteria modified from the Roche, Wainer, and Thissen method and Pyle and Hoerr\\'s atlas of the knee. Reference charts are presented which display the timeline for each of the grades of development of the seven indicators. Mean age was found to increase significantly with successive grades of development of each of the seven indicators. A significant difference was noted between males and females at the same grade of development for six of the seven indicators. The narrowest age range reported for a single grade of development was 2.2 years for Grade 2 of development of the tibial tuberosity for males. The information on changing morphology of the epiphyses at the knee in the present study may provide an adjunct to methods used for evaluation of skeletal maturity before surgery for orthopedic disorders or to evaluate skeletal age in clinical scenarios where either delayed or precocious skeletal maturation is suspected.

  5. Epiphyseal union of the cervical vertebral centra: its relationship to skeletal age and maturation of thoracic vertebral centra.

    Science.gov (United States)

    Albert, Midori A; Maier, Christopher A

    2013-11-01

    Epiphyseal union stages for cervical vertebral centra (ring epiphyses) were documented for 55 individuals (females and males, ages 14-27 years) from the Terry Collection, using the Albert and Maples method 1, to examine both its relationship to age at death and to thoracic data collected from the same individuals using the same method. Results showed a moderate correlation between cervical ring union and age (r = 0.63, p = 0.000), and a fairly low correlation between cervical and thoracic ring union (r = 0.41, p = 0.002). Paired samples t-tests yielded a statistically significant difference between cervical and thoracic union mean values (p = 0.01). Union progressed earlier in cervical vertebrae and in females. Results indicated fairly substantial variation in both sexes. Findings may serve as a basic guideline for estimating a general age range at death for unknown skeletal remains and to corroborate findings from other skeletal age indicators. © 2013 American Academy of Forensic Sciences.

  6. Hip Fracture

    Science.gov (United States)

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

  7. Type IX Collagen Gene Mutations Can Result in Multiple Epiphyseal Dysplasia That Is Associated With Osteochondritis Dissecans and a Mild Myopathy

    NARCIS (Netherlands)

    Jackson, Gail C.; Marcus-Soekarman, Dominique; Stolte-Dijkstra, Irene; Verrips, Aad; Taylor, Jacqueline A.; Briggs, Michael D.

    Multiple epiphyseal dysplasia (MED) is a clinically variable and genetically heterogeneous disease that is characterized by mild short stature and early onset osteoarthritis. Autosomal dominant forms are caused by mutations in the genes that encode type IX collagen, cartilage oligomeric matrix

  8. Familial multiple epiphyseal dysplasia due to a matrilin-3 mutation : Further delineation of the phenotype including 40 years follow-up

    NARCIS (Netherlands)

    Mostert, AK; Dijkstra, PF; Jansen, BRH; van Horn, [No Value; de Graaf, B; Heutink, P; Lindhout, D

    2003-01-01

    In this study, we followed-up the family with bilateral hereditary micro-epiphyseal dysplasia (BHMED) originally described by Elsbach [1959: J Bone Joint Surg [Br] 41B:514-523]. Clinical re-examination of all available family members resulted in further delineation of the clinical and radiological

  9. Type IX collagen gene mutations can result in multiple epiphyseal dysplasia that is associated with osteochondritis dissecans and a mild myopathy.

    NARCIS (Netherlands)

    Jackson, G.C.; Marcus-Soekarman, D.; Stolte-Dijkstra, I.; Verrips, A.; Taylor, J.A.; Briggs, M.D.

    2010-01-01

    Multiple epiphyseal dysplasia (MED) is a clinically variable and genetically heterogeneous disease that is characterized by mild short stature and early onset osteoarthritis. Autosomal dominant forms are caused by mutations in the genes that encode type IX collagen, cartilage oligomeric matrix

  10. Bilateral Simultaneous Avulsion Fractures of the Proximal Tibia in a 14-Year-Old Athlete with Vitamin-D Deficiency

    Directory of Open Access Journals (Sweden)

    Ziad Harb

    2015-01-01

    Full Text Available Fractures involving the proximal tibial epiphysis are rare and form 0.5% of all epiphyseal injuries. The specific anatomical and developmental features of the proximal tibial epiphysis make it vulnerable to unique patterns of fractures. Vitamin-D plays a vital role in bone homeostasis and its deficiency has an impact on fracture risk and healing. We present the first ever reported case of simultaneous bilateral proximal tibial physeal fractures in an athlete with vitamin-D deficiency. Treatment consisted of plaster immobilisation, and the patient made a full recovery and returned to preinjury level of activities. We report this case for its uniqueness and as an educational review of the importance of the developmental anatomy of the proximal tibia. We review the literature and discuss how the stages of the growing physis determine the type of fracture sustained.

  11. Radiological aspects on the course of development of porcine epiphyseal osteochondrosis (OCD) from 42 up to 147 days of age

    International Nuclear Information System (INIS)

    Bittegeko, S.B.P.; Arnbjerg, J.

    1994-01-01

    The articular-epiphyseal (A-E) cartilage complex of the distal humeral and femoral epiphyseal condyles of eight intact pigs (4 male & 4 female) of the same age were radiologically examined every 3 weeks, beginning at 42 days up to 147 days of age; to determine the age of onset, the course and trend of development of osteochondrosis (OCD). The earliest Dyschondroplasia (Osteochondrotic) lesions were demonstrated radiologically in the A-E complexes of the humeral condyles of 42-day-old pigs and in the femoral condyles at 63 days of age. Thus the radiographic examination of live animals to demonstrate subchondral radiolucency typical for OCD lesions in the condylar A-E complexes of pigs is not of limited value until the animals were > 100 days old as indicated in earlier reports. Also the course of further development of OCD lesions associated with A-E complexes was followed. The radiolucency was seen to develop to a certain extent, and then either to regress, and stabilize or even to progress as the animal grows. Some lesions regressed completely. Also some of the regressed lesions may become active again and become progressive. However, the course of development of femoral condyle A-E complexes OCD lesions was seen to be progressive continuously, or progressive then stable and then progressive again. The regressive course and trend of osteochondrotic lesions was not observed in the femoral condyle A-E complexes up to day 147 of age. Therefore, the course and trend of development of the A-E complexes OCD is not constantly the same

  12. Rib Fractures

    Science.gov (United States)

    ... Video) Achilles Tendon Tear Additional Content Medical News Rib Fractures By Thomas G. Weiser, MD, MPH, Associate Professor, ... Tamponade Hemothorax Injury to the Aorta Pulmonary Contusion Rib Fractures Tension Pneumothorax Traumatic Pneumothorax (See also Introduction to ...

  13. Root fractures

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  14. Stress Fractures

    Science.gov (United States)

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

  15. Acetabular Fracture

    Directory of Open Access Journals (Sweden)

    Chad Correa

    2017-09-01

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

  16. Minimally invasive plate osteosynthesis for humerus diaphyseal fractures

    Directory of Open Access Journals (Sweden)

    M Shantharam Shetty

    2011-01-01

    Full Text Available Background: Minimally invasive plate osteosynthesis (MIPO technique is reported as a satisfactory procedure for the treatment of humeral shaft fractures by the anterior approach by several authors. However, none of the published reports had a significant follow-up nor have they reported patient outcomes. We evaluated the clinical, radiographic, and functional outcome over a minimum follow-up of 2 years using the same MIPO technique to humeral shaft fracture. Materials and Methods: 32 adult patients with diaphyseal fractures of the humerus treated with MIPO between June 2007 and October 2008 were included in the study. Patients with metabolic bone disease, polytrauma, and Gustilo and Anderson type 3 open fractures with injury severity score >16 were excluded from the study. All cases were treated with closed indirect reduction and locking plate fixation using the MIPO technique. The surgery time, radiation exposure, and time for union was noted. The shoulder and elbow function was assessed using the UCLA shoulder and Mayo elbow performance scores, respectively. Results: Of the 32 patients in the study, 19 were males and 13 were females. The mean age was 39 years (range: 22-70 years. Twenty-seven of the thirty-two patients (84.3% had the dominant side fractured. We had eight cases of C2 type; five cases of C1 and A2 type; four cases of B2 type; three cases each of B3, B1, and A1 type; and one case of A3 type of fracture. The mean surgical time was 91.5 minutes (range: 70-120 minutes and mean radiation exposure was 160.3 seconds (range: 100-220 seconds. The mean radiological fracture union time was 12.9 weeks (range: 10-20 weeks. Shoulder function was excellent in 27 cases (84.3% and good in remaining 5 cases (15.6% on the UCLA score. Elbow function was excellent in 26 cases (81.2%, good in 5 cases (15.6%, and fair in 1 case (3.1% who had an associated olecranon fracture that was fixed by tension band wire in the same sitting. Conclusion: MIPO of

  17. The epiphyseal union of the medial clavicle determined by CT - an axillary method in age identification during adolescence and 3rd decade of life?

    International Nuclear Information System (INIS)

    Kreitner, K.F.; Schweden, F.; Schild, H.H.; Riepert, T.; Nafe, B.

    1997-01-01

    Purpose: To establish a reference population for the stages of epiphyseal union of the medical clavicle determined by CT. Material and methods: Retrospectively, the thoracic CTs of patients under 30 years of age were reevaluated. Basic conditions were the lack of a bone development disorder and a sufficient assessment of the medial clavicle in a bone window setting. The stages of epiphyseal union were categorized as follows: Stage 1 refers to nonunion without ossification of the epiphysis, Stage 2 to nonunion with a separate and ossified epiphysis, Stage 3 to partial, and Stage 4 to complete union. Results: Up to now, 279 individuals coul be included in the study. Stage 1 was observed till age 16, Stage 2 occurred from ages 13 through 22, Stage 3 was found from ages 16 through 26. Stage 4 was first noted at age 22, and in 100% of the sample at age 27. Conclusions: CT is well suitable to determine the stages of epiphyseal union of the medial clavicle. It may become a generally accepted method of age identification during adolescence and the 3rd decade of life. The presented data serve as a reference population at least for white Europeans. (orig.) [de

  18. A mutation in KIF7 is responsible for the autosomal recessive syndrome of macrocephaly, multiple epiphyseal dysplasia and distinctive facial appearance

    Directory of Open Access Journals (Sweden)

    Ali Bassam R

    2012-05-01

    Full Text Available Abstract Background We previously reported the existence of a unique autosomal recessive syndrome consisting of macrocephaly, multiple epiphyseal dysplasia and distinctive facial appearance mapping to chromosome 15q26. Methods In this manuscript, we have used whole exome sequencing on two affected members of a consanguineous family with this condition and carried out detailed bioinformatics analysis to elucidate the causative mutation. Results Our analysis resulted in the identification of a homozygous p.N1060S missense mutation in a highly conserved residue in KIF7, a regulator of Hedgehog signaling that has been recently found to be causing Joubert syndrome, fetal hydrolethalus and acrocallosal syndromes. The phenotype in our patients partially overlaps with the phenotypes associated with those syndromes but they also exhibit some distinctive features including multiple epiphyseal dysplasia. Conclusions We report the first missense homozygous disease-causing mutation in KIF7 and expand the clinical spectrum associated with mutations in this gene to include multiple epiphyseal dysplasia. The missense nature of the mutation might account for the unique presentation in our patients.

  19. Mandible Fractures.

    Science.gov (United States)

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

    2017-05-01

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

  20. Facial Fractures.

    Science.gov (United States)

    Ghosh, Rajarshi; Gopalkrishnan, Kulandaswamy

    2018-06-01

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

  1. Precise localization of multiple epiphyseal dysplasia and pseudoachondroplasia mutations by genetic and physical mapping of chromosome 19

    Energy Technology Data Exchange (ETDEWEB)

    Knowlton, R.G.; Cekleniak, J.A. [Jefferson Medical College, Philadelphia, PA (United States); Cohn, D.H. [Cedars-Sinai Medical Center, Los Angeles, CA (United States)] [and others

    1994-09-01

    Multiple epiphyseal dysplasia (EDM1), a dominantly inherited chondrodysplasia resulting in peripheral joint deformities and premature osteoarthritis, and pseudoachondroplasia (PSACH), a more severe disorder associated with short-limbed dwarfism, have recently been mapped to the pericentromeric region of chromosome 19. Chondrocytes from some PSACH patients accumulate lamellar deposits in the endoplasmic reticulum that are immunologically cross-reactive with aggrecan. However, neither aggrecan nor any known candidate gene maps to the EDM1/PSACH region of chromosome 19. Genetic linkage mapping in two lage families had placed the disease locus between D19S215 (19p12) and D19S212 (19p13.1), an interval of about 3.5 Mb. With at least five potentially informative cross-overs within this interval, recombination mapping at greater resolution was undertaken. From cosmids assigned to the region by fluorescence in situ hybridization and contig assembly, dinucleotide repeat tracts were identified for use as polymorphic genetic markers. Linkage data from three new dinucleotide repeat markers from cosmids mapped between D19S212 and D19S215 limit the EDM1/PSACH locus to an interval spanning approximately 2 Mb.

  2. The difference in the appearance of proximal humeral epiphyseal ossification center on chest radiograph between the preterm and full-term infants

    International Nuclear Information System (INIS)

    Park, Hee Hong; Kim, Seung Cheol; Chang, Young Pyo; Park, Jin Young; Kwon, Ho Jang; Lee, Jee Young; Yoo, Dong Soo; Kim, You Me; Jeong, Chun Keun; Lee, Young Seok

    1997-01-01

    To assess the difference in the appearance of the proximal humeral epiphyseal ossification center, as seen on chest radiograph, between preterm and full-term infants at the same corrected ages. Forty two preterm infants born at 26--35 weeks of gestational age and 218 normal full-term infants born at 38-42 weeks were investigated. Because of various perinatal problems, the preterm infants were treated at a neonatal intensive care unit. Proximal humeral epiphyseal ossification centers were evaluated from chest radiographs, and in cases of preterm infants, the corrected age of 0 month was defined as postconceptional 40 weeks. In preterm infants, the numbers of chest radiographs obtained were 42 at 0 month, 40 at 1 month, 37 at 2 months and 36 at 3 months of corrected age, while in those who were full-term, the numbers were 103 cases at 0 month, 42 at 1 month, 42 at 2 months and 31 at 3 months of age In the preterm group, alkaline phosphatase, calcium, phosphorus levels and simple wrist radiographs were checked. We then evaluated the difference of appearance of the proximal humeral epiphyseal ossification center between preterm and full-term infants at the same corrected ages, as well as the difference between causative diseases, between the normal and abnormal serologic group and between the normal and abnormal wrist group in preterm infants at the same corrected ages. Using Fisher's exact test, the data were analysed. The incidences of the proximal humeral epiphyseal ossification center in preterm infants were 2.4% (1/42) at 0 month, 20.0% (8/40) at 1 month, 43.2% (16/37) at 2 months and 69.4%(25/36) at 3 months; in full-term infants, the figures were 24.3% (25/103) at 0 month, 66.7%(28/42) at 1 month, 83.3% (35/42) at 2 months and 90.3% (28/31) at 3 months. At 0, 1, and 2 months, the incidences were thus seen to be lower in preterm than in full-term infants(p 0.05). In preterm infants, there were no statistical differences between causative diseases, between the

  3. Fracture sacrum.

    Directory of Open Access Journals (Sweden)

    Dogra A

    1995-04-01

    Full Text Available An extremely rare case of combined transverse and vertical fracture of sacrum with neurological deficit is reported here with a six month follow-up. The patient also had an L1 compression fracture. The patient has recovered significantly with conservative management.

  4. Fracture Mechanics

    CERN Document Server

    Zehnder, Alan T

    2012-01-01

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

  5. Which radiological investigations should be performed to identify fractures in suspected child abuse?

    International Nuclear Information System (INIS)

    Kemp, A.M.; Butler, A.; Morris, S.; Mann, M.; Kemp, K.W.; Rolfe, K.; Sibert, J.R.; Maguire, S.

    2006-01-01

    Aims: To determine which radiological investigations should be performed and which children should be investigated. Materials and methods: An all language literature search of original articles; from 1950-October 2005. Two reviewers independently reviewed each article. A third was carried out on disagreement. Each study was assessed using standardised data extraction, critical appraisal and evidence forms. Results: Thirty-four studies were included. Fifteen addressed the question: which investigation has a higher yield, skeletal surveys (SS) or bone scintigraphy (BS)? Studies gave conflicting results. Overall neither investigation is as good as the two combined. BS predominately missed skull, metaphyseal and epiphyseal fractures, whereas SS commonly missed rib fractures. Two studies showed that a repeat SS 2 weeks after the initial study provided significant additional information about tentative findings, the number and age of fractures. A comparative study evaluated additional oblique views of ribs in 73 children and showed improved diagnostic sensitivity, specificity and accuracy. Four studies addressed the diagnostic yield for occult fractures with respect to age. This was significant for children under 2-years old. Conclusions: In children under 2-years old, where physical abuse is suspected, diagnostic imaging of the skeleton should be mandatory. SS or BS alone is inadequate to identify all fractures. It is recommended that all SS should include oblique views of the ribs. This review suggests that the following options would optimize the diagnostic yield. However, each needs to be evaluated prospectively: SS that includes oblique views, SS and BS, a SS with repeat SS or selected images 2 weeks later or a BS plus skull radiography and coned views of metaphyses and epiphyses

  6. Which radiological investigations should be performed to identify fractures in suspected child abuse?

    Energy Technology Data Exchange (ETDEWEB)

    Kemp, A.M.; Butler, A.; Morris, S.; Mann, M.; Kemp, K.W.; Rolfe, K.; Sibert, J.R.; Maguire, S

    2006-09-15

    Aims: To determine which radiological investigations should be performed and which children should be investigated. Materials and methods: An all language literature search of original articles; from 1950-October 2005. Two reviewers independently reviewed each article. A third was carried out on disagreement. Each study was assessed using standardised data extraction, critical appraisal and evidence forms. Results: Thirty-four studies were included. Fifteen addressed the question: which investigation has a higher yield, skeletal surveys (SS) or bone scintigraphy (BS)? Studies gave conflicting results. Overall neither investigation is as good as the two combined. BS predominately missed skull, metaphyseal and epiphyseal fractures, whereas SS commonly missed rib fractures. Two studies showed that a repeat SS 2 weeks after the initial study provided significant additional information about tentative findings, the number and age of fractures. A comparative study evaluated additional oblique views of ribs in 73 children and showed improved diagnostic sensitivity, specificity and accuracy. Four studies addressed the diagnostic yield for occult fractures with respect to age. This was significant for children under 2-years old. Conclusions: In children under 2-years old, where physical abuse is suspected, diagnostic imaging of the skeleton should be mandatory. SS or BS alone is inadequate to identify all fractures. It is recommended that all SS should include oblique views of the ribs. This review suggests that the following options would optimize the diagnostic yield. However, each needs to be evaluated prospectively: SS that includes oblique views, SS and BS, a SS with repeat SS or selected images 2 weeks later or a BS plus skull radiography and coned views of metaphyses and epiphyses.

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

    Directory of Open Access Journals (Sweden)

    Rohan Bansal

    2013-04-01

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

  8. A Pitfall in Fixation of Distal Humeral Fractures with Pre-Contoured Locking Compression Plate

    Directory of Open Access Journals (Sweden)

    Prakash Jayakumar

    2015-04-01

    Full Text Available Anatomically precontoured locking plates are intended to facilitate the fixation of articular fractures and particularly those associated with osteoporosis. Fractures of the distal humerus are relatively uncommon injuries where operative intervention can be exceptionally challenging. The distal humeral trochlea provides a very narrow anatomical window through which to pass a fixed-angle locking screw, which must also avoid the olecranon, coronoid, and radial fossae. We describe 3 patients (ages 27, 49, and 73 years with a bicolumnar fracture of the distal humerus where very short distal locking screws were used. Intra-articular screw placement was avoided but loss of fixation occurred in two patients and a third was treated with a prolonged period of immobilization. We postulate that fixed-angle screw trajectories may make it difficult for the surgeon to place screws of adequate length in this anatomically confined region, and may lead to insufficient distal fixation. Surgical tactics should include placement of as many screws as possible into the distal fragment, as long as possible, and that each screw pass through a plate without necessarily locking in.

  9. Completed Ulnar Shaft Stress Fracture in a Fast-Pitch Softball Pitcher.

    Science.gov (United States)

    Wiltfong, Roger E; Carruthers, Katherine H; Popp, James E

    2017-03-01

    Stress fractures of the upper extremity have been previously described in the literature, yet reports of isolated injury to the ulna diaphysis or olecranon are rare. The authors describe a case involving an 18-year-old fast-pitch softball pitcher. She presented with a long history of elbow and forearm pain, which was exacerbated during a long weekend of pitching. Her initial physician diagnosed her as having forearm tendinitis. She was treated with nonsurgical means including rest, anti-inflammatory medications, therapy, and kinesiology taping. She resumed pitching when allowed and subsequently had an acute event immediately ceasing pitching. She presented to an urgent care clinic that evening and was diagnosed as having a complete ulnar shaft fracture subsequently needing surgical management. This case illustrates the need for a high degree of suspicion for ulnar stress fractures in fast-pitch soft-ball pitchers with an insidious onset of unilateral forearm pain. Through early identification and intervention, physicians may be able to reduce the risk of injury progression and possibly eliminate the need for surgical management. [Orthopedics. 2017; 40(2):e360-e362.]. Copyright 2016, SLACK Incorporated.

  10. Fracture mechanics

    CERN Document Server

    Perez, Nestor

    2017-01-01

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

  11. Fracture analysis

    International Nuclear Information System (INIS)

    Ueng, Tzoushin; Towse, D.

    1991-01-01

    Fractures are not only the weak planes of a rock mass, but also the easy passages for the fluid flow. Their spacing, orientation, and aperture will affect the deformability, strength, heat transmittal, and fluid transporting properties of the rock mass. To understand the thermomechanical and hydrological behaviors of the rock surrounding the heater emplacement borehole, the location, orientation, and aperture of the fractures of the rock mass should be known. Borehole television and borescope surveys were performed to map the location, orientation, and aperture of the fractures intersecting the boreholes drilled in the Prototype Engineered Barrier System Field Tests (PEBSFT) at G-Tunnel. Core logging was also performed during drilling. However, because the core was not oriented and the depth of the fracture cannot be accurately determined, the results of the core logging were only used as reference and will not be discussed here

  12. Facial Fractures.

    Science.gov (United States)

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

    2016-02-01

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

  13. Epiphyseal abnormalities, trabecular bone loss and articular chondrocyte hypertrophy develop in the long bones of postnatal Ext1-deficient mice.

    Science.gov (United States)

    Sgariglia, Federica; Candela, Maria Elena; Huegel, Julianne; Jacenko, Olena; Koyama, Eiki; Yamaguchi, Yu; Pacifici, Maurizio; Enomoto-Iwamoto, Motomi

    2013-11-01

    Long bones are integral components of the limb skeleton. Recent studies have indicated that embryonic long bone development is altered by mutations in Ext genes and consequent heparan sulfate (HS) deficiency, possibly due to changes in activity and distribution of HS-binding/growth plate-associated signaling proteins. Here we asked whether Ext function is continuously required after birth to sustain growth plate function and long bone growth and organization. Compound transgenic Ext1(f/f);Col2CreERT mice were injected with tamoxifen at postnatal day 5 (P5) to ablate Ext1 in cartilage and monitored over time. The Ext1-deficient mice exhibited growth retardation already by 2weeks post-injection, as did their long bones. Mutant growth plates displayed a severe disorganization of chondrocyte columnar organization, a shortened hypertrophic zone with low expression of collagen X and MMP-13, and reduced primary spongiosa accompanied, however, by increased numbers of TRAP-positive osteoclasts at the chondro-osseous border. The mutant epiphyses were abnormal as well. Formation of a secondary ossification center was significantly delayed but interestingly, hypertrophic-like chondrocytes emerged within articular cartilage, similar to those often seen in osteoarthritic joints. Indeed, the cells displayed a large size and round shape, expressed collagen X and MMP-13 and were surrounded by an abundant Perlecan-rich pericellular matrix not seen in control articular chondrocytes. In addition, ectopic cartilaginous outgrowths developed on the lateral side of mutant growth plates over time that resembled exostotic characteristic of children with Hereditary Multiple Exostoses, a syndrome caused by Ext mutations and HS deficiency. In sum, the data do show that Ext1 is continuously required for postnatal growth and organization of long bones as well as their adjacent joints. Ext1 deficiency elicits defects that can occur in human skeletal conditions including trabecular bone loss

  14. Pisiform fractures

    International Nuclear Information System (INIS)

    Fleege, M.A.; Jebson, P.J.; Renfrew, D.L.; El-Khoury, G.Y.; Steyers, C.M. Jr.

    1991-01-01

    Fractures of the pisiform are often missed due to improper radiographic evaluation and a tendency to focus on other, more obvious injuries. Delayed diagnosis may result in disabling sequelae. A high index of clinical suspicion and appropriate radiographic examination will establish the correct diagnosis. Ten patients with pisiform fracture are presented. The anatomy, mechanism of injury, clinical presentation, radiographic features, and evaluation of this injury are discussed. (orig.)

  15. Stress fractures

    International Nuclear Information System (INIS)

    Berquist, T.H.; Cooper, K.L.; Pritchard, D.J.

    1985-01-01

    The diagnosis of a stress fracture should be considered in patients presented with pain after a change in activity, especially if the activity is strenuous and the pain is in the lower extremities. Since evidence of the stress fracture may not be apparent for weeks on routine radiographs, proper use of other imaging techniques will allow an earlier diagnosis. Prompt diagnosis is especially important in the femur, where displacement may occur

  16. Non-operative treatment of a fracture to the coracoid process with acromioclavicular dislocation in an adolescent

    Directory of Open Access Journals (Sweden)

    Vera Pedersen

    2014-08-01

    Full Text Available Coracoid process fractures are rare and often associated with dislocations of the acromioclavicular (AC joint. There is little evidence about the treatment of these injuries in adolescents, but the few case reports published recommend surgery. We report a case of a dislocated epiphyseal fracture to the base of the coracoid process with AC joint dislocation in a 14-year-old ice-hockey player following direct impact to his left shoulder. Since magnetic resonance tomography revealed intact AC and coracoclavicular ligaments, we initiated non-operative treatment with immobilization and unloading of the shoulder by an abduction brace allowing limited rotation for 6 weeks. This treatment resulted in complete recovery after 8 weeks and return to full sports on first league level after 3 month. In conclusion, non-operative treatment of coracoid base fractures with concomitant AC-joint injury in the adolescent can result in excellent functional results and early recovery.

  17. Scaphoid Fracture

    Directory of Open Access Journals (Sweden)

    Esther Kim, BS

    2018-04-01

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

  18. Base of coracoid process fracture with acromioclavicular dislocation in a child

    Science.gov (United States)

    2010-01-01

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

  19. All-Epiphyseal Anterior Cruciate Ligament Femoral Tunnel Drilling: Avoiding Injury to the Physis, Lateral Collateral Ligament, Anterolateral Ligament, and Popliteus-A 3-Dimensional Computed Tomography Study.

    Science.gov (United States)

    Shea, Kevin G; Cannamela, Peter C; Fabricant, Peter D; Terhune, Elizabeth B; Polousky, John D; Milewski, Matthew D; Anderson, Allen F; Ganley, Theodore J

    2018-01-25

    To investigate the relation of the at-risk structures (distal femoral physis, lateral collateral ligament, anterolateral ligament, popliteus, and articular cartilage) during all-epiphyseal femoral tunnel drilling. A second purpose was 2-fold: (1) to develop recommendations for tunnel placement and orientation that anatomically reconstruct the anterior cruciate ligament (ACL) while minimizing the risk of injury to these at-risk structures, and (2) to allow for maximal tunnel length to increase the amount of graft in the socket to facilitate healing. Three-dimensional models of 6 skeletally immature knees (aged 7-11 years) were reconstructed from computed tomography and used to simulate all-epiphyseal femoral tunnels. Tunnels began within the ACL footprint and were directed laterally or anterolaterally, with the goal of avoiding injury to at-risk structures. The spatial relation between the ideal tunnel and these structures was evaluated. Full-length tunnels and partial length condyle sockets were simulated in the models using the same trajectories. An anterolateral tunnel could be placed to avoid direct injury to lateral structures. The safe zone on the anterolateral aspect of the femur was larger than that of a tunnel with a direct lateral trajectory (median 127 mm 2 vs 83 mm 2 , P = .028). Anterolateral tunnels were longer than direct lateral tunnels (median 30 mm vs 24 mm, P = .041). Safe angles for anterolateral tunnels were 34° to 40° from the posterior condylar axis; direct lateral tunnels were drilled 4° to 9° from the posterior condylar axis. Sockets could be placed without direct injury to structures at risk with either orientation. An all-epiphyseal ACL femoral tunnel can be placed without causing direct injury to at-risk structures. A tunnel angled anterolaterally from the ACL origin is longer and has a larger safe zone compared with the direct lateral tunnel. The largest safe zone for femoral all-epiphyseal ACL drilling was (1) anterior to

  20. Trochanteric fractures

    International Nuclear Information System (INIS)

    Herrlin, K.; Stroemberg, T.; Lidgren, L.; Walloee, A.; Pettersson, H.; Lund Univ.

    1988-01-01

    Four hundred and thirty trochanteric factures operated upon with McLaughlin, Ender or Richard's osteosynthesis were divided into 6 different types based on their radiographic appearance before and immediately after reposition with special reference to the medial cortical support. A significant correlation was found between the fracture type and subsequent mechanical complications where types 1 and 2 gave less, and types 4 and 5 more complications. A comparison of the various osteosyntheses showed that Richard's had significantly fewer complications than either the Ender or McLaughlin types. For Richard's osteosynthesis alone no correlation to fracture type could be made because of the small number of complications in this group. (orig.)

  1. Fracture Blisters

    Directory of Open Access Journals (Sweden)

    Uebbing, Claire M

    2011-02-01

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

  2. Effect of nicotine and preventive role of camellia sinensis on the histomorphology of developing epiphyseal plate of thigh bone of chick

    International Nuclear Information System (INIS)

    Shan, M.; Butt, S.A.

    2014-01-01

    Objective: To determine the effect of nicotine and camellia sinensis (green tea) on the developing epiphyseal plate of thigh bone of chick. Design: Randomized controlled trial. Place and Duration of Study: Army medical college, Rawalpindi, Pakistan from April 2012 to May 2012. Material and Method: Freshly laid fertilized eggs of Fayoumi breed chick eggs were selected at zero hour of incubation. Four groups were made, group G1 was control group treated with normal saline. Experimental group G2 was treated with camellia sinensis extract (green tea), group G3 was given nicotine whereas group G4 was injected with working solution nicotine and camellia sinensis (green tea), in 0.1 ml quantity. Double exposure one at 48 hour of incubation and other at 48 hours after hatching of chicks. SPSS version 15 was used to analyze the data. Results: It was observed that the weight of chick at one month of age and weight of femur of chicks of nicotine treated groups G3 and group G4 were reduced in comparison to control group G1. Mean number of cells in hypertrophy zone of developing epiphyseal plate of thigh bone were reduced of nicotine treated groups in comparison to control group. Conclusion: Camellia sinensis (green tea) helped to reduce the harmful effects of nicotine treated group but cannot reverse the oxidative injury. (author)

  3. Reliability of Schmeling's stages of ossification of medial clavicular epiphyses and its validity to assess 18 years of age in living subjects.

    Science.gov (United States)

    Cameriere, R; De Luca, S; De Angelis, D; Merelli, V; Giuliodori, A; Cingolani, M; Cattaneo, C; Ferrante, L

    2012-11-01

    Nowadays, due to the global increase in migration movements, forensic age estimation of living young adults has become an important focus of interest. Minors often have no identification documents providing their correct birth dates. Establishing the age of majority is therefore fundamental in order to determine whether juvenile penal systems or penal systems in force for adults are to be applied. Radiological examination of the clavicles is one of the methods recommended by the Study Group on Forensic Age Diagnostics. In this retrospective study, a sample of chest radiographs of 274 subjects, aged between 12 and 25 years, was studied according to Schmeling's method in order to examine the ossification of both medial clavicular epiphyses. All stage classifications were evaluated by five examiners. Intra- and inter-examiner reliability was analysed by Cohen's K statistic. Intra-examiner agreement was insufficient for two of the experts. Inter-examiner agreement, among the other three operators, was moderate (K = 0.509). Study of reliability highlighted difficulties in interpretation, the need to select qualified personnel and choice of the best radiographic image in order to reduce any anatomic overlaps. Although ossification of the medial clavicular epiphyses is recommended to assess whether an individual has already reached the age of majority or not, these results suggested that it is very difficult to clearly identify the five stages of ossification by using conventional chest radiography.

  4. Premature Epiphyseal Closure of the Lower Extremities Contributing to Short Stature after cis-Retinoic Acid Therapy in Medulloblastoma: A Case Report.

    Science.gov (United States)

    Noyes, Jessica J; Levine, Michael A; Belasco, Jean B; Mostoufi-Moab, Sogol

    2016-01-01

    Prolonged cis-retinoic acid (RA) exposure contributes to premature epiphyseal closure. cis-RA is administered in various treatment regimens for pediatric cancers, thus increasing the risk for bone deformities and compromised growth. We present a case of premature epiphyseal closure in a 9-year-old female with a history of medulloblastoma and treatment with a multimodal regimen including cis-RA. She was subsequently diagnosed with radiation-induced endocrine late effects including hypothyroidism and growth hormone deficiency (GHD). Seven months after initiation of GH therapy, an increased prominence of the wrists and knees combined with a deceleration in growth velocity prompted further evaluation; radiographs revealed bilateral premature closure of the distal femur and proximal tibia growth plates despite normal left wrist bone age. High doses of vitamin A and its analogs are linked to premature closure of the lower-extremity growth plates in animals and children. Pediatric brain tumor patients are at increased risk of growth failure due to concurrent radiation-induced GHD, damage to the spinal bones, and cis-RA-associated premature closure of the lower-extremity growth plates, with significant reduction in adult stature. A better appreciation of the detrimental effect of cis-RA on the growing skeleton is needed to monitor at-risk patients and to provide timely interventions. © 2015 S. Karger AG, Basel.

  5. Elbow Fractures

    Science.gov (United States)

    ... is also an important factor when treating elbow fractures. Casts are used more frequently in children, as their risk of developing elbow stiffness is small; however, in an adult, elbow stiffness is much more likely. Rehabilitation directed by your doctor is often used to ...

  6. Wrist Fractures

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Wrist Fractures Email to a friend * required fields ...

  7. Shoulder Fractures

    Science.gov (United States)

    ... All Topics A-Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is a Hand Therapist? Media Find a Hand Surgeon Home Anatomy Shoulder Fractures Email to a friend * required fields ...

  8. [Epiphyseal osteoid osteoma].

    Science.gov (United States)

    Villas, C; Garbayo, A J; Martínez Denegri, J; Cañadell, J

    1990-01-01

    Three more cases of osteoid osteoma located in epiphysis are presented. All of them had special features, as a reactive synovitis due to the proximity of the lesion to the joint and the lower movility arch of these joints. The x-ray was essential for the diagnosis and definitive treatment was surgical resection.

  9. Bimalleolar ankle fracture with proximal fibular fracture

    NARCIS (Netherlands)

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

    2005-01-01

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

  10. Fracture mechanics

    International Nuclear Information System (INIS)

    Miannay, D.P.

    1995-01-01

    This book entitle ''Fracture Mechanics'', the first one of the monograph ''Materiologie'' is geared to design engineers, material engineers, non destructive inspectors and safety experts. This book covers fracture mechanics in isotropic homogeneous continuum. Only the monotonic static loading is considered. This book intended to be a reference with the current state of the art gives the fundamental of the issues under concern and avoids the developments too complicated or not yet mastered for not making reading cumbersome. The subject matter is organized as going from an easy to a more complicated level and thus follows the chronological evolution in the field. Similarly the microscopic scale is considered before the macroscopic scale, the physical understanding of phenomena linked to the experimental observation of the material preceded the understanding of the macroscopic behaviour of structures. In this latter field the relatively recent contribution of finite element computations with some analogy with the experimental observation is determining. However more sensitive analysis is not skipped

  11. Non-epiphyseal chondroblastoma arising in the iliac bone, and complicated by an aneurysmal bone cyst: a case report and review of the literature

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jin; Kumar, Rajendra [The University of Texas MD Anderson Cancer Center, Department of Diagnostic Radiology, Houston, TX (United States); Raymond, A.K. [Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX (United States); Ayala, Alberto G. [The Methodist Hospital, Department of Pathology, Houston, TX (United States)

    2010-06-15

    Chondroblastoma is a benign bone tumor that typically arises in the epiphysis of a long bone. However, when it occurs in non-epiphyseal location in flat bones, it may create a diagnostic problem. We describe such a case of chondroblastoma arising in the iliac bone. A 29-year-old man was incidentally found to have a bony pelvic lesion while undergoing evaluation for Crohn's disease. The radiographs and CT revealed an expansile lytic lesion in the right iliac bone. A core biopsy of the lesion was performed. The histopathology revealed the lesion to be a chondroblastoma with secondary features of aneurysmal bone cyst. An en bloc surgical resection of the tumor was performed. (orig.)

  12. Effects of Melatonin and Epiphyseal Proteins on Fluoride-Induced Adverse Changes in Antioxidant Status of Heart, Liver, and Kidney of Rats

    Directory of Open Access Journals (Sweden)

    Vijay K. Bharti

    2014-01-01

    Full Text Available Several experimental and clinical reports indicated the oxidative stress-mediated adverse changes in vital organs of human and animal in fluoride (F toxicity. Therefore, the present study was undertaken to evaluate the therapeutic effect of buffalo (Bubalus bubalis epiphyseal (pineal proteins (BEP and melatonin (MEL against F-induced oxidative stress in heart, liver, and kidney of experimental adult female rats. To accomplish this experimental objective, twenty-four adult female Wistar rats (123–143 g body weights were divided into four groups, namely, control, F, F + BEP, and F + MEL and were administered sodium fluoride (NaF, 150 ppm elemental F in drinking water, MEL (10 mg/kg BW, i.p., and BEP (100 µg/kg BW, i.p. for 28 days. There were significantly P<0.05 high levels of lipid peroxidation and catalase and low levels of reduced glutathione, superoxide dismutase, glutathione reductase, and glutathione peroxidase in cardiac, hepatic, and renal tissues of F-treated rats. Administration of BEP and MEL in F-treated rats, however, significantly P<0.05 attenuated these adverse changes in all the target components of antioxidant defense system of cardiac, hepatic, and renal tissues. The present data suggest that F can induce oxidative stress in liver, heart, and kidney of female rats which may be a mechanism in F toxicity and these adverse effects can be ameliorated by buffalo (Bubalus bubalis epiphyseal proteins and melatonin by upregulation of antioxidant defense system of heart, liver, and kidney of rats.

  13. Multiple bilateral lower limb fractures in a 2-year-old child: previously unreported injury with a unique mechanism

    Directory of Open Access Journals (Sweden)

    Anuj Jain

    2014-10-01

    Full Text Available 【Abstract】Fall from height is a common cause of unintentional injuries in children and accounts for 6% of all trauma-related childhood deaths, usually from head injury. We report a case of a 2-year-old child with multiple fractures of the bilateral lower limbs due to this reason. A child fell from a height of around 15 feet after toppling from a alcony. He developed multiple fractures involving the right femoral shaft, right distal femoral epiphysis (Salter Harris type 2, right distal metaphysis of the tibia and fi bula, and undisplaced Salter Harris type 2 epiphyseal injury of the left distal tibia. There were no head, abdominal or spinal injuries. The patient was taken into emergency operation theatre after initial management which consisted of intravenous fl uids, blood transfusion, and splintage of both lower limbs. Fracture of the femoral shaft was treated by closed reduction and fixation using two titanium elastic nails. Distal femoral physeal injury required open eduction and fixation with K wires. Distal tibia fractures were closely reduced and managed nonoperatively in both the lower limbs. All the fractures united in four weeks. At the last follow-up, the child had no disability and was able to perform daily ctivities comfortably. We also proposed the unique mechanism of injury in this report. Key words: Multiple bilateral lower limb fractures; Fall; Child

  14. Can high-resolution peripheral quantitative computed tomography imaging of subchondral and cortical bone predict condylar fracture in Thoroughbred racehorses?

    Science.gov (United States)

    Trope, G D; Ghasem-Zadeh, A; Anderson, G A; Mackie, E J; Whitton, R C

    2015-07-01

    High-resolution 3D imaging may improve the prediction and/or early identification of condylar fractures of the distal metacarpus/tarsus and reduce the frequency of breakdown injury in racehorses. To test the hypotheses that horses suffering condylar fractures have higher bone volume fraction (BV/TV) of the distal metacarpal epiphysis, greater subchondral bone thickness at the fracture site and higher second moment of inertia in the metacarpal midshaft as identified with high-resolution 3D imaging. Cross-sectional study using cadaver material. Thoroughbreds that died on racetracks were grouped as: 1) horses with third metacarpal (McIII) fractures with a condylar component (cases, n = 13); 2) horses with no limb fracture (controls, n = 8); 3) horses with fractures in other bones or suspensory apparatus disruption (other fatal injuries, n = 16). The palmar condyles of McIII and the midshaft were examined with high resolution peripheral quantitative computed tomography (HR-pQCT). Statistical analysis included logistic regression and Spearman's correlation. There were no significant differences in BV/TV of distal McIII and second moment of inertia of the midshaft between cases and controls. Epiphyseal bone BV/TV was greater in injured limbs of horses with any fatal limb injury (Groups 1 and 3 combined) compared with controls (odds ratio = 1.20, 95% confidence interval 1.01-1.42, P = 0.034). An epiphyseal BV/TV>0.742 resulted in a sensitivity of 82.8% and specificity of 62.5% in identifying horses with fatal limb injury. In horses without condylar fracture, increased subchondral bone thickness was associated with palmar osteochondral disease lesions in the adjacent condyle (rs = 0.65, Phorses at risk of any fatal breakdown injury but not metacarpal condylar fractures. Measurement of parasagittal groove subchondral bone thickness is complicated by adjacent palmar osteochondral disease lesions. Thus, high-resolution imaging of the distal metacarpus appears to have limited

  15. Hip fracture - discharge

    Science.gov (United States)

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

  16. Proximal femoral fractures.

    Science.gov (United States)

    Webb, Lawrence X

    2002-01-01

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

  17. Three-part head-splitting proximal humerus fracture through a unicameral bone cyst.

    Science.gov (United States)

    Younghein, John A; Eskander, Mark S; DeAngelis, Nicola A; Wixted, John J

    2012-06-01

    Unicameral bone cysts are rare in adults and are most often found incidentally on radiographs. However, they can persist from the adolescent period and may be present in locations that predispose to or exacerbate fractures.This article describes a case of a healthy 40-year-old woman who sustained a proximal humerus trauma that involved a large unicameral bone cyst, resulting in a 3-part head-splitting fracture. The epiphyseal location of the cyst contributed to the severity and extent of the fracture that resulted from a simple fall. Given the age of the patient, open reduction and internal fixation with a locking plate and lag screws was performed. The patient chose open reduction and internal fixation to preserve a hemiarthroplasty procedure in case of future revision. Successful humeral head reconstruction was achieved, and the patient fully recovered. One year postoperatively, the patient underwent arthroscopic debridement to alleviate subjective stiffness and decreased range of motion.Multipart head-splitting fractures require complex repair strategies. The gold standard for the treatment of these injuries is hemiarthroplasty. However, the decision process is difficult in a young patient given the average survival of autoplastic prostheses and the added difficulty of later revision. The current case demonstrates the complexity of decision making resulting from a rare injury in a young, healthy patient and shows that open reduction and internal fixation can provide acceptable reconstruction in such situations. Copyright 2012, SLACK Incorporated.

  18. A geometric morphometrics comparative analysis of Neandertal humeri (epiphyses-fused) from the El Sidrón cave site (Asturias, Spain).

    Science.gov (United States)

    Rosas, Antonio; Pérez-Criado, Laura; Bastir, Markus; Estalrrich, Almudena; Huguet, Rosa; García-Tabernero, Antonio; Pastor, Juan Francisco; de la Rasilla, Marco

    2015-05-01

    A new collection of 49,000 year old Neandertal fossil humeri from the El Sidrón cave site (Asturias, Spain) is presented. A total of 49 humeral remains were recovered, representing 10 left and 8 right humeri from adults, adolescents, and a juvenile (not included in the analyses). 3D geometric morphometric (GM) methods as well as classic anthropological variables were employed to conduct a broad comparative analysis by means of mean centroid size and shape comparisons, principal components analysis, and cluster studies. Due to the fragmentary nature of the fossils, comparisons were organized in independent analyses according to different humeral portions: distal epiphysis, diaphysis, proximal epiphysis, and the complete humerus. From a multivariate viewpoint, 3D-GM analyses revealed major differences among taxonomic groups, supporting the value of the humerus in systematic classification. Notably, the Australopithecus anamensis (KP-271) and Homo ergaster Nariokotome (KNM-WT 15000) distal humerus consistently clusters close to those of modern humans, which may imply a primitive condition for Homo sapiens morphology. Australopithecus specimens show a high degree of dispersion in the morphospace. The El Sidrón sample perfectly fits into the classic Neandertal pattern, previously described as having a relatively wide olecranon fossa, as well as thin lateral and medial distodorsal pillars. These characteristics were also typical of the Sima de los Huesos (Atapuerca) sample, African mid-Pleistocene Bodo specimen, and Lower Pleistocene TD6-Atapuerca remains and may be considered as a derived state. Finally, we hypothesize that most of the features thought to be different between Neandertals and modern humans might be associated with structural differences in the pectoral girdle and shoulder joint. Copyright © 2015 Elsevier Ltd. All rights reserved.

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

    Science.gov (United States)

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

    2016-03-01

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

  20. [Treatment of type C intercondylar fractures of distal humerus using dual plating].

    Science.gov (United States)

    Liu, Ya-Ke; Xu, Hua; Liu, Fan; Wang, You-Hua; Tao, Ran; Cao, Yi; Wang, Hong; Zhou, Zhen-Yu; Zhu, Yong

    2009-06-15

    To evaluate the clinical outcome of dual plating in the treatment of humeral intercondylar type-C fractures in adults. From June 2004 to October 2007, 38 cases of type-C distal humeral fractures were stabilised with dual plating. There were 21 males and 17 females. The average age was 43 years with a range from 21 to 71 years. According to the AO classification, 9 cases were of type C1, 17 of C2 and 12 of C3. The posterior midline approach was selected. Twenty-one cases were exposed through the trans-olecranon osteotomy, 11 through the Campbell (Van Gorder) approach, 6 through triceps sparing approach. Autogenous bone graft was performed in 5 cases because of severe comminution. Thirty-five patients were followed-up for 14-30 months (mean 24.2 months). At the latest follow-up, the elbow flexion averaged 119 degrees (range 90 degrees - 135 degrees ), and the loss of extension averaged 16.2 degrees (range 5 degrees - 25 degrees ). All the patients got bony healing, the average healing period was 14 weeks. The patients were evaluated using the criteria of Aitken and Rorabeek and the scores were 13 excellent, 16 good, 6 fair. Twenty-nine patients (82.9%) had a good or excellent results. Complications included 4 cases of traumatic osteoarthritis, 2 heterotopic ossification, 1 ulnar neuropathy. Infection as well as loosening or breakage of the implant was not found. The dual plating is able to provide rigid fixation for the humeral intercondylar fractures. In addition, it can allow early functional exercise after operation, decrease the related complications significantly, and improve the functional results.

  1. Traumatic thoracolumbar spine fractures

    NARCIS (Netherlands)

    J. Siebenga (Jan)

    2013-01-01

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

  2. Fractures in multiple sclerosis

    DEFF Research Database (Denmark)

    Stenager, E; Jensen, K

    1991-01-01

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

  3. Assessment of fracture risk

    International Nuclear Information System (INIS)

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

    2009-01-01

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

  4. Forensic age estimation by magnetic resonance imaging of the knee: the definite relevance in bony fusion of the distal femoral- and the proximal tibial epiphyses using closest-to-bone T1 TSE sequence

    Energy Technology Data Exchange (ETDEWEB)

    Ottow, Christian; Heindel, Walter [University Hospital Muenster, Department of Clinical Radiology, Muenster (Germany); Schulz, Ronald; Pfeiffer, Heidi; Schmeling, Andreas [University Hospital Muenster, Institute of Legal Medicine, Muenster (Germany); Vieth, Volker [University Hospital Muenster, Department of Clinical Radiology, Muenster (Germany); Klinikum Ibbenbueren, Clinic for Radiology, Ibbenbueren (Germany)

    2017-12-15

    To clarify the relevance of the bony fusion of the distal femoral and the proximal tibial epiphyses by means of magnetic resonance imaging (MRI), a prospective cross-sectional cohort study was performed with a special focus on a reliable determination of the 14th, 16th and 18th years of life. We scanned 658 German volunteers in the age bracket 12-24 years using a 3.0 T MR-scanner and utilising a T1 turbo spin-echo sequence representing true bone anatomy. Minimum, maximum, mean ± standard deviation and median with lower and upper quartiles were defined. Intra- and interobserver agreements were determined (Cohen's kappa). The statistical relevance of sex-related differences was analysed (Mann-Whitney U test, p < 0.05, exact, two-sided). The bony fusion took place before the 18th year of life in both epiphyses. The Mann-Whitney U test results imply significant sex-related differences for most stages. For both epiphyses, the intra observer (κ femur 0.961; tibia 0.971) and interobserver (κ femur 0.941; tibia 0.951) agreement levels were very good. The 14th and the 16th years of life can be determined in both sexes, but the completion of the 18th year of life cannot solely be determined by the bony fusion, as depicted by closest-to-bone MRI. (orig.)

  5. Forensic age estimation by magnetic resonance imaging of the knee: the definite relevance in bony fusion of the distal femoral- and the proximal tibial epiphyses using closest-to-bone T1 TSE sequence

    International Nuclear Information System (INIS)

    Ottow, Christian; Heindel, Walter; Schulz, Ronald; Pfeiffer, Heidi; Schmeling, Andreas; Vieth, Volker

    2017-01-01

    To clarify the relevance of the bony fusion of the distal femoral and the proximal tibial epiphyses by means of magnetic resonance imaging (MRI), a prospective cross-sectional cohort study was performed with a special focus on a reliable determination of the 14th, 16th and 18th years of life. We scanned 658 German volunteers in the age bracket 12-24 years using a 3.0 T MR-scanner and utilising a T1 turbo spin-echo sequence representing true bone anatomy. Minimum, maximum, mean ± standard deviation and median with lower and upper quartiles were defined. Intra- and interobserver agreements were determined (Cohen's kappa). The statistical relevance of sex-related differences was analysed (Mann-Whitney U test, p < 0.05, exact, two-sided). The bony fusion took place before the 18th year of life in both epiphyses. The Mann-Whitney U test results imply significant sex-related differences for most stages. For both epiphyses, the intra observer (κ femur 0.961; tibia 0.971) and interobserver (κ femur 0.941; tibia 0.951) agreement levels were very good. The 14th and the 16th years of life can be determined in both sexes, but the completion of the 18th year of life cannot solely be determined by the bony fusion, as depicted by closest-to-bone MRI. (orig.)

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

    Science.gov (United States)

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

    2015-03-01

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

  7. Management of neglected lateral condyle fractures of humerus in children: A retrospective study

    Directory of Open Access Journals (Sweden)

    Anil Agarwal

    2012-01-01

    Full Text Available Background: Late presentation of humeral lateral condylar fracture in children is a surgical dilemma. Osteosynthesis of the fracture fragment or correction of elbow deformity with osteotomies and ulnar nerve transposition or sometimes both procedures combined is a controversial topic. We retrospectively evaluated open reduction and fixation cases in late presentation of lateral humeral condyle fracture in pediatric cases with regards to union and functional results. Materials and Methods: Twenty two pediatric (≤12 years patients with fractures of lateral condyle presenting 4 weeks or more post injury between the study period of 2006 and 2010 were included. Multiple K-wires / with or without screws along with bone grafting were used. At final evaluation, union (radiologically and elbow function (Liverpool Elbow Score, LES was assessed. Results: There were 19 boys and 3 girls. Followup averaged 33 months. Pain (n=9, swelling (n=6, restriction of elbow motion (n=6, prominence of lateral condylar region (n=4, valgus deformity (n=4 were the main presenting symptoms. Ulnar nerve function was normal in all patients. There were nine Milch type I and 13 type II fractures. Union occurred in 20 cases. One case had malunion and in another case there was resorption of condyle following postoperative infection and avascular necrosis. Prominent lateral condyles (4/12, fish tail appearance (n=7, premature epiphyseal closure (n=2 were other observations. LES averaged 8.12 (range, 6.66-9.54 at final followup. Conclusions: There is high rate of union and satisfactory elbow function in late presenting lateral condyle fractures in children following osteosynthesis attempt. Our study showed poor correlation between patient′s age, duration of late presentation or Milch type I or II and final elbow function as determined by LES.

  8. New insights into the biomechanics of Legg-Calvé-Perthes' disease: The Role of Epiphyseal Skeletal Immaturity in Vascular Obstruction.

    Science.gov (United States)

    Pinheiro, M; Dobson, C A; Perry, D; Fagan, M J

    2018-02-01

    Legg-Calvé-Perthes' disease (LCP) is an idiopathic osteonecrosis of the femoral head that is most common in children between four and eight years old. The factors that lead to the onset of LCP are still unclear; however, it is believed that interruption of the blood supply to the developing epiphysis is an important factor in the development of the condition. Finite element analysis modelling of the blood supply to the juvenile epiphysis was investigated to understand under which circumstances the blood vessels supplying the femoral epiphysis could become obstructed. The identification of these conditions is likely to be important in understanding the biomechanics of LCP. The results support the hypothesis that vascular obstruction to the epiphysis may arise when there is delayed ossification and when articular cartilage has reduced stiffness under compression. The findings support the theory of vascular occlusion as being important in the pathophysiology of Perthes disease. Cite this article : M. Pinheiro, C. A. Dobson, D. Perry, M. J. Fagan. New insights into the biomechanics of Legg-Calvé-Perthes' disease: The Role of Epiphyseal Skeletal Immaturity in Vascular Obstruction. Bone Joint Res 2018;7:148-156. DOI: 10.1302/2046-3758.72.BJR-2017-0191.R1. © 2018 Pinheiro et al.

  9. Fracture mechanical materials characterisation

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  10. Fractures (Broken Bones): First Aid

    Science.gov (United States)

    First aid Fractures (broken bones) Fractures (broken bones): First aid By Mayo Clinic Staff A fracture is a ... 10, 2018 Original article: http://www.mayoclinic.org/first-aid/first-aid-fractures/basics/ART-20056641 . Mayo Clinic ...

  11. Fracture toughness correlations

    International Nuclear Information System (INIS)

    Wallin, Kim

    1986-09-01

    In this study existing fracture parameter correlations are reviewed. Their applicability and reliability are discussed in detail. A new K IC -CVN-correlation, based on a theoretical brittle fracture model, is presented

  12. Rib fracture - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000539.htm Rib fracture - aftercare To use the sharing features on this page, please enable JavaScript. A rib fracture is a crack or break in one or ...

  13. Sprains, Strains and Fractures

    Science.gov (United States)

    ... fractures. Many fractures and sprains occur during sports. Football players are particularly vulnerable to foot and ankle ... feet and ankles and take a complete medical history. He or she will also order tests, including ...

  14. Infant skull fracture (image)

    Science.gov (United States)

    Skull fractures may occur with head injuries. Although the skull is both tough and resilient and provides excellent ... or blow can result in fracture of the skull and may be accompanied by injury to the ...

  15. Ankle fracture - aftercare

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000548.htm Ankle fracture - aftercare To use the sharing features on this page, please enable JavaScript. An ankle fracture is a break in 1 or more ankle ...

  16. Atraumatic First Rib Fracture

    OpenAIRE

    Koray Aydogdu

    2014-01-01

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

  17. Metatarsal stress fractures - aftercare

    Science.gov (United States)

    ... Metatarsal stress fracture. In: Safran MR, Zachazewski J, Stone DA, eds. Instructions for Sports Medicine Patients . 2nd ed. Elsevier Saunders; 2012:648-652. Smith MS. Metatarsal fractures. In: Eiff PM, Hatch R, eds. Fracture Management for Primary Care . 3rd ed. ...

  18. Relationships between fractures

    Science.gov (United States)

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

    2018-01-01

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

  19. Obesity and fracture risk

    OpenAIRE

    Gonnelli, Stefano; Caffarelli, Carla; Nuti, Ranuccio

    2014-01-01

    Obesity and osteoporosis are two common diseases with an increasing prevalence and a high impact on morbidity and mortality. Obese women have always been considered protected against osteoporosis and osteoporotic fractures. However, several recent studies have challenged the widespread belief that obesity is protective against fracture and have suggested that obesity is a risk factor for certain fractures.

  20. Imaging of insufficiency fractures

    Energy Technology Data Exchange (ETDEWEB)

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

    2009-09-15

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

  1. Time-Dependent Changes in T1 during Fracture Healing in Juvenile Rats: A Quantitative MR Approach.

    Directory of Open Access Journals (Sweden)

    Katharina Baron

    Full Text Available Quantitative magnetic resonance imaging (qMRI offers several advantages in imaging and determination of soft tissue alterations when compared to qualitative imaging techniques. Although applications in brain and muscle tissues are well studied, its suitability to quantify relaxation times of intact and injured bone tissue, especially in children, is widely unknown. The objective observation of a fracture including its age determination can become of legal interest in cases of child abuse or maltreatment. Therefore, the aim of this study is the determination of time dependent changes in intact and corresponding injured bones in immature rats via qMRI, to provide the basis for an objective and radiation-free approach for fracture dating. Thirty-five MR scans of 7 Sprague-Dawley rats (male, 4 weeks old, 100 ± 5 g were acquired on a 3T MRI scanner (TimTrio, Siemens AG, Erlangen, Germany after the surgical infliction of an epiphyseal fracture in the tibia. The images were taken at days 1, 3, 7, 14, 28, 42 and 82 post-surgery. A proton density-weighted and a T1-weighted 3D FLASH sequence were acquired to calculate the longitudinal relaxation time T1 of the fractured region and the surrounding tissues. The calculation of T1 in intact and injured bone resulted in a quantitative observation of bone development in intact juvenile tibiae as well as the bone healing process in the injured tibiae. In both areas, T1 decreased over time. To evaluate the differences in T1 behaviour between the intact and injured bone, the relative T1 values (bone-fracture were calculated, showing clear detectable alterations of T1 after fracture occurrence. These results indicate that qMRI has a high potential not only for clinically relevant applications to detect growth defects or developmental alterations in juvenile bones, but also for forensically relevant applications such as the dating of fractures in cases of child abuse or maltreatment.

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

    Science.gov (United States)

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

    2018-02-01

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

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

    International Nuclear Information System (INIS)

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

    2012-01-01

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

  4. Effects of non-steroidal anti-inflammatory drugs on cell proliferation and death in cultured epiphyseal-articular chondrocytes of fetal rats

    International Nuclear Information System (INIS)

    Chang, J.-K.; Wu, S.-C.; Wang, G.-J.

    2006-01-01

    Previous reports indicated that non-steroidal anti-inflammatory drugs (NSAIDs) suppress bone repair. Our previous study further found that ketorolac delayed the endochondral bone formation, and the critical effective timing was at the early stage of repair. Furthermore, we found that NSAIDs suppressed proliferation and induced cell death of cultured osteoblasts. In this study, we hypothesized that chondrocytic proliferation and death, which plays an important role at the early stage of endochondral bone formation, might be affected by NSAIDs. Non-selective NSAIDs, indomethacin, ketorolac, diclofenac and piroxicam; cyclooxygenase-2 (COX-2) selective NSAIDs, celecoxib and DFU (an analog of rofecoxib); prostaglandins (PGs), PGE1, PGE2 and PGF2α; and each NSAID plus each PG were tested. The effects of NSAIDs on proliferation, cell cycle kinetics, cytotoxicity and cell death of epiphyseal-articular chondrocytes of fetal rats were examined. The results showed that all the tested NSAIDs, except DFU, inhibited thymidine incorporation of chondrocytes at a concentration range (10 -8 to 10 -4 M) covering the theoretic therapeutic concentrations. Cell cycle was arrested by NSAIDs at the G /G 1 phase. Upon a 24 h treatment, LDH leakage and cell death (both apoptosis and necrosis) were significantly induced by the four non-selective NSAIDs in chondrocyte cultures. However, COX-2 inhibitors revealed non-significant effects on cytotoxicity of chondrocytes except higher concentration of celecoxib (10 -4 M). Replenishments of PGE1, PGE2 or PGF2α could not reverse the effects of NSAIDs on chondrocytic proliferation and cytotoxicity. In this study, we found that therapeutic concentrations of non-selective NSAIDs caused proliferation suppression and cell death of chondrocytes, suggesting these adverse effects may be one of the reasons that NSAIDs delay the endochondral ossification during bone repair found in previous studies. Furthermore, these effects of NSAIDs may act via PG

  5. Orbital fractures: a review

    Directory of Open Access Journals (Sweden)

    Jeffrey M Joseph

    2011-01-01

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

  6. Mechanics of Hydraulic Fractures

    Science.gov (United States)

    Detournay, Emmanuel

    2016-01-01

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

  7. Fracture in Soft Materials

    DEFF Research Database (Denmark)

    Hassager, Ole

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

  8. Ballistic fractures: indirect fracture to bone.

    Science.gov (United States)

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

    2011-11-01

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

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

    Science.gov (United States)

    Spering, C; Lesche, V; Dresing, K

    2015-08-01

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

  10. Atraumatic First Rib Fracture

    Directory of Open Access Journals (Sweden)

    Koray Aydogdu

    2014-12-01

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

  11. Fracture mechanics safety approaches

    International Nuclear Information System (INIS)

    Roos, E.; Schuler, X.; Eisele, U.

    2004-01-01

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

  12. Scaphoid fractures in children

    Directory of Open Access Journals (Sweden)

    Gajdobranski Đorđe

    2014-01-01

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

  13. Pathological fractures in children

    Science.gov (United States)

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

    2012-01-01

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

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

    Directory of Open Access Journals (Sweden)

    K N Dubey

    2013-01-01

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

  15. A micro-architectural evaluation of osteoporotic human femoral heads to guide implant placement in proximal femoral fractures.

    Science.gov (United States)

    Jenkins, Paul J; Ramaesh, Rishikesan; Pankaj, Pankaj; Patton, James T; Howie, Colin R; Goffin, Jérôme M; Merwe, Andrew van der; Wallace, Robert J; Porter, Daniel E; Simpson, A Hamish

    2013-10-01

    The micro-architecture of bone has been increasingly recognized as an important determinant of bone strength. Successful operative stabilization of fractures depends on bone strength. We evaluated the osseous micro-architecture and strength of the osteoporotic human femoral head. 6 femoral heads, obtained during arthroplasty surgery for femoral neck fracture, underwent micro-computed tomography (microCT) scanning at 30 μm, and bone volume ratio (BV/TV), trabecular thickness, structural model index, connection density, and degree of anisotropy for volumes of interest throughout the head were derived. A further 15 femoral heads underwent mechanical testing of compressive failure stress of cubes of trabecular bone from different regions of the head. The greatest density and trabecular thickness was found in the central core that extended from the medial calcar to the physeal scar. This region also correlated with the greatest degree of anisotropy and proportion of plate-like trabeculae. In the epiphyseal region, the trabeculae were organized radially from the physeal scar. The weakest area was found at the apex and peripheral areas of the head. The strongest region was at the center of the head. The center of the femoral head contained the strongest trabecular bone, with the thickest, most dense trabeculae. The apical region was weaker. From an anatomical and mechanical point of view, implants that achieve fixation in or below this central core may achieve the most stable fixation during fracture healing.

  16. The Process of Hydraulic Fracturing

    Science.gov (United States)

    Hydraulic fracturing, know as fracking or hydrofracking, produces fractures in a rock formation by pumping fluids (water, proppant, and chemical additives) at high pressure down a wellbore. These fractures stimulate the flow of natural gas or oil.

  17. [Trochanteric femoral fractures].

    Science.gov (United States)

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

    2013-01-01

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

  18. Hand fracture - aftercare

    Science.gov (United States)

    ... an orthopedic surgeon if: Your metacarpal bones are broken and shifted out of place Your fingers do not line up correctly Your fracture nearly went through the skin Your fracture went through the skin Your pain is severe or becoming worse Self-care at Home You may have pain and swelling for 1 ...

  19. TIBIAL SHAFT FRACTURES.

    Science.gov (United States)

    Kojima, Kodi Edson; Ferreira, Ramon Venzon

    2011-01-01

    The long-bone fractures occur most frequently in the tibial shaft. Adequate treatment of such fractures avoids consolidation failure, skewed consolidation and reoperation. To classify these fractures, the AO/OTA classification method is still used, but it is worthwhile getting to know the Ellis classification method, which also includes assessment of soft-tissue injuries. There is often an association with compartmental syndrome, and early diagnosis can be achieved through evaluating clinical parameters and constant clinical monitoring. Once the diagnosis has been made, fasciotomy should be performed. It is always difficult to assess consolidation, but the RUST method may help in this. Radiography is assessed in two projections, and points are scored for the presence of the fracture line and a visible bone callus. Today, the dogma of six hours for cleaning the exposed fracture is under discussion. It is considered that an early start to intravenous antibiotic therapy and the lesion severity are very important. The question of early or late closure of the lesion in an exposed fracture has gone through several phases: sometimes early closure has been indicated and sometimes late closure. Currently, whenever possible, early closure of the lesion is recommended, since this diminishes the risk of infection. Milling of the canal when the intramedullary nail is introduced is still a controversial subject. Despite strong personal positions in favor of milling, studies have shown that there may be some advantage in relation to closed fractures, but not in exposed fractures.

  20. Physeal Fractures in Foals.

    Science.gov (United States)

    Levine, David G; Aitken, Maia R

    2017-08-01

    Physeal fractures are common musculoskeletal injuries in foals and should be included as a differential diagnosis for the lame or nonweightbearing foal. Careful evaluation of the patient, including precise radiographic assessment, is paramount in determining the options for treatment. Prognosis mostly depends on the patient's age, weight, and fracture location and configuration. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Treatment of midfacial fractures

    International Nuclear Information System (INIS)

    Schubert, J.

    2007-01-01

    Fractures of the midface constitute half of all traumas involving facial bones. Computed tomography is very useful in primary diagnosis. Isolated fractures of the nasal bone and lateral midfacial structures may be diagnosed sufficiently by conventional X-rays. An exact description of the fracture lines along the midfacial buttresses is essential for treatment planning. For good aesthetics and function these have to be reconstructed accurately, which can be checked with X-rays. The treatment of midfacial fractures has been revolutionized over the last two decades. A stable three-dimensional reconstruction of the facial shape is now possible and the duration of treatment has shortened remarkably. The frequently occurring isolated fractures in the lateral part of the midface may be treated easily and effectively by semisurgical methods such as the Gillies procedure or hook-repositioning. (orig.)

  2. Dating fractures in infants

    Energy Technology Data Exchange (ETDEWEB)

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

    2011-11-15

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

  3. Dating fractures in infants

    International Nuclear Information System (INIS)

    Halliday, K.E.; Broderick, N.J.; Somers, J.M.; Hawkes, R.

    2011-01-01

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

  4. Tibial Plateau Fractures

    DEFF Research Database (Denmark)

    Elsøe, Rasmus

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

  5. Fracturing formations in wells

    Energy Technology Data Exchange (ETDEWEB)

    Daroza, R A

    1964-05-15

    This well stimulation method comprises introducing through the well bore a low-penetrating, dilatant fluid, and subjecting the fluid to sufficient pressure to produce fractures in the formation. The fluid is permitted to remain in contact with the formation so as to become diluted by the formation fluids, and thereby lose its properties of dilatancy. Also, a penetrating fluid, containing a propping agent suspended therein, in introduced into contact with the fractures at a pressure substantially reduced with respect to that pressure which would have been required, prior to the fracturing operation performed using the low-penetrating dilatant fluid. The propping agent is deposited within the fractures, and thereafter, fluid production is resumed from the fractured formation. (2 claims)

  6. Epiphyseal osteoblastoma-like osteosarcoma

    Energy Technology Data Exchange (ETDEWEB)

    Bonar, S.F. [Douglass Hanly Moir Pathology, 95 Epping Road, North Ryde, NSW 2113 (Australia); McCarthy, S.; Stalley, P.; Schatz, J.; Soper, J.; Scolyer, R. [Departments of Pathology, Radiology and Orthopaedic Surgery, Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050 (Australia); Barrett, I. [Department of Orthopaedic Surgery, The Children' s Hospital, Westmead, NSW 2145 (Australia)

    2004-01-01

    Osteoblastoma-like osteosarcoma is a rare variant of osteosarcoma occurring in this instance in a highly unusual location: the lateral femoral condyle of a 13-year-old girl. The radiological features were non-aggressive and, although slightly unusual, were most suggestive of chondroblastoma. (orig.)

  7. Computed tomograms of blowout fracture

    International Nuclear Information System (INIS)

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

    1985-01-01

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

  8. Computed tomograms of blowout fracture

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-02-01

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

  9. Radiological diagnosis of fractures

    International Nuclear Information System (INIS)

    Finlay, D.B.L.; Allen, M.J.

    1984-01-01

    This book is about radiology of fractures. While it contains sections of clinical features it is not intended that readers should rely entirely upon these for the diagnosis and management of the injured patient. As in the diagnosis and treatment of all medical problems, fracture management must be carried out in a logical step-by-step fashion - namely, history, examination, investigation, differential diagnosis, diagnosis and then treatment. Each section deals with a specific anatomical area and begins with line drawings of the normal radiographs demonstrating the anatomy. Accessory views that may be requested, and the indications for these, are included. Any radiological pitfalls for the area in general are then described. The fractures in adults are then examined in turn, their radiological features described, and any pitfalls in their diagnosis discussed. A brief note of important clinical findings is included. A brief mention is made of pediatric fractures which are of significance and their differences to the adult pattern indicated. Although fractures can be classified into types with different characteristics, in life every fracture is individual. Fractures by and large follow common patterns, but many have variations

  10. Spontaneous rib fractures.

    Science.gov (United States)

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

    2015-07-01

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

  11. Why ductile fracture mechanics

    International Nuclear Information System (INIS)

    Ritchie, R.O.

    1983-01-01

    Until recently, the engineering application of fracture mechanics has been specific to a description of macroscopic fracture behavior in components and structural parts which remain nominally elastic under loading. While this approach, termed linear elastic fracture mechanics, has been found to be invaluable for the continuum analysis of crack growth in brittle and high strength materials, it is clearly inappropriate for characterizing failure in lower strength ductile alloys where extensive inelastic deformation precedes and accompanies crack initiation and subsequent propagation. Accordingly, much effort has been devoted in recent years toward the development of nonlinear or ductile fracture mechanics methodology to characterize fracture behavior under elastic/plastic conditions; an effort which has been principally motivated by problems in nuclear industry. In this paper, the concepts of ductile (elastic/plastic) fracture mechanics are introduced and applied to the problem of both stationary and nonstationary cracks. Specifically, the limitations inherent in this approach are defined, together with a description of the microstructural considerations and applications relevant to the failure of ductile materials by fracture, fatigue, and creep

  12. Orbital wall fractures

    International Nuclear Information System (INIS)

    Iinuma, Toshitaka; Ishio, Ken-ichirou; Yoshinami, Hiroyoshi; Kuriyama, Jun-ichi; Hirota, Yoshiharu.

    1993-01-01

    A total of 59 cases of mild facial fractures (simple orbital wall fractures, 34 cases, other facial fractures, 25 cases) with the clinical suspects of orbital wall fractures were evaluated both by conventional views (Waters' and Caldwell views) and coronal CT scans. Conventional views were obtained, as an average, after 4 days and CT after 7 days of injuries. Both the medial wall and the floor were evaluated at two sites, i.e., anterior and posterior. The ethmoid-maxillary plate was also included in the study. The degree of fractures was classified as, no fractures, fractures of discontinuity, dislocation and fragmentation. The coronal CT images in bone window condition was used as reference and the findings were compared between conventional views and CT. The correct diagnosis was obtained as follows: orbital floor (anterior, 78%, posterior, 73%), medial orbital wall (anterior, 72%, posterior, 72%) and ethmoid-maxillary plate (64%). The false positive diagnosis was as follows: orbital floor (anterior only, 13%), medial orbital wall (anterior only, 7%) and ethmoid-maxillary plate (11%). The false negative diagnosis was as follows: orbital floor (anterior, 9%, posterior, 10%), medial orbital wall (anterior, 21%, posterior, 28%) and ethmoid-maxillary plate (21%). The results were compared with those of others in the past. (author)

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

    Directory of Open Access Journals (Sweden)

    Teh KK

    2009-11-01

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

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

    Directory of Open Access Journals (Sweden)

    Egemen Kucuk

    2014-04-01

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

  15. Fracture characteristics in Japanese rock

    International Nuclear Information System (INIS)

    Ijiri, Yuji; Sawada, Atsushi; Akahori, Kuniaki

    1999-11-01

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

  16. Aspects of modern fracture statistics

    International Nuclear Information System (INIS)

    Tradinik, W.; Pabst, R.F.; Kromp, K.

    1981-01-01

    This contribution begins with introductory general remarks about fracture statistics. Then the fundamentals of the distribution of fracture probability are described. In the following part the application of the Weibull Statistics is justified. In the fourth chapter the microstructure of the material is considered in connection with calculations made in order to determine the fracture probability or risk of fracture. (RW) [de

  17. Fracture Phenomena in Amorphous Selenium

    DEFF Research Database (Denmark)

    Lindegaard-Andersen, Asger; Dahle, Birgit

    1966-01-01

    Fracture surfaces of amorphous selenium broken in flexure at room temperature have been studied. The fracture velocity was found to vary in different regions of the fracture surface. Peculiar features were observed in a transition zone between fast and slower fracture. In this zone cleavage steps...

  18. Vertebral Compression Fractures

    Science.gov (United States)

    ... and monitored to avoid putting pressure on the ribs that can cause new fractures. Surgical Procedures • When there is severe incapacitating pain • When healing is delayed or when bone fragments ...

  19. Paediatric talus fracture.

    LENUS (Irish Health Repository)

    Byrne, Ann-Maria

    2012-01-01

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

  20. Elevated temperature fracture mechanics

    International Nuclear Information System (INIS)

    Tomkins, B.

    1979-01-01

    The application of fracture mechanics concepts to cracks at elevated temperatures is examined. Particular consideration is given to the characterisation of crack tip stress-strain fields and parameters controlling crack extension under static and cyclic loads. (author)

  1. Stress fractures in athletes

    International Nuclear Information System (INIS)

    Kirschberger, R.; Henning, A.; Graff, K.H.

    1984-01-01

    The early exclusion of the presence of a stress fracture may be decisive for the success of an athlete. Scintigraphy with a bone-seeking radiopharmaceutical is suitable for the early detection of stress lesions. Of 30 athletes, fractures were demonstrated in 17 whereas in 6 they were excluded. We found most fractures in the tarsal bones such as os naviculare pedis, ossa cuneiformia and talus. The type of sport engaged in appears to be an important factor in determining the location of the fracture. Scintiphotos were taken in several views using region of interest techniques and two phase-scintigraphy. This method is considered to be useful for localization and follow-up of skeletal stress lesions as well as for differential diagnosis. (orig.) [de

  2. Stress fractures in athletes

    Energy Technology Data Exchange (ETDEWEB)

    Kirschberger, R; Henning, A; Graff, K H

    1984-12-01

    The early exclusion of the presence of a stress fracture may be decisive for the success of an athlete. Scintigraphy with a bone-seeking radiopharmaceutical is suitable for the early detection of stress lesions. Of 30 athletes, fractures were demonstrated in 17 whereas in 6 they were excluded. We found most fractures in the tarsal bones such as os naviculare pedis, ossa cuneiformia and talus. The type of sport engaged in appears to be an important factor in determining the location of the fracture. Scintiphotos were taken in several views using region of interest techniques and two phase-scintigraphy. This method is considered to be useful for localization and follow-up of skeletal stress lesions as well as for differential diagnosis.

  3. Fatigue and insufficiency fractures

    International Nuclear Information System (INIS)

    Lodwick, G.S.; Rosenthal, D.I.; Kattapuram, S.V.; Hudson, T.M.

    1987-01-01

    The incidence of stress fracture is increasing. In our younger society this is due largely to a preocupation with physical conditioning, but in our elderly population it is due to improved recognition and better methods of detection and diagnosis. Stress fracture of the elderly is an insufficiency fracture which occurs in the spine, the pelvis, the sacrum and other bones afflicted with disorders which cause osteopenia. Stress fracture is frequently misdiagnosed as a malignant lesion of bone resulting in biopsy. Scintiscanning provides the greatest frequency of detection, while computed tomography often provides the definitive diagnosis. With increased interest and experience a better insight into the disease has been achieved, and what was once thought of as a simple manifestation of mechanical stress is now known to be an orderly, complex pattern of physiological changes in bone which conform to a model by Frost. The diffuse nature of these changes can be recognized by scintigraphy, radiography and magnetic resonance imaging. 27 refs.; 8 figs

  4. Ontology of fractures

    Science.gov (United States)

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

    2009-03-01

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

  5. Osteoporotic fractures in older adults

    OpenAIRE

    Colón-Emeric, Cathleen S.; Saag, Kenneth G.

    2006-01-01

    Osteoporotic fractures are emerging as a major public health problem in the aging population. Fractures result in increased morbidity, mortality and health expenditures. This article reviews current evidence for the management of common issues following osteoporotic fractures in older adults including: (1) thromboembolism prevention; (2) delirium prevention; (3) pain management; (4) rehabilitation; (5) assessing the cause of fracture; and (6) prevention of subsequent fractures. Areas for prac...

  6. Classical fracture mechanics methods

    International Nuclear Information System (INIS)

    Schwalbe, K.H.; Heerens, J.; Landes, J.D.

    2007-01-01

    Comprehensive Structural Integrity is a reference work which covers all activities involved in the assurance of structural integrity. It provides engineers and scientists with an unparalleled depth of knowledge in the disciplines involved. The new online Volume 11 is dedicated to the mechanical characteristics of materials. This paper contains the chapter 11.02 of this volume and is structured as follows: Test techniques; Analysis; Fracture behavior; Fracture toughness tests for nonmetals

  7. [Periprosthetic knee fractures].

    Science.gov (United States)

    Mittlmeier, T; Beck, M; Bosch, U; Wichelhaus, A

    2016-01-01

    The cumulative incidence of periprosthetic fractures around the knee is increasing further because of an extended indication for knee replacement, previous revision arthroplasty, rising life expectancy and comorbidities. The relevance of local parameters such as malalignment, osseous defects, neighbouring implants, aseptic loosening and low-grade infections may sometimes be hidden behind the manifestation of a traumatic fracture. A differentiated diagnostic approach before the treatment of a periprosthetic fracture is of paramount importance, while the physician in-charge should also have particular expertise in fracture treatment and in advanced techniques of revision endoprosthetics. The following work gives an overview of this topic. Valid classifications are available for categorising periprosthetic fractures of the femur, the tibia and the patella respectively, which are helpful for the selection of treatment. With the wide-ranging modern treatment portfolio bearing in mind the substantial rate of complications and the heterogeneous functional outcome, the adequate analysis of fracture aetiology and the corresponding transformation into an individualised treatment concept offer the chance of an acceptable functional restoration of the patient at early full weight-bearing and prolonged implant survival. The management of complications is crucial to the final outcome.

  8. A Fracture Decoupling Experiment

    Science.gov (United States)

    Stroujkova, A. F.; Bonner, J. L.; Leidig, M.; Ferris, A. N.; Kim, W.; Carnevale, M.; Rath, T.; Lewkowicz, J.

    2012-12-01

    Multiple observations made at the Semipalatinsk Test Site suggest that conducting nuclear tests in the fracture zones left by previous explosions results in decreased seismic amplitudes for the second nuclear tests (or "repeat shots"). Decreased seismic amplitudes reduce both the probability of detection and the seismically estimated yield of a "repeat shot". In order to define the physical mechanism responsible for the amplitude reduction and to quantify the degree of the amplitude reduction in fractured rocks, Weston Geophysical Corp., in collaboration with Columbia University's Lamont Doherty Earth Observatory, conducted a multi-phase Fracture Decoupling Experiment (FDE) in central New Hampshire. The FDE involved conducting explosions of various yields in the damage/fracture zones of previously detonated explosions. In order to quantify rock damage after the blasts we performed well logging and seismic cross-hole tomography studies of the source region. Significant seismic velocity reduction was observed around the source regions after the initial explosions. Seismic waves produced by the explosions were recorded at near-source and local seismic networks, as well as several regional stations throughout northern New England. Our analysis confirms frequency dependent seismic amplitude reduction for the repeat shots compared to the explosions in un-fractured rocks. The amplitude reduction is caused by pore closing and/or by frictional losses within the fractured media.

  9. FRACTURING FLUID CHARACTERIZATION FACILITY

    Energy Technology Data Exchange (ETDEWEB)

    Subhash Shah

    2000-08-01

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

  10. Sequential MRI Study of Graft Integrity and Signal Following Pediatric All-epiphyseal ACL Reconstruction: Does the “Sharp Turn” at the Socket of the Distal Femoral Aperture Matter?

    Science.gov (United States)

    Tuca, Maria; Greditzer, Harry Gus; Gausden, Elizabeth Bishop; Uppstrom, Tyler J.; Potter, Hollis G.; Cordasco, Frank A.; Green, Daniel W.

    2017-01-01

    Objectives: To analyze graft structure and signal with particular emphasis on the distal femoral socket aperture following all-epiphyseal ACLR using hamstring autografts with sequential MRI in skeletally immature athletes. Methods: Retrospective cohort study of 23 skeletally immature patients who underwent ACLR by the same surgical team at a tertiary center during 2011-2013. Athletes had at least two follow-up MRIs, the first MRI 6-12 months after surgery and the second MRI >18 months, were included. Exclusion criteria included those athletes with inMRI follow-up (6) or with a failure of their reconstructions (1). All athletes were treated with an arthroscopic all-inside, all-epiphyseal ACLR, using hamstring autograft, secured with adjustable loop cortical buttons on both tibia and femur. MRI images were analyzed independently and blinded by an orthopaedic surgery fellow and a musculoskeletal radiology fellow. Using a GE Functional Analysis Software, the signal intensity (SI) of the graft was measured in 5 different locations: 1) femoral tunnel, 2) intra-articular proximal turn, 3) midsubstance, 4) intra-articular distal turn, and 5) tibial tunnel. Values were normalized to cortical bone density. The amount of perigraft scarring and synovitis was analyzed. An intraclass correlation coefficient was used to quantify inter-rater reliability, non-parametric Wilcoxon test for perigraft scarring and synovitis, one-way ANOVA to test if significant differences of SI were seen between the different graft locations, and a 2-tailed student t-test for SI changes from 1st to 2nd MRI. Results: The study included 16 patients (5 girls and 11 boys), with an average age at surgery of 11.9 years (range 10-15). The first follow-up MRI was on average at 8.4 months (range 6-12 months), while the 2nd MRI was on average 30.7 months (range 18-40) after surgery. Intra-class correlation coefficients were above 0.7 for all measurements, indicating an excellent concordance between observers

  11. Fractures of the Jaw and Midface

    Science.gov (United States)

    ... switch to the Professional version Home Injuries and Poisoning Facial Injuries Fractures of the Jaw and Midface Symptoms Diagnosis Treatment Treatment of mandible fractures Treatment of maxillary fractures ...

  12. Radiological classification of mandibular fractures

    International Nuclear Information System (INIS)

    Mihailova, H.

    2009-01-01

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

  13. Computer model for ductile fracture

    International Nuclear Information System (INIS)

    Moran, B.; Reaugh, J. E.

    1979-01-01

    A computer model is described for predicting ductile fracture initiation and propagation. The computer fracture model is calibrated by simple and notched round-bar tension tests and a precracked compact tension test. The model is used to predict fracture initiation and propagation in a Charpy specimen and compare the results with experiments. The calibrated model provides a correlation between Charpy V-notch (CVN) fracture energy and any measure of fracture toughness, such as J/sub Ic/. A second simpler empirical correlation was obtained using the energy to initiate fracture in the Charpy specimen rather than total energy CVN, and compared the results with the empirical correlation of Rolfe and Novak

  14. Polymer liquids fracture like solids

    DEFF Research Database (Denmark)

    Huang, Qian; Hassager, Ole

    2017-01-01

    While fracture in brittle solids has been studied for centuries until today, there are few studies on fracture in polymer liquids. Recent developments in experimental techniques, especially the combination of controlled filament stretching rheometry and high speed imaging, have opened new windows...... into the detailed study of fracture processes for polymer liquids. High speed imaging shows that polymer liquids fracture like solids with initiation and propagation of an edge fracture. However, remarkable features such as highly reproducible critical stress, independent appearance of multiple fractures...

  15. Management of penile fractures

    International Nuclear Information System (INIS)

    Ghilan, Abdulelah M. M.; Al-Asbahi, Waleed A.; Alwan, Mohammed A.; Al-Khanbashi, Omar M.; Ghafour, Mohammed A.

    2008-01-01

    Objective was to present our experience with surgical and conservative management of penile fracture. This prospective study was carried out in the Urology and Nephrology Center, at Al-Thawra General and Teaching Hospital, Sana'a, Yemen from June 2003 to September 2007 and included 30 patients presenting with penile fracture. Diagnosis was made clinically in all our patients. Six patients with simple fracture were treated conservatively while 24 patients with more severe injuries were operated upon. Patient's age ranged from 24-52 years (mean 31.3 years) 46.7% of patients were under the age of 30 years and 56.7% were unmarried. Hard manipulation of the erect penis for example during masturbation was the most frequent mechanism of fracture in 53.3% of patients. Solitary tear was found in 22 patients and bilateral corporal tears associated with urethral injury were found in 2 patients. Corporal tears were saturated with synthetic absorbable sutures and urethral injury was repaired primarily. All operated patients described full erection with straight penis except 3 of the 8 patients who were managed by direct longitudinal incision, in whom mild curvature during erection was observed. The conservatively treated patients described satisfactory penile straightness and erection. The optimal functional and cosmetic results are achieved following immediate surgical repair of penis fracture. Good results can also be obtained in some selected patients with conservative management. (author)

  16. Stress fractures in athletes

    International Nuclear Information System (INIS)

    Steingruber, I.E.; Wolf, C.; Gruber, H.; Czermak, B.V.; Mallouhi, A.; Jaschke, W.; Gabriel, M.

    2002-01-01

    Stress fractures may pose a diagnostic dilemma for radiologists since they are sometimes difficult to demonstrate on plain films and may simulate a tumour. They were first described in military personnel and professional athletes. Recently, there is an increasing incidence in the general population due to increasing sportive activities. Stress fractures occur most often in the lower extremities, especially in the tibia, the tarsal bone, the metatarsal bone, the femur and the fibula. In the upper extremities, they are commonly found in the humerus, the radius and the ulna. Some fractures of the lower extremities appear to be specific for particular sports, for example, fractures of the tibia affect mostly distance runners. Whereas stress fractures of the upper extremities are generally associated with upper limb-dominated sports. A correct diagnosis requires a careful clinical evaluation. The initial plain radiography may be normal. Further radiological evaluation could be performed by means of computerised tomography, magnetic resonance imaging and bone scanning. The latter two techniques are especially helpful for establishing a correct initial diagnosis. (orig.) [de

  17. 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.

  18. DEM Particle Fracture Model

    Energy Technology Data Exchange (ETDEWEB)

    Zhang, Boning [Univ. of Colorado, Boulder, CO (United States); Herbold, Eric B. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Homel, Michael A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Regueiro, Richard A. [Univ. of Colorado, Boulder, CO (United States)

    2015-12-01

    An adaptive particle fracture model in poly-ellipsoidal Discrete Element Method is developed. The poly-ellipsoidal particle will break into several sub-poly-ellipsoids by Hoek-Brown fracture criterion based on continuum stress and the maximum tensile stress in contacts. Also Weibull theory is introduced to consider the statistics and size effects on particle strength. Finally, high strain-rate split Hopkinson pressure bar experiment of silica sand is simulated using this newly developed model. Comparisons with experiments show that our particle fracture model can capture the mechanical behavior of this experiment very well, both in stress-strain response and particle size redistribution. The effects of density and packings o the samples are also studied in numerical examples.

  19. [Distal clavicle fracture].

    Science.gov (United States)

    Seppel, G; Lenich, A; Imhoff, A B

    2014-06-01

    Reposition and fixation of unstable distal clavicle fractures with a low profile locking plate (Acumed, Hempshire, UK) in conjunction with a button/suture augmentation cerclage (DogBone/FibreTape, Arthrex, Naples, FL, USA). Unstable fractures of the distal clavicle (Jäger and Breitner IIA) in adults. Unstable fractures of the distal clavicle (Jäger and Breitner IV) in children. Distal clavicle fractures (Jäger and Breitner I, IIB or III) with marked dislocation, injury of nerves and vessels, or high functional demand. Patients in poor general condition. Fractures of the distal clavicle (Jäger and Breitner I, IIB or III) without marked dislocation or vertical instability. Local soft-tissue infection. Combination procedure: Initially the lateral part of the clavicle is exposed by a 4 cm skin incision. After reduction of the fracture, stabilization is performed with a low profile locking distal clavicle plate. Using a special guiding device, a transclavicular-transcoracoidal hole is drilled under arthroscopic view. Additional vertical stabilization is arthroscopically achieved by shuttling the DogBone/FibreTape cerclage from the lateral portal cranially through the clavicular plate. The two ends of the FibreTape cerclage are brought cranially via adjacent holes of the locking plate while the DogBone button is placed under the coracoid process. Thus, plate bridging is achieved. Finally reduction is performed and the cerclage is secured by surgical knotting. Use of an arm sling for 6 weeks. Due to the fact that the described technique is a relatively new procedure, long-term results are lacking. In the short term, patients postoperatively report high subjective satisfaction without persistent pain.

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

    Science.gov (United States)

    Reesink, Heidi L

    2017-08-01

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

  1. Fractured Petroleum Reservoirs

    Energy Technology Data Exchange (ETDEWEB)

    Firoozabadi, Dr. Abbas

    2000-01-18

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

  2. Elastic plastic fracture mechanics

    International Nuclear Information System (INIS)

    Simpson, L.A.

    1978-07-01

    The application of linear elastic fracture mechanics (LEFM) to crack stability in brittle structures is now well understood and widely applied. However, in many structural materials, crack propagation is accompanied by considerable crack-tip plasticity which invalidates the use of LEFM. Thus, present day research in fracture mechanics is aimed at developing parameters for predicting crack propagation under elastic-plastic conditions. These include critical crack-opening-displacement methods, the J integral and R-curve techniques. This report provides an introduction to these concepts and gives some examples of their applications. (author)

  3. Dynamic fracture characterization of material

    International Nuclear Information System (INIS)

    Kobayashi, A.S.; Emery, A.F.; Liaw, B.M.

    1981-01-01

    The influences of a wide range of material properties, i.e. of A533B steel, a silicon nitride ceramic and a Homalite-100 photoelastic polymer, as well as the influences of the specimen sizes on the dynamic fracture response of fracture specimens are presented in this paper. The results of a numerical study show that the dynamic fracture responses of these fracture specimens of proportional dimensions were indistinguishable provided the normalized dynamic fracture toughness versus normalized crack velocity relations of the three materials coincide. The limited results suggest that should the normalized dynamic fracture toughness versus normalized crack velocity relations between prototype and model materials coincide, then dynamic fracture experiments on scaled models can be used to infer the dynamic fracture response of the prototype. (orig./HP)

  4. Fracture surfaces of granular pastes.

    Science.gov (United States)

    Mohamed Abdelhaye, Y O; Chaouche, M; Van Damme, H

    2013-11-01

    Granular pastes are dense dispersions of non-colloidal grains in a simple or a complex fluid. Typical examples are the coating, gluing or sealing mortars used in building applications. We study the cohesive rupture of thick mortar layers in a simple pulling test where the paste is initially confined between two flat surfaces. After hardening, the morphology of the fracture surfaces was investigated, using either the box counting method to analyze fracture profiles perpendicular to the mean fracture plane, or the slit-island method to analyze the islands obtained by cutting the fracture surfaces at different heights, parallel to the mean fracture plane. The fracture surfaces were shown to exhibit scaling properties over several decades. However, contrary to what has been observed in the brittle or ductile fracture of solid materials, the islands were shown to be mass fractals. This was related to the extensive plastic flow involved in the fracture process.

  5. Flexible fixation and fracture healing

    DEFF Research Database (Denmark)

    Schmal, Hagen; Strohm, Peter C; Jaeger, Martin

    2011-01-01

    , noncomminuted fractures. External fixation uses external bars for stabilization, whereas internal fixation is realized by subcutaneous placement of locking plates. Both of these "biologic" osteosynthesis methods allow a minimally invasive approach and do not compromise fracture hematoma and periosteal blood...

  6. Gene Therapy for Fracture Repair

    National Research Council Canada - National Science Library

    Lau, William

    2005-01-01

    .... We have identified a murine leukemia virus (MLV) vector that provides robust transgene expression in fracture tissues, and applied it to the rat femur fracture model to express therapeutic transgenes...

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

    Science.gov (United States)

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

    2016-01-01

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

  8. Statistics and thermodynamics of fracture

    Science.gov (United States)

    Chudnovsky, A.

    1984-01-01

    A probabilistic model of the fracture processes unifying the phenomenological study of long term strength of materials, fracture mechanics and statistical approaches to fracture is briefly outlined. The general framework of irreversible thermodynamics is employed to model the deterministic side of the failure phenomenon. The stochastic calculus is used to account for thg failure mechanisms controlled by chance; particularly, the random roughness of fracture surfaces.

  9. Complications in ankle fracture surgery

    OpenAIRE

    Ovaska, Mikko

    2015-01-01

    Mikko Ovaska. Complications in Ankle Fracture Surgery. Helsinki Bone and Joint Research Group, Department of Orthopaedic Surgery and Traumatology, Faculty of Medicine, University of Helsinki, Finland. Helsinki 2014. Ankle fractures are among the most frequently encountered surgically treated fractures. The operative treatment of this fracture may be associated with several complications. The most frequently encountered complications are related wound healing, and deep infection may have d...

  10. Management of osteoporotic vertebral fractures

    OpenAIRE

    Dionyssiotis, Yannis

    2010-01-01

    Yannis DionyssiotisRhodes General Hospital, Rhodes, GreeceAbstract: Osteoporotic vertebral fractures are associated with considerable reduction of quality of life, morbidity, and mortality. The management of patients with vertebral fractures should include treatment for osteoporosis and measures to reduce pain and improve mobility. This article provides information for management and rehabilitation of vertebral fractures based on clinical experience and literature.Keywords: vertebral fracture...

  11. Osteoporotic Hip and Spine Fractures

    OpenAIRE

    Cannada, Lisa K.; Hill, Brian W.

    2014-01-01

    Hip and spine fractures represent just a portion of the burden of osteoporosis; however, these fractures require treatment and often represent a major change in lifestyle for the patient and their family. The orthopedic surgeon plays a crucial role, not only in the treatment of these injuries but also providing guidance in prevention of future osteoporotic fractures. This review provides a brief epidemiology of the fractures, details the surgical techniques, and outlines the current treatment...

  12. Some probabilistic aspects of fracture

    International Nuclear Information System (INIS)

    Thomas, J.M.

    1982-01-01

    Some probabilistic aspects of fracture in structural and mechanical components are examined. The principles of fracture mechanics, material quality and inspection uncertainty are formulated into a conceptual and analytical framework for prediction of failure probability. The role of probabilistic fracture mechanics in a more global context of risk and optimization of decisions is illustrated. An example, where Monte Carlo simulation was used to implement a probabilistic fracture mechanics analysis, is discussed. (orig.)

  13. Hydrologic behavior of fracture networks

    International Nuclear Information System (INIS)

    Long, J.C.S.; Endo, H.K.; Karasaki, K.; Pyrak, L.; MacLean, P.; Witherspoon, P.A.

    1985-01-01

    This paper reviews recent research on the nature of flow and transport in discontinuous fracture networks. The hydrologic behavior of these networks has been examined using two- and three-dimensional numerical models. The numerical models represent random realizations of fracture networks based on statistical field measurements of fracture geometry and equivalent hydraulic aperture. The authors have compared the flux and mechanical transported behavior of these networks to the behavior of equivalent continua. In this way they were able to determine whether a given fracture network could be modeled as an equivalent porous media in both flux and advective transport studies. They have examined departures from porous media behavior both as a function of interconnectivity and heterogeneity. Parameter studies have revealed behavior patterns such as: given a fracture frequency that can be measured in the field, porous media like behavior and the magnitude of permeability are both enhanced if the fractures are longer and the standard deviation of fracture permeabilities is smaller. The behavior of well tests in fractured networks has been modeled and compared to a new analytical well test solution which accounts for the early time dominance of the fractures intersecting the well. Finally, a three-dimensional fracture flow model has been constructed which assumes fractures are randomly located discs. This model has been constructed which assumes fractures are randomly located discs. This model uses a semi-analytical solution for flow such that it is relatively easy to use the model as a tool for stochastic analysis. 13 references, 12 figures

  14. CT evaluation of acetabular fractures

    Energy Technology Data Exchange (ETDEWEB)

    Piazza, P; Girelli, G; Coran, F; Lutman, M

    1986-01-01

    The paper deals with sixteen cases of acetabular fractures studied with CT. After a short description of the normal CT findings, the different kind of fractures are reported. The usefulness of CT examination in evaluating acetabular fractures and their complications is confirmed both in conservative treatment and surgical approach.

  15. Fracture of the occipital condyle

    International Nuclear Information System (INIS)

    Wessels, L.S.

    1990-01-01

    The term fracture of the occipital condyle is a misnomer and and usually represents an extensive fracture of the posterior fossa skull base extending onto the squamous portion of the occipital bone and even further forward. These fractures should be suspected when the lower cranial nerves are affected after severe cranial trauma. Conservative management appears to be indicated. 2 figs., 5 refs

  16. Pediatric maxillary fractures.

    Science.gov (United States)

    Yu, Jack; Dinsmore, Robert; Mar, Philip; Bhatt, Kirit

    2011-07-01

    Pediatric craniofacial structures differ from those of adults in many ways. Because of these differences, management of pediatric craniofacial fractures is not the same as those in adults. The most important differences that have clinical relevance are the mechanical properties, craniofacial anatomy, healing capacity, and dental morphology. This article will review these key differences and the management of pediatric maxillary fractures. From the mechanical properties' perspective, pediatric bones are much more resilient than adult bones; as such, they undergo plastic deformation and ductile failure. From the gross anatomic perspective, the relative proportion of the cranial to facial structures is much larger for the pediatric patients and the sinuses are not yet developed. The differences related to dentition and dental development are more conical crowns, larger interdental spaces, and presence of permanent tooth buds in the pediatric population. The fracture pattern, as a result of all the above, does not follow the classic Le Fort types. The maxillomandibular fixation may require circum-mandibular wires, drop wires, or Ivy loops. Interfragmentary ligatures using absorbable sutures play a much greater role in these patients. The use of plates and screws should take into consideration the future development with respect to growth centers and the location of the permanent tooth buds. Pediatric maxillary fractures are not common, require different treatments, and enjoy better long-term outcomes.

  17. Fracture Mechanics of Concrete

    DEFF Research Database (Denmark)

    Ulfkjær, Jens Peder

    Chapter 1 Chapter l contains the introduction to this thesis. The scope of the thesis is partly to investigate different numerical and analytical models based on fracture mechanical ideas, which are able to predict size effects, and partly to perform an experimental investigation on high-strength......Chapter 1 Chapter l contains the introduction to this thesis. The scope of the thesis is partly to investigate different numerical and analytical models based on fracture mechanical ideas, which are able to predict size effects, and partly to perform an experimental investigation on high......-strength concrete. Chapter 2 A description of the factors which influence the strength and cracking of concrete and high strength concrete is made. Then basic linear fracture mechanics is outlined followed by a description and evaluation of the models used to describe concrete fracture in tension. The chapter ends...... and the goveming equations are explicit and simple. These properties of the model make it a very powerful tool, which is applicable for the designing engineer. The method is also extended to reinforced concrete, where the results look very promising. The large experimental investigation on high-strength concrete...

  18. Fracture mechanics and microstructures

    International Nuclear Information System (INIS)

    Gee, M.G.; Morrell, R.

    1986-01-01

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

  19. Fractal description of fractures

    International Nuclear Information System (INIS)

    Lung, C.W.

    1991-06-01

    Recent studies on the fractal description of fractures are reviewed. Some problems on this subject are discussed. It seems hopeful to use the fractal dimension as a parameter for quantitative fractography and to apply fractal structures to the development of high toughness materials. (author). 28 refs, 7 figs

  20. Fracture Mechanics of Concrete

    Indian Academy of Sciences (India)

    R. Narasimhan (Krishtel eMaging) 1461 1996 Oct 15 13:05:22

    the international workshop on concrete fracture, organised by A Carpinteri, at Torino ... The next question is how to bring the size effect into codes of practice on the ... analysis of the recent collapse of the World Trade Center in New York by Z P ...

  1. Oblique Axis Body Fracture

    DEFF Research Database (Denmark)

    Takai, Hirokazu; Konstantinidis, Lukas; Schmal, Hagen

    2016-01-01

    type" fracture pattern. The first patient was treated conservatively with cervical spine immobilization in a semirigid collar. However, gross displacement was noted at the 6-week follow-up visit. The second patient was therefore treated operatively by C1-C3/4 posterior fusion and the course...... for this injury and suggest early operative stabilization....

  2. Proximal femoral fractures

    DEFF Research Database (Denmark)

    Palm, Henrik; Teixidor, Jordi

    2015-01-01

    searched the homepages of the national heath authorities and national orthopedic societies in West Europe and found 11 national or regional (in case of no national) guidelines including any type of proximal femoral fracture surgery. RESULTS: Pathway consensus is outspread (internal fixation for un...

  3. Fracture mechanics and parapsychology

    Science.gov (United States)

    Cherepanov, G. P.

    2010-08-01

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

  4. Metatarsal fracture (acute) - aftercare

    Science.gov (United States)

    ... of your 5th metatarsal bone closest to the ankle is called a Jones fracture. This area of the bone has low blood ... Swelling, pain, numbness, or tingling in your leg, ankle, or foot that becomes worse Your leg or foot turns purple Fever

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

    International Nuclear Information System (INIS)

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

    2001-04-01

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

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

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

    International Nuclear Information System (INIS)

    Meny, Lucienne.

    1979-06-01

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

  8. Cough-induced rib fractures.

    Science.gov (United States)

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

    2005-07-01

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

  9. Sealing of rock fractures

    International Nuclear Information System (INIS)

    Pusch, R.; Erlstroem, M.; Boergesson, L.

    1985-12-01

    The major water-bearing fractures in granite usually from fairly regular sets but the extension and degree of connectivity is varying. This means that only a few fractures that are interconnected with the deposition holes and larger water-bearing structures in a HLW repository are expected and if they can be identified and cut off through sealing it would be possible to improve the isolation of waste packages very effectively. Nature's own fracture sealing mechanisms may be simulated and a survey of the involved processes actually suggests a number of possible filling methods and substances. Most of them require high temperature and pressure and correspondingly sophisticated techniques, but some are of potential interest for immediate application with rather moderate effort. Such a technique is to fill the fractures with clayey substances which stay flexible and low-permeable provided that they remain physically and chemically intact. It is demonstrated in the report that effective grouting requires a very low viscosity and shear strength of the substance and this can be achieved by mechanical agitation as demonstrated in this report. Thus, by superimposing static pressure and shear waves induced by percussion hammering at a suitable frequency, clays and fine-grained silts as well as cement can be driven into fractures with an average aperture as small as 0.1 mm. Experiments were made in the laboratory using concrete and steel plates, and a field pilot test was also conducted under realistic conditions on site in Stripa. They all demonstrated the practicality of the 'dynamic injection technique' and that the fluid condition of the grouts yielded complete filling of the injected space to a considerable distance from the injection point. The field test indicated a good sealing ability as well as a surprisingly high resistance to erosion and piping. (author)

  10. Proximal humerus fractures: a comparative biomechanical analysis of intra and extramedullary implants.

    Science.gov (United States)

    Füchtmeier, B; May, R; Hente, R; Maghsudi, M; Völk, M; Hammer, J; Nerlich, M; Prantl, L

    2007-08-01

    The biomechanical stability of a newly developed humerus nail (Sirustrade mark) for the treatment of fractures of the proximal humerus was analyzed in comparison to established systems. In total, three randomized groups were formed (n = 4 pairs) from 12 matched pairs of human cadaver humeri. All intact bones were mechanically characterized by five subsequent load cycles under bending and torsional loading. The bending moment at the osteotomy was 7.5 N m the torsional moment was 8.3 N m over the hole specimen length. Loading was consistently initiated at the distal epiphysis and the deformation at the distal epiphysis was continuously recorded. Prior to implant reinforcement, a defect of 5 mm was created to simulate an unstable subcapital humerus fracture. For paired comparison, one humerus of each pair was stabilized with the Sirus proximal humerus nail while the counterpart was stabilized by a reference implant. In detail, the following groups were created: Sirus versus Proximal humerus nail (PHN) with spiral blade (group I); Sirus versus PHILOS plate (group II); Sirus versus 4.5 mm AO T-plate (group III). The Sirus nail demonstrated significantly higher stiffness values compared to the reference implants for both bending and torsional loading. The following distal epiphyseal displacements were recorded for a bending moment of 7.5 N m at the osteotomy: Sirus I: 8.8 mm, II: 8.4 mm, III: 7.7 mm (range 6.9-10.9), PHN 21.1 mm (range 15.7-25.2) (P = 0.005), PHILOS plate 27.5 mm (range 21.6-35.8) (P model presented here. Supplementary, the Sirus Nail showed higher stiffness values than the PHN. However, the latter are gaining in importance due to the possibility of minimal invasive implantation. Whether this will be associated with functional advantages requires further clinical investigation.

  11. Social inequality and hip fracture

    DEFF Research Database (Denmark)

    Harvey, N. C.; Hansen, L.; Judge, A.

    2015-01-01

    Social inequality appears to be increasing in many countries. We explored whether risk of hip fracture was associated with markers of inequality and whether these relationships changed with time, using data from Danish Health Registries. Methods: All patients 60 years or older with a primary hip...... fracture (ICD10: S720, S721, S722 and S729) were identified from 1 January 1995 to 31 December 2011. Hip fracture patients were matched 1:1 on age, gender and year of fracture to a non-hip fracture control. An individual's education attainment was defined as basic, secondary or higher, and their income...

  12. Seismic characterization of fracture properties

    International Nuclear Information System (INIS)

    Myer, L.R.; Hopkins, D.; Cook, N.G.W.; Pyrak-Nolte, L.J.

    1990-01-01

    The purpose of this paper is to show that there is a relationship, both empirical and theoretical, between the measured seismic response, the mechanical stiffness (also referred to as specific stiffness) of fractures and their hydraulic conductivity. Laboratory measurements of the mechanical stiffness, hydraulic conductivity and seismic properties of natural fractures are summarized. A theoretical model for the amplitude and group time delay for compressional and shear waves transmitted across a single fracture is presented. Predictions based on this model are compared with laboratory measurements. Finally, the results for a single fracture are extended to multiple parallel fractures. 13 refs., 6 figs

  13. Pubic insufficiency fracture: MRI findings

    International Nuclear Information System (INIS)

    Min, Tae Kyu; Lee, Yeon Soo; Park, Jeong Mi; Kim, Jee Young; Chung, Hong Jun; Lee, Eun Hee; Lee, Eun Ja; Kang, So Won; Han Tae Il

    2000-01-01

    To evaluate the characteristic MRI findings of pubic insufficiency fracture. In nine cases of pubic insufficiency fracture, the findings of plain radiography (n=9), MRI (n=9), and bone scintigraphy (n=8) were reviewed. We retrospectively analyzed, with regard to fracture site, the destructive pattern revealed by plain radiography, and uptake by other pelvic bones, as demonstrated by RI bone scanning. The MR findings evaluated were the fracture gap and its signal intensity, the site and signal intensity of the soft tissue mass, and other pelvic bone fractures. Plain radiography revealed osteolysis and sclerosis of pubic bone in eight of nine cases (89%), and parasymphyseal fractures in seven (78%). RI indicated uptake by the sacrum in six cases (66%), and by the ilium in three (33%). MR findings of fracture gap (seven cases, 78%) were hypo to isointensity on T1WI, hyper intensity on T2WI and the absence of contrast enhancement. Soft tissue masses were found in seven cases (78%); in four of these the location was parasymphyseal, and in three, surrounding muscle was involved. Hypo to isointensity was revealed by T1WI, hyperintensity by T2WI, and there was peripheral enhancement. Other associated pelvic bone fractures involved the sacrum in seven cases and the ilium in four. The characteristic MR findings of pubic insufficiency fracture were parasymphyseal location, fracture gap, peripherally enhanced soft tissue mass formation, and fractures of other pelvic bones, namely the sacrum and ilium

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

    Science.gov (United States)

    Zhou, Jing

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

  15. Tuning Fractures With Dynamic Data

    Science.gov (United States)

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

    2018-02-01

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

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

    Directory of Open Access Journals (Sweden)

    Yuwei Li

    2018-05-01

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

  17. FRACTURE SHAFT HUMERUS: INTERLOCKING

    Directory of Open Access Journals (Sweden)

    Deepak Kaladagi

    2014-12-01

    Full Text Available BACKGROUND: The incidence of humeral fracture has significantly increased during the present years due to the population growth and road traffic, domestic, industrial, automobile accidents & disasters like tsunami, earthquakes, head-on collisions, polytrauma etc. In order to achieve a stable fixation followed by early mobilization, numerous surgical implants have been devised. PURPOSE: The purpose of this study is to analyze the results of intramedullary fixation of proximal 2/3rd humeral shaft fractures using an unreamed interlocking intramedullary nail. INTRODUCTION: In 40 skeletally matured patients with fracture shaft of humerus admitted in our hospital, we used unreamed antegrade interlocking nails. MATERIAL: We carried out a prospective analysis of 40 patients randomly selected between 2001 to 2014 who were operated at JNMC Belgaum, MMC Mysore & Navodaya Medical College, Raichur. All cases were either RTAs, Domestic, Industrial, automobile accidents & also other modes of injury. METHOD: Routine investigations with pre-anaesthetic check-up & good quality X-rays of both sides of humerus was taken. Time of surgery ranged from 5-10 days from the time of admission. Only upper 1/3rd & middle 1/3rd humeral shaft fractures were included in the study. In all the cases antegrade locked unreamed humeral nails were inserted under C-arm. Patient was placed in supine position & the shoulder was kept elevated by placing a sandbag under the scapula. In all patients incision taken from tip of acromion to 3cm over deltoid longitudinally. Postoperatively sling applied with wrist & shoulder movements started after 24 hours. All the patients ranged between the age of 21-50 years. RESULTS: Total 40 patients were operated. Maximum fracture site were in the middle third- 76%, 14% upper 1/3rd. All 40 patients achieved union. The average time of union was 8-10 weeks. All patients regained full range of movements except in few cases, where there was shoulder

  18. Pelvic and acetabular fractures

    International Nuclear Information System (INIS)

    Mears, D.C.; Rubash, H.E.

    1986-01-01

    This treatise focuses primarily on the clinical aspects of diagnosis and treatments of pelvic and acetabular fractures. However, considerable attention is also paid to the radiographic diagnosis of trauma and postoperative effects. The book begins with a succinct review of pelvic and acetabular anatomy and pelvic biomechanics. It continues with a radiographic classification of pelvic injury, which will represent the major source of the book's interest for radiologists. The remainder of the book is concerned with clinical management of pelvic and acetabular trauma, including preoperative planning, surgical approaches, techniques of reduction, internal fixation, eternal fixation, post-operative care, and late problems. Even throughout this later portion of the book there are extensive illustrations, including plain radiographs, computed tomographic (CT) scans, reconstructed three-dimensional CT scans, and schematic diagrams of diverse pelvic and acetabular fractures and the elementary surgical techniques for their repair

  19. Double segmental tibial fractures - an unusual fracture pattern

    Directory of Open Access Journals (Sweden)

    Bali Kamal

    2012-02-01

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

  20. FRACTURED PETROLEUM RESERVOIRS

    Energy Technology Data Exchange (ETDEWEB)

    Abbas Firoozabadi

    1999-06-11

    The four chapters that are described in this report cover a variety of subjects that not only give insight into the understanding of multiphase flow in fractured porous media, but they provide also major contribution towards the understanding of flow processes with in-situ phase formation. In the following, a summary of all the chapters will be provided. Chapter I addresses issues related to water injection in water-wet fractured porous media. There are two parts in this chapter. Part I covers extensive set of measurements for water injection in water-wet fractured porous media. Both single matrix block and multiple matrix blocks tests are covered. There are two major findings from these experiments: (1) co-current imbibition can be more efficient than counter-current imbibition due to lower residual oil saturation and higher oil mobility, and (2) tight fractured porous media can be more efficient than a permeable porous media when subjected to water injection. These findings are directly related to the type of tests one can perform in the laboratory and to decide on the fate of water injection in fractured reservoirs. Part II of Chapter I presents modeling of water injection in water-wet fractured media by modifying the Buckley-Leverett Theory. A major element of the new model is the multiplication of the transfer flux by the fractured saturation with a power of 1/2. This simple model can account for both co-current and counter-current imbibition and computationally it is very efficient. It can be orders of magnitude faster than a conventional dual-porosity model. Part II also presents the results of water injection tests in very tight rocks of some 0.01 md permeability. Oil recovery from water imbibition tests from such at tight rock can be as high as 25 percent. Chapter II discusses solution gas-drive for cold production from heavy-oil reservoirs. The impetus for this work is the study of new gas phase formation from in-situ process which can be significantly

  1. Innovations in the management of hip fractures.

    Science.gov (United States)

    Teasdall, Robert D; Webb, Lawrence X

    2003-08-01

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

  2. Characterisation of fracture network and groundwater preferential ...

    African Journals Online (AJOL)

    Characterisation of fractured rocks and evaluation of fracture connectivity are essential for the study of subsurface flow and transport in fractured rock aquifers. In this study, we use a new method to present fracture networks and analyse the connectivity of the fractures, based on the technique of randomly-generated ...

  3. On size effects in fracture

    International Nuclear Information System (INIS)

    Sinclair, G.B.

    1985-01-01

    This paper discusses the dependence of fracture stress on size. This conclusion is based on classical energy arguments. For an in-plane scaled specimen pair, the larger the specimen the smaller the fracture stress. In contrast the same theory gives a different dependence for out-of-plane specimen and the dependence involves plane stress, strain, fracture stresses and Poisson's ratio. The objective of this paper is to examine how well these predictions are actually complied with

  4. Overview of Mandibular Condyle Fracture

    OpenAIRE

    Park, Su-Seong; Lee, Keun-Cheol; Kim, Seok-Kwun

    2012-01-01

    The mandibular condyle is a region that plays a key role in the opening and closing of the mouth, and because fracture causes functional and aesthetic problems such as facial asymmetry, it is very important to perform accurate reduction. Traditionally, there has been disagreement on how to manage fracture of the mandibular condyle. This review explores the misunderstanding of mandibular condyle fracture treatment and modern-day treatment strategies.

  5. Overview of Mandibular Condyle Fracture

    Directory of Open Access Journals (Sweden)

    Su-Seong Park

    2012-07-01

    Full Text Available The mandibular condyle is a region that plays a key role in the opening and closing of the mouth, and because fracture causes functional and aesthetic problems such as facial asymmetry, it is very important to perform accurate reduction. Traditionally, there has been disagreement on how to manage fracture of the mandibular condyle. This review explores the misunderstanding of mandibular condyle fracture treatment and modern-day treatment strategies.

  6. Overview of Mandibular Condyle Fracture

    Directory of Open Access Journals (Sweden)

    Su-Seong Park

    2012-07-01

    Full Text Available The mandibular condyle is a region that plays a key role in the opening and closing ofthe mouth, and because fracture causes functional and aesthetic problems such as facialasymmetry, it is very important to perform accurate reduction. Traditionally, there has beendisagreement on how to manage fracture of the mandibular condyle. This review exploresthe misunderstanding of mandibular condyle fracture treatment and modern-day treatmentstrategies.

  7. Golfer's fracture of the ribs

    International Nuclear Information System (INIS)

    Lim, J. H.

    1980-01-01

    Golfer's fracture is stress fracture of the posterior portion of left 3, 4, 5, 6 or 7th ribs of golfer's, usually beginners,and it is considered due to exposure to unaccustomed severe exercise of this fascinating sport. Healing is usually uneventful, but possible complication may occur, because symptom is mild and golfers continue the exercise with physical therapy such as massage. Author report 4 cases of golfer's fracture, including 1 case complicated by platelike at electasis of lung.

  8. Golfer's fracture of the ribs

    Energy Technology Data Exchange (ETDEWEB)

    Lim, J H [Seoul District Armed Forces General Hospital, Seoul (Korea, Republic of)

    1980-06-15

    Golfer's fracture is stress fracture of the posterior portion of left 3, 4, 5, 6 or 7th ribs of golfer's, usually beginners,and it is considered due to exposure to unaccustomed severe exercise of this fascinating sport. Healing is usually uneventful, but possible complication may occur, because symptom is mild and golfers continue the exercise with physical therapy such as massage. Author report 4 cases of golfer's fracture, including 1 case complicated by platelike at electasis of lung.

  9. Torsion fracture of carbon nanocoils

    Science.gov (United States)

    Yonemura, Taiichiro; Suda, Yoshiyuki; Tanoue, Hideto; Takikawa, Hirofumi; Ue, Hitoshi; Shimizu, Kazuki; Umeda, Yoshito

    2012-10-01

    We fix a carbon nanocoil (CNC) on a substrate in a focused ion beam instrument and then fracture the CNC with a tensile load. Using the CNC spring index, we estimate the maximum to average stress ratio on the fractured surface to range from 1.3 to 1.7, indicating stress concentration on the coil wire inner edge. Scanning electron microscopy confirms a hollow region on the inner edge of all fractured surfaces.

  10. Clavicular fractures: Classification, diagnosis, therapy

    International Nuclear Information System (INIS)

    Schunk, K.; Strunk, H.; Schild, H.; Lohr, S.

    1988-01-01

    Clavicular fracture is one of the most frequent skeletal lesions. In most cases the median third of the clavicula is affected (this is due to the peculiar biomechanical structure). Accompanying lesions and complications of clavicular fractures are rare. A total of 13 X-ray diagnostic techniques are described of clavicular fractures. X-ray film should, as a matter of principle, always be taken in two planes. Definitely the major part of clavicular fractures are treated conservatively (rucsac dressing), whereas surgery is reserved for few and strictly defined indications. (orig.) [de

  11. [Intramedullary stabilisation of clavicula fractures].

    Science.gov (United States)

    Prokop, A; Schiffer, G; Jubel, A; Chmielnicki, M

    2013-10-01

    With an incidence of 64/100,000, clavicular shaft fractures are one of the most common fractures. Intramedullary fixation with Prevot nails was initially reported in the late 1990s. This procedure offers minimally invasive stabilization of the fracture, thus enabling immediate mobilization and rapid loading capacity. Using a case study, the positioning and procedure are demonstrated on video. The intramedullary implant accommodates the varying tension loading of the clavicle. This treatment is ideal for clavicular fractures with 2-3 fragments. Compared to patients treated conservatively, operated patients achieve more rapid and improved mobility. Employment disability is shorter, and malunion occurs less frequently. Georg Thieme Verlag KG Stuttgart · New York.

  12. Clavicular fractures: Classification, diagnosis, therapy

    Energy Technology Data Exchange (ETDEWEB)

    Schunk, K.; Strunk, H.; Schild, H.; Lohr, S.

    1988-09-01

    Clavicular fracture is one of the most frequent skeletal lesions. In most cases the median third of the clavicula is affected (this is due to the peculiar biomechanical structure). Accompanying lesions and complications of clavicular fractures are rare. A total of 13 X-ray diagnostic techniques are described of clavicular fractures. X-ray film should, as a matter of principle, always be taken in two planes. Definitely the major part of clavicular fractures are treated conservatively (rucsac dressing), whereas surgery is reserved for few and strictly defined indications.

  13. Management of civilian ballistic fractures.

    Science.gov (United States)

    Seng, V S; Masquelet, A C

    2013-12-01

    The management of ballistic fractures, which are open fractures, has often been studied in wartime and has benefited from the principles of military surgery with debridement and lavage, and the use of external fixation for bone stabilization. In civilian practice, bone stabilization of these fractures is different and is not performed by external fixation. Fifteen civilian ballistic fractures, Gustilo II or IIIa, two associated with nerve damage and none with vascular damage, were reviewed. After debridement and lavage, ten internal fixations and five conservative treatments were used. No superficial or deep surgical site infection was noted. Fourteen of the 15 fractures (93%) healed without reoperation. Eleven of the 15 patients (73%) regained normal function. Ballistic fractures have a bad reputation due to their many complications, including infections. In civilian practice, the use of internal fixation is not responsible for excessive morbidity, provided debridement and lavage are performed. Civilian ballistic fractures, when they are caused by low-velocity firearms, differ from military ballistic fractures. Although the principle of surgical debridement and lavage remains the same, bone stabilization is different and is similar to conventional open fractures. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  14. Rehabilitation after falls and fractures.

    Science.gov (United States)

    Dionyssiotis, Y; Dontas, I A; Economopoulos, D; Lyritis, G P

    2008-01-01

    Falls are one of the most common geriatric problems threatening the independence of older persons. Elderly patients tend to fall more often and have a greater tendency to fracture their bones. Fractures occur particularly in osteoporotic people due to increased bone fragility, resulting in considerable reduction of quality of life, morbidity, and mortality. This article provides information for the rehabilitation of osteoporotic fractures pertaining to the rehabilitation of the fractured patient, based on personal experience and literature. It also outlines a suggested effective and efficient clinical strategy approach for preventing falls in individual patients.

  15. A newborn with multiple fractures

    International Nuclear Information System (INIS)

    Kantorova, E.; Kratky, L.; Nevsimal, I.; Marik, K.; Kozlowski, K.

    2008-01-01

    Sometimes newborns with multiple fractures are diagnosed as osteogenesis imperfecta in spite of absence of radiographic findings supporting this diagnosis. A newborn with multiple fractures was diagnosed as osteogenesis imperfecta. Analysis of the structure of the long bones, pattern of fractures and poorly developed muscles suggested the diagnosis of fetal akinesia deformation syndrome. This was confirmed by pregnancy history and clinical findings. Multiple fractures in a newborn may present with diagnostic radiographic features as in osteogenesis imperfecta, or as in lethal gracile bone dysplasias or achondrogenesis type IA. If those features are absent, other diseases should be considered. Radiographs should be compared with pregnancy history and clinical findings in the newborn. (authors)

  16. Hydraulic properties of fracture networks

    International Nuclear Information System (INIS)

    Dreuzy, J.R. de

    1999-12-01

    Fractured medium are studied in the general framework of oil and water supply and more recently for the underground storage of high level nuclear wastes. As fractures are generally far more permeable than the embedding medium, flow is highly channeled in a complex network of fractures. The complexity of the network comes from the broad distributions of fracture length and permeability at the fracture scale and appears through the increase of the equivalent permeability at the network scale. The goal of this thesis is to develop models of fracture networks consistent with both local-scale and global-scale observations. Bidimensional models of fracture networks display a wide variety of flow structures ranging from the sole permeable fracture to the equivalent homogeneous medium. The type of the relevant structure depends not only on the density and the length and aperture distributions but also on the observation scale. In several models, a crossover scale separates complex structures highly channeled from more distributed and homogeneous-like flow patterns at larger scales. These models, built on local characteristics and validated by global properties, have been settled in steady state. They have also been compared to natural well test data obtained in Ploemeur (Morbihan) in transient state. The good agreement between models and data reinforces the relevance of the models. Once validated and calibrated, the models are used to estimate the global tendencies of the main flow properties and the risk associated with the relative lack of data on natural fractures media. (author)

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

    NARCIS (Netherlands)

    Barnhoorn, A.; Cox, S.F.

    2012-01-01

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

  18. Instability in dynamic fracture

    Science.gov (United States)

    Fineberg, J.; Marder, M.

    1999-05-01

    The fracture of brittle amorphous materials is an especially challenging problem, because the way a large object shatters is intimately tied to details of cohesion at microscopic scales. This subject has been plagued by conceptual puzzles, and to make matters worse, experiments seemed to contradict the most firmly established theories. In this review, we will show that the theory and experiments fit within a coherent picture where dynamic instabilities of a crack tip play a crucial role. To accomplish this task, we first summarize the central results of linear elastic dynamic fracture mechanics, an elegant and powerful description of crack motion from the continuum perspective. We point out that this theory is unable to make predictions without additional input, information that must come either from experiment, or from other types of theories. We then proceed to discuss some of the most important experimental observations, and the methods that were used to obtain the them. Once the flux of energy to a crack tip passes a critical value, the crack becomes unstable, and it propagates in increasingly complicated ways. As a result, the crack cannot travel as quickly as theory had supposed, fracture surfaces become rough, it begins to branch and radiate sound, and the energy cost for crack motion increases considerably. All these phenomena are perfectly consistent with the continuum theory, but are not described by it. Therefore, we close the review with an account of theoretical and numerical work that attempts to explain the instabilities. Currently, the experimental understanding of crack tip instabilities in brittle amorphous materials is fairly detailed. We also have a detailed theoretical understanding of crack tip instabilities in crystals, reproducing qualitatively many features of the experiments, while numerical work is beginning to make the missing connections between experiment and theory.

  19. Fatigue and fracture: Overview

    Science.gov (United States)

    Halford, G. R.

    1984-01-01

    A brief overview of the status of the fatigue and fracture programs is given. The programs involve the development of appropriate analytic material behavior models for cyclic stress-strain-temperature-time/cyclic crack initiation, and cyclic crack propagation. The underlying thrust of these programs is the development and verification of workable engineering methods for the calculation, in advance of service, of the local cyclic stress-strain response at the critical life governing location in hot section compounds, and the resultant crack initiation and crack growth lifetimes.

  20. Femoral shaft fractures

    International Nuclear Information System (INIS)

    Bender, C.E.; Campbell, D.C. II

    1985-01-01

    The femur is the longest, largest, and strongest bone in the body. Because of its length, width, and role as primary weight-bearing bone, it must tolerate the extremes of axial loading and angulatory stresses. Massive musculature envelopes the femur. This masculature provides abundant blood supply to the bone, which also allows great potential for healing. Thus, the most significant problem relating to femoral shaft fractures is not healing, but restoration of bone length and alignment so that the femoral shaft will tolerate the functional stresses demanded of it

  1. Fracturing of subterranean formations

    Energy Technology Data Exchange (ETDEWEB)

    Kiel, O.M.; Kidwell, A.L.

    1968-03-19

    This method of propping fractured formations results in high conductivities. In the method, certain naturally occurring crystals are used as propping agents. Suitable crystals include garnet, corundum, zircon, rutile, high-temperature quartz, and other minerals which have Moh's hardness values of about 6 or greater and weather out as individual crystals of about 40 mesh or larger. These are said to result in permeabilities significantly higher than those obtained with ordinary quartz sand, metallic shot, glass beads, plastic particles, walnut hulls, or similar materials. (10 claims)

  2. Characterisation of hydraulically-active fractures in a fractured ...

    African Journals Online (AJOL)

    ... in the initial stage of a site investigation to select the optimal site location or to evaluate the hydrogeological properties of fractures in underground exploration studies, such as those related geothermal reservoir evaluation and radioactive waste disposal. Keywords: self-potential method, hydraulically-conductive fractures, ...

  3. Quantifying Discrete Fracture Network Connectivity in Hydraulic Fracturing Stimulation

    Science.gov (United States)

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

    2017-12-01

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

  4. Ankle fractures have features of an osteoporotic fracture.

    Science.gov (United States)

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

    2013-11-01

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

  5. Basic principles of fracture treatment in children.

    Science.gov (United States)

    Ömeroğlu, Hakan

    2018-04-01

    This review aims to summarize the basic treatment principles of fractures according to their types and general management principles of special conditions including physeal fractures, multiple fractures, open fractures, and pathologic fractures in children. Definition of the fracture is needed for better understanding the injury mechanism, planning a proper treatment strategy, and estimating the prognosis. As the healing process is less complicated, remodeling capacity is higher and non-union is rare, the fractures in children are commonly treated by non-surgical methods. Surgical treatment is preferred in children with multiple injuries, in open fractures, in some pathologic fractures, in fractures with coexisting vascular injuries, in fractures which have a history of failed initial conservative treatment and in fractures in which the conservative treatment has no/little value such as femur neck fractures, some physeal fractures, displaced extension and flexion type humerus supracondylar fractures, displaced humerus lateral condyle fractures, femur, tibia and forearm shaft fractures in older children and adolescents and unstable pelvis and acetabulum fractures. Most of the fractures in children can successfully be treated by non-surgical methods.

  6. Hydrologic behavior of fracture networks

    International Nuclear Information System (INIS)

    Long, J.C.S.; Endo, H.K.; Karasaki, K.; Pyrak, L.; MacLean, P.; Witherspoon, P.A.

    1984-10-01

    This paper reviews recent research on the nature of flow and transport in discontinuous fracture networks. The hydrologic behavior of these networks has been examined using two- and three-dimensional numerical models. The numerical models represent random realizations of fracture networks based on statistical field measurements of fracture geometry and equivalent hydraulic aperture. We have compared the flux and mechanical transport behavior of these networks to the behavior of equivalent continua. In this way we are able to determine whether a given fracture network can be modeled as an equivalent porous media in both flux and advective transport studies. We have examined departures from porous media behavior both as a function of interconnectivity and heterogeneity. Parameter studies have revealed behavior patterns such as: given a fracture frequency that can be measured in the field, porous media like behavior and the magnitude of permeability are both enhanced if the fractures are longer and the standard deviation of fracture permeabilities is smaller. Transport studies have shown that the ratio between flux and velocity is not necessarily constant when the direction of flow is changed in systems which do behave like a porous media for flux. Thus the conditions under which porous media analysis can be used in transport studies are more restrictive than the condition for flux studies. We have examined systems which do not behave like porous media and have shown how the in situ behavior varies as a function of scale of observation. The behavior of well tests in fractured networks has been modeled and compared to a new analytical well test solution which accounts for the early time dominance of the fractures intersecting the well. Finally, a three-dimensional fracture flow model has been constructed which assumes fractures are randomly located discs. 13 references, 12 figures

  7. Mandibular ramus fractures: a rarity.

    Science.gov (United States)

    Kale, Tejraj Pundalik; Kotrashetti, S M; Louis, Archana; Lingaraj, J B; Sarvesh, B U

    2013-01-01

    To determine the incidence of mandibular ramus fractures in KLE's PK Hospital and to analyze the outcome of open reduction and internal fixation of these fractures. Using a retrospective study design, records of all trauma patients who reported to the Department of Oral and Maxillofacial Surgery, KLE's PK Hospital Belgaum, between the years January 2006 to October 2011 was obtained from the medical records office. The data variables that were analyzed were the name, age, sex, cause of injury, pretreatment occlusion, treatment given, period of MMF and post-treatment occlusion. Total number of mandibular fracture cases was 298. Ramus fractures were 10 in number which accounted for 3.3% of fractures. The age range of these 10 patients was seen to be between 20 to 80 years with the average age being 35.6 years. Of these 10 patients, 9 were male and 1 was female and 7 patients were treated by open reduction and internal fixation and the remaining 3 by closed reduction. The average period of MMF was 3 days for the patients who underwent open reduction and internal fixation. There was improvement in occlusion in all 10 patients post-treatment and there was no complication reported in any of the cases. Ramus fractures accounted for 3.3% of all mandibular fractures. Open reduction and internal fixation of ramus fractures ensures adequate functional and anatomic reduction. This study makes an attempt to throw a light on the increasing incidence of ramus fractures and a successful management of these fractures by open reduction and internal fixation. How to cite this article: Kale TP, Kotrashetti SM, Louis A, Lingaraj JB, Sarvesh BU. Mandibular Ramus Fractures: A Rarity. J Contemp Dent Pract 2013;14(1):39-42. Source of support: Nil Conflict of interest: None declared.

  8. GUNSHOT FRACTURES OF TIBIA AND FEMUR - EXCELLENT ...

    African Journals Online (AJOL)

    2011-10-10

    Oct 10, 2011 ... fractures due to gunshot injury grafted with reamed bone marrow and immobilised with Surgical ... open fractures, which pose a challenging problem .... Table 2. Gustillo-Anderson Classification of fractures and infection.

  9. Image diagnosis of nasal bone fracture

    International Nuclear Information System (INIS)

    Hirota, Yoshiharu; Shimizu, Yayoi; Iinuma, Toshitaka.

    1988-01-01

    Twenty cases of nasal bone fractures were evaluated as to the types of fractures based upon HRCT findings. Conventional X-Ray films for nasal bones were analyzed and compared with HRCT findings. Nasal bone fractures were classified into lateral and frontal fractures. HRCT images were evaluated in three planes including upper, middle and lower portions of the nasal bone. Fractures favored males of teens. Lateral fracture gave rise to the fractures of the nasal bone opposite to the external force, loosening of the ipsilateral nasomaxillary sutures and fractures of the frontal process of the maxilla. Conventional X-Ray films were reevaluated after HRCT evaluation and indications of nasal bone fractures were determined. In addition to the discontinuity of the nasal dorsum, fracture lines parallel to and beneath the nasal dorsum and indistinct fracture lines along the nasomaxillary sutures are the indication of nasal bone fractures by conventional X-Ray films. (author)

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

    Science.gov (United States)

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

    1997-04-01

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

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

    Science.gov (United States)

    Ristiniemi, Jukka

    2007-06-01

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

  12. Rock fracture processes in chemically reactive environments

    Science.gov (United States)

    Eichhubl, P.

    2015-12-01

    Rock fracture is traditionally viewed as a brittle process involving damage nucleation and growth in a zone ahead of a larger fracture, resulting in fracture propagation once a threshold loading stress is exceeded. It is now increasingly recognized that coupled chemical-mechanical processes influence fracture growth in wide range of subsurface conditions that include igneous, metamorphic, and geothermal systems, and diagenetically reactive sedimentary systems with possible applications to hydrocarbon extraction and CO2 sequestration. Fracture processes aided or driven by chemical change can affect the onset of fracture, fracture shape and branching characteristics, and fracture network geometry, thus influencing mechanical strength and flow properties of rock systems. We are investigating two fundamental modes of chemical-mechanical interactions associated with fracture growth: 1. Fracture propagation may be aided by chemical dissolution or hydration reactions at the fracture tip allowing fracture propagation under subcritical stress loading conditions. We are evaluating effects of environmental conditions on critical (fracture toughness KIc) and subcritical (subcritical index) fracture properties using double torsion fracture mechanics tests on shale and sandstone. Depending on rock composition, the presence of reactive aqueous fluids can increase or decrease KIc and/or subcritical index. 2. Fracture may be concurrent with distributed dissolution-precipitation reactions in the hostrock beyond the immediate vicinity of the fracture tip. Reconstructing the fracture opening history recorded in crack-seal fracture cement of deeply buried sandstone we find that fracture length growth and fracture opening can be decoupled, with a phase of initial length growth followed by a phase of dominant fracture opening. This suggests that mechanical crack-tip failure processes, possibly aided by chemical crack-tip weakening, and distributed solution-precipitation creep in the

  13. Pediatric mandibular fractures.

    Science.gov (United States)

    Schweinfurth, J M; Koltai, P J

    1998-01-01

    Over the last 20 years, a revolution in the management of facial fractures has taken place. Refinements in biocompatible materials of great delicacy and strength along with advances in our understanding of biomechanics of the face, have rendered complex injuries consistently amenable to accurate 3-dimensional reconstruction. Furthermore, with the availability of education in the techniques of internal rigid fixation, these advanced techniques have become routine practice in adults. However, the suitability of rigid internal fixation for children remains controversial. There are many concerns about the effect of implanted hardware in the mandible of a growing child. In addition, some evidence suggests that the elevation of functional matrix off of bone may result in alterations in development. The goal is to restore the underlying bony architecture to its pre-injury position in a stable fashion, with a minimal of aesthetic and functional impairment. However, in children the treatment of bony injuries is most easily accomplished by techniques that may adversely effect craniofacial development. While it is not entirely possible to resolve this dilemma, there exists an extensive body of experimental and clinical information on the appropriate management of pediatric mandibular fractures which can be used to formulate a rational treatment plan for most cases. This paper presents an overview of the contemporary understanding and application of these treatment principles.

  14. Hydraulic fracturing proppants

    Directory of Open Access Journals (Sweden)

    V. P. P. de Campos

    Full Text Available Abstract Hydrocarbon reservoirs can be classified as unconventional or conventional depending on the oil and gas extraction difficulty, such as the need for high-cost technology and techniques. The hydrocarbon extraction from bituminous shale, commonly known as shale gas/oil, is performed by using the hydraulic fracturing technique in unconventional reservoirs where 95% water, 0.5% of additives and 4.5% of proppants are used. Environmental problems related to hydraulic fracturing technique and better performance/development of proppants are the current challenge faced by companies, researchers, regulatory agencies, environmentalists, governments and society. Shale gas is expected to increase USA fuel production, which triggers the development of new proppants and technologies of exploration. This paper presents a review of the definition of proppants, their types, characteristics and situation in the world market and information about manufacturers. The production of nanoscale materials such as anticorrosive and intelligent proppants besides proppants with carbon nanotubes is already carried out on a scale of tonnes per year in Belgium, Germany and Asia countries.

  15. Fracture induced electromagnetic radiation

    International Nuclear Information System (INIS)

    Frid, V; Rabinovitch, A; Bahat, D

    2003-01-01

    In our laboratory, we combine accurate electromagnetic radiation (EMR) measurements during fracture of rocks (carbonate and igneous) and transparent materials (glass, PMMA and glass ceramics) with careful fractographic methods. A critical analysis of experimental observations, accumulated here during the last decade together with supporting material from the works of other authors are used in this study to demonstrate the failure of all current models to explain the properties of EMR arising from fracture. The basic elements of a new model are proposed. These are (a) the EMR amplitude increases as long as the crack continues to grow, since new atomic bonds are severed and their contribution is added to the EMR. As a result, the atoms on both sides of the bonds are moved to 'non-equilibrium' positions relative to their steady state ones and begin to oscillate collectively in a manner similar to Debye model bulk oscillations - 'surface vibrational optical waves'; (b) when the crack halts, the waves and the EMR pulse amplitude decay by relaxation. These basic elements are already enough to describe the characteristics of the experimentally obtained isolated individual EMR pulses. These characteristics include the shape of the EMR pulse envelope, and the frequency, time duration and rise - fall time of the pulse

  16. Fracture induced electromagnetic radiation

    Energy Technology Data Exchange (ETDEWEB)

    Frid, V [Geological and Environmental Sciences Department, Deichmann Rock Mechanics Laboratory of the Negev, Ben Gurion University of the Negev, Beer Sheva (Israel); Rabinovitch, A [Physics Department, Deichmann Rock Mechanics Laboratory of the Negev, Ben Gurion University of the Negev, Beer Sheva (Israel); Bahat, D [Geological and Environmental Sciences Department, Deichmann Rock Mechanics Laboratory of the Negev, Ben Gurion University of the Negev, Beer Sheva (Israel)

    2003-07-07

    In our laboratory, we combine accurate electromagnetic radiation (EMR) measurements during fracture of rocks (carbonate and igneous) and transparent materials (glass, PMMA and glass ceramics) with careful fractographic methods. A critical analysis of experimental observations, accumulated here during the last decade together with supporting material from the works of other authors are used in this study to demonstrate the failure of all current models to explain the properties of EMR arising from fracture. The basic elements of a new model are proposed. These are (a) the EMR amplitude increases as long as the crack continues to grow, since new atomic bonds are severed and their contribution is added to the EMR. As a result, the atoms on both sides of the bonds are moved to 'non-equilibrium' positions relative to their steady state ones and begin to oscillate collectively in a manner similar to Debye model bulk oscillations - 'surface vibrational optical waves'; (b) when the crack halts, the waves and the EMR pulse amplitude decay by relaxation. These basic elements are already enough to describe the characteristics of the experimentally obtained isolated individual EMR pulses. These characteristics include the shape of the EMR pulse envelope, and the frequency, time duration and rise - fall time of the pulse.

  17. Osteoporosis, Fractures, and Diabetes

    Directory of Open Access Journals (Sweden)

    Peter Jackuliak

    2014-01-01

    Full Text Available It is well established that osteoporosis and diabetes are prevalent diseases with significant associated morbidity and mortality. Patients with diabetes mellitus have an increased risk of bone fractures. In type 1 diabetes, the risk is increased by ∼6 times and is due to low bone mass. Despite increased bone mineral density (BMD, in patients with type 2 diabetes the risk is increased (which is about twice the risk in the general population due to the inferior quality of bone. Bone fragility in type 2 diabetes, which is not reflected by bone mineral density, depends on bone quality deterioration rather than bone mass reduction. Thus, surrogate markers and examination methods are needed to replace the insensitivity of BMD in assessing fracture risks of T2DM patients. One of these methods can be trabecular bone score. The aim of the paper is to present the present state of scientific knowledge about the osteoporosis risk in diabetic patient. The review also discusses the possibility of problematic using the study conclusions in real clinical practice.

  18. Cough-induced rib fractures.

    Science.gov (United States)

    Sano, Atsushi; Tashiro, Ken; Fukuda, Tsutomu

    2015-10-01

    Occasionally, patients who complain of chest pain after the onset of coughing are diagnosed with rib fractures. We investigated the characteristics of cough-induced rib fractures. Between April 2008 and December 2013, 17 patients were referred to our hospital with chest pain after the onset of coughing. Rib radiography was performed, focusing on the location of the chest pain. When the patient had other signs and symptoms such as fever or persistent cough, computed tomography of the chest was carried out. We analyzed the data retrospectively. Rib fractures were found in 14 of the 17 patients. The age of the patients ranged from 14 to 86 years (median 39.5 years). Ten patients were female and 4 were male. Three patients had chronic lung disease. There was a single rib fracture in 9 patients, and 5 had two or more fractures. The middle and lower ribs were the most commonly involved; the 10th rib was fractured most frequently. Cough-induced rib fractures occur in every age group regardless of the presence or absence of underlying disease. Since rib fractures often occur in the lower and middle ribs, rib radiography is useful for diagnosis. © The Author(s) 2015.

  19. Mechanical properties of fracture zones

    International Nuclear Information System (INIS)

    Leijon, B.

    1993-05-01

    Available data on mechanical characteristics of fracture zones are compiled and discussed. The aim is to improve the basis for adequate representation of fracture zones in geomechanical models. The sources of data researched are primarily borehole investigations and case studies in rock engineering, involving observations of fracture zones subjected to artificial load change. Boreholes only yield local information about the components of fracture zones, i.e. intact rock, fractures and various low-strength materials. Difficulties are therefore encountered in evaluating morphological and mechanical properties of fracture zones from borehole data. Although often thought of as macroscopically planar features, available field data consistently show that fracture zones are characterized by geometrical irregularities such as thickness variations, surface undulation and jogs. These irregularities prevail on all scales. As a result, fracture zones are on all scales characterized by large, in-plane variation of strength- and deformational properties. This has important mechanical consequences in terms of non-uniform stress transfer and complex mechanisms of shear deformation. Field evidence for these findings, in particular results from the underground research laboratory in Canada and from studies of induced fault slip in deep mines, is summarized and discussed. 79 refs

  20. Diplopia and Orbital Wall Fractures

    NARCIS (Netherlands)

    Boffano, P.; Roccia, F.; Gallesio, C.; Karagozoglu, K.H.; Forouzanfar, T.

    2014-01-01

    Diplopia is a symptom that is frequently associated with orbital wall fractures. The aim of this article was to present the incidence and patterns of diplopia after orbital wall blow-out fractures in 2 European centers, Turin and Amsterdam, and to identify any correlation between this symptom and

  1. Diplopia and orbital wall fractures

    NARCIS (Netherlands)

    Boffano, P.; Roccia, F.; Gallesio, C.; Karagozoglu, K.H.; Forouzanfar, T.

    2014-01-01

    Diplopia is a symptom that is frequently associated with orbital wall fractures. The aim of this article was to present the incidence and patterns of diplopia after orbital wall blow-out fractures in 2 European centers, Turin and Amsterdam, and to identify any correlation between this symptom and

  2. Mathematical modelling of fracture hydrology

    International Nuclear Information System (INIS)

    Herbert, A.W.; Hodgkinson, D.P.; Lever, D.A.; Robinson, P.C.; Rae, J.

    1985-06-01

    This report summarises the work performed between January 1983 and December 1984 for the CEC/DOE contract 'Mathematical Modelling of Fracture Hydrology', under the following headings: 1) Statistical fracture network modelling, 2) Continuum models of flow and transport, 3) Simplified models, 4) Analysis of laboratory experiments and 5) Analysis of field experiments. (author)

  3. Ankle Fractures: The Operative Outcome

    Directory of Open Access Journals (Sweden)

    Ahmad Hafiz Z

    2011-03-01

    Full Text Available Ankle fractures are commonly seen in orthopaedic practice. This retrospective study of patients with ankle fractures who underwent surgical treatment in our institution from January 2000 to December 2003 was undertaken to analyze the common causes and patterns of ankle fractures; and the functional outcome of operative treatment for these fractures. Eighty patients were identified and reviewed. There were 65 male (81.3% and 15 female patients (18.7% with age ranging from 13 to 71 years old (mean, 32.3y. Common causes of ankle fractures were trauma (especially motor vehicle accidents, sports injuries and the osteoporotic bones in the elderly. Weber C (64.0% was the most common pattern of fracture at presentation. The most common operative treatment for ankle fractures was open reduction and internal fixation (73 patients, 91.2%. Excellent and good outcomes were achieved in 93.8% of cases when measured using the Olerud and Molander scoring system for foot and ankle. In conclusion, operative treatment for ankle fractures restores sufficient stability and allowed mobility of the ankle joint.

  4. Isolated Transverse Sacrum Fracture: A Case Report

    Directory of Open Access Journals (Sweden)

    Cemil Kavalci

    2011-01-01

    Full Text Available Sacral fracture commonly results from high-energy trauma. Most insufficiency fractures of the sacrum are seen in women after the age of 70. Fractures of the sacrum are rare and generally combined with a concomitant pelvic fracture. Transverse sacral fractures are even less frequent which constitute only 3–5% of all sacral fractures. This type of fractures provide a diagnostic challenge. We report a unique case of isolated transverse fracture of sacrum in a young man sustained low-energy trauma. The patient presented to our emergency department after several hours of injury, and diagnosed by clinical features and roentgenogram findings.

  5. Fracture mechanisms and fracture control in composite structures

    Science.gov (United States)

    Kim, Wone-Chul

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

  6. Radiographic evaluation of maxillofacial fractures

    International Nuclear Information System (INIS)

    Litwan, M.; Fliegel, C.

    1986-01-01

    The course and configuration of typical maxillofacial fractures (type Le Fort I-III) and lateral maxillary fractures including the zygomatic arch were reconstructed in detail by application of barium paste on a bony skull and radiogrpahs in standard projections were performed and evaluated. It was obvious from the resulting radiographs that for most maxillofacial fractures a half axial or Water's view was most helpful. Lateral views only give additional information when there is a considerable degree of dislocation of fragments. Comparison with a prediatric skull of 8 years of age demonstrated that fractures of the zygomatic arch in this age group cannot be demonstrated by the typical submento-vertical view, but are shown on a Towne projection. The radiographic appearance of important maxillofacial fractures is demonstrated. The necessity of further studies in cases where reconstructive surgery appears necessary is discussed and CT rather then conventional tomography is advocated. (orig.) [de

  7. Collagen turnover after tibial fractures

    DEFF Research Database (Denmark)

    Joerring, S; Krogsgaard, M; Wilbek, H

    1994-01-01

    Collagen turnover after tibial fractures was examined in 16 patients with fracture of the tibial diaphysis and in 8 patients with fracture in the tibial condyle area by measuring sequential changes in serological markers of turnover of types I and III collagen for up to 26 weeks after fracture....... The markers were the carboxy-terminal extension peptide of type I procollagen (PICP), the amino-terminal extension peptide of type III procollagen (PIIINP), and the pyridinoline cross-linked carboxy-terminal telopeptide of type I collagen (ICTP). The latter is a new serum marker of degradation of type I...... collagen. A group comparison showed characteristic sequential changes in the turnover of types I and III collagen in fractures of the tibial diaphysis and tibial condyles. The turnover of type III collagen reached a maximum after 2 weeks in both groups. The synthesis of type I collagen reached a maximum...

  8. Computer simulation of ductile fracture

    International Nuclear Information System (INIS)

    Wilkins, M.L.; Streit, R.D.

    1979-01-01

    Finite difference computer simulation programs are capable of very accurate solutions to problems in plasticity with large deformations and rotation. This opens the possibility of developing models of ductile fracture by correlating experiments with equivalent computer simulations. Selected experiments were done to emphasize different aspects of the model. A difficult problem is the establishment of a fracture-size effect. This paper is a study of the strain field around notched tensile specimens of aluminum 6061-T651. A series of geometrically scaled specimens are tested to fracture. The scaled experiments are conducted for different notch radius-to-diameter ratios. The strains at fracture are determined from computer simulations. An estimate is made of the fracture-size effect

  9. Pathogenesis of osteoporotic hip fractures.

    Science.gov (United States)

    McClung, Michael R

    2003-01-01

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

  10. [Comparing clinical effects of titanic elastic nail and locking compression pine fixation in treating subtrochanteric fractures in older children].

    Science.gov (United States)

    Zhu, Kang-xiang; Yin, Shan-qing

    2013-12-01

    To explore optimal choice of surgical treatment for subtrochanteric fractures in older children. A retrospective study of 36 older children with subtrochanteric fractures was performed between January 2010 and January 2012. Among them, 18 patients (11 males and 7 females) aged from 7 to 13 years old with an average of 9.4 were treated with titanic elastic nail (TEN) fixation, 4 cases were Type II A, 3 cases were II B, 2 cases were II C, 4 cases were III A, 3 cases were III B according to Seinsheimer classification. Eighteen patients (10 males and 8 females) aged was from 8 to 13 years with an average of 9.6 were treated with locking compression pine (LCP) fixation, and 3 cases were Type II A, 4 cases were II B, 3 cases were II C, 4 cases were IIIA, 2 cases were III B. Fracture healing time, postoperative complications (including wound infection, failure and breakage of internal fixtion, deformities of angular on the sagittal view, deformities of coxa vara) and recovery of hip joint function were observed and recorded. All children were followed up from 15 to 36 months with an average of 21. Fracture were all healed, the time ranged from 7 to 16 weeks (mean 9.5). Three cases in TEN group occurred mild deformities of angular on the sagittal view, 3 cases occurred deformities of coxa vara and 2 cases occurred limb shortening; while 1 case occurred mild deformities of angular on the sagittal view, and no deformities of coxa vara and limb shortening occurred in LCP group. No early close of epiphyseal injury, avascular necrosis of femoral head occurred. Clinical efficacy were evaluated by Sanders standard, 14 cases got excellent results, 3 cases were moderate in LCP group, while 9 cases in excellent, 4 in moderate in TEN group. There were no significant differences between two group in recovery of hip joint function and complications. For the treatment of subtrochanteric fractures in older children,the efficacy of LCP fixation is better than that of TFN fixation, which

  11. Relative Permeability of Fractured Rock

    Energy Technology Data Exchange (ETDEWEB)

    Mark D. Habana

    2002-06-30

    Contemporary understanding of multiphase flow through fractures is limited. Different studies using synthetic fractures and various fluids have yielded different relative permeability-saturation relations. This study aimed to extend the understanding of multiphase flow by conducting nitrogen-water relative permeability experiments on a naturally-fractured rock from The Geysers geothermal field. The steady-state approach was used. However, steady state was achieved only at the endpoint saturations. Several difficulties were encountered that are attributed to phase interference and changes in fracture aperture and surface roughness, along with fracture propagation/initiation. Absolute permeabilities were determined using nitrogen and water. The permeability values obtained change with the number of load cycles. Determining the absolute permeability of a core is especially important in a fractured rock. The rock may change as asperities are destroyed and fractures propagate or st rain harden as the net stresses vary. Pressure spikes occurred in water a solute permeability experiments. Conceptual models of an elastic fracture network can explain the pressure spike behavior. At the endpoint saturations the water relative permeabilities obtained are much less than the nitrogen gas relative permeabilities. Saturations were determined by weighing and by resistivity calculations. The resistivity-saturation relationship developed for the core gave saturation values that differ by 5% from the value determined by weighing. Further work is required to complete the relative permeability curve. The steady-state experimental approach encountered difficulties due to phase interference and fracture change. Steady state may not be reached until an impractical length of time. Thus, unsteady-state methods should be pursued. In unsteady-state experiments the challenge will be in quantifying rock fracture change in addition to fluid flow changes.

  12. Fracture behavior of human molars.

    Science.gov (United States)

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

    2012-12-01

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

  13. Recessive multiple epiphyseal dysplasia (rMED with homozygosity for C653S mutation in the DTDST gene - Phenotype, molecular diagnosis and surgical treatment of habitual dislocation of multilayered patella: Case report

    Directory of Open Access Journals (Sweden)

    Bonafé Luisa

    2010-06-01

    Full Text Available Abstract Background Multiple epiphyseal dysplasia (MED is one of the more common generalised skeletal dysplasias. Due to its clinical heterogeneity diagnosis may be difficult. Mutations of at least six separate genes can cause MED. Joint deformities, joint pain and gait disorders are common symptoms. Case Presentation We report on a 27-year-old male patient suffering from clinical symptoms of autosomal recessive MED with habitual dislocation of a multilayered patella on both sides, on the surgical treatment and on short-term clinical outcome. Clinical findings were: bilateral hip and knee pain, instability of femorotibial and patellofemoral joints with habitual patella dislocation on both sides, contractures of hip, elbow and second metacarpophalangeal joints. Main radiographic findings were: bilateral dislocated multilayered patella, dysplastic medial tibial plateaus, deformity of both femoral heads and osteoarthritis of the hip joints, and deformity of both radial heads. In the molecular genetic analysis, the DTDST mutation g.1984T > A (p.C653S was found at the homozygote state. Carrier status was confirmed in the DNA of the patient's parents. The mutation could be considered to be the reason for the patient's disease. Surgical treatment of habitual patella dislocation with medialisation of the tibial tuberosity led to an excellent clinical outcome. Conclusions The knowledge of different phenotypes of skeletal dysplasias helps to select genes for genetic analysis. Compared to other DTDST mutations, this is a rather mild phenotype. Molecular diagnosis is important for genetic counselling and for an accurate prognosis. Even in case of a multilayered patella in MED, habitual patella dislocation could be managed successfully by medialisation of the tibial tuberosity.

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

    Science.gov (United States)

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

    2018-04-04

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

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

    Directory of Open Access Journals (Sweden)

    Gultekin Gulbahar

    2015-01-01

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

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

    OpenAIRE

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

    2015-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

  18. Probabilistic fracture finite elements

    Science.gov (United States)

    Liu, W. K.; Belytschko, T.; Lua, Y. J.

    1991-05-01

    The Probabilistic Fracture Mechanics (PFM) is a promising method for estimating the fatigue life and inspection cycles for mechanical and structural components. The Probability Finite Element Method (PFEM), which is based on second moment analysis, has proved to be a promising, practical approach to handle problems with uncertainties. As the PFEM provides a powerful computational tool to determine first and second moment of random parameters, the second moment reliability method can be easily combined with PFEM to obtain measures of the reliability of the structural system. The method is also being applied to fatigue crack growth. Uncertainties in the material properties of advanced materials such as polycrystalline alloys, ceramics, and composites are commonly observed from experimental tests. This is mainly attributed to intrinsic microcracks, which are randomly distributed as a result of the applied load and the residual stress.

  19. Fracture flow code

    International Nuclear Information System (INIS)

    Dershowitz, W; Herbert, A.; Long, J.

    1989-03-01

    The hydrology of the SCV site will be modelled utilizing discrete fracture flow models. These models are complex, and can not be fully cerified by comparison to analytical solutions. The best approach for verification of these codes is therefore cross-verification between different codes. This is complicated by the variation in assumptions and solution techniques utilized in different codes. Cross-verification procedures are defined which allow comparison of the codes developed by Harwell Laboratory, Lawrence Berkeley Laboratory, and Golder Associates Inc. Six cross-verification datasets are defined for deterministic and stochastic verification of geometric and flow features of the codes. Additional datasets for verification of transport features will be documented in a future report. (13 figs., 7 tabs., 10 refs.) (authors)

  20. Tracer transport in fractured rocks

    International Nuclear Information System (INIS)

    Tsang, C.F.; Tsang, Y.W.; Hale, F.V.

    1988-07-01

    Recent interest in the safety of toxic waste underground disposal and nuclear waste geologic repositories has motivated many studies of tracer transport in fractured media. Fractures occur in most geologic formations and introduce a high degree of heterogeneity. Within each fracture, the aperture is not constant in value but strongly varying. Thus for such media, tracer tends to flow through preferred flowpaths or channels within the fractures. Along each of these channels, the aperture is also strongly varying. A detailed analysis is carried out on a 2D single fracture with variable apertures and the flow through channels is demonstrated. The channels defined this way are not rigidly set pathways for tracer transport, but are the preferred flow paths in the sense of stream-tubes in the potential theory. It is shown that such variable-aperture channels can be characterized by an aperture probability distribution function, and not by the exact deterministic geometric locations. We also demonstrate that the 2D tracer transport in a fracture can be calculated by a model of a system of 1D channels characterized by this distribution function only. Due to the channeling character of tracer transport in fractured rock, random point measurements of tracer breakthrough curves may give results with a wide spread in value due to statistical fluctuations. The present paper suggests that such a wide spread can probably be greatly reduced by making line/areal (or multiple) measurements covering a few spatial correlation lengths. 13 refs., 11 figs., 1 tab

  1. Stress fractures and bone pain

    International Nuclear Information System (INIS)

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

    1984-01-01

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

  2. Possible factors for ankle fractures

    Directory of Open Access Journals (Sweden)

    Tabaković Dejan

    2010-01-01

    Full Text Available Background/Aim. Classification of ankle fractures is commonly used for selecting an appropriate treatment and prognosing an outcome of definite management. One of the most used classifications is the Danis-Weber classification. To the best of our knowledge, in the available literature, there are no parameters affecting specific types of ankle fractures according to the Danis-Weber classification. The aim of this study was to analyze the correlation of the following parameters: age, body weight, body mass index (BMI, height, osteoporosis, osteopenia and physical exercises with specific types of ankle fractures using the Danis-Weber classification. Methods. A total of 85 patients grouped by the Danis-Weber classification fracture types were analyzed and the significance of certain parameters for specific types of ankle fractures was established. Results. The proportion of females was significantly higher (p < 0.001 with a significantly higher age (59.9 years, SD ± 14.2 in relation to males (45.1 years, SD ± 12.8 (p < 0.0001. Type A fracture was most frequent in the younger patients (34.2 years, SD ± 8.6, and those with increased physical exercises (p = 0.020. In type B fracture, the risk factor was osteoporosis (p = 0.0180, while in type C fracture, body weight (p = 0.017 and osteoporosis (p = 0.004 were significant parameters. Conclusion. Statistical analysis using the Danis-Weber classification reveals that there are certain parameters suggesting significant risk factors for specific types of ankle fractures.

  3. Age- and severity-adjusted treatment of proximal humerus fractures in children and adolescents-A systematical review and meta-analysis.

    Directory of Open Access Journals (Sweden)

    Lisa Hohloch

    Full Text Available Fractures of the proximal humerus in patients under the age of 18 years show a low incidence; existing clinical studies only comprise small patient numbers. Different treatment methods are mentioned in the literature but a comparison of the outcome of these methods is rarely made. Up to now, no evidence-based algorithm for conservative and operative treatment is available. The aim of this systematic review with meta-analysis was therefore to gather the best evidence of different treatment methods and their associated functional outcome, complication rates, rates of limb length discrepancies and radiological outcome.The OVID database was systematically searched on September 30th in 2016 in order to find all published clinical studies on the subject of proximal humerus fractures of patients ≤18 years. Exclusion criteria were previously defined. The Coleman Methodology Score was used to evaluate the quality of the single studies. 886 studies have been identified by the search strategy. 19 studies with a total of 643 children (mean age: 11.8 years were included into the meta-analysis with a mean Coleman Methodology Score of 71 ± 7.4 points. 18 of the 19 studies eligible for inclusion were retrospective ones, of the best quality available (mean follow-up ≥ 1 year, mean follow-up rate ≥ 65%. 56% of the patients were male. Proximal humerus fractures were treated conservatively in 41% and surgically in 59% of the cases (Elastic Stable Intramedullary Nailing (ESIN: 31%; K-wires: 20%; 8% other methods, e.g. plate osteosynthesis, olecranon traction. The overall success rate (good/excellent outcome for all treatment methods was 93%. The success rate of ESIN (98% and of K- wire fixation (95% was significantly higher (p = 0.01 than the success rate of conservative treatment options (91%. A subgroup analysis of severely displaced fractures (Neer grade III/IV, angulation ≥ 20° resulted in a change of success rates, to the disadvantage of conservative

  4. Characterisation of hydraulically-active fractures in a fractured ...

    African Journals Online (AJOL)

    2015-01-07

    Jan 7, 2015 ... injection and recovery tests were conducted for verification of the ... Keywords: self-potential method, hydraulically-conductive fractures, constant pressure injection and recovery ...... porous media 1: theory of the zeta potential.

  5. Fracture Union in Closed Interlocking Nail in Humeral Shaft Fractures

    Directory of Open Access Journals (Sweden)

    Ramji Lal Sahu

    2015-01-01

    Conclusions: The results of the present study indicates that in the presence of proper indications, reamed antegrade intramedullary interlocked nailing appears to be a method of choice for internal fixation of osteoporotic and pathologic fractures.

  6. Computed tomography of stress fracture

    International Nuclear Information System (INIS)

    Murcia, M.; Brennan, R.E.; Edeiken, J.

    1982-01-01

    An athletic young female developed gradual onset of pain in the right leg. Plain radiographs demonstrated solid periosteal reaction in the tibia compatible with stress fracture. She stopped sport activites but her pain continued. Follow-up radiographs of the tibia revealed changes suspicious for osteoid osteoma. Computed tomography (CT) scan demonstrated periosteal reaction, but in addition, lucent fracture lines in the tibial cortex were evident. CT obviated the need for more invasive diagnostic procedures in this patient. In selected cases CT may be useful to confirm the diagnosis of stress fracture when plain radiographic or routine tomographic studies are not diagnostic. (orig.)

  7. Sternal fractures and their management

    Directory of Open Access Journals (Sweden)

    Al-achraf Khoriati

    2013-01-01

    Full Text Available Sternal fractures are predominantly associated with deceleration injuries and blunt anterior chest trauma. Sternal trauma must be carefully evaluated by monitoring of vital parameters and it is of paramount importance that concomitant injuries are excluded. Nevertheless, routine admission of patients with isolated sternal fractures for observation is still common in today′s practice, which is often unnecessary. This article aims to describe the prognosis, the recommended assessment and management of patients with sternal fractures, to help clinicians make an evidence-based judgment regarding the need for hospitalization.

  8. Stress Fractures of the Foot.

    Science.gov (United States)

    Hossain, Munier; Clutton, Juliet; Ridgewell, Mark; Lyons, Kathleen; Perera, Anthony

    2015-10-01

    Stress fractures of the foot and ankle may be more common among athletes than previously reported. A low threshold for investigation is warranted and further imaging may be appropriate if initial radiographs remain inconclusive. Most of these fractures can be treated conservatively with a period of non-weight-bearing mobilization followed by gradual return to activity. Early surgery augmented by bone graft may allow athletes to return to sports earlier. Risk of delayed union, nonunion, and recurrent fracture is high. Many of the patients may also have risk factors for injury that should be modified for a successful outcome. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Elastic fracture in driven media

    International Nuclear Information System (INIS)

    Lung Chiwei; Wang Shenggang; Long Qiyi

    1999-08-01

    Fracture as one of the mechanical properties of materials is structurally dependent. Defects, defect assemblies, grain boundaries and sub-boundaries materials, modify the local stress intensity factors intensively. Brittle fracture prefers to confine to the grain boundary where the specific surface energy is lower than that in the grain. Again, transgranular cracking may occur on the crystal cleavage plane or planes where the local toughness is lowered by dislocation interaction and motion. This paper shows the complexity of the fractal dimension or roughness index of fractured surfaces in materials with metallographic structures or in inhomogeneous media. (author)

  10. Occupational therapy and Colles' fractures.

    Science.gov (United States)

    Christensen, O M; Kunov, A; Hansen, F F; Christiansen, T C; Krasheninnikoff, M

    2001-01-01

    In this randomized trial, we enrolled 30 patients treated for a distal radius Colles' type fracture. The fractures were reduced if necessary and fixed in a below-elbow plaster cast for 5 weeks. One group consisting of 14 patients received instructions for shoulder; elbow and finger exercise and the other group consisting of 16 patients had occupational therapy. At 5 weeks, 3 and 9 months we measured the functional scores. There were no statistically significant differences between the groups at any time. It seems that for non-surgically treated patients with a distal radius fracture only instructions are necessary.

  11. Fractures of the proximal humerus

    DEFF Research Database (Denmark)

    Brorson, Stig

    2013-01-01

    Fractures of the proximal humerus have been diagnosed and managed since the earliest known surgical texts. For more than four millennia the preferred treatment was forceful traction, closed reduction, and immobilization with linen soaked in combinations of oil, honey, alum, wine, or cerate......, classification of proximal humeral fractures remains a challenge for the conduct, reporting, and interpretation of clinical trials. The evidence for the benefits of surgery in complex fractures of the proximal humerus is weak. In three systematic reviews I studied the outcome after locking plate osteosynthesis...

  12. Computed tomography of stress fracture

    International Nuclear Information System (INIS)

    Murcia, M.; Brennan, R.E.; Edeiken, J.

    1982-01-01

    An athletic young female developed gradual onset of pain in the right leg. Plain radiographs demonstrated solid periosteal reaction in the tibia compatible with stress fracture. She stopped sport activites but her pain continued. Follow-up radiographs of the tibia revealed changes suspicious for osteoid osteoma. Computed tomography (CT) scan demonstrated periosteal reaction, but in addition, lucent fracture lines in the tibial cortex were evident. CT obviated the need for more invasive diagnostic procedures in this patient. In selected cases CT may be useful to confirm the diagnosis of stress fracture when plain radiographic or routine tomographic studies are not diagnostic

  13. Insufficiency fracture after radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Dong Ryul; Huh, Seung Jae [Dept.of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2014-12-15

    Insufficiency fracture occurs when normal or physiological stress applied to weakened bone with demineralization and decreased elastic resistance. Recently, many studies reported the development of IF after radiation therapy (RT) in gynecological cancer, prostate cancer, anal cancer and rectal cancer. The RT-induced insufficiency fracture is a common complication during the follow-up using modern imaging studies. The clinical suspicion and knowledge the characteristic imaging patterns of insufficiency fracture is essential to differentiate it from metastatic bone lesions, because it sometimes cause severe pain, and it may be confused with bone metastasis.

  14. Contemporary management of subtrochanteric fractures.

    Science.gov (United States)

    Joglekar, Siddharth B; Lindvall, Eric M; Martirosian, Armen

    2015-01-01

    Cephalomedullary interlocking nails that allow for trochanteric entry and minimally invasive fixation have revolutionized the contemporary management of subtrochanteric fractures with improved union rates and decreased incidence of fixation failure. The most successful alternative to intramedullary fixation remains the angled blade plate. Despite biomechanical superiority of contemporary intramedullary implants to previous intramedullary devices, the importance of achieving and maintaining satisfactory fracture reduction prior to and during hardware insertion cannot be overemphasized. In comminuted and more challenging fractures, additional techniques, such as limited open reduction with clamps and/or cables, can allow for canal restoration and more anatomic reductions prior to and/or during nail insertion. Published by Elsevier Inc.

  15. Atypical fractures on long term bisphosphonates therapy.

    LENUS (Irish Health Repository)

    Hussein, W

    2011-01-01

    Bisphosphonates reduce fractures risk in patients with osteoporosis. A new pattern of fractures is now being noted in patients on prolonged bisphosphonate therapy. We report a case of an atypical femoral fracture with preceding pain and highlight the characteristics of these fractures.

  16. Leakage losses from a hydraulic fracture and fracture propagation

    International Nuclear Information System (INIS)

    Johnson, R.E.; Gustafson, C.W.

    1988-01-01

    The fluid mechanics of viscous fluid injection into a fracture embedded in a permeable rock formation is studied. Coupling between flow in the fracture and flow in the rock is retained. The analysis is based on a perturbation scheme that assumes the depth of penetration of the fluid into the rock is small compared to the characteristic length w 3 0 /k, where w 0 is the characteristic crack width and k is the permeability. This restriction, however, is shown to be minor. The spatial dependence of the leakage rate per unit length from the fracture is found to be linear, decreasing from the well bore to the fracture tip where it vanishes. The magnitude of the leakage rate per unit length is found to decay in time as t -1 /sup // 3 if the injection rate at the well bore is constant, and as t -1 /sup // 2 if the well bore pressure is held constant. The results cast considerable doubt on the validity of Carter's well-known leakage formula (Drilling Prod. Prac. API 1957, 261) derived from a one-dimensional theory. Using the simple fracture propagation model made popular by Carter, the present work also predicts that the fracture grows at a rate proportional to t 1 /sup // 3 for a fixed well bore injection rate and a rate proportional to t 1 /sup // 4 for a fixed well bore pressure

  17. Coupled Fracture and Flow in Shale in Hydraulic Fracturing

    Science.gov (United States)

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

    2014-12-01

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

  18. Transverse posterior element fractures associated with torsion

    International Nuclear Information System (INIS)

    Abel, M.S.

    1989-01-01

    Six examples of a previously undescribed class of transverse vertebral element fractures are presented. These fractures differ from Chance and Smith fractures and their variants in the following respects: (1) the etiology is torsion and not flexion; (2) there is neither distraction of posterior ring fragments nor posterior ligament tears; (3) in contrast to Chance and Smith fractures, extension of the fracture into the vertebral body is absent or minimal; (4) the transverse process of the lumbar vertebra is avulsed at its base with a vertical fracture, not split horizontally. These fractures occur in cervical, lumbar, and sacral vertebrae in normal or compromised areas of the spine. (orig.)

  19. Routine functional assessment for hip fracture patients

    DEFF Research Database (Denmark)

    Pedersen, Tonny J; Lauritsen, Jens M

    2016-01-01

    Background and purpose - Pre-fracture functional level has been shown to be a consistent predictor of rehabilitation outcomes in older hip fracture patients. We validated 4 overall pre-fracture functional level assessment instruments in patients aged 65 or more, used the prediction of outcome at 4...... months post-fracture, and assessed cutoff values for decision making in treatment and rehabilitation. Patients and methods - 165 consecutive patients with acute primary hip fracture were prospectively included in the study. Pre-fracture Barthel-20, Barthel-100, cumulated ambulation score, and new...... investigation of usage for guidance of clinical and rehabilitation decisions concerning hip fracture patients is warranted....

  20. Fractures of the growing mandible.

    Science.gov (United States)

    Kushner, George M; Tiwana, Paul S

    2009-03-01

    Oral and maxillofacial surgeons must constantly weigh the risks of surgical intervention for pediatric mandible fractures against the wonderful healing capacity of children. The majority of pediatric mandibular fractures can be managed with closed techniques using short periods of maxillomandibular fixation or training elastics alone. Generally, the use of plate- and screw-type internal fixation is reserved for difficult fractures. This article details general and special considerations for this surgery including: craniofacial growth & development, surgical anatomy, epidemiology evaluation, various fractures, the role rigid internal fixation and the Risdon cable in pediatric maxillofacial trauma. It concludes with suggestions concerning long-term follow-up care in light of the mobility, insurance obstacles, and family dynamics facing the patient population.

  1. The treatment of subtrochanteric fractures

    Directory of Open Access Journals (Sweden)

    Vučetić Čedomir S.

    2011-01-01

    Full Text Available Subtrochanteric fractures of the femur have a special place because of a significant number of complications following treatment. Powerful loading forces asymmetrically acting to this bone segment, as well as poor vascularization interfere with bone union. There are basically two current approaches in the fixation of subtrochanteric fractures; the first involves a plate with a compression screw and another one is intramedullary (IM nail, with two options: centromedullary (standard interlocking femoral nail and cephalomedullary femoral nail with two modifications, reconstructive and trochanteric. All IM nails may be used by open technique or closed minimal invasive method. IM nailing is favoured in view of a shorter operative time, shorter hospitalisation and complications. Indirect fracture reduction and knowledge of biology of bone fracture may result in full success without any bone graft.

  2. Computed tomography of pelvic fractures

    Energy Technology Data Exchange (ETDEWEB)

    Kimoto, Makoto; Hashimoto, Keiji; Hiraki, Yoshio

    1984-12-01

    Plain x-ray and computed tomographic (CT) findings were compared in 7 patients with pelvic fractures (2 males and 5 females) aged between 35 and 50 year. Plain x-rays had a higher sensitivity than CT in detecting fractures of the ischiatic and pubic ramuses, and deviation of bone fragments. CT was superior to plain x-rays near the acetabulum and in detecting deviation of bone fragments. Although there were no differences between the two modalities in detecting fractures of the wing of ilium, CT was more useful than plain x-rays in visualizing deviation of bone fragments. CT clearly visualized not only fractures but also injuries of the soft tissues, such as pelvic viscera and muscles, and the presence of hematoma. CT seems to be a useful method for observing the condition and process of pelvic injuries and for deciding treatment protocols.

  3. Penis Fracture: Is It Possible?

    Science.gov (United States)

    ... intercourse, but can also occur due to aggressive masturbation or taqaandan, a cultural practice in which the ... article: http://www.mayoclinic.org/healthy-lifestyle/sexual-health/expert-answers/penis-fracture/faq-20058154 . Mayo Clinic ...

  4. Edge Fracture in Complex Fluids.

    Science.gov (United States)

    Hemingway, Ewan J; Kusumaatmaja, Halim; Fielding, Suzanne M

    2017-07-14

    We study theoretically the edge fracture instability in sheared complex fluids, by means of linear stability analysis and direct nonlinear simulations. We derive an exact analytical expression for the onset of edge fracture in terms of the shear-rate derivative of the fluid's second normal stress difference, the shear-rate derivative of the shear stress, the jump in shear stress across the interface between the fluid and the outside medium (usually air), the surface tension of that interface, and the rheometer gap size. We provide a full mechanistic understanding of the edge fracture instability, carefully validated against our simulations. These findings, which are robust with respect to choice of rheological constitutive model, also suggest a possible route to mitigating edge fracture, potentially allowing experimentalists to achieve and accurately measure flows stronger than hitherto possible.

  5. New C2 synchondrosal fracture classification system

    Energy Technology Data Exchange (ETDEWEB)

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

    2015-06-15

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

  6. Rehabilitation in osteoporotic vertebral fractures

    OpenAIRE

    Pratelli, Elisa; Cinotti, Irene; Pasquetti, Pietro

    2010-01-01

    Vertebral fractures occur particularly in osteoporotic patients due to an increased bone fragility. Vertebral fractures influence the quality of life, mobility and mortality. Preventive training exercises and proprioception reeducation can be utilised for improving posture, balance and level of daily function and for decreasing pain. Quality of life is improved even beyond the active training period. This mini review provides information based on the literature for the rehabilitation of osteo...

  7. Occupational therapy and Colles' fractures

    OpenAIRE

    Christensen, O.M.; Kunov, A.; Hansen, F.F.; Christiansen, T.C.; Krasheninnikoff, M.

    2000-01-01

    In this randomized trial, we enrolled 30 patients treated for a distal radius Colles' type fracture. The fractures were reduced if necessary and fixed in a below-elbow plaster cast for 5 weeks. One group consisting of 14 patients received instructions for shoulder; elbow and finger exercise and the other group consisting of 16 patients had occupational therapy. At 5 weeks, 3 and 9 months we measured the functional scores. There were no statistically significant differences between the groups ...

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

    Science.gov (United States)

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

    2014-12-01

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

  9. Avulsion fractures of the scapula

    International Nuclear Information System (INIS)

    Heyse-Moore, G.H.; Stoker, D.J.

    1982-01-01

    Fractures of the scapula due to direct violence are relatively common. Wilber and Evans [18] reported 40 scapular fractures and reviewed the literature. All those injured has received direct trauma to the shoulder and they were able to divide their cases into two groups, based on anatomical location and functional results. Scapular fractures due to avulsion of the muscular attachments are uncommon and, as reports of these injuries in the literature are usually confined to single cases, no classification has been established which takes account of the anatomical sites at which these fractures occur and the mechanism of injury involved. In this paper the more common sites of avulsion injury of the scapula are described and illustrated by case reports. In several of these the skeletal injury resulted from muscle contraction against a resisted force on the upper limb during the course of an accident. This mechanism has been implicated in fractures of the coracoid and acromion, but is shown in this paper to contribute to other avulsion fractures. (orig.)

  10. Dimensional threshold for fracture linkage and hooking

    Science.gov (United States)

    Lamarche, Juliette; Chabani, Arezki; Gauthier, Bertrand D. M.

    2018-03-01

    Fracture connectivity in rocks depends on spatial properties of the pattern including length, abundance and orientation. When fractures form a single-strike set, they hardly cross-cut each other and the connectivity is limited. Linkage probability increases with increasing fracture abundance and length as small fractures connect to each other to form longer ones. A process for parallel fracture linkage is the "hooking", where two converging fracture tips mutually deviate and then converge to connect due to the interaction of their crack-tip stresses. Quantifying the processes and conditions for fracture linkage in single-strike fracture sets is crucial to better predicting fluid flow in Naturally Fractured Reservoirs. For 1734 fractures in Permian shales of the Lodève Basin, SE France, we measured geometrical parameters in 2D, characterizing three stages of the hooking process: underlapping, overlapping and linkage. We deciphered the threshold values, shape ratios and limiting conditions to switch from one stage to another one. The hook set up depends on the spacing (S) and fracture length (Lh) with the relation S ≈ 0.15 Lh. Once the hooking is initiated, with the fracture deviation length (L) L ≈ 0.4 Lh, the fractures reaches the linkage stage only when the spacing is reduced to S ≈ 0.02 Lh and the convergence (C) is < 0.1 L. These conditions apply to multi-scale fractures with a shape ratio L/S = 10 and for fracture curvature of 10°-20°.

  11. Transverse dispersion in heterogeneous fractures

    International Nuclear Information System (INIS)

    Dershowitz, Bill; Shuttle, Dawn; Klise, Kate; Outters, Nils; Hermanson, Jan

    2004-12-01

    This report evaluates the significance of transverse dispersion processes for solute transport in a single fracture. Transverse dispersion is a potentially significant process because it increases the fracture surface area available for sorptive and diffusive properties, and has the potential to transport solute between what would otherwise be distinctive, streamline pathways. Transverse dispersion processes are generally ignored in one-dimensional repository performance assessment approaches. This report provides an initial assessment of the magnitude of transverse dispersion effect in a single heterogeneous fracture on repository safety assessment. This study builds on a previous report which considered the network effects on transport dispersion including streamline routing and mixing at fracture intersections. The project uses FracMan software. This platform has been extensively used by SKB in other projects. FracMan software is designed to generate and analyze DFN's as well as to compute fluid flow in DFN's with the MAFIC Finite element method (FEM) code. Solute transport was modeled using the particle tracking inside MAFIC, the 2-D Laplace Transform Galerkin inside PAWorks/LTG, and the 1-D Laplace Transform approach designed to replicate FARF31 inside GoldSim.The study reported here focuses on a single, 20-meter scale discrete fracture, with simplified boundary conditions intended to represent the position of this fracture within a fracture network. The range of assumptions made regarding fracture heterogeneity were as follows: Base case, Heterogeneous fracture, geostatistical field, correlation length 0.01 m. Case 1a, Homogeneous fracture, transmissivity = 10 -7 m 2 /s. Case 1b, Heterogeneous fracture, non-channeled geostatistical field correlation length 5 m. Case 1c, Heterogeneous fracture, channeled, anisotropic geostatistical field. Case 1d, Heterogeneous fracture, fracture intersection zone (FIZ) permeability enhanced. Case 5, Simple channelized

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

    International Nuclear Information System (INIS)

    Tsang, C.F.

    1986-12-01

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

  13. Radiological study of the mandibular fractures

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Ju Won; Kim, Kyoung A; Koh, Kwang Jun [Department of Oral and Maxillofacial Radiology, School of Dentistry, and Institute of Oral Bio Science, Chonbuk National University, Jeonju (Korea, Republic of)

    2009-06-15

    To classify and evaluate mandibular fractures. The author classified mandibular fractures of 284 patients who were referred to the Chonbuk National University Dental Hospital during the period from March 2004 to June 2007. This study was based on the conventional radiographs as well as computed tomographs which were pertained to the 284 patients who have had the mandibular fractures including the facial bone fractures. And mandibular fractures were classified with respect to gender, age, site and type of the fractures. More frequently affected gender with mandibular fracture was male with the ratio of 3.3 : 1. The most frequently affected age with mandibular fracture was third decade (38%), followed by fourth decade (16%), second decade (15%), fifth decade (11%), sixth decade (7%), seventh decade (5%), eighth decade (4%), first decade (4%), and ninth decade (0.3%). The most frequent type of mandibular fracture was single fracture (58%), followed by double fracture (39%), triple fracture (3%). The most common site of mandibular fracture was mandibular condyle as 113 cases (27.7%) and the next was mandibular symphysis as 109 cases (26.7%), mandibular angle as 103 cases (25.3%), mandibular body as 83 cases (20.3%) in order. The sum of fracture sites were 408 sites and there were 1.4 fracture sites per one patient. The number of mandible fractures accompanied with facial bone fractures were 41 cases (14.4%). The results showed the most frequent type and common site of mandibular fracture was single fracture and mandibular condyle respectively.

  14. Radiological study of the mandibular fractures

    International Nuclear Information System (INIS)

    Kim, Ju Won; Kim, Kyoung A; Koh, Kwang Jun

    2009-01-01

    To classify and evaluate mandibular fractures. The author classified mandibular fractures of 284 patients who were referred to the Chonbuk National University Dental Hospital during the period from March 2004 to June 2007. This study was based on the conventional radiographs as well as computed tomographs which were pertained to the 284 patients who have had the mandibular fractures including the facial bone fractures. And mandibular fractures were classified with respect to gender, age, site and type of the fractures. More frequently affected gender with mandibular fracture was male with the ratio of 3.3 : 1. The most frequently affected age with mandibular fracture was third decade (38%), followed by fourth decade (16%), second decade (15%), fifth decade (11%), sixth decade (7%), seventh decade (5%), eighth decade (4%), first decade (4%), and ninth decade (0.3%). The most frequent type of mandibular fracture was single fracture (58%), followed by double fracture (39%), triple fracture (3%). The most common site of mandibular fracture was mandibular condyle as 113 cases (27.7%) and the next was mandibular symphysis as 109 cases (26.7%), mandibular angle as 103 cases (25.3%), mandibular body as 83 cases (20.3%) in order. The sum of fracture sites were 408 sites and there were 1.4 fracture sites per one patient. The number of mandible fractures accompanied with facial bone fractures were 41 cases (14.4%). The results showed the most frequent type and common site of mandibular fracture was single fracture and mandibular condyle respectively.

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

    Directory of Open Access Journals (Sweden)

    Ana Lecia Carneiro Leão de Araújo Lima

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

  16. Atypical femoral fractures related to bisphosphonate therapy

    Directory of Open Access Journals (Sweden)

    Tarun Pankaj Jain

    2012-01-01

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

  17. Subclinical Thyroid Dysfunction and Fracture Risk

    DEFF Research Database (Denmark)

    Blum, Manuel R; Bauer, Douglas C; Collet, Tinh-Hai

    2015-01-01

    . Levels of thyroid function were defined as euthyroidism (thyroid-stimulating hormone [TSH], 0.45-4.49 mIU/L), subclinical hyperthyroidism (TSH hypothyroidism (TSH ≥4.50-19.99 mIU/L) with normal thyroxine concentrations. MAIN OUTCOME AND MEASURES: The primary outcome was hip...... fracture. Any fractures, nonspine fractures, and clinical spine fractures were secondary outcomes. RESULTS: Among 70,298 participants, 4092 (5.8%) had subclinical hypothyroidism and 2219 (3.2%) had subclinical hyperthyroidism. During 762,401 person-years of follow-up, hip fracture occurred in 2975...... hyperthyroidism (excluding thyroid medication users) was associated with HRs of 1.52 (95% CI, 1.19-1.93) for hip fracture, 1.42 (95% CI, 1.16-1.74) for any fracture, and 1.74 (95% CI, 1.01-2.99) for spine fracture. No association was found between subclinical hypothyroidism and fracture risk. CONCLUSIONS...

  18. Risk factors for stress fractures.

    Science.gov (United States)

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

    1999-08-01

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

  19. Growth Kinematics of Opening-Mode Fractures

    Science.gov (United States)

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

    2014-12-01

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

  20. Rare stress fracture: longitudinal fracture of the femur.

    Science.gov (United States)

    Pérez González, M; Velázquez Fragua, P; López Miralles, E; Abad Moretón, M M

    42-year-old man with pain in the posterolateral region of the right knee that began while he was running. Initially, it was diagnosed by magnetic resonance (MR) as a possible aggressive process (osteosarcoma or Ewing's sarcoma) but with computed tomography it was noted a cortical hypodense linear longitudinal image with a continuous, homogeneous and solid periosteal reaction without clear soft tissue mass that in this patient suggest a longitudinal distal femoral fatigue stress fracture. This type of fracture at this location is very rare. Stress fractures are entities that can be confused with an agressive process. MR iscurrently the most sensitive and specific imaging method for its diagnosis. Copyright © 2017 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  1. Selective perceptions of hydraulic fracturing.

    Science.gov (United States)

    Sarge, Melanie A; VanDyke, Matthew S; King, Andy J; White, Shawna R

    2015-01-01

    Hydraulic fracturing (HF) is a focal topic in discussions about domestic energy production, yet the American public is largely unfamiliar and undecided about the practice. This study sheds light on how individuals may come to understand hydraulic fracturing as this unconventional production technology becomes more prominent in the United States. For the study, a thorough search of HF photographs was performed, and a systematic evaluation of 40 images using an online experimental design involving N = 250 participants was conducted. Key indicators of hydraulic fracturing support and beliefs were identified. Participants showed diversity in their support for the practice, with 47 percent expressing low support, 22 percent high support, and 31 percent undecided. Support for HF was positively associated with beliefs that hydraulic fracturing is primarily an economic issue and negatively associated with beliefs that it is an environmental issue. Level of support was also investigated as a perceptual filter that facilitates biased issue perceptions and affective evaluations of economic benefit and environmental cost frames presented in visual content of hydraulic fracturing. Results suggested an interactive relationship between visual framing and level of support, pointing to a substantial barrier to common understanding about the issue that strategic communicators should consider.

  2. 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.

  3. CT of the acetabular fracture

    International Nuclear Information System (INIS)

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

    1993-01-01

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

  4. Fracture toughness of irradiated beryllium

    International Nuclear Information System (INIS)

    Beeston, J.M.

    1978-01-01

    The fracture toughness of nuclear grade hot-pressed beryllium upon irradiation to fluences of 3.5 to 5.0 x 10 21 n/cm 2 , E greater than 1 MeV, was determined. Procedures and data relating to a round-robin test contributing to a standard ASTM method for unirradiated beryllium are discussed in connection with the testing of irradiated specimens. A porous grade of beryllium was also irradiated and tested, thereby enabling some discrimination between the models for describing the fracture toughness behavior of porous beryllium. The fracture toughness of unirradiated 2 percent BeO nuclear grade beryllium was 12.0 MPa m/sup 1 / 2 /, which was reduced 60 percent upon irradiation at 339 K and testing at 295 K. The fracture toughness of a porous grade of beryllium was 13.1 MPa m/sup 1 / 2 /, which was reduced 68 percent upon irradiation and testing at the same conditions. Reasons for the reduction in fracture toughness upon irradiation are discussed

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

    Science.gov (United States)

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

    2017-02-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2016-11-15

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

  7. Plain film analysis of acetabular fracture

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Chang Soo; Han, Sang Suk; Yoon, Eu Giene; Cha, Seong Sook; Eun, Tchoong Kie; Chung, Duck Hwan [Inje Medical College Paik Hospital, Pusan (Korea, Republic of)

    1986-02-15

    Acetabular fracture can result in severe limitation of the motion of the hip joint, which supports total weight of human body. Because of different methods of surgical approach according to fracture type, precise interpretation of X-ray films of acetabular fracture is required. We reviewed 38 cases of simple X-ray films showing acetabular fracture. The results were as follows: 1. Almost 60% of the cases-were in their 2nd and 3rd decades. 2. Twenty cases were male, and 18 cases were female. 3. The most common cause of the injury was traffic accident (33 cases, 86.8%), followed by fall down (4 cases, 10.5%), and slip down (1 case, 2.7%). 4. Elementary fractures were 21 cases (55.3%), and associated fractures were 17 cases (44.7%). 5. Among elementary fractures, posterior wall fractures were 9 cases (23.7%), followed by anterior column fractures (8 cases, 21.1%), anterior wall fractures (4 cases, 10.5%). 6. Among associated fractures, T-shaped fractures were 8 cases (21.1%), followed by both column fractures (6 cases, 15.8%), anterior and hemitransverse fractures (3 cases, 7.8%). 7. Other pelvic bone fractures associated with the acetabular fracture were as follows: fractures of contralateral pubic rami (6 cases, 15.8%) contralateral iliac bone (1 case, 2.6%) and ipsilateral iliac bone (1 case, 2.6%). 8. Injuries of other organs adjacent to the acetabulum were as follows: rupture of the bladder (3 cases, 7.9%), urethra (2 cases, 5.3%) and uterus (1 cases, 2.6%)

  8. Plain film analysis of acetabular fracture

    International Nuclear Information System (INIS)

    Kim, Chang Soo; Han, Sang Suk; Yoon, Eu Giene; Cha, Seong Sook; Eun, Tchoong Kie; Chung, Duck Hwan

    1986-01-01

    Acetabular fracture can result in severe limitation of the motion of the hip joint, which supports total weight of human body. Because of different methods of surgical approach according to fracture type, precise interpretation of X-ray films of acetabular fracture is required. We reviewed 38 cases of simple X-ray films showing acetabular fracture. The results were as follows: 1. Almost 60% of the cases-were in their 2nd and 3rd decades. 2. Twenty cases were male, and 18 cases were female. 3. The most common cause of the injury was traffic accident (33 cases, 86.8%), followed by fall down (4 cases, 10.5%), and slip down (1 case, 2.7%). 4. Elementary fractures were 21 cases (55.3%), and associated fractures were 17 cases (44.7%). 5. Among elementary fractures, posterior wall fractures were 9 cases (23.7%), followed by anterior column fractures (8 cases, 21.1%), anterior wall fractures (4 cases, 10.5%). 6. Among associated fractures, T-shaped fractures were 8 cases (21.1%), followed by both column fractures (6 cases, 15.8%), anterior and hemitransverse fractures (3 cases, 7.8%). 7. Other pelvic bone fractures associated with the acetabular fracture were as follows: fractures of contralateral pubic rami (6 cases, 15.8%) contralateral iliac bone (1 case, 2.6%) and ipsilateral iliac bone (1 case, 2.6%). 8. Injuries of other organs adjacent to the acetabulum were as follows: rupture of the bladder (3 cases, 7.9%), urethra (2 cases, 5.3%) and uterus (1 cases, 2.6%).

  9. Cleavage and creep fracture of rock salt

    International Nuclear Information System (INIS)

    Chan, K.S.; Munson, D.E.; Bodner, S.R.

    1996-01-01

    The dominant failure mechanism in rock salt at ambient temperature is either cleavage or creep fracture. Since the transition of creep fracture to cleavage in a compressive stress field is not well understood, failure of rock salt by cleavage and creep fracture is analyzed in this paper to elucidate the effect of stress state on the competition between these two fracture mechanisms. For cleavage fracture, a shear crack is assumed to cause the formation and growth of a symmetric pair of wing cracks in a predominantly compressive stress field. The conditions for wing-crack instability are derived and presented as the cleavage fracture boundary in the fracture mechanism map. Using an existing creep fracture model, stress conditions for the onset of creep fracture and isochronous failure curves of specified times-to-rupture are calculated and incorporated into the fracture mechanism map. The regimes of dominance by cleavage and creep fracture are established and compared with experimental data. The result indicates that unstable propagation of cleavage cracks occurs only in the presence of tensile stress. The onset of creep fracture is promoted by a tensile stress, but can be totally suppressed by a high confining pressure. Transition of creep fracture to cleavage occurs when critical conditions of stress difference and tensile stress for crack instability are exceeded

  10. Acetabular fractures: anatomic and clinical considerations.

    Science.gov (United States)

    Lawrence, David A; Menn, Kirsten; Baumgaertner, Michael; Haims, Andrew H

    2013-09-01

    Classifying acetabular fractures can be an intimidating topic. However, it is helpful to remember that there are only three basic types of acetabular fractures: column fractures, transverse fractures, and wall fractures. Within this framework, acetabular fractures are classified into two broad categories: elementary or associated fractures. We will review the osseous anatomy of the pelvis and provide systematic approaches for reviewing both radiographs and CT scans to effectively evaluate the acetabulum. Although acetabular fracture classification may seem intimidating, the descriptions and distinctions discussed and shown in this article hopefully make the topic simpler to understand. Approach the task by recalling that there are only three basic types of acetabular fractures: column fractures (coronally oriented on CT images), transverse fractures (sagittally oriented on CT images), and wall fractures (obliquely oriented on CT images). We have provided systematic approaches for reviewing both conventional radiographs and CT scans to effectively assess the acetabulum. The clinical implications of the different fracture patterns have also been reviewed because it is critically important to include pertinent information for our clinical colleagues to provide the most efficient and timely clinical care.

  11. Genetics Home Reference: multiple epiphyseal dysplasia

    Science.gov (United States)

    ... Hamel BC, Spranger J, Zabel B, Cohn DH, Cole WG, Hecht JT, Superti-Furga A. Recessive multiple ... medicine? What is newborn screening? New Pages Lyme disease Fibromyalgia White-Sutton syndrome All New & Updated Pages ...

  12. Humeral Shaft Fracture: Intramedullary Nailing.

    Science.gov (United States)

    Konda, Sanjit R; Saleh, Hesham; Fisher, Nina; Egol, Kenneth A

    2017-08-01

    This video demonstrates the technique of intramedullary nailing for a humeral shaft fracture. The patient is a 30-year-old man who sustained a gunshot wound to his right arm. The patient was indicated for humeral nailing given the comminuted nature of the diaphysis and to allow for minimal skin incisions. Other relative indications include soft-tissue compromise about the arm precluding a large surgical exposure. This video presents a case of a comminuted humeral shaft fracture treated with an intramedullary nail. Anatomic reduction and stable fixation was obtained with this technique. This case demonstrates a soft-tissue sparing technique of humeral shaft fixation using a humeral intramedullary nail. The technique is easy to perform and has significant benefits in minimizing surgical exposure, decreasing operative time, and decreasing blood loss. In the correct clinical setting, humeral nailing provides an expeditious form of fixation that restores length, alignment, and rotation of the fracture humeral diaphysis.

  13. Epidural Analgesia after Rib Fractures.

    Science.gov (United States)

    Zaw, Andrea A; Murry, Jason; Hoang, David; Chen, Kevin; Louy, Charles; Bloom, Matthew B; Melo, Nicolas; Alban, Rodrigo F; Margulies, Daniel R; Ley, Eric J

    2015-10-01

    Pain associated with rib fractures impairs respiratory function and increases pulmonary morbidity. The purpose of this study was to determine how epidural catheters alter mortality and complications in trauma patients. We performed a retrospective study involving adult blunt trauma patients with moderate-to-severe injuries from January 1, 2004 to December 31, 2013. During the 10-year period, 526 patients met the inclusion criteria; 43/526 (8%) patients had a catheter placed. Mean age of patients with epidural catheter (CATH) was higher compared with patients without epidural catheter (NOCATH) (54 vs 48 years, P = 0.021), Injury Severity Score was similar (26 CATH vs 27 NOCATH, P = 0.84), and CATH had higher mean rib fractures (7.4 vs 4.1, P ribs fractured. The epidural cohort had longer hospital LOS and decreased mortality. In contrast to other studies, DVT rates were increased in patients who received epidural catheters.

  14. Fractured Penis: Not So Rare!

    Science.gov (United States)

    Tamhankar, Ashwin S; Pawar, Prakash W; Sawant, Ajit S; Kasat, Gaurav V; Savaliya, Abhishek; Mundhe, Shankar; Patil, Sunil; Narwade, Sayalee

    2017-01-01

    Penile fracture is a relatively common phenomenon. The main problem associated with this condition is the lack of patients' awareness on the urgency of the situation. This study reports the different modes of presentations and treatment results. We reviewed 21 cases of penile fracture over 5 years. Parameters were mode of injury, age group, time interval before presentation, management, site of injury, urethral involvement, results, complications and erectile function at follow-up. The mean age of patients was 34 years, the mean time interval until presentation was 26 h. Cases involving the right corpus cavernosum comprised 57.14% and 42.85% were cases involving the left corpus cavernosum. Two patients had full circumferential urethral tear. Two patients developed wound infections and 2 patients developed mild penile curvature (40 h). Urologists need to consider penile fracture a urological emergency and atypical presentations need to be considered when deciding on management. © 2017 S. Karger AG, Basel.

  15. Bone shortening of clavicular fractures

    DEFF Research Database (Denmark)

    Thorsmark, A H; Muhareb Udby, P; Ban, I

    2017-01-01

    BACKGROUND: The indication for operative treatment of clavicular fractures with bone shortening over 2 cm is much debated. Correct measurement of clavicular length is essential, and reliable measures of clavicular length are therefore highly requested by clinical decision-makers. The aim of this ......BACKGROUND: The indication for operative treatment of clavicular fractures with bone shortening over 2 cm is much debated. Correct measurement of clavicular length is essential, and reliable measures of clavicular length are therefore highly requested by clinical decision-makers. The aim......-fracture bone lengthening that indicated methodological problems. The Hill et al. and Silva et al. methods had high minimal detectable change, making their use unreliable. CONCLUSION: As all three measurement methods had either reliability or methodological issues, we found it likely that differences...

  16. Fracture as a material sink

    Science.gov (United States)

    Volokh, K. Y.

    2017-12-01

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

  17. Hydrogen fracture toughness tester completion

    Energy Technology Data Exchange (ETDEWEB)

    Morgan, Michael J. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2015-09-30

    The Hydrogen Fracture Toughness Tester (HFTT) is a mechanical testing machine designed for conducting fracture mechanics tests on materials in high-pressure hydrogen gas. The tester is needed for evaluating the effects of hydrogen on the cracking properties of tritium reservoir materials. It consists of an Instron Model 8862 Electromechanical Test Frame; an Autoclave Engineering Pressure Vessel, an Electric Potential Drop Crack Length Measurement System, associated computer control and data acquisition systems, and a high-pressure hydrogen gas manifold and handling system.

  18. Probabilistic application of fracture mechanics

    International Nuclear Information System (INIS)

    Dufresne, J.

    1981-04-01

    The different methods used to evaluate the rupture probability of a pressure vessel are reviewed. Data collection and processing of all parameters necessary for fracture mechanics evaluation are presented with particular attention to the size distribution of defects in actual vessels. Physical process is followed during crack growth and unstable propagation, using LEFM (Linear Elastic Fracture Mechanism) and plastic instability. Results show that the final failure probability for a PWR pressure vessel is 3.5 10 -8 , and is due essentially to LOCAs for any break size. The weakest point is the internal side of the belt line

  19. Ultrasonographic diagnosis of pancreatic fracture

    International Nuclear Information System (INIS)

    Woo, Seong Ku; Lim, Jae Hoon; Ko, Young Tae; Choi, Yong Dae; Yoon, Yup; Kim, Soo yong

    1983-01-01

    The pancreatic fracture, known also as complete transection of the pancreas, is severe injury of the pancreas characterized by complete vertical transection of its body overlying the body of the vertebra. The authors diagnosed three cases of traumatic fracture of the pancreas by ultrasonography and these were confirmed surgically. Ultrasonography disclosed an anechoic fluid collection between the separated parenchyma of the body of the pancreas anterior to the superior mesenteric artery. The remaining pancreas enlarged diffusely and decreased in echogenecity. Associated feature was accumulation of fluid in the lesser sac and the peritoneal cavity

  20. Fracture mechanics. With an introduction to micromechanics

    International Nuclear Information System (INIS)

    Gross, D.

    2006-01-01

    Concerned with the fundamental concepts and methods of fracture mechanics and micromechanics, Fracture Mechanics primarily focuses on the mechanical description of the fracture process; however, material specific aspects are also discussed. The presentation of continuum mechanical and phenomenological foundations is followed by an introduction into classical failure hypotheses. A major part of the book is devoted to linear elastic and elastic-plastic fracture mechanics. Further subjects are creep fracture, dynamic fracture mechanics, damage mechanics, probabilistic fracture mechanics, failure of thin films and fracture of piezoelectric materials. The book also contains an extensive introduction into micromechanics. Self-contained and well-illustrated, this text serves as a graduate-level text and reference

  1. [Vertical fractures: apropos of 2 clinical cases].

    Science.gov (United States)

    Félix Mañes Ferrer, J; Micò Muñoz, P; Sánchez Cortés, J L; Paricio Martín, J J; Miñana Laliga, R

    1991-01-01

    The aim of the study is to present a clinical review of the vertical root fractures. Two clinical cases are presented to demonstrates the criteria for obtaining a correct diagnosis of vertical root fractures.

  2. Deep gold mine fracture zone behaviour

    CSIR Research Space (South Africa)

    Napier, JAL

    1998-12-01

    Full Text Available The investigation of the behaviour of the fracture zone surrounding deep level gold mine stopes is detailed in three main sections of this report. Section 2 outlines the ongoing study of fundamental fracture process and their numerical...

  3. Fracture Union in Closed Interlocking Nail in Femoral Fracture

    Directory of Open Access Journals (Sweden)

    R L Sahu

    2010-09-01

    Full Text Available INTRODUCTION: Fractures shaft femur is a major cause of morbidity and mortality in patients with lower extremity injuries. The objective of this study was to find out the outcome of Interlocking nail in fracture femur. METHODS: This study was conducted in the Department of Orthopaedic surgery in M. M. Medical College from July 2006 to November 2008. Seventy eight patients were recruited from Emergency and out patient department having closed fracture of femoral shaft. All patients were operated under general or spinal anesthesia. All patients were followed for nine months. RESULTS: Out of seventy eight patients, sixty nine patients underwent union in 90 to 150 days with a mean of 110.68 days. Touch down weight bearing was started on 2nd post-operative day. Complications found in four patients who had non-union, and five patients had delayed union which was treated with dynamization and bone graft. The results were excellent in 88.46% and good in 6.41% patients. CONCLUSIONS: We concluded that this technique is advantageous because of early mobilization (early weight bearing, less complication with good results and is economical. Keywords: close reamed interlocking nail, dynamization, femoral shaft fractures, union

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

    Science.gov (United States)

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

    2017-04-01

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

  5. The incidence of associated fractures of the upper limb in fractures of the radial head

    NARCIS (Netherlands)

    Kaas, Laurens; van Riet, Roger P.; Vroemen, Jos P. A. M.; Eygendaal, Denise

    2008-01-01

    Radial head fractures are common injuries. In American publications, one-third of the patients with these fractures have been shown to have associated injuries. The aim of this retrospective study is to describe the epidemiology of radial head fractures and associated fractures of the ipsilateral

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

    NARCIS (Netherlands)

    Gong, J.; Rossen, W.R.

    2018-01-01

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

  7. Isolated rib fractures in geriatric patients

    OpenAIRE

    Elmistekawy, Elsayed M.; Hammad, Abd Almohsen M.

    2007-01-01

    Introduction: The goal of this study was to investigate the short-term outcomes in patients older than 60 years with isolated rib fractures and admitted to emergency hospital. Materials and Methods: This study included patients who were 60 years old or more and sustained blunt chest injury and had isolated rib fractures. The following data were obtained from the medical records: age, gender, number of fracture ribs, side of fracture ribs, mechanism and nature of injury, preexisting medical...

  8. Pedicular stress fracture in the lumbar spine

    International Nuclear Information System (INIS)

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

    1997-01-01

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

  9. Pedicular stress fracture in the lumbar spine

    Energy Technology Data Exchange (ETDEWEB)

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

    1997-08-01

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

  10. High temperature fracture of ceramic materials

    International Nuclear Information System (INIS)

    Wiederhorn, S.M.

    1979-01-01

    A review is presented of fracture mechanisms and methods of lifetime prediction in ceramic materials. Techniques of lifetime prediction are based on the science of fracture mechanics. Application of these techniques to structural ceramics is limited by our incomplete understanding of fracture mechanisms in these materials, and by the occurrence of flaw generation in these materials at elevated temperatures. Research on flaw generation and fracture mechanisms is recommended as a way of improving the reliability of structural ceramics

  11. Quantifying Fracture Heterogeneity in Different Domains of Folded Carbonate Rocks to Improve Fractured Reservoir Analog Fluid Flow Models

    NARCIS (Netherlands)

    Bisdom, K.; Bertotti, G.; Gauthier, B.D.M.; Hardebol, N.J.

    2013-01-01

    Fluid flow in carbonate reservoirs is largely controlled by multiscale fracture networks. Significant variations of fracture network porosity and permeability are caused by the 3D heterogeneity of the fracture network characteristics, such as intensity, orientation and size. Characterizing fracture

  12. Fractures of the distal phalanx in the horse

    International Nuclear Information System (INIS)

    Yovich, J.V.

    1989-01-01

    Fractures of the distal phalanx are an important cause of lameness referable to the foot. Depending on the fracture configuration and articular involvement, conservative or surgical treatment may be required. Fractures of the distal phalanx have been divided into six categories based on fracture configuration. Discussion of clinical features, management, and prognosis for horses with distal phalangeal fractures is presented for each fracture type

  13. Recurrent Hip Fracture Prevention With Osteoporosis Management

    Directory of Open Access Journals (Sweden)

    A. Shahla

    2007-02-01

    Full Text Available Background:Osteoporosis is a major public health threat,and hip fracture is a serious consequence of osteoporosis.Apatient with an osteoporosis-related hip fracture has an increased risk for a second hip fracture.The effect of osteoporosis management on the risk of recurrent hip fracture was evaluated in this study.Methods:58 hip fracture patients older than 50yr and BMD < 2.5 were discharged from hospital with Ca-Vitamin D- Alendronate prescriptions, and followed up for 4 years to determine the rate of recurrent hip fractures. Rate of second hip fractures was compared with 58 hip fractures in the control group (without osteoporosis treatment which were also followed for 4 years. Results:72% of patients continued treatment for 2 years. There were no second hip fractures in the critical first 12 months in the treated group.Overall second hip fractures in osteoporosis treated and control groups were 3.4% and 8.6%(p<0.03, respectively.Conclusion:Management of hip fractures in the elderly should include bone mineral density determination and osteoporosis treatment to prevent further fractures.

  14. Fractures in infants and toddlers with rickets

    Energy Technology Data Exchange (ETDEWEB)

    Chapman, Teresa; Done, Stephen [Seattle Children' s Hospital, Department of Radiology, Seattle, WA (United States); Sugar, Naomi; Feldman, Kenneth [Seattle Children' s Hospital, Children' s Protection Program, Seattle, WA (United States); Marasigan, Joanne; Wambold, Nicolle [University of Washington, College of Arts and Sciences, Seattle, WA (United States)

    2010-07-15

    Rickets affects young infants and toddlers. However, there is a paucity of literature regarding the types of fractures that occur in rachitic patients. To evaluate the age of patients at which radiographically evident rickets occurs, and to characterize the age incidence and fractures that are observed in infants and toddlers with radiographically evident rickets. A retrospective study of children younger than 24 months was performed. Clinical data and radiographs were reviewed. Radiographs obtained within 1 month of the diagnosis were evaluated for the presence or absence of osteopenia, presence or absence of fraying-cupping, and presence and characterization of fractures. After exclusion criteria were applied, 45 children were included in the study. Children with rickets evident by radiograph were in the age range of 2-24 months. Fractures were present in 17.5% of the study group, exclusively in mobile infants and toddlers. Fracture types included transverse long bone fractures, anterior and anterior-lateral rib fractures, and metaphyseal fractures. All fractures occurred exclusively in patients with severe, overtly evident rickets. Fractures occur in older infants and toddlers with overt rickets and can be seen by radiograph. Fractures do not resemble high-risk non-accidental trauma fractures. (orig.)

  15. Demographics and outcome of metatarsal fractures

    NARCIS (Netherlands)

    Cakir, H.; van Vliet-Koppert, S. T.; van Lieshout, E. M. M.; de Vries, M. R.; van der Elst, M.; Schepers, T.

    2011-01-01

    Although metatarsal fractures are amongst the most common injuries of the foot, this is the first study on outcome after metatarsal fractures. All consecutive patients with metatarsal fractures treated between January 2006 and September 2008 were re-evaluated. Patients aged 16 to 75 were sent a

  16. Functional outcome after a spinal fracture

    NARCIS (Netherlands)

    Post, Richard Bernardus

    2008-01-01

    This thesis takes a closer look at the functional outcome after a spinal fracture. An introduction to different aspects regarding spinal fractures is presented in Chapter 1. The incidence of traumatic thoracolumbar spinal fractures without neurological deficit in the Netherlands is approximately 1.2

  17. Subtrochanteric fractures in bisphosphonate-naive patients

    DEFF Research Database (Denmark)

    Adachi, Jonathan D; Lyles, Kenneth; Boonen, Steven

    2011-01-01

    Our purpose was to characterize the risks of osteoporosis-related subtrochanteric fractures in bisphosphonate-naive individuals. Baseline characteristics of patients enrolled in the HORIZON-Recurrent Fracture Trial with a study-qualifying hip fracture were examined, comparing those who sustained ...

  18. Biodegradable interlocking nails for fracture fixation

    NARCIS (Netherlands)

    van der Elst, M.; Bramer, J. A.; Klein, C. P.; de Lange, E. S.; Patka, P.; Haarman, H. J.

    1998-01-01

    Serious problems such as stress shielding, allergic reactions, and corrosion are associated with the use of metallic fracture fixation devices in fractured long bones. Metal implants often are removed during a second retrieval operation after fracture healing has completed. A biocompatible implant

  19. Review of treatment modalities of malleolar fractures

    Directory of Open Access Journals (Sweden)

    Xinhao Li

    2015-01-01

    Full Text Available The frequency of malleolar fractures according to available literature data is about 40% of bone fractures, the majority of them are severe articular or compound fractures. The article covers the experience, accumulated by the generations of orthopedists concerning diagnostics, choice of efficient treatment, decrease of disability and improvement of patients' living standards.

  20. Fluid transfers in fractured media: scale effects

    International Nuclear Information System (INIS)

    Bour, Olivier

    1996-01-01

    As there has been a growing interest in the study of fluid circulations in fractured media for the last fifteen years, for example for projects of underground storage of different waste types, or to improve water resources, or for exploitation of underground oil products or geothermal resources, this research thesis first gives a large overview of the modelling and transport properties of fractured media. He presents the main notions related to fluid transfers in fractured media (structures of fracture networks, hydraulic properties of fractured media), and the various adopted approaches (the effective medium theory, the percolation theory, double porosity models, deterministic discrete fracture models, equivalent discontinuous model, fractal models), and outlines the originality of the approach developed in this research: scale change, conceptual hypotheses, methodology, tools). The second part addresses scale rules in fracture networks: presentation of fracture networks (mechanical aspects, statistical analysis), distribution of fracture lengths and of fracture networks, length-position relationship, modelling attempt, lessons learned and consequences in terms of hydraulic and mechanical properties, and of relationship between length distribution and fractal dimension. The third part proposes two articles published by the author and addressing the connectivity properties of fracture networks. The fifth chapter reports the application to natural media. It contains an article on the application of percolation theory to 2D natural fracture networks, and reports information collected on a site [fr

  1. Lithium use and the risk of fractures

    NARCIS (Netherlands)

    Wilting, Ingeborg; de Vries, Frank; Thio, Brahm M. K. S.; Cooper, Cyrus; Heerdink, Eibert R.; Leutkens, Hubert G. M.; Nolen, Willem A.; Egberts, Antoine C. G.; van Staa, Tjeerd P.

    A recent study reported a decreased risk of fractures among lithium users. We conducted a case-control study within the UK General Practice Research Database, comparing never, ever, current, recent and past lithium use in 231,778 fracture cases to matched controls. In addition, the risk of fractures

  2. Phalangeal bone mineral density predicts incident fractures

    DEFF Research Database (Denmark)

    Friis-Holmberg, Teresa; Brixen, Kim; Rubin, Katrine Hass

    2012-01-01

    This prospective study investigates the use of phalangeal bone mineral density (BMD) in predicting fractures in a cohort (15,542) who underwent a BMD scan. In both women and men, a decrease in BMD was associated with an increased risk of fracture when adjusted for age and prevalent fractures...

  3. Calcaneal fracture classification: a comparative study

    NARCIS (Netherlands)

    Schepers, Tim; van Lieshout, Esther M. M.; Ginai, Abida Z.; Mulder, Paul G. H.; Heetveld, Martin J.; Patka, Peter

    2009-01-01

    Comparing different types of calcaneal fractures, associated treatment options, and outcome data is currently hampered by the lack of consensus regarding fracture classification. A systematic search for articles dealing with calcaneal fracture was performed, and the prevalence of use of each

  4. Fracture risk assessed by Fracture Risk Assessment Tool (FRAX) compared with fracture risk derived from population fracture rates

    DEFF Research Database (Denmark)

    Rubin, Katrine Hass; Abrahamsen, Bo; Hermann, Anne Pernille

    2011-01-01

    Purpose: To evaluate the performance of the Swedish version of Fracture Risk Assessment Tool (FRAX)) without bone mass density (BMD) in a Danish population to examine the possibility of applying this version to Danish women. METHODS: From the Danish National Register of social security numbers, we...

  5. Stress fractures in military training

    International Nuclear Information System (INIS)

    Jofre, M.J.; Sierralta, M.P.

    2002-01-01

    During military training, the incidence of overuse injuries like stress fractures increase. The aim of the study was to investigate the utility of bone scan in a military population with clinical suspected stress fractures or periostitis. Material and methods: A three-year retrospective analysis was made on patients who were clinically diagnosed with stress fractures at the Military Hospital Nuclear Medicine Department. Thirty-seven patients were studied (mean age 23. +/- 8 y.o; 31 males), 28 cases of which (76%) had tibial stress syndrome. Other localizations were lumbar spine, femoral, fibular, tarsal or metatarsal. Bone scintigraphy was performed injecting 1036 MBq of Tc99m-MDP i.v. Whole body images and lateral projections of lower extremities were done. Results: Bone scan in tibial syndrome was positive for 23 cases (82%), 65% of them were bilateral and 13% also had femoral injuries. X-rays were done in 10 cases and were all negative. In other localizations, the bone scans were negative, but demonstrated other degenerative lesions. All stress fractures were conservatively treated with non-steroidal anti-inflammatories and suspension of physical activity. Conclusions: Bone scan is a reliable confirmatory tool for tibial stress syndrome diagnosis. In addition, it helps to determine both the severity and extension of the injury as well as support the indication of rest in the military population

  6. Stress fractures in military training

    Energy Technology Data Exchange (ETDEWEB)

    Jofre, M J; Sierralta, M P [Military Hospital Nuclear Medicine Department, Santiago (Chile)

    2002-09-01

    During military training, the incidence of overuse injuries like stress fractures increase. The aim of the study was to investigate the utility of bone scan in a military population with clinical suspected stress fractures or periostitis. Material and methods: A three-year retrospective analysis was made on patients who were clinically diagnosed with stress fractures at the Military Hospital Nuclear Medicine Department. Thirty-seven patients were studied (mean age 23. +/- 8 y.o; 31 males), 28 cases of which (76%) had tibial stress syndrome. Other localizations were lumbar spine, femoral, fibular, tarsal or metatarsal. Bone scintigraphy was performed injecting 1036 MBq of Tc99m-MDP i.v. Whole body images and lateral projections of lower extremities were done. Results: Bone scan in tibial syndrome was positive for 23 cases (82%), 65% of them were bilateral and 13% also had femoral injuries. X-rays were done in 10 cases and were all negative. In other localizations, the bone scans were negative, but demonstrated other degenerative lesions. All stress fractures were conservatively treated with non-steroidal anti-inflammatories and suspension of physical activity. Conclusions: Bone scan is a reliable confirmatory tool for tibial stress syndrome diagnosis. In addition, it helps to determine both the severity and extension of the injury as well as support the indication of rest in the military population.

  7. Gas-driven fracture propagation

    International Nuclear Information System (INIS)

    Nilson, R.H.

    1981-10-01

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

  8. Mathematical modelling of fracture hydrology

    International Nuclear Information System (INIS)

    Rae, J.; Hodgkinson, D.P.; Robinson, P.C.; Herbert, A.W.

    1984-04-01

    This progress report contains notes on three aspects of hydrological modelling. Work on hydrodynamic dispersion in fractured media has been extended to transverse dispersion. Further work has been done on diffusion into the rock matrix and its effect on solute transport. The program NAMSOL has been used for the MIRAGE code comparison exercise being organised by Atkins R and D. (author)

  9. Fracture mechanics model of fragmentation

    International Nuclear Information System (INIS)

    Glenn, L.A.; Gommerstadt, B.Y.; Chudnovsky, A.

    1986-01-01

    A model of the fragmentation process is developed, based on the theory of linear elastic fracture mechanics, which predicts the average fragment size as a function of strain rate and material properties. This approach permits a unification of previous results, yielding Griffith's solution in the low-strain-rate limit and Grady's solution at high strain rates

  10. [Navigation surgery and fracture treatment

    NARCIS (Netherlands)

    Schep, N.W.; Vugt, A.B. van

    2006-01-01

    During operative fracture treatment the surgeon depends on fluoroscopic or X-ray radiological images as well as CT scans or MRI scans. This means that the surgeon sees only images at a given moment. Continuous imaging is technically complex and is accompanied by considerable exposure to radiation.

  11. External fixation of "intertrochanteric" fractures.

    Science.gov (United States)

    Gani, Naseem Ul; Kangoo, Khursheed Ahmed; Bashir, Arshad; Muzaffer, Rahil; Bhat, Mohammad Farooq; Farooq, Munir; Badoo, Abdul Rashid; Dar, Imtiyaz Hussian; Wani, Mudassir Maqbool

    2009-10-10

    In developing countries, due to limited availability of modern anesthesia and overcrowding of the hospitals with patients who need surgery, high-risk patients with "intertrochanteric" fractures remain unsuita ble for open reduction and internal fixation.The aim of this study was to analyze the results of external fixation of "intertrochanteric" fractures in high-risk geriatric patients in a developing country.The results of 62 ambulatory high-risk geriatric patients with a mean age of 70 years (range 58-90 years) with "intertrochanteric" fractures, in whom external fixation was performed, are reported.Eight patients died during follow-up due to medical causes unrelated to the surgical procedure. So only 54 patients were available for final assessment. Procedure is simple, performed under local anesthesia, requires less time for surgery and is associated with less blood loss. Good fixation and early ambulation was achieved in most of the patients. Average time to union was 14 weeks. Thirty-one patients developed superficial pin tract infection and 28 patients had average shortening of 15 mm due to impaction and varus angulation. Functional outcome was assessed using Judet's point system. Good to excellent results were achieved in 44 patients.This study demonstrated that external fixation of "intertrochantric" fractures performed under local anesthesia offers significant advantage in ambulatory high-risk geriatric patients especially in a developing country.

  12. Eponyms in elbow fracture surgery

    NARCIS (Netherlands)

    Somford, Matthijs P.; Wiegerinck, Johannes I.; Hoornenborg, Daniël; van den Bekerom, Michel P. J.; Eygendaal, Denise

    2015-01-01

    Eponyms are common in medicine and in orthopaedic surgery. For future reference and historical considerations, we present common eponyms in elbow fracture surgery. We describe in short the biography of the name giver and give, where possible, the original description on which the eponym was based.

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

    Science.gov (United States)

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

    2015-02-01

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

  14. Incidence and epidemiology of tibial shaft fractures.

    Science.gov (United States)

    Larsen, Peter; Elsoe, Rasmus; Hansen, Sandra Hope; Graven-Nielsen, Thomas; Laessoe, Uffe; Rasmussen, Sten

    2015-04-01

    The literature lacks recent population-based epidemiology studies of the incidence, trauma mechanism and fracture classification of tibial shaft fractures. The purpose of this study was to provide up-to-date information on the incidence of tibial shaft fractures in a large and complete population and report the distribution of fracture classification, trauma mechanism and patient baseline demographics. Retrospective reviews of clinical and radiological records. A total of 196 patients were treated for 198 tibial shaft fractures in the years 2009 and 2010. The mean age at time of fracture was 38.5 (21.2SD) years. The incidence of tibial shaft fracture was 16.9/100,000/year. Males have the highest incidence of 21.5/100,000/year and present with the highest frequency between the age of 10 and 20, whereas women have a frequency of 12.3/100,000/year and have the highest frequency between the age of 30 and 40. AO-type 42-A1 was the most common fracture type, representing 34% of all tibial shaft fractures. The majority of tibial shaft fractures occur during walking, indoor activity and sports. The distribution among genders shows that males present a higher frequency of fractures while participating in sports activities and walking. Women present the highest frequency of fractures while walking and during indoor activities. This study shows an incidence of 16.9/100,000/year for tibial shaft fractures. AO-type 42-A1 was the most common fracture type, representing 34% of all tibial shaft fractures. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Hydraulic conductivity of rock fractures

    International Nuclear Information System (INIS)

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

    1994-10-01

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

  16. Rib Fracture Diagnosis in the Panscan Era.

    Science.gov (United States)

    Murphy, Charles E; Raja, Ali S; Baumann, Brigitte M; Medak, Anthony J; Langdorf, Mark I; Nishijima, Daniel K; Hendey, Gregory W; Mower, William R; Rodriguez, Robert M

    2017-12-01

    With increased use of chest computed tomography (CT) in trauma evaluation, traditional teachings in regard to rib fracture morbidity and mortality may no longer be accurate. We seek to determine rates of rib fracture observed on chest CT only; admission and mortality of patients with isolated rib fractures, rib fractures observed on CT only, and first or second rib fractures; and first or second rib fracture-associated great vessel injury. We conducted a planned secondary analysis of 2 prospectively enrolled cohorts of the National Emergency X-Radiography Utilization Study chest studies, which evaluated patients with blunt trauma who were older than 14 years and received chest imaging in the emergency department. We defined rib fractures and other thoracic injuries according to CT reports and followed patients through their hospital course to determine outcomes. Of 8,661 patients who had both chest radiograph and chest CT, 2,071 (23.9%) had rib fractures, and rib fractures were observed on chest CT only in 1,368 cases (66.1%). Rib fracture patients had higher admission rates (88.7% versus 45.8%; mean difference 42.9%; 95% confidence interval [CI] 41.4% to 44.4%) and mortality (5.6% versus 2.7%; mean difference 2.9%; 95% CI 1.8% to 4.0%) than patients without rib fracture. The mortality of patients with rib fracture observed on chest CT only was not statistically significantly different from that of patients with fractures also observed on chest radiograph (4.8% versus 5.7%; mean difference -0.9%; 95% CI -3.1% to 1.1%). Patients with first or second rib fractures had significantly higher mortality (7.4% versus 4.1%; mean difference 3.3%; 95% CI 0.2% to 7.1%) and prevalence of concomitant great vessel injury (2.8% versus 0.6%; mean difference 2.2%; 95% CI 0.6% to 4.9%) than patients with fractures of ribs 3 to 12, and the odds ratio of great vessel injury with first or second rib fracture was 4.4 (95% CI 1.8 to 10.4). Under trauma imaging protocols that commonly

  17. Stress fractures of the femora in soldiers

    International Nuclear Information System (INIS)

    Meurman, K.O.A.; Somer, K.; Lamminen, A.

    1981-01-01

    Amongst 936 stress fractures found in soldiers, there were 58 in the femora (6%); of these 31 were in the neck and 27 in the shaft. Two were bilateral, and two patients had other stress fractures. Three displacements were found in the necks. In the shaft, 20 fractures were proximal, four were in the middle third and three in the distal third. In the latter group, it is necessary to differentiate from a sarcoma. CT is a new aid in this respect. Sport in highly motivated individuals appears to contribute particularly to fractures of the shaft. The symptoms from these fractures are relatively mild. (orig.) [de

  18. Stress fractures of the femora in soldiers

    Energy Technology Data Exchange (ETDEWEB)

    Meurman, K O.A.; Somer, K; Lamminen, A

    1981-05-01

    Amongst 936 stress fractures found in soldiers, there were 58 in the femora (6%); of these 31 were in the neck and 27 in the shaft. Two were bilateral, and two patients had other stress fractures. Three displacements were found in the necks. In the shaft, 20 fractures were proximal, four were in the middle third and three in the distal third. In the latter group, it is necessary to differentiate from a sarcoma. CT is a new aid in this respect. Sport in highly motivated individuals appears to contribute particularly to fractures of the shaft. The symptoms from these fractures are relatively mild.

  19. Tensile and fracture behavior of polymer foams

    International Nuclear Information System (INIS)

    Kabir, Md. E.; Saha, M.C.; Jeelani, S.

    2006-01-01

    Tensile and mode-I fracture behavior of cross-linked polyvinyl chloride (PVC) and rigid polyurethane (PUR) foams are examined. Tension tests are performed using prismatic bar specimens and mode-I fracture tests are performed using single edge notched bend (SENB) specimens under three-point bending. Test specimens are prepared from PVC foams with three densities and two different levels of cross-linking, and PUR foam with one density. Tension and quasi-static fracture tests are performed using a Zwick/Rowell test machine. Dynamic fracture tests are performed using a DYNATUP model 8210 instrumented drop-tower test set up at three different impact energy levels. Various parameters such as specimen size, loading rate, foam density, cross-linking, crack length, cell orientation (flow and rise-direction) and solid polymer material are studied. It is found that foam density and solid polymer material have a significant effect on tensile strength, modulus, and fracture toughness of polymer foams. Level of polymer cross-linking is also found to have a significant effect on fracture toughness. The presence of cracks in the rise- and flow direction as well as loading rate has minimal effect. Dynamic fracture behavior is found to be different as compared to quasi-static fracture behavior. Dynamic fracture toughness (K d ) increases with impact energy. Examination of fracture surfaces reveals that the fracture occurs in fairly brittle manner for all foam materials

  20. RESEARCH PROGRAM ON FRACTURED PETROLEUM RESERVOIRS

    Energy Technology Data Exchange (ETDEWEB)

    Abbas Firoozabadi

    2002-04-12

    Numerical simulation of water injection in discrete fractured media with capillary pressure is a challenge. Dual-porosity models in view of their strength and simplicity can be mainly used for sugar-cube representation of fractured media. In such a representation, the transfer function between the fracture and the matrix block can be readily calculated for water-wet media. For a mixed-wet system, the evaluation of the transfer function becomes complicated due to the effect of gravity. In this work, they use a discrete-fracture model in which the fractures are discretized as one dimensional entities to account for fracture thickness by an integral form of the flow equations. This simple step greatly improves the numerical solution. Then the discrete-fracture model is implemented using a Galerkin finite element method. The robustness and the accuracy of the approach are shown through several examples. First they consider a single fracture in a rock matrix and compare the results of the discrete-fracture model with a single-porosity model. Then, they use the discrete-fracture model in more complex configurations. Numerical simulations are carried out in water-wet media as well as in mixed-wet media to study the effect of matrix and fracture capillary pressures.