Locking plate fixation for proximal humerus fractures.

LENUS (Irish Health Repository)

Burke, Neil G

2012-02-01

Locking plates are increasingly used to surgically treat proximal humerus fractures. Knowledge of the bone quality of the proximal humerus is important. Studies have shown the medial and dorsal aspects of the proximal humeral head to have the highest bone strength, and this should be exploited by fixation techniques, particularly in elderly patients with osteoporosis. The goals of surgery for proximal humeral fractures should involve minimal soft tissue dissection and achieve anatomic reduction of the head complex with sufficient stability to allow for early shoulder mobilization. This article reviews various treatment options, in particular locking plate fixation. Locking plate fixation is associated with a high complication rate, such as avascular necrosis (7.9%), screw cutout (11.6%), and revision surgery (13.7%). These complications are frequently due to the varus deformation of the humeral head. Strategic screw placement in the humeral head would minimize the possibility of loss of fracture reduction and potential hardware complications. Locking plate fixation is a good surgical option for the management of proximal humerus fractures. Complications can be avoided by using better bone stock and by careful screw placement in the humeral head.

Tympanic plate fractures in temporal bone trauma: prevalence and associated injuries.

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Wood, C P; Hunt, C H; Bergen, D C; Carlson, M L; Diehn, F E; Schwartz, K M; McKenzie, G A; Morreale, R F; Lane, J I

2014-01-01

The prevalence of tympanic plate fractures, which are associated with an increased risk of external auditory canal stenosis following temporal bone trauma, is unknown. A review of posttraumatic high-resolution CT temporal bone examinations was performed to determine the prevalence of tympanic plate fractures and to identify any associated temporal bone injuries. A retrospective review was performed to evaluate patients with head trauma who underwent emergent high-resolution CT examinations of the temporal bone from July 2006 to March 2012. Fractures were identified and assessed for orientation; involvement of the tympanic plate, scutum, bony labyrinth, facial nerve canal, and temporomandibular joint; and ossicular chain disruption. Thirty-nine patients (41.3 ± 17.2 years of age) had a total of 46 temporal bone fractures (7 bilateral). Tympanic plate fractures were identified in 27 (58.7%) of these 46 fractures. Ossicular disruption occurred in 17 (37.0%). Fractures involving the scutum occurred in 25 (54.4%). None of the 46 fractured temporal bones had a mandibular condyle dislocation or fracture. Of the 27 cases of tympanic plate fractures, 14 (51.8%) had ossicular disruption (P = .016) and 18 (66.6%) had a fracture of the scutum (P = .044). Temporomandibular joint gas was seen in 15 (33%) but was not statistically associated with tympanic plate fracture (P = .21). Tympanic plate fractures are commonly seen on high-resolution CT performed for evaluation of temporal bone trauma. It is important to recognize these fractures to avoid the preventable complication of external auditory canal stenosis and the potential for conductive hearing loss due to a fracture involving the scutum or ossicular chain.

The mechanical benefit of medial support screws in locking plating of proximal humerus fractures.

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Wen Zhang

Full Text Available BACKGROUND: The purpose of this study was to evaluate the biomechanical advantages of medial support screws (MSSs in the locking proximal humeral plate for treating proximal humerus fractures. METHODS: Thirty synthetic left humeri were randomly divided into 3 subgroups to establish two-part surgical neck fracture models of proximal humerus. All fractures were fixed with a locking proximal humerus plate. Group A was fixed with medial cortical support and no MSSs; Group B was fixed with 3 MSSs but without medial cortical support; Group C was fixed with neither medial cortical support nor MSSs. Axial compression, torsional stiffness, shear stiffness, and failure tests were performed. RESULTS: Constructs with medial support from cortical bone showed statistically higher axial and shear stiffness than other subgroups examined (P<0.0001. When the proximal humerus was not supported by medial cortical bone, locking plating with medial support screws exhibited higher axial and torsional stiffness than locking plating without medial support screws (P ≤ 0.0207. Specimens with medial cortical bone failed primarily by fracture of the humeral shaft or humeral head. Specimens without medial cortical bone support failed primarily by significant plate bending at the fracture site followed by humeral head collapse or humeral head fracture. CONCLUSIONS: Anatomic reduction with medial cortical support was the stiffest construct after a simulated two-part fracture. Significant biomechanical benefits of MSSs in locking plating of proximal humerus fractures were identified. The reconstruction of the medial column support for proximal humerus fractures helps to enhance mechanical stability of the humeral head and prevent implant failure.

Fixed-angle plates in patella fractures - a pilot cadaver study

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Wild M

2011-01-01

Full Text Available Abstract Objective Modified anterior tension wiring with K-wires and cannulated lag screws with anterior tension wiring are currently the fixation of choice for patellar fractures. Failure of fixation, migration of the wires, postoperative pain and resulting revision surgery, however, are not uncommon. After preliminary biomechanical testing of a new fixed-angle plate system especially designed for fixation of patella fractures the aim of this study was to evaluate the surgical and anatomical feasibility of implanting such a plate-device at the human patella. Methods In six fresh unfixed female cadavers without history of previous fractures around the knee (average age 88.8 years a bilateral fixed-angle plate fixation of the patella was carried out after previous placement of a transverse central osteotomy. Operative time, intra-operative problems, degree of retropatellar arthritis (following Outerbridge, quality of reduction and existence of any intraarticular screw placement have been raised. In addition, lateral and anteroposterior radiographs of all specimens were made. Results Due to the high average age of 88.8 years no patella showed an unimpaired retropatellar articular surface and all were severely osteoporotic, which made a secure fixation of the reduction forceps during surgery difficult. The operation time averaged 49 minutes (range: 36-65. Although in postoperative X-rays the fracture gap between the fragments was still visible, the analysis of the retropatellar surface showed no residual articular step or dehiscence > 0.5 mm. Also in a total of 24 inserted screws not one intraarticular malposition was found. No intraoperative complications were noticed. Conclusions Osteosynthesis of a medial third patella fracture with a bilateral fixed-angle plate-device is surgically and anatomically feasible without difficulties. Further studies have to depict whether the bilateral fixed-angle plate-osteosynthesis of the patella displays

Dilemma in pediatric mandible fractures: resorbable or metallic plates?

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Taylan Filinte, Gaye; Akan, İsmail Mithat; Ayçiçek Çardak, Gülçin Nujen; Özkaya Mutlu, Özay; Aköz, Tayfun

2015-12-01

The aim of this study was to compare the efficiency of resorbable and metallic plates in open reduction and internal fixation of mandible fractures in children. Thirty-one patients (mean age, 8.05 years; range 20 months-14 years) were operated on various fractures of the mandible (26 [60.4%] symphysis- parasymphysis, 12 [27.9%] condylar-subcondylar fractures, 5 [11.6%] angulus and ramus fractures). Twelve patients were treated with resorbable plates and 19 patients with metallic plates. Mean follow-up time was 41 months (11-74 months) in the metallic hardware group and was 22 months (8-35 months) in the resorbable plate group. Both groups were investigated for primary bone healing, complications, number of operations, and mandibular growth. The results were discussed below. Both groups demonstrated primary bone healing. Minor complications were similar in both groups. The metallic group involved secondary operations for plate removal. Mandibular growth was satisfactory in both groups. Resorbable plates cost more than the metallic ones; however, when the secondary operations are included in the total cost, resorbable plates were favourable. As mandibular growth and complication parameters are similar in both groups, resorbable plates are favored due to avoidance of potential odontogenic injury, elimination of long-term foreign body retention and provision of adequate stability for rapid bone healing. However, learning curve and concerns for decreased stability against heavy forces of mastication accompanied with the resorbable plates when compared to the metallic ones should be kept in mind.

Minimally invasive plating osteosynthesis for mid-distal third humeral shaft fractures.

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Lian, Kejian; Wang, Lei; Lin, Dasheng; Chen, Zhiwen

2013-08-01

Mid-distal third humeral shaft fractures can be effectively treated with minimally invasive plating osteosynthesis and intramedullary nailing (IMN). However, these 2 treatments have not been adequately compared. Forty-seven patients (47 fractures) with mid-distal third humeral shaft fractures were randomly allocated to undergo either minimally invasive plating osteosynthesis (n=24) or IMN (n=23). The 2 groups were similar in terms of fracture patterns, fracture location, age, and associated injuries. Intraoperative measurements included blood loss and operative time. Clinical outcome measurements included fracture healing, radial nerve recovery, and elbow and shoulder discomfort. Radiographic measurements included fracture alignment, time to healing, delayed union, and nonunion. Functional outcome was satisfactory in both groups. Mean American Shoulder and Elbow Surgeons score and Mayo score were both better for the minimally invasive plating osteosynthesis group than for the IMN group (98.2 vs 97.6, respectively, and 93.5 vs 94.1, respectively; Pshaft fractures. Minimally invasive plating osteosynthesis is more suitable for complex fractures, especially for radial protection and motion recovery of adjacent joints, compared with IMN for simple fractures. Copyright 2013, SLACK Incorporated.

Biocompatibility of Bespoke 3D-Printed Titanium Alloy Plates for Treating Acetabular Fractures

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Xuezhi Lin

2018-01-01

Full Text Available Treatment of acetabular fractures is challenging, not only because of its complicated anatomy but also because of the lack of fitting plates. Personalized titanium alloy plates can be fabricated by selective laser melting (SLM but the biocompatibility of these three-dimensional printing (3D-printed plates remains unknown. Plates were manufactured by SLM and their cytocompatibility was assessed by observing the metabolism of L929 fibroblasts incubated with culture medium extracts using a CCK-8 assay and their morphology by light microscopy. Allergenicity was tested using a guinea pig maximization test. In addition, acute systemic toxicity of the 3D-printed plates was determined by injecting extracts from the implants into the tail veins of mice. Finally, the histocompatibility of the plates was investigated by implanting them into the dorsal muscles of rabbits. The in vitro results suggested that cytocompatibility of the 3D-printed plates was similar to that of conventional plates. The in vivo data also demonstrated histocompatibility that was comparable between the two manufacturing techniques. In conclusion, both in vivo and in vitro experiments suggested favorable biocompatibility of 3D-printed titanium alloy plates, indicating that it is a promising option for treatment of acetabular fractures.

Less invasive plate osteosynthesis in humeral shaft fractures.

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Apivatthakakul, Theerachai; Phornphutkul, Chanakarn; Laohapoonrungsee, Anupong; Sirirungruangsarn, Yuddhasert

2009-12-01

Stable internal fixation of the humeral shaft by less invasive percutaneous plate insertion using two separate (proximal and distal) incisions, indirect reduction by closed manipulation and fixation to preserve the soft tissue and blood supply at the fracture zone. Early mobilization of the shoulder and elbow to ensure a good functional outcome. Humeral shaft fractures (classified according to AO classification as: 12-A, B, C). Humeral shaft fractures extending to the proximal or distal shaft, small or deformed medullary canal or open growth plate. Humeral shaft fractures with primary radial nerve palsy. Proximal humeral shaft fractures extending to the humeral head. Distal humeral fractures extending to the elbow joint. Two incisions proximal and distal to the fracture zone are used. A 3-cm proximal incision lies between the lateral border of the proximal part of the biceps and the medial border of the deltoid. Distally, a 3-cm incision is made along the lateral border of the biceps. The interval between biceps and brachialis is identified. The biceps is retracted medially to expose the musculocutaneous nerve. The brachialis muscle has dual innervation, the medial half being innervated by the musculocutaneous nerve and the lateral half by the radial nerve. The brachialis is split longitudinally at its midline. The musculocutaneous nerve is retracted along with the medial half of the brachialis, while the lateral half of the brachialis serves as a cushion to protect the radial nerve. A deep subbrachial tunnel is created from the distal to the proximal incision. The selected plate is tied with a suture to a hole at the tip of the tunneling instrument for pulling the plate back along the prepared track. The plate is aligned in the correct position on the anterior surface of the humerus. Traction is applied and the fracture reduced to restore alignment by image intensifier, followed by plate fixation with at least two bicortical locking screws or three bicortical

Fracture Analyses of Cracked Delta Eye Plates in Ship Towing

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Huang, Xiangbing; Huang, Xingling; Sun, Jizheng

2018-01-01

Based on fracture mechanics, a safety analysis approach is proposed for cracked delta eye plates in ship towing. The static analysis model is presented when the delta eye plate is in service, and the fracture criterion is introduced on basis of stress intensity factor, which is estimated with domain integral method. Subsequently, three-dimensional finite element analyses are carried out to obtain the effective stress intensity factors, and a case is studied to demonstrate the reasonability of the approach. The results show that the classical strength theory is not applicable to evaluate the cracked plate while fracture mechanics can solve the problem very well, and the load level, which a delta eye plate can carry on, decreases evidently when it is damaged.

Fracture toughness and crack growth resistance of pressure vessel plate and weld metal steels

International Nuclear Information System (INIS)

Moskovic, R.

1988-01-01

Compact tension specimens were used to measure the initiation fracture toughness and crack growth resistance of pressure vessel steel plates and submerged arc weld metal. Plate test specimens were manufactured from four different casts of steel comprising: aluminium killed C-Mn-Mo-Cu and C-Mn steel and two silicon killed C-Mn steels. Unionmelt No. 2 weld metal test specimens were extracted from welds of double V butt geometry having either the C-Mn-Mo-Cu steel (three weld joints) or one particular silicon killed C-Mn steel (two weld joints) as parent plate. A multiple specimen test technique was used to obtain crack growth data which were analysed by simple linear regression to determine the crack growth resistance lines and to derive the initiation fracture toughness values for each test temperature. These regression lines were highly scattered with respect to temperature and it was very difficult to determine precisely the temperature dependence of the initiation fracture toughness and crack growth resistance. The data were re-analysed, using a multiple linear regression method, to obtain a relationship between the materials' crack growth resistance and toughness, and the principal independent variables (temperature, crack growth, weld joint code and strain ageing). (author)

Minimally invasive percutaneous plate fixation of distal tibia fractures.

LENUS (Irish Health Repository)

Bahari, Syah

2007-10-01

We report a series of 42 patients reviewed at a mean of 19.6 months after treatment of distal tibial and pilon fractures using the AO distal tibia locking plate with a minimally invasive percutaneous plate osteosynthesis (MIPPO) technique. Mean time to union was 22.4 weeks. All fractures united with acceptable alignment and angulation. Two cases of superficial infection were noted, with one case of deep infection. Mean SF36 score was 85 and mean AOFAS score was 90 at a mean of 19 months follow-up. We report satisfactory outcomes with the use of the AO distal tibia locking plate in treatment of unstable distal tibial fractures. Eighty-nine percent of the patients felt that they were back to their pre injury status and 95% back to their previous employment.

Analysis and experimental validation of through-thickness cracked large-scale biaxial fracture tests

International Nuclear Information System (INIS)

Wiesner, C.S.; Goldthorpe, M.R.; Andrews, R.M.; Garwood, S.J.

1999-01-01

Since 1984 TWI has been involved in an extensive series of tests investigating the effects of biaxial loading on the fracture behaviour of A533B steel. Testing conditions have ranged from the lower to upper shelf regions of the transition curve and covered a range of biaxiality ratios. In an attempt to elucidate the trends underlying the experimental results, finite element-based mechanistic models were used to analyse the effects of biaxial loading. For ductile fracture, a modified Gunson model was used and important effects on tearing behaviour were found for through thickness cracked wide plates, as observed in upper shelf tests. For cleavage fracture, both simple T-stress methods and the Anderson-Dodds and Beremin models were used. Whilst the effect of biaxiality on surface cracked plates was small, a marked effect of biaxial loading was found for the through-thickness crack. To further validate the numerical predictions for cleavage fracture, TWI have performed an additional series of lower shelf through thickness cracked biaxial wide plate fracture tests. These tests were performed using various biaxiality loading conditions varying from simple uniaxial loading, through equibiaxial loading, to a biaxiality ratio equivalent to a circumferential crack in a pressure vessel. These tests confirmed the predictions that there is a significant effect of biaxial loading on cleavage fracture of through thickness cracked plate. (orig.)

LNG cascading damage study. Volume I, fracture testing report.

Energy Technology Data Exchange (ETDEWEB)

Petti, Jason P.; Kalan, Robert J.

2011-12-01

As part of the liquefied natural gas (LNG) Cascading Damage Study, a series of structural tests were conducted to investigate the thermal induced fracture of steel plate structures. The thermal stresses were achieved by applying liquid nitrogen (LN{sub 2}) onto sections of each steel plate. In addition to inducing large thermal stresses, the lowering of the steel temperature simultaneously reduced the fracture toughness. Liquid nitrogen was used as a surrogate for LNG due to safety concerns and since the temperature of LN{sub 2} is similar (-190 C) to LNG (-161 C). The use of LN{sub 2} ensured that the tests could achieve cryogenic temperatures in the range an actual vessel would encounter during a LNG spill. There were four phases to this test series. Phase I was the initial exploratory stage, which was used to develop the testing process. In the Phase II series of tests, larger plates were used and tested until fracture. The plate sizes ranged from 4 ft square pieces to 6 ft square sections with thicknesses from 1/4 inches to 3/4 inches. This phase investigated the cooling rates on larger plates and the effect of different notch geometries (stress concentrations used to initiate brittle fracture). Phase II was divided into two sections, Phase II-A and Phase II-B. Phase II-A used standard A36 steel, while Phase II-B used marine grade steels. In Phase III, the test structures were significantly larger, in the range of 12 ft by 12 ft by 3 ft high. These structures were designed with more complex geometries to include features similar to those on LNG vessels. The final test phase, Phase IV, investigated differences in the heat transfer (cooling rates) between LNG and LN{sub 2}. All of the tests conducted in this study are used in subsequent parts of the LNG Cascading Damage Study, specifically the computational analyses.

PEEK versus titanium locking plates for proximal humerus fracture fixation: a comparative biomechanical study in two- and three-part fractures.

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Schliemann, Benedikt; Seifert, Robert; Theisen, Christina; Gehweiler, Dominic; Wähnert, Dirk; Schulze, Martin; Raschke, Michael J; Weimann, Andre

2017-01-01

The high rigidity of metal implants may be a cause of failure after fixation of proximal humerus fractures. Carbon fiber-reinforced polyetheretherketone (PEEK) plates with a modulus similar to human cortical bone may help to overcome this problem. The present study assesses the biomechanical behavior of a PEEK plate compared with a titanium locking plate. Unstable two- and three-part fractures were simulated in 12 pairs of cadaveric humeri and were fixed with either a PEEK or a titanium locking plate using a pairwise comparison. With an optical motion capture system, the stiffness, failure load, plate bending, and the relative motion at the bone-implant interface and at the fracture site were evaluated. The mean load to failure for two- and three-part fracture fixations was, respectively, 191 N (range 102-356 N) and 142 N (range 102-169 N) in the PEEK plate group compared with 286 N (range 191-395 N) and 258 N (range 155-366 N) in the titanium locking plate group. The PEEK plate showed significantly more bending in both the two- and three-part fractures (p PEEK plate showed lower fixation strength and increased motion at the bone-implant interface compared with a titanium locking plate.

Posterior column acetabular fracture fixation using a W-shaped angular plate: A biomechanical analysis.

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Ke Su

Full Text Available The purpose of this study was to compare the stability and feasibility of four fixation constructs in a posterior column acetabular fracture: one reconstruction plate, one reconstruction plate and lag screw, two reconstruction plates, and a W-shaped acetabular angular plate.Twenty embalmed cadaveric pelvises with a posterior column acetabular fractures were allocated to one of four groups: 1 a reconstruction plate, 2 a reconstruction plate with a posterior column lag screw, 3 double reconstruction plates, and 4 a W-shaped acetabular angular plate. These constructs were mechanically loaded on a testing machine, and construct stiffness values were measured. Strain gauges were utilized to measure the mechanical behavior in the condition of compressive force.Final stiffness was not different between the two reconstruction plates (445.81±98.30 N/mm and the W-shaped acetabular angular plate (447.43±98.45 N/mm, p = 0.524, both of which were superior to a single reconstruction plate (248.90±61.95 N/mm and a combined plate and lag screw (326.41±94.34 N/mm. Following the fixation of the W-shaped acetabular angular plate, the strain distribution was similar to the intact condition around the acetabulum. The parameters of the W-shaped acetabular angular plate that were observed at the superior region of the acetabulum were less than those of a single reconstruction plate (p<0.05, a single reconstruction plate with lag screw (p<0.05, and two reconstruction plates (p<0.05.The novel W-shaped acetabular angular plate fixation technique was able to provide the biomechanically stiffest construct for stabilization of a posterior column acetabular fracture; it also resulted in a partial restoration of joint loading parameters toward the intact state.

Locking plates in distal humerus fractures: study of 43 patients

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Gupta Rakesh Kumar

2013-08-01

Full Text Available 【Abstract】Objective: The treatment of multi-fragmentary, intraarticular fractures of the distal humerus is difficult, even in young patients with bone of good quality. Small distal fragment, diminished bone mineral quality and increased trauma-associated joint destruction make stable joint reconstruction more problematic. The anatomically preshaped locking plates allow angular stable fixation for these complex fractures. We evaluated functional results of patients treated with open reduction and internal fixation with distal humerus locking plates for complex distal hu-merus fractures. Methods: Forty-three consecutive patients with ar-ticular fractures of the distal humerus were treated by open reduction and internal fixation with AO distal humerus plate system and locking reconstruction plates. Forty patients were available for the final outcome analysis. According to AO/ASIF classification, there were 2 cases of type A2, 4 cases of type A3, 1 case of type B1, 1 case of type B2, 14 cases of type C1, 7 cases of type C2 and 11 cases of type C3. Open reduction with triceps splitting technique was used in all patients. The clinical and radiographic follow-up was performed and outcome measures included pain assessment, range of motion, and Mayo elbow performance score. Results: Forty patients were available for the final outcome analysis. There were 29 males and 11 females with an average age of 38.4 years (18-73 years. Clinical and ra-diological consolidation of the fracture was observed in all cases at an average of 11.6 weeks (9-14 weeks. The average follow-up was 12 months (10-18 months. Using the Mayo elbow performance score the results obtained were graded as excellent or good results in 33 patients (82.5%. One pa-tient had superficial infection, and 4 had myositis ossificans. There were no cases of primary malposition or secondary displacement, implant failure or ulnar neuropathy. Conclusion: Anatomically preshaped distal humerus locking

Displaced proximal humeral fractures: an Indian experience with locking plates

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Aggarwal Sameer

2010-08-01

Full Text Available Abstract Background The treatment of displaced proximal humerus fractures, especially in elderly, remains controversial. The objective of this study was to evaluate functional outcome of locking plate used for fixation of these fractures after open reduction. We also attempted to evaluate the complications and predictors of loss of fixation for such an implant. Methods Over two and a half years, 56 patients with an acute proximal humerus fracture were managed with locking plate osteosynthesis. 47 of these patients who completed a minimum follow up of 1 year were evaluated using Constant score calculation. Statistical analysis was done using SPSS 16 and a p value of less than 0.05 was taken as statistically significant. Results The average follow up period was around 21.5 months. Outcomes were excellent in 17%, good in 38.5%, moderate in 34% while poor in 10.5%. The Constant score was poorer for AO-OTA type 3 fractures as compared to other types. The scores were also inferior for older patients (> 65 years old. Complications included screw perforation of head, AVN, subacromial impingement, loss of fixation, axillary nerve palsy and infection. A varus malalignment was found to be a strong predictor of loss of fixation. Conclusion Locking plate osteosynthesis leads to satisfactory functional outcomes in all the patients. Results are better than non locking plates in osteoporotic fractures of the elderly. However the surgery has steep learning curve and various complications could be associated with its use. Nevertheless we believe that a strict adherence to the principles of locking plate use can ensure good result in such challenging fractures.

OUTCOME OF LOCKING PLATES IN DISTAL TIBIA FRACTURES TREATMENT

OpenAIRE

Lokesh; Dayanand; Deepak; Hemanth

2016-01-01

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

A biomechanical comparison of four fixed-angle dorsal plates in a finite element model of dorsally-unstable radius fracture.

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Knežević, Josip; Kodvanj, Janoš; Čukelj, Fabijan; Pamuković, Frane; Pavić, Arsen

2017-11-01

To compare the finite element models of two different composite radius fracture patterns, reduced and stabilised with four different fixed-angle dorsal plates during axial, dorsal and volar loading conditions. Eight different plastic models representing four AO/ASIF type 23-A3 distal radius fractures and four AO/ASIF 23-C2 distal radius fractures were obtained and fixed each with 1 of 4 methods: a standard dorsal non-anatomical fixed angle T-plate (3.5mm Dorsal T-plate, Synthes), anatomical fixed-angle double plates (2.4mm LCP Dorsal Distal Radius, Synthes), anatomical fixed angle T-plate (2.4mm Acu-Loc Dorsal Plate, Acumed) or anatomical variable-angle dorsal T-plate (3.5mm, Dorsal Plate, Zrinski). Composite radius with plate and screws were scanned with a 3D optical scanner and later processed in Abaqus Software to generate the finite element model. All models were axially loaded at 3 points (centrally, volarly and dorsally) with 50 N forces to avoid the appearance of plastic deformations of the models. Total displacements at the end of the bone and the stresses in the bones and plates were determined and compared. Maximal von Mises stress in bone for 3-part fracture models was very similar to that in 2-part fracture models. The biggest difference between models and the largest displacements were seen during volar loading. The stresses in all models were the highest above the fracture gap. The best performance in all parameters tested was with the Zrinski plate and the most modest results were with the Synthes T-plate. There was no significant difference between 2-part (AO/ASIF type 23-A3) and 3-part (AO/ASIF 23-C2) fracture models. Maximal stresses in the plates appeared above the fracture gap; therefore, it is worth considering the development of plates without screw holes above the gap. © 2017 Elsevier Ltd. All rights reserved.

Treatment for proximal humeral fractures with percutaneous plating: our first results.

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Imarisio, D; Trecci, A; Sabatini, L; Scagnelli, R

2013-06-01

Proximal humeral fractures are common lesions; there is no generally accepted strategy about the treatment for displaced and unstable two- to four-part fractures. We have nowadays many different surgical solutions, ranging from percutaneous pinning to shoulder arthroplasty. Percutaneous plating can be a good solution to treat some of these fractures using a minimally invasive technique and performing stable fixation that can allow early mobilization. Purpose of this paper is to evaluate the results of our first cases of percutaneous plating in proximal humeral fractures in order to assess the theoretical advantages and the incidence of possible complications. From June 2009 to February 2012, we treated 29 proximal humeral fractures with a percutaneous plating (NCB-PH plate) through an anterolateral deltoid split. For each patient, we evaluated the clinical outcome according to Constant score and the radiographic results, paying attention to fracture healing, loss of reduction, hardware complications, and head necrosis. The clinical evaluation gave a mean Constant score value of 79 points. Comparing each value to the unaffected shoulder, we could find these results: 7 excellent, 10 good, 8 fair, and 4 poor. No axillary nerve lesions were clinically detected. The radiographic evaluation showed a complete bone healing in all cases within the first 3 months. No head necrosis was detected, as well as screws loosening. In two cases, the X-ray at 2 months revealed a little loss of reduction in varus. Two patients had an anterior pain; in one of these two cases, the plate was removed. In our series, we had no cases of head necrosis, screws cutout, fracture collapse, hardware mobilization, and we think this could be the real advantage of the percutaneous technique compared to the open one, thanks to the reduced biological damage. We had some poor results, related more to patient's age than to other factors. The safety of the technique for the axillary nerve is

Treatment of proximal humerus fractures with locking plates: a systematic review.

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Thanasas, Christos; Kontakis, George; Angoules, Antonios; Limb, David; Giannoudis, Peter

2009-01-01

Locking plates with special configuration for the anatomic region of the proximal humerus have been introduced recently to address the difficulties of stabilizing proximal humeral fractures. The purpose of this study was to carry out a systematic review of the literature on the efficacy and early to medium term functional results of locking plates for stabilization of proximal humeral fractures. Using the PubMed database, a systematic review of the English and German literature was carried out in order to assess the efficacy and complications related to the use of these plates and the patients' functional outcome, using the key words "locking plates proximal humeral fractures," "angular stability plates proximal humeral fractures," "PHILOS plate," and "LPHP plate." Our criteria for eligibility were clinical studies with more than ten cases followed-up, adult patients, and adequate data provided at least in terms of implant related complications. Articles written in English and German language were included. Exclusion criteria were: studies dealing exclusively with 2-part fractures (since this category has a more favorable outcome); experimental studies; case reports; and, literature other than English or German. Each one of the articles was evaluated for quality of the study using the Structured Effectiveness Quality Evaluation Scale (SEQES). Twelve studies including 791 patients met the inclusion criteria. Patients in these studies continued to improve up to one year, achieving a mean Constant score of 74.3. The incidence of the reported complications was: avascular necrosis 7.9%, screw cut-out 11.6% and re-operation rate 13.7%. The high incidence of cut-out may be secondary to the rigidity of the implant in combination with medial inadequate support, in cases compromised by severe underlying osteoporotic bone. Definition of indications for the use of locking plates and attention on technical aspects of applying them would help optimization of the results

Perioperative lateral trochanteric wall fractures: sliding hip screw versus percutaneous compression plate for intertrochanteric hip fractures.

Science.gov (United States)

Langford, Joshua; Pillai, Gita; Ugliailoro, Anthony D; Yang, Edward

2011-04-01

This study was performed to determine the incidence of perioperative lateral wall fractures with a standard sliding hip screw (SHS) versus a percutaneous compression plate (PCCP) using identical meticulous closed reduction techniques in both groups. Retrospective analysis of a prospective trauma registry. Urban Level I trauma center. Over a 7-year period, 337 patients with intertrochanteric hip fractures were treated with either a SHS or a PCCP at our institution. The PCCP group (Group 1) consisted of 200 patients, of which 141 (71%) had adequate images to be included in the study. The SHS group (Group 2) consisted of 137 patients, of which 100 (73%) had adequate images to be included in the study. Closed reduction and plate application with either a standard sliding hip screw or a percutaneous compression plate for an Orthopaedic Trauma Association 31A1 or 31A2 intertrochanteric hip fracture. : Radiographic evidence of lateral trochanteric wall fracture as measured by intraoperative and perioperative radiographs. There was an overall lateral wall fracture incidence of 20% in the SHS group versus 1.4% in the PCCP group (P fracture types, there was a lateral wall fracture incidence of 29.8% in the SHS group versus 1.9% in the PCCP group (P trochanteric wall fracture compared with the SHS group. This difference became greater when just unstable intertrochanteric fractures were analyzed. An anatomic reduction, combined with a device (PCCP) that uses small-diameter defects in the lateral trochanteric wall, essentially eliminates perioperative lateral trochanteric wall fractures.

Locking plate fixation in distal metaphyseal tibial fractures: series of 79 patients.

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Gupta, Rakesh K; Rohilla, Rajesh Kumar; Sangwan, Kapil; Singh, Vijendra; Walia, Saurav

2010-12-01

Open reduction and internal fixation in distal tibial fractures jeopardises fracture fragment vascularity and often results in soft tissue complications. Minimally invasive osteosynthesis, if possible, offers the best possible option as it permits adequate fixation in a biological manner. Seventy-nine consecutive adult patients with distal tibial fractures, including one patient with a bilateral fracture of the distal tibia, treated with locking plates, were retrospectively reviewed. The 4.5-mm limited-contact locking compression plate (LC-LCP) was used in 33 fractures, the metaphyseal LCP in 27 fractures and the distal medial tibial LCP in the remaining 20 fractures. Fibula fixation was performed in the majority of comminuted fractures (n = 41) to maintain the second column of the ankle so as to achieve indirect reduction and to prevent collapse of the fracture. There were two cases of delayed wound breakdown in fractures fixed with the 4.5-mm LC-LCP. Five patients required primary bone grafting and three patients required secondary bone grafting. All cases of delayed union (n = 7) and nonunion (n = 3) were observed in cases where plates were used in bridge mode. Minimally invasive plate osteosynthesis (MIPO) with LCP was observed to be a reliable method of stabilisation for these fractures. Peri-operative docking of fracture ends may be a good option in severely impacted fractures with gap. The precontoured distal medial tibial LCP was observed to be a better tolerated implant in comparison to the 4.5-mm LC-LCP or metaphyseal LCP with respect to complications of soft tissues, bone healing and functional outcome, though its contour needs to be modified.

Fracture Characteristics Analysis of Double-layer Rock Plates with Both Ends Fixed Condition

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S. R. Wang

2014-07-01

Full Text Available In order to research on the fracture and instability characteristics of double-layer rock plates with both ends fixed, the three-dimension computational model of double-layer rock plates under the concentrated load was built by using PFC3D technique (three-dimension particle flow code, and the mechanical parameters of the numerical model were determined based on the physical model tests. The results showed the instability process of the double-layer rock plates had four mechanical response phases: the elastic deformation stage, the brittle fracture of upper thick plate arching stage, two rock-arch bearing stage and two rock-arch failure stage; moreover, with the rock plate particle radius from small to large change, the maximum vertical force of double rock-arch appeared when the particle size was a certain value. The maximum vertical force showed an upward trend with the increase of the rock plate temperature, and in the case of the same thickness the maximum vertical force increased with the increase of the upper rock plate thickness. When the boundary conditions of double-layer rock plates changed from the hinged support to the fixed support, the maximum horizontal force observably decreased, and the maximum vertical force showed small fluctuations and then tended towards stability with the increase of cohesive strength of double-layer rock plates.

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.

Posterior coronal plating for tibial fractures: technique and advantages

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Montu Jain

2014-04-01

Full Text Available Objective:Tibial shaft fractures are straightforward to treat but when associated with soft tissue injury particularly at the nail entry/plate insertion site or there is significant comminution proximally or a large butterfly fragment/a second split component in the posterior coronal plane, it is a challenge to the treating surgeon. The aim of the present report is to describe the technique of posterior coronal plating in such a scenario and its advantages. Methods:Between July 2008 and June 2011, 12 patients were pro spectively treated by this approach using 4.5 mm broad dynamic compression plates. Results:The time of bony consolidation and full weight bearing averaged 21.7 weeks (range, 16-26 weeks. Patients were followed up for at least 24 months (range, 24-48 months. At 1 year postoper atively, no loss in reduction or alignment was observed. Mean Hospital for Lower Extremity Measurement Functional Score was 72.8 (range, 64-78. All patients were satisfied with their treatment outcomes. Conclusion:Direct posterior approach and fixation using prone position helps to visualise the fracture fragments and provide rigid fixation. The approach is simple and extensile easily, apart from advantages of less soft tissue and hardware problems compared to standard medial or lateral plating. Key words: Tibial fractures; Bone plates; Orthopedic procedures

External fixation using locking plate in distal tibial fracture: a finite element analysis.

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Zhang, Jingwei; Ebraheim, Nabil; Li, Ming; He, Xianfeng; Schwind, Joshua; Liu, Jiayong; Zhu, Limei

2015-08-01

External fixation of tibial fractures using a locking plate has been reported with favorable results in some selected patients. However, the stability of external plate fixation in this fracture pattern has not been previously demonstrated. We investigated the stability of external plate fixation with different plate-bone distances. In this study, the computational processing model of external fixation of a distal tibial metaphyseal fracture utilizing the contralateral femoral less invasive stabilization system plate was analyzed. The plate was placed on the anteromedial aspect of tibia with different plate-bone distances: 1, 10, 20, and 30 mm. Under axial load, the stiffness of construct in all groups was higher than intact tibia. Under axial load with an internal rotational force, the stiffness of construct with 1 and 10 mm plate-bone distances was similar to that of an intact tibia and the stiffness of the construct with 20 and 30 mm distances was lower than that of an intact tibia. Under axial load with an external rotational force, the stiffness of the construct in all groups was lower than that of an intact tibia. The maximum plate stresses were concentrated at the two most distal screws and were highest in the construct with the 10 mm plate-bone distance, and least in the construct with a 1 mm plate-bone distance. To guarantee a stable external plate fixation in distal tibial fracture, the plate-bone distance should be less than 30 mm.

Comparison of circummandibular wiring with resorbable bone plates in pediatric mandibular fractures.

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Saikrishna, D; Gupta, Nimish

2010-06-01

Pediatric patients present a unique challenge to maxillofacial surgeons in terms of their treatment planning as well as in their functional and nutritional needs which are different from that of adult patients. Early literature has advocated conservative closed management of pediatric fractures to prevent complications. However recent advances in maxillofacial surgery has enabled us to use biodegradable plates and screws, which overcomes the limitations of metallic plates. We present a comparison of two cases of parasymphysis fracture treated with circum-mandibular wiring and biodegradable plate fixation their outcome in terms of fracture healing and functional stability.

Development plates for stable internal fixation: Study of mechanical resistance in simulated fractures of the mandibular condyle.

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Celegatti Filho, Tóride Sebastião; Rodrigues, Danillo Costa; Lauria, Andrezza; Moreira, Roger William Fernandes; Consani, Simonides

2015-01-01

To develop Y-shaped plates with different thicknesses to be used in simulated fractures of the mandibular condyle. Ten plates were developed in Y shape, containing eight holes, and 30 synthetic polyurethane mandible replicas were developed for the study. The load test was performed on an Instron Model 4411 universal testing machine, applying load in the mediolateral and anterior-posterior positions on the head of the condyle. Two-way ANOVA with Tukey testing with a 5% significance level was used. It was observed that when the load was applied in the medial-lateral plate of greater thickness (1.5 mm), it gave the highest strength, while in the anteroposterior direction, the plate with the highest resistance was of the lesser thickness (0.6 mm). A plate with a thickness of 1.5 mm was the one with the highest average value for all displacements. In the anteroposterior direction, the highest values of resistance were seen in the displacement of 15 mm. After comparing the values of the biomechanical testing found in the scientific literature, it is suggested that the use of Y plates are suitable for use in subcondylar fractures within the limitations of the study. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Evaluation of Bone Atrophy After Treatment of Forearm Fracture Using Nonlinear Finite Element Analysis: A Comparative Study of Locking Plates and Conventional Plates.

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Matsuura, Yusuke; Rokkaku, Tomoyuki; Suzuki, Takane; Thoreson, Andrew Ryan; An, Kai-Nan; Kuniyoshi, Kazuki

2017-08-01

Forearm diaphysis fractures are usually managed by open reduction internal fixation. Recently, locking plates have been used for treatment. In the long-term period after surgery, some patients present with bone atrophy adjacent to the plate. However, a comparison of locking and conventional plates as a cause of atrophy has not been reported. The aim of this study was to investigate long-term bone atrophy associated with use of locking and conventional plates for forearm fracture treatment. In this study we included 15 patients with forearm fracture managed by either locking or conventional plates and with more than 5 years of follow-up. Computed tomographic imaging of both forearms was performed to assess bone thickness and local bone mineral density and to predict bone strength without plate reinforcement based on finite element analysis. Mean patient age at surgery was 48.0 years. Eight patients underwent reduction with fixed locking plates and were followed up for a mean of 79.5 months; the remaining 7 patients were treated with conventional plates and were followed up for a mean of 105.0 months. Compared with the conventional plate group, the locking plate group had the same fractured limb-contralateral limb ratio of cortex bone thickness, but had significantly lower ratios of mineral density adjacent to the plate and adjusted bone strength. This study demonstrated bone atrophy after locking plate fixation for forearm fractures. Treatment plans for forearm fracture should take into consideration the impact of bone atrophy long after plate fixation. Therapeutic IV. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Surgical repair of skull fractures in four horses using cuttable bone plates.

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Dowling, B A; Dart, A J; Trope, G

2001-05-01

Three horses with severely comminuted, open facial bone fractures and one horse with a comminuted, open orbital rim fracture were referred for treatment. Severe facial bone asymmetry and epistaxis were apparent in all cases and subcutaneous emphysema was present in two, however physical and neurological examinations were otherwise normal. Radiography and endoscopy were of some use in assessing the degree of damage, although the true extent of the damage was more apparent at surgery. Surgical reduction of the fractures was recommended to maximise cosmetic and functional outcome. After surgical debridement and reduction of the fractures the bone fragments remained unstable and were not amenable to stabilisation with interfragmentary wires alone, so 2 mm cuttable bone plates were used to maintain fracture alignment. Screw migration occurred in three horses and in one of these horses the plate had to be removed. Other complications were minor and in all horses the fractures healed with good cosmetic and functional outcome. The use of cuttable bone plates should be considered as a reasonable alternative to inter-fragmentary wiring for unstable, comminuted fractures of the facial bones, even where fractures are open.

To evaluate the efficacy of biodegradable plating system for fixation of maxillofacial fractures: A prospective study.

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Bali, Rishi K; Sharma, Parveen; Jindal, Shalu; Gaba, Shivani

2013-07-01

The present study was undertaken to evaluate the efficacy of biodegradable plating system for fixation of maxillofacial fractures and to study the morbidity associated with the use of biodegradable plates and screws. This prospective study consisted of 10 patients with maxillofacial fractures requiring open reduction and internal fixation. Fractures with infection, comminuted and pathological fractures were excluded. All were plated with biodegradable system (Inion CPS) using standard plating principles and observed for a total period of 24 weeks. Characteristics of the fractures, ease of use of bioresorbable plate/screw system and post operative complications were assessed. Of total 10 patients, eight patients were of midface fracture and two pediatric patients with mandibular fracture, with nine male and one female. The mean age was 32.8 years. Out of 20 plates and 68 screws applied to the 10 fractures sites; there were three incidences of screw breakage with no other intraoperative difficulties. Paresthesia of the infraorbital nerve was present in two patients, and recovered completely in four weeks after surgery. Fracture reduction was considered to be satisfactory in all cases. One patient developed postsurgical infection and was managed with oral antibiotics and analgesics. Favorable healing can be observed through the use of biodegradable plates and screws to stabilize selected midface fractures in patients of all ages, as well as mandible fractures in early childhood, however further studies with more sample size are required.

Non-linear finite element analyses of wide plate fracture mechanics experiments

International Nuclear Information System (INIS)

Harrop, L.P.; Gibson, S.

1988-06-01

A series of centre-cracked, wide plate fracture mechanics tests is being conducted with plates made from 0.36% carbon steel. This report gives an account of post-test finite element analyses performed to compare with the results of one of these tests (designated CSTP4) and a pre-test analysis of the next test which has a slightly different geometry (CSTP5). The plates are relatively thick (75mm) and have a width of 1.62m. The finite element analyses use a two-dimensional plane stress mesh. The work shows good agreement between the post-test analysis results and the overall experimental results for CSTP4. It is not expected that the analysis results will be accurate within the dimensions of the process zone ahead of the crack tip; the mesh is not sufficient for this. A vital ingredient in attaining the good overall agreement is the representation of the actual stress-strain curve of the material. The predicted response of test CSTP5 is markedly different from that of CSTP4 even though the only change is the increase in the height of the plate. In particular the shape and size of the plastic zone ahead of the crack tip is quite different in the two tests at the same nominal remote applied load. (author)

Clinical use of AO three-dimensionally preformed titanium mesh plates for orbital fractures

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Ming Chen

2015-01-01

Full Text Available AIM:To evaluate the accuracy and practicability of three-dimensionally preformed Arbeitsgemeinschaft Osteosynthese AO titanium mesh plates for orbital fractures.METHODS:Forty-seven patients with isolated blow-out orbital fractures were included in this study. Fracture locations were as follows: floor/medial wall(n=26, 55%, medial wall(n=12, 26%, and floor(n=9, 19%. The floor fractures were exposed by a standard transconjunctival approach, whereas a combined transcaruncular transconjunctival approach was used in patients with medial wall fractures with temporary dissection of inferior oblique muscle. A three-dimensionally preformed AO titanium mesh plate was selected according to the size of the defect previously measured on the preoperative computed tomographic scan examination and fixed at the inferior orbital rim with 2 screws. The accuracy of plate positioning of the reconstructed orbit was assessed on the postoperative computed tomography(CTscan. The practicability of clinical use of AO three-dimensionally preformed titanium mesh plates was assessed on the preoperative and postoperative clinical data.RESULTS: Postoperative orbital CT scan showed an anatomic three-dimensional placement of the orbital mesh plates in all of the patients. All patients had a successful treatment outcome without clinical complications. 40 patients(87%had a successful enophthalmos correction. 25 patients(86%had a successful recovery from diplopia.CONCLUSION: Three-dimensionally preformed AO titanium mesh plates for orbital fracture reconstruction results in an accurate anatomic restoration of the bony orbital contour with a high rate of success to correctenophthalmos and diplopia.

Plasticity, Fracture and Friction in Steady-State Plate Cutting

DEFF Research Database (Denmark)

Simonsen, Bo Cerup; Wierzbicki, Tomasz

1997-01-01

perpendicular to the direction of motion is derived theoretically in a consistent manner. The perpendicular reaction force is of paramount importance for prediction the structural damage of a ship hull because it governs the vertical ship motion and rock penetration which is strongly coupled with the horizontal...... extension of the presented plate model to include more structural members as for example the stiffeners attached to a ship bottom plating. The fracture process is discussed and the model is formulated partly on the basis of the material fracture toughness. The effect of friction and the reaction force...

Operative treatment of intra-articular calcaneal fractures with calcaneal plates and its complications

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Rak Vaclav

2009-01-01

Full Text Available Background: In a retrospective study we analysed intra-articular calcaneal fracture treatment by comparing results and complications related to fracture stabilization with nonlocking calcaneal plates and locking compression plates. Materials and Methods: We performed 76 osteosynthesis (67 patients of intra-articular calcaneal fractures using the standard extended lateral approach from February 2004 to October 2007. Forty-two operations using nonlocking calcaneal plates (group A were performed during the first three years, and 34 calcaneal fractures were stabilized using locking compression plates (group B in 2007. In the Sanders type IV fractures, reconstruction of the calcaneal shape was attempted. Depending on the type of late complication, we performed subtalar arthroscopy in six cases, arthroscopically assisted subtalar distraction bone block arthrodesis in six cases, and plate removal with lateral-wall decompression in five cases. The patients were evaluated by the AOFAS Ankle-Hindfoot Scale. Results: Wound healing complications were 7/42 (17% in group A and 1/34 (3% in group B. No patient had deep osseous infection or foot rebound compartment syndrome. Preoperative size of Bφhler´s angle correlated with postoperative clinical results in both groups. There were no late complications necessitating corrective procedure or arthroscopy until December 2008 in Group B. All late complications ccurred in Group A. The overall results according to the AOFAS Ankle Hindfoot Scale were good or excellent in 23/42 (55% in group A and in 30/34 (85% in group B. Conclusion: Open reduction and internal fixation of intra-articular calcaneal fractures has become a standard surgical method. Fewer complications and better results related to treatment with locking compression plates confirmed in comparison to nonlocking ones were noted for all Sanders types of intra-articular calcaneal fractures. Age and Sanders type IV fractures are not considered to be the

"A" shape plate for open rigid internal fixation of mandible condyle neck fracture.

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Kozakiewicz, Marcin; Swiniarski, Jacek

2014-09-01

Reduction of the fracture is crucial for proper outcome of the treatment. The stability of reduction is closed connected to the method of its fixation. The topic of condylar fracture osteosynthesis still remains highly controversial and challenging. That is why authors decided to propose novel design of the fixating plate and the example of its application. The aim of this study was to present A-shape plate dedicated to rigid fixation of mandible condyle neck fracture. A-shape condylar plate (ACP) design is prepared of 1.0 mm thick titanium alloy (grade 5) sheet: posterior and anterior bars are reinforced by widening to 2.5 mm and anatomically curved along the compression and traction lines in ramus and condylar neck. Superior three-hole-group has triangular organization and located on the level of condylar head. The inferior extensions of the bars are equipped in three holes located at each of lower tails. Connecting bar (2.0 mm wide) connects the first hole of each lower tails closing upper part of ACP in triangular shape. The connecting bar runs along compression line of condylar neck. Holes in ACP has 2.0 mm diameter for locking or normal screws. Height of ACP is 31 mm. The proposed new type of plate was compared by finite element analysis (FEA) to nowadays manufactured 9-hole trapezoid plate as the most similar device. ACP design was evaluated by finite element analysis (FEA) and later applied in patient affected with high condylar neck fracture complicated by fracture of coronoid process. FEA revealed high strength of ACP and more stabile fixation than trapezoid plate. The result was caused by multipoint fixation at three regions of the plate and reinforced bars supported by semi-horizontal connecting bar. Clinical application of ACP was as versatile as makes possible to simultaneous fixation of high condylar neck and coronoid process fracture. Application of proposed A-shape condylar plate would be possible in all levels of neck fractures and can be use

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

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

2010-03-01

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

A prospective randomized study of operative treatment for noncomminuted humeral shaft fractures: conventional open plating versus minimal invasive plate osteosynthesis.

Science.gov (United States)

Kim, Ji Wan; Oh, Chang-Wug; Byun, Young-Soo; Kim, Jung Jae; Park, Ki Chul

2015-04-01

To compare the clinical and radiologic results of conventional open plating (COP) and minimally invasive plate osteosynthesis (MIPO) in the treatment of noncomminuted humeral shaft fractures. Randomized prospective study. Five level 1 trauma centers. Sixty-eight consecutive patients were randomized into 2 study groups: those treated by COP (COP group; n = 32) and those treated by MIPO (MIPO group; n = 36). Simple humeral shaft fractures (AO/OTA classification types A and B) were reduced by open reduction or closed reduction and fixed with a narrow 4.5/5.0 locking compression plate, metaphyseal locking compression plate, or proximal humeral internal locking system plate to the anterior lateral aspect of the humerus. Fracture healing time, operative time, radiation exposure time, and intraoperative nerve injury. To assess shoulder and elbow function, we used the University of California, Los Angeles (UCLA) scoring system and the Mayo elbow performance index, including the range of motion and pain. Radiographic measurements included fracture alignment, delayed union, and nonunion. Thirty-one fractures (97%) healed in the COP group within 16 weeks, whereas 36 fractures (100%) were healed in the MIPO group by 15 weeks. No significant difference was observed in the operative time or complication rates. In both groups, all fractures achieved union without malunion and with excellent functional outcomes by definition of the Mayo elbow performance index and UCLA scoring system. This study confirmed a high overall rate of union and excellent functional outcomes in both MIPO and COP groups. MIPO is equivalent to COP as a safe and effective method for simple types of humeral shaft fractures when surgery is indicated, and the surgeon is experienced in the technique. Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.

Biomechanical in vitro assessment of screw augmentation in locked plating of proximal humerus fractures.

Science.gov (United States)

Röderer, Götz; Scola, Alexander; Schmölz, Werner; Gebhard, Florian; Windolf, Markus; Hofmann-Fliri, Ladina

2013-10-01

Proximal humerus fracture fixation can be difficult because of osteoporosis making it difficult to achieve stable implant anchorage in the weak bone stock even when using locking plates. This may cause implant failure requiring revision surgery. Cement augmentation has, in principle, been shown to improve stability. The aim of this study was to investigate whether augmentation of particular screws of a locking plate aimed at a region of low bone quality is effective in improving stability in a proximal humerus fracture model. Twelve paired human humerus specimens were included. Quantitative computed tomography was performed to determine bone mineral density (BMD). Local bone quality in the direction of the six proximal screws of a standard locking plate (PHILOS, Synthes) was assessed using mechanical means (DensiProbe™). A three-part fracture model with a metaphyseal defect was simulated and fixed with the plate. Within each pair of humeri the two screws aimed at the region of the lowest bone quality according to the DensiProbe™ were augmented in a randomised manner. For augmentation, 0.5 ml of bone cement was injected in a screw with multiple outlets at its tip under fluoroscopic control. A cyclic varus-bending test with increasing upper load magnitude was performed until failure of the screw-bone fixation. The augmented group withstood significantly more load cycles. The correlation of BMD with load cycles until failure and BMD with paired difference in load cycles to failure showed that augmentation could compensate for a low BMD. The results demonstrate that augmentation of screws in locked plating in a proximal humerus fracture model is effective in improving primary stability in a cyclic varus-bending test. The augmentation of two particular screws aimed at a region of low bone quality within the humeral head was almost as effective as four screws with twice the amount of bone cement. Screw augmentation combined with a knowledge of the local bone quality

An alternative method in mandibular fracture treatment: bone graft use instead of a plate.

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Alagöz, Murat Sahin; Uysal, Ahmet Cagri; Sensoz, Omer

2008-03-01

In the treatment of the mandibular fractures, one of the main principles is to use the least amount of foreign material. We present an alternative technique that the bone grafts harvested from the fracture borders or from the iliac crest were used instead of plates and the fixation was done with screws. In the study including 24 mandible fractures, the bone grafts harvested from the fracture borders were used in the 10 favorable fractures and the bone grafts harvested from the iliac crest were used in the 14 unfavorable fractures. In the combined mandible fractures, four fractures were fixated with titanium plates and the other side with the bone graft. The patients, who were followed up for 12 to 20 months, were evaluated with macroscopic occlusion, panoramic graphs, and three-dimensional computerized tomographs. The advantage of this technique of fixation with the autogenous tissue is reduced infection rates and reduced operation costs. In the pediatric patients, the second session operation of plate removal is not necessary.

To evaluate the efficacy of biodegradable plating system for fixation of maxillofacial fractures: A prospective study

OpenAIRE

Bali, Rishi K.; Sharma, Parveen; Jindal, Shalu; Gaba, Shivani

2013-01-01

Aims: The present study was undertaken to evaluate the efficacy of biodegradable plating system for fixation of maxillofacial fractures and to study the morbidity associated with the use of biodegradable plates and screws. Materials and Methods: This prospective study consisted of 10 patients with maxillofacial fractures requiring open reduction and internal fixation. Fractures with infection, comminuted and pathological fractures were excluded. All were plated with biodegradable system (Inio...

Relationship between plate removal and Soong grading following surgery for fractured distal radius

NARCIS (Netherlands)

Selles, Caroline A.; Reerds, Sam T. H.; Roukema, Gert; van der Vlies, Kees H.; Cleffken, Berry I.; Schep, Niels W. L.

2018-01-01

The aim of this study was to determine the relationship between volar plate removal and the Soong classification following fixation for fractured distal radius. In this retrospective cohort study, all consecutive patients who had volar plate fixation for a distal radius fracture in 2011-2015 were

Femoral fracture repair using a locking plate technique in an adult captive polar bear (Ursus maritimus).

Science.gov (United States)

Zimmerman, Dawn M; Dew, Terry; Douglass, Michael; Perez, Edward

2010-02-01

To report successful femoral fracture repair in a polar bear. Case report. Female polar bear (Ursus maritimus) 5 years and approximately 250 kg. A closed, complete, comminuted fracture of the distal midshaft femur was successfully reduced and stabilized using a compression plating technique with 2 specialized human femur plates offering axial, rotational, and bending support, and allowing the bone to share loads with the implant. Postoperative radiographs were obtained at 11.5 weeks, 11 months, and 24 months. Bone healing characterized by marked periosteal reaction was evident at 11 months with extensive remodeling evident at 24 months. No complications were noted. Distal mid shaft femoral fracture was reduced, stabilized, and healed in an adult polar bear with a locking plate technique using 2 plates. Previously, femoral fractures in polar bears were considered irreparable. Use of 2 plates applied with a locking plate technique can result in successful fracture repair despite large body weight and inability to restrict postoperative activity.

Effectiveness of sonography assisted minimal invasive plate osteosynthesis (MIPO) compare with fluoroscope assisted in femoral shaft fracture: A cadaveric study.

Science.gov (United States)

Saengsin, Jirawat; Vaseenon, Tanawat; Pattamapaspong, Nuttaya; Kritsaneephaiboon, Apipop

2017-08-01

A minimal invasive plate osteosynthesis (MIPO) has an advantage of biological soft tissue preservation that consists of preserving bony blood supply, fracture hematoma and less soft tissue damage which leads to decreasing of infection rate and rapid bone healing. However, the radiation exposure is still a disadvantage of this technique. A sonography that provides dynamic real time imaging may be used as an alternative technique for assisting MIPO. The aim of this study was to compare the effectiveness of MIPO in femoral shaft fracture between the sonography assisted and the fluoroscopy assisted. Twenty-eight cadaveric limbs were subjected to create femoral shaft fracture. Then, sonography assisted reduction with temporary external fixation and MIPO were performed. Images of the sonography and the fluoroscopy were recorded including before reduction, after reduction and after MIPO in order to identify fracture displacements in anteroposterior and mediolateral directions. Moreover, the anterior and posterior distances from edge of the bone to the plate were measured to confirm plate position. The effectiveness of this technique was defined as the proper plate position and acceptable alignment after fixation. All distances from the sonography and the fluoroscopy were also analyzed and compared using Pearson correlation and Bland-Altman method to assess the agreements between two tests. All of the subjects were met the criteria for acceptable alignment. We found only three femoral shaft fracture (11%) operated with MIPO by sonography assisted that showed slipped plate off femoral bones. According to Pearson correlation, there were good to excellent agreements in term of measuring fracture displacement before (Pearson Correlation >0.7) and after reduction (Pearson Correlation >0.7) between these two tests. There was moderate agreement regarding to evaluation of plate position (Pearson Correlation 03.-0.7). When we compared two methods of measurement using Bland

Minimally-invasive plate osteosynthesis in distal tibial fractures: Results and complications.

Science.gov (United States)

Vidović, Dinko; Matejčić, Aljoša; Ivica, Mihovil; Jurišić, Darko; Elabjer, Esmat; Bakota, Bore

2015-11-01

Distal tibial or pilon fractures are usually the result of combined compressive and shear forces, and may result in instability of the metaphysis, with or without articular depression, and injury to the soft tissue. The complexity of injury, lack of muscle cover and poor vascularity make these fractures difficult to treat. Surgical treatment of distal tibial fractures includes several options: external fixation, IM nailing, ORIF and minimally-invasive plate osteosynthesis (MIPO). Management of distal tibial fractures with MIPO enables preservation of soft tissue and remaining blood supply. This is a report of a series of prospectively studied closed distal tibial and pilon fractures treated with MIPO. A total of 21 patients with closed distal tibial or pilon fractures were enrolled in the study between March 2008 and November 2013 and completed follow-up. Demographic characteristics, mechanism of injury, time required for union, ankle range of motion and complications were recorded. Fractures were classified according to the AO/OTA classification. Nineteen patients were initially managed with an ankle-spanning external fixator. When the status of the soft tissue had improved and swelling had subsided enough, a definitive internal fixation with MIPO was performed. Patients were invited for follow-up examinations at 3 and 6 weeks and then at intervals of 6 to 8 weeks until 12 months. Mean age of the patients was 40.1 years (range 19-67 years). Eighteen cases were the result of high-energy trauma and three were the result of low-energy trauma. According to the AO/OTA classification there were extraarticular and intraarticular fractures, but only simple articular patterns without depression or comminution. The average time for fracture union was 19.7 weeks (range 12-38 weeks). Mean range of motion was 10° of dorsiflexion (range 5-15°) and 28.3° of plantar flexion (range 20-35°). Three cases were metalwork-related complications. Two patients underwent plate removal

Supraglenoid tubercle fractures repair with transverse locking compression plates in 4 horses.

Science.gov (United States)

Ahern, B J; Bayliss, I P M; Zedler, S T; Getman, L M; Richardson, D W

2017-05-01

To report on a series of 4 horses with supraglenoid tubercle fractures repaired with locking compression plates. Case series. Four horses ranging in age from 6 weeks to 20 months and weighing from 121 to 425 kg with supraglenoid tubercle fractures of 1 day to 6 weeks in duration. Supraglenoid tubercle fractures were reduced and stabilized with transversely positioned locking compression plate(s) with and without additional tension band wiring. All fractures reached bony union. Two postoperative surgical site infections were managed with drainage and antibiotherapy. Three of the 4 horses continued onto athletic careers including flat racing, dressage, and hunter/jumper competition. The remaining horse was lame for a prolonged period, but was sound at 4 years. The application of one or two, transversely positioned LCPs should be considered for the repair of SGT fractures because of the relative ease of the technique, and its elimination of a biceps brachii tenotomy. All screws can be inserted in a lateral to medial direction without transection or drill penetration of the biceps brachii tendon. SGT fractures of various durations can be repaired in a wide range of horses with transversely positioned LCPs, and allow return to athletic function. © 2017 The American College of Veterinary Surgeons.

A FUNCTIONAL EVALUATION STUDY OF DISTAL FEMORAL FRACTURES FIXED WITH DISTAL FEMORAL LOCKING PLATE

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Manikumar C. J

2017-04-01

Full Text Available BACKGROUND Fractures of the distal femur present considerable challenges in management. Older patients especially women sustain fractures due to osteoporosis. Supracondylar fractures of femur have a bimodal distribution. They account for 6% of all femur fractures and 31% if hip fractures were excluded. Nearly, 50% of distal femur intra-articular fractures are open fractures. Before 1970, most supracondylar fractures were treated nonoperatively; however, difficulties were often encountered including persistent angulatory deformity, knee joint incongruity, loss of knee motion and delayed mobilisation. The trend of open reduction and internal fixation has become evident in recent years with good results being obtained with AO blade plate, dynamic condylar screw, intramedullary supracondylar nail and locking compression plate. Elderly patients and osteoporosis pose difficulty in treating intra-articular fractures of the lower end of femur. Loss of stable fixation is of great concern in these cases. Hence, locking compression plate use has an advantage in these patients. MATERIALS AND METHODS In this study, 20 patients with closed fracture of distal femur were studied. All the cases were treated at the Department of Orthopaedics, Rangaraya Medical College/Government General Hospital, Kakinada, Andhra Pradesh, between November 2013 and November 2015. The method used for fracture fixation was open reduction and internal fixation with distal femoral locking plate. The duration of follow up ranged from 3 months to 24 months. All the fractures in this series were posttraumatic. The patients were functionally evaluated with Neer’s scoring system. 1 RESULTS Twenty distal femoral fractures were treated with distal femoral locking plates. 15 patients were males and 5 patients were females. The median age was 47 years ranging from 28-70 years. 16 of the fractures were caused by road traffic accidents and 2 were due to fall, 2 were due to assault. 12 patients

Philosophy, design and testing of a uniform applied load flat plate testing machine

International Nuclear Information System (INIS)

Quirk, A.; Crook, C.

1976-08-01

The presence of a central crack, and its associated plastic zones may significantly affect distribution of the stress applied by a loading machine, to a test plate. As a result the fracture stress may be affected, usually optimistically. Examples of these effects are discussed. The design of a machine in which the load is uniformly applied to the test specimen is described and preliminary test data presented. (author)

Comparative evaluation of 2.3 mm locking plate system vs conventional 2.0 mm non locking plate system for mandibular condyle fracture fixation: a seven year retrospective study.

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Zhang, J; Wang, X; Wu, R-H; Zhuang, Q-W; Gu, Q P; Meng, J

2015-01-01

This retrospective study evaluated the efficacy of a 2.3 mm locking plate/screw system compared with a 2.0-mm non-locking plate/screw system in fixation of isolated non comminuted mandibular condyle fractures. Surgical records of 101 patients who received either a 2.3 mm locking plate (group A, n = 51) or 2.0 mm non locking plate (group B, n = 50) were analyzed. All patients were followed up to a minimum of 6 months postoperatively and evaluated for hardware related complications, occlusal stability, need for and duration of MMF and mandibular functional results. Four complications occurred in the locking group and eighteen in the non locking group with complication rates equalling 8% and 36% respectively. When comparing the overall results according to plates used, the χ2 test showed a statistically significant difference between the locking and non locking plates (p Mandibular condyle fractures treated with a 2.3 mm locking plate exhibited stable osteosynthesis, were associated with minimal complications and resulted in acceptable mandibular range of motion compared with a 2.0 mm non locking plate.

Tension Band Plating for Chronic Anterior Tibial Stress Fractures in High-Performance Athletes.

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Zbeda, Robert M; Sculco, Peter K; Urch, Ekaterina Y; Lazaro, Lionel E; Borens, Olivier; Williams, Riley J; Lorich, Dean G; Wellman, David S; Helfet, David L

2015-07-01

Anterior tibial stress fractures are associated with high rates of delayed union and nonunion, which can be particularly devastating to a professional athlete who requires rapid return to competition. Current surgical treatment strategies include intramedullary nailing, which has satisfactory rates of fracture union but an associated risk of anterior knee pain. Anterior tension band plating is a biomechanically sound alternative treatment for these fractures. Tension band plating of chronic anterior tibial stress fractures leads to rapid healing and return to physical activity and avoids the anterior knee pain associated with intramedullary nailing. Case series; Level of evidence, 4. Between 2001 and 2013, there were 13 chronic anterior tibial stress fractures in 12 professional or collegiate athletes who underwent tension band plating after failing nonoperative management. Patient charts were retrospectively reviewed for demographics, injury history, and surgical details. Radiographs were used to assess time to osseous union. Follow-up notes and phone interviews were used to determine follow-up time, return to training time, and whether the patient was able to return to competition. Cases included 13 stress fractures in 12 patients (9 females, 3 males). Five patients were track-and-field athletes, 4 patients played basketball, 2 patients played volleyball, and 1 was a ballet dancer. Five patients were Division I collegiate athletes and 7 were professional or Olympic athletes. Average age at time of surgery was 23.6 years (range, 20-32 years). Osseous union occurred on average at 9.6 weeks (range, 5.3-16.9 weeks) after surgery. Patients returned to training on average at 11.1 weeks (range, 5.7-20 weeks). Ninety-two percent (12/13) eventually returned to preinjury competition levels. Thirty-eight percent (5/13) underwent removal of hardware for plate prominence. There was no incidence of infection or nonunion. Anterior tension band plating for chronic tibial stress

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

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

2013-06-01

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

Complications associated with distraction plate fixation of wrist fractures.

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Hanel, Douglas P; Ruhlman, Scott David; Katolik, Leo I; Allan, Christopher H

2010-05-01

This article discusses the major and minor complications of distal plating in the light of a cohort study carried out by the authors, who reviewed all patients undergoing bridge distraction plate fixation of distal radius fractures by three surgeons in a single level I trauma center. The article discusses the effectiveness and the complication rates associated with the technique. Copyright (c) 2010 Elsevier Inc. All rights reserved.

Adult periarticular locking plates for the treatment of pediatric and adolescent subtrochanteric hip fractures.

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Sanders, Samuel; Egol, Kenneth A

2009-01-01

Two cases are presented in which adult, precontoured, lower-extremity periarticular locking plates were utilized for fixation of subtrochanteric femur fractures in pediatric patients. Recognition of the fact that a distal tibial locking plate in a small child and a proximal tibial locking plate in an adolescent anatomically ft the proximal femur in each case may provide a surgeon treating subtrochanteric hip fractures in this population increased options for operative stabilization.

Minimally invasive plate osteosynthesis of humeral shaft fractures: a technique to aid fracture reduction and minimize complications.

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Shin, Sang-Jin; Sohn, Hoon-Sang; Do, Nam-Hoon

2012-10-01

To introduce a modified operative technique for minimally invasive plate osteosynthesis (MIPO) for acute displaced humeral shaft fractures and to evaluate the clinical and radiological outcomes. : Prospective clinical series study. University hospital. Twenty-one patients with acute displaced humeral shaft fractures were treated by MIPO with a modified fracture reduction technique. A narrow 4.5/5.0-mm locking compression plate was applied to the anterior aspect of the humerus. Fracture reduction and manipulation were performed using a plate and drill bits. The operating time, time to union, humeral alignment, and functional outcome of the shoulder and elbow joints were evaluated using the University of California Los Angeles shoulder score and Mayo elbow performance score. No patient experienced a neurological complication. Bony union was obtained in 20/21 patients at a mean 17.5 weeks postoperatively. Eighteen patients had excellent and 3 patients had good results in the University of California Los Angeles score. The average Mayo elbow performance score was 97.5. Two patients were converted to an open reduction during operation due to a failure of MIPO. There was 1 nonunion and 1 malunion in this series. Although the MIPO technique for humeral shaft fractures is technically demanding, satisfactory clinical outcomes in terms of bony union and shoulder and elbow function can be obtained using the modified fracture reduction method. Potential postoperative complications, such as malreduction and nonunion, must be considered. Appropriate surgical indications, a thorough understanding of the neurovascular anatomy and skillful surgical technique, are needed to reduce potential complications.

Dorsal bridge plating or transarticular screws for Lisfranc fracture dislocations.

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Kirzner, N; Zotov, P; Goldbloom, D; Curry, H; Bedi, H

2018-04-01

Aims The aim of this retrospective study was to compare the functional and radiological outcomes of bridge plating, screw fixation, and a combination of both methods for the treatment of Lisfranc fracture dislocations. Patients and Methods A total of 108 patients were treated for a Lisfranc fracture dislocation over a period of nine years. Of these, 38 underwent transarticular screw fixation, 45 dorsal bridge plating, and 25 a combination technique. Injuries were assessed preoperatively according to the Myerson classification system. The outcome measures included the American Orthopaedic Foot and Ankle Society (AOFAS) score, the validated Manchester Oxford Foot Questionnaire (MOXFQ) functional tool, and the radiological Wilppula classification of anatomical reduction. Results Significantly better functional outcomes were seen in the bridge plate group. These patients had a mean AOFAS score of 82.5 points, compared with 71.0 for the screw group and 63.3 for the combination group (p bridge plate group, 38.1 in the screw group, and 45.5 in the combination group (p bridge plating have better functional and radiological outcomes than those treated with transarticular screws or a combination technique. Cite this article: Bone Joint J 2018;100-B:468-74.

Locking compression plate osteosynthesis of complicated mandibular fractures in six horses.

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Kuemmerle, J M; Kummer, M; Auer, J A; Nitzl, D; Fürst, A E

2009-01-01

Complicated mandibular fractures were recognised in one foal, one pony and four horses. The foal was two months old while the adult animals ranged in age from 12 to 24 years. Three horses had a unilateral horizontal ramus fracture. Two fractures were open and one was closed. Comminution was present in one of these patients while the other two horses had marked displacement of the fragments. Two suffered from comminuted fractures of the horizontal and vertical ramus of the mandible. One of these patients had open and infected fractures. One foal had a bilateral horizontal ramus fracture with marked periosteal 'new bone' formation and malalignement which required corrective osteotomy. Each horse underwent locking compression plate (LCP) osteosynthesis consisting of open fracture reduction and application of one to three 4.5/5.0 mm LCP at the ventral, lateral or caudal aspect of the mandible under fluoroscopic control. Two 3.5 mm LCP were used in the foal. Plate fixation was supported by application of a cerclage wire construct between the incisor and premolar teeth in most patients. Complete fracture healing, with an excellent functional and cosmetic outcome, was achieved in all of the patients. Complications encountered included seroma formation, screw and wire breakage, as well as implant and apical tooth root infections. The LCP was removed after fracture healing had occurred in four patients.

Two peg spade plate for distal radius fractures A novel technique

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Sharad M Hardikar

2015-01-01

Conclusions: The two peg volar spade plate provides a stable subchondral support in comminuted intraarticular fractures and maintains reduction in osteoporotic fractures of the distal radius. Early mobilization with this implant helps in restoring wrist motion and to prevent development of wrist stiffness.

Finite element analysis of functionally graded bone plate at femur bone fracture site

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Satapathy, Pravat Kumar; Sahoo, Bamadev; Panda, L. N.; Das, S.

2018-03-01

This paper focuses on the analysis of fractured Femur bone with functionally graded bone plate. The Femur bone is modeled by using the data from the CT (Computerized Tomography) scan and the material properties are assigned using Mimics software. The fracture fixation plate used here is composed of Functionally Graded Material (FGM). The functionally graded bone plate is considered to be composed of different layers of homogeneous materials. Finite element method approach is adopted for analysis. The volume fraction of the material is calculated by considering its variation along the thickness direction (z) according to a power law and the effective properties of the homogeneous layers are estimated. The model developed is validated by comparing numerical results available in the literature. Static analysis has been performed for the bone plate system by considering both axial compressive load and torsional load. The investigation shows that by introducing FG bone plate instead of titanium, the stress at the fracture site increases by 63 percentage and the deformation decreases by 15 percentage, especially when torsional load is taken into consideration. The present model yields better results in comparison with the commercially available bone plates.

Stability of midface fracture repair using absorbable plate and screw system pilot holes drilled and pin placement at angles other than 90°.

Science.gov (United States)

Carron, Michael A; Zuliani, Giancarlo; Pereira, Lucio; Abuhamdan, Maher; Thibault, Adrianna; Dau, Nathan; Bir, Cynthia

2014-01-01

Conventional plating systems use titanium plates for fixation of fractures, with benefits of strength and biocompatibility. However, titanium plates require that screws be placed at a 90° angle to the pilot holes. In the midface, this becomes extremely difficult. Today, a variety of craniomaxillofacial osteosynthesis systems are available, including resorbable plating systems. Specifically, the KLS Martin Sonic Weld system ultrasonically fuses the plate and the head of the pin when placed and will fill the pilot hole grooves completely even at less than 90° angles, which provides a tremendous advantage in midface fracture repair. To determine if the KLS Martin Sonic Weld system provides plate-screw construct stability in human heads even when placed at acute angles at the midface buttresses. DESIGN, SETTING, AND SPECIMENS: Twenty cadaveric head specimens with the mandible removed were prepared by creating osteotomies in the midface buttresses bilaterally. Specimens were defleshed and placed in a 2-part testing rig to hold and position the head for testing in a standard material testing system. Testing was performed at the Wayne State University Bioengineering test laboratories, Detroit, Michigan, using an Instron device and high-speed camera. Specimens were plated on one side of the midface using the KLS Martin Sonic Weld system with pilot holes and pins placed at 90° angles. On the contralateral side, the buttresses were plated with the KLS Martin Sonic Weld system at 60°, 45°, and 30° angles. Data were collected using the TDAS data acquisition system and were compared with matched pairs within each specimen. Ultrasonically vibrated pins placed into absorbable mini-plates at less than 90° angles with the KLS Martin Sonic Weld system were compared with the same amount of stress as the system placed at a 90° angle before demonstrating plate-screw construct failure. RESULTS Fifty-seven paired tests were collected, with 114 total tests. Twenty failures were

Analysis of Plasticity, Fracture and Friction in Steady State Plate Cutting

DEFF Research Database (Denmark)

Simonsen, Bo Cerup; Wierzbicki, Tomasz

1996-01-01

perpendicular to the direction of motion is derived theoretically in a new consistent manner. The perpendicular reaction force is of paramount importance for predicting the structural damage of a ship hull because it governs the vertical ship motion and rock penetration which is strongly coupled...... extension of the presented plate model to include more structural members as for example the stiffeners attached to a ship bottom plating. The fracture process is discussed and the model is formulated partly on the basis of the material fracture toughness. The effect of friction and the reaction force...

Minimally invasive plate osteosynthesis for humerus diaphyseal fractures

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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

MINIMUM INCISION PERCUTANEOUS PLATE OSTEOSYNTHESIS FOR DISTAL FIBULAR FRACTURES: A PROSPECTIVE STUDY

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Ramkumar Reddy

2015-09-01

Full Text Available Distal fibular fractures are usually communitted and most of the times osteoporotic especially if they are occurring in females and in geriatric age group. These fractures are usu ally associated with other fractures, which necessitates them to be fixed accurately. Owing to the fact that distal fragment is subcutaneous with scanty soft tissue over bone, which pose these fracture fixations become difficult by open methods in view of wound healing. A prospective study of 26 patients with distal fibular fractures were treated with MIPPO with hook plate were healed with less complications and better outcome. With this background we suggest a minimally invasive incision over proximal frag ment where sufficient soft tissue cover is present. From there pushing the special hook plate subperiosteally to distal fragment, hooking the tip of fibula and fixing the proximal fragment after reduction gives a simple and effective stable fixation

Percutaneous locking plates for fractures of the distal tibia: our experience and a review of the literature.

Science.gov (United States)

Ahmad, Mudussar Abrar; Sivaraman, Alagappan; Zia, Ahmed; Rai, Amarjit; Patel, Amratlal D

2012-02-01

Distal tibial metaphyseal fractures pose many complexities. This study assessed the outcomes of distal tibial fractures treated with medial locking plates. Eighteen patients were selected based on the fracture pattern and classified using the AO classification and stabilized with an AO medial tibial locking plate. Time to fracture union, complications, and outcomes were assessed with the American Orthopedic Foot and Ankle Society Ankle score at 12 months. Sixteen of the 18 patients achieved fracture union, with 1 patient lost to follow-up. Twelve fractures united within 24 weeks, with an average union time of 23.1 weeks. Three delayed unions, two at 28 weeks and one at 56 weeks. The average time to union was 32 weeks in the smokers and 15.3 weeks in the nonsmokers. Five of the 18 patients (27%) developed complications. One superficial wound infection, and one chronic wound infection, resulting in nonunion at 56 weeks, requiring revision. Two patients required plate removal, one after sustaining an open fracture at the proximal end of the plate 6 months after surgery (postfracture union)and the other for painful hardware. One patient had implant failure of three proximal diaphyseal locking screws at the screwhead/neck junction, but successful fracture union. The average American Orthopedic Foot and Ankle Society ankle score was 88.8 overall, and 92.1 in fractures that united within 24 weeks. Distal tibial locking plates have high fracture union rates, minimum soft tissue complications, and good functional outcomes. The literature shows similar fracture union and complication rates in locking and nonlocking plates. Copyright © 2012 by Lippincott Williams & Wilkins

Radiographic Outcomes of Dorsal Distraction Distal Radius Plating for Fractures With Dorsal Marginal Impaction.

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Huish, Eric G; Coury, John G; Ibrahim, Mohamed A; Trzeciak, Marc A

2017-04-01

The purpose of this study is to compare radiographic outcomes of patients treated with dorsal spanning plates with previously reported normal values of radiographic distal radius anatomy and compare the results with prior publications for both external fixation and internal fixation with volar locked plates. Patients with complex distal radius fractures including dorsal marginal impaction pattern necessitating dorsal distraction plating at the discretion of the senior authors (M.A.T. and M.A.I.) from May 30, 2013, to December 29, 2015, were identified and included in the study. Retrospective chart and radiograph review was performed on 19 patients, 11 male and 8 female, with mean age of 47.83 years (22-82). No patients were excluded from the study. All fractures united prior to plate removal. The average time the plate was in place was 80.5 days (49-129). Follow-up radiographs showed average radial inclination of 20.5° (13.2°-25.5°), radial height of 10.7 mm (7.5-14 mm), ulnar variance of -0.3 mm (-2.1 to 3.1 mm), and volar tilt of 7.9° (-3° to 15°). One patient had intra-articular step-off greater than 2 mm. Dorsal distraction plating of complex distal radius fractures yields good radiographic results with minimal complications. In cases of complex distal radius fractures including dorsal marginal impaction where volar plating is not considered adequate, a dorsal distraction plate should be considered as an alternative to external fixation due to reduced risk for infection and better control of volar tilt.

Reduction of rib fractures with a bioresorbable plating system: preliminary observations.

Science.gov (United States)

Vu, Kim-Chi; Skourtis, Mia E; Gong, Xi; Zhou, Minhao; Ozaki, Wayne; Winn, Shelley R

2008-05-01

Operative fixation of rib fractures can reduce morbidity and mortality. Currently, resorbable fixation devices are used in a variety of surgical procedures. A standard osteotomy was prepared in 30 New Zealand white rabbits at the 12th rib. Eighteen had surgical repair with bioresorbable plates and 12 underwent nonoperative management. Half the animals in each group were killed at 3-week postfracture and the remaining animals were killed at 6-week postfracture. Ribs were radiographed and processed histologically to assess fracture healing. Rib reduction was defined as the alignment of the rib ends in a structural condition similar to the prefractured state and quantitative radiomorphometry measured the radiopaque callus surrounding the rib injury sites. Statistical analysis was performed using Fisher's exact test and an unpaired Student's t test and significance was established at p rib fractures remained reduced in the operative group, whereas zero of six and three of six of the rib fractures remained reduced, respectively, in the nonoperative group. A statistically significant increase in radiopaque callus surrounding the rib injury sites was observed at 3 and 6 weeks in the fixed groups. Fixation of rib fractures with a bioresorbable miniplate system was superior to nonoperative treatment at the 3-week interval, with a statistically significant increase in radiopaque callus formation at both 3 and 6 weeks. Additional studies will evaluate the biomechanical outcomes and degradation tissue response after extended in vivo intervals.

Surgical treatment of proximal humerus fractures using PHILOS plate

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Vijay Sharma

2014-10-01

Full Text Available 【Abstract】Objective: To evaluate functional outcome and complications of open reduction and internal fixation with proximal humeral internal locking system (PHILOS plate for proximal humerus fractures. Methods: We reviewed 51 patients who underwent open reduction and internal fixation with PHILOS plate between the years 2007 to 2012. There were 35 men and 16 women with a mean age of 38 years (range 24-68. There were 41 patients in the age group of <60 years and 10 patients in the age group of >60 years. According to Neer classification system, 8, 15 and 23 patients had 2-part, 3-part, and 4-part fractures, respectively and 5 patients had 4-part fracture dislocation. All surgeries were carried out at our tertiary care trauma centre. Functional evaluation of the shoulder at final follow-up was done using Constant-Murley score. Results: The mean follow-up period was 30 months (range 12-44 months. Two patients were lost to followup. Of the remaining 49 patients, all fractures were united clinically and radiologically. The mean time for radiological union was 12 weeks (range 8-20 weeks. At the final follow-up the mean Constant-Murley score was 79 (range 50-100. The results were excellent in 25 patients, good in 13 patients, fair in 6 atients and poor in 5 patients. During the follow-up, four cases of varus malunion, one case of subacromial impingement, one case of deep infection, one case of intraarticular screw penetration and one case of failure of fi xation were noted. No cases of avascular necrosis, hardware failure, locking screw loosening or nonunion were noted. Conclusion: PHILOS provides stable fixation in proximal humerus fractures. To prevent potential complications like avascular necrosis, meticulous surgical dissection to preserve vascularity of humeral head is necessary. Key words: Proximal humerus fracture; Fracture fixation, internal; Proximal humeral internal locking system

Locking plate fixation in distal metaphyseal tibial fractures: series of 79 patients

OpenAIRE

Gupta, Rakesh K.; Rohilla, Rajesh Kumar; Sangwan, Kapil; Singh, Vijendra; Walia, Saurav

2009-01-01

Open reduction and internal fixation in distal tibial fractures jeopardises fracture fragment vascularity and often results in soft tissue complications. Minimally invasive osteosynthesis, if possible, offers the best possible option as it permits adequate fixation in a biological manner. Seventy-nine consecutive adult patients with distal tibial fractures, including one patient with a bilateral fracture of the distal tibia, treated with locking plates, were retrospectively reviewed. The 4.5-...

Effectiveness of external fixator combined with T-plate internal fixation for the treatment of comminuted distal radius fractures.

Science.gov (United States)

Han, L R; Jin, C X; Yan, J; Han, S Z; He, X B; Yang, X F

2015-03-31

This study compared the efficacy between external fixator combined with palmar T-plate internal fixation and simple plate internal fixation for the treatment of comminuted distal radius fractures. A total of 61 patients classified as type C according to the AO/ASIF classification underwent surgery for comminuted distal radius fractures. There were 54 and 7 cases of closed and open fractures, respectively. Moreover, 19 patients received an external fixator combined with T-plate internal fixation, and 42 received simple plate internal fixation. All patients were treated successfully during 12-month postoperative follow-up. The follow-up results show that the palmar flexion and dorsiflexion of the wrist, radial height, and palmar angle were significantly better in those treated with the external fixator combined with T-plate compared to those treated with the simple plate only (P 0.05). Hence, the effectiveness of external fixator combined with T-plate internal fixation for the treatment of comminuted distal radius fractures was satisfactory. Patients sufficiently recovered wrist, forearm, and hand function. In conclusion, compared to the simple T-plate, the external fixator combined with T-plate internal fixation can reduce the possibility of the postoperative re-shifting of broken bones and keep the distraction of fractures to maintain radial height and prevent radial shortening.

[Internal screwed plate for recent fractures of the humeral diaphysis in adults].

Science.gov (United States)

Dayez, J

1999-06-01

Can medial plating of the humerus, through an antero lateral approach, diminish incidence of iatrogenic radial palsies? We carried out a prospective study of medial plating of humeral shaft fractures through an antero lateral approach between 1988 and 1997. 41 fractures were fixed, 36 were followed up for a mean period of 5.8 years. The indications were multiple injuries (10), displaced fractures (23), and failure of conservative treatment (3). Road traffic accidents and sports injuries were the cause in 68 per cent of cases. Two fractures were open and in 9 cases there was a radial palsy. Bone graft was never used. The approach to the medial aspect of the humerus an antero lateral incision was the essential feature of the technique. After a slightly curved incision on the antero lateral aspect of the arm, the space between biceps and brachialis anterior was bluntly dissected. The assistant holded the elbow flexed in order to relax the biceps and rotated il laterally to expose the medial aspect of the bone. Splitting brachialis fibres longitudinally exposed the fracture site. It was easy to check if the radial nerve was trapped and, if not, the nerve seen during the operation. Postoperatively patients were given a simple sling and mobilised freely, including rotation. We had no intra-operative complications, no infections, no fixation failure, no post operative radial palsies and no non-unions. Results were excellent in 89 per cent of cases (full recovery of pain free range of movement). Four patient had a restriction of elbow movements of 10 degrees but without any discomfort. The mean time to union was 80 days. All radial nerve palsies recovered between 24 hours and 1 year. The plate was removed in 11 cases. Iatrogenic complications of humeral plating have led to the increased popularity of intramedullary nailing. Even if secondary radial palsies and non-unions have decreased, union of the humeral shafts is often difficult. Placing the plate into the medial

[Medial versus lateral plating in distal tibial fractures: a prospective study of 40 fractures].

Science.gov (United States)

Encinas-Ullán, C A; Fernandez-Fernandez, R; Rubio-Suárez, J C; Gil-Garay, E

2013-01-01

Tibial plafond fractures are one of the most challenging injuries in orthopaedic surgery. Their results could be improved by following the new guidelines for the management, and modern plating techniques. The results and complication rate between anteromedial and anterolateral approach for open reduction and internal fixation of these fractures were compared. A study was conducted on 40 patients treated by open reduction an internal fixation between 2007 and 2008. The surgical approach was selected by the surgeon in charge, depending on fracture pattern and skin situation. Patients were evaluated clinically and radiographically by an independent orthopaedic surgeon, not involved in the surgical procedure, using clinical (American Orthopaedic Foot and Ankle Society score) and radiological criteria at a minimum of two years. The appearance of complications after both approaches was recorded. Forty patients were included. The mean age was 53 years, with 24 males and 16 females. Seventeen of the injuries were of high energy, and there were 8 open fractures (3 of type i, 4 type ii and one type iii), and 12 of the closed injuries were grade ii or iii in the Tscherne classification. Six patients (15%) had associated injuries. At final follow-up there were 33 (82%) excellent or good results. No statistical differences were found between either surgical approach regarding time to bone union, rate of delayed union and infection rate. Three plates of the anteromedial group and none of the anterolateral group needed to be removed. Open reduction and internal fixation of distal tibia fractures produced reliable results, with no statistical differences found between anteromedial and anterolateral surgical approaches. Clinical and radiological results and complication rate were mainly related to the fracture type. Copyright © 2012 SECOT. Published by Elsevier Espana. All rights reserved.

Ductile fracture toughness of modified A 302 grade B plate materials. Volume 2

International Nuclear Information System (INIS)

McCabe, D.E.; Manneschmidt, E.T.; Swain, R.L.

1997-02-01

The objective of this work was to develop ductile fracture toughness data in the form of J-R curves for modified A 302 grade B plate materials typical of those used in fabricating reactor pressure vessels. A previous experimental study at Materials Engineering Associates (MEA) on one particular heat of A 302 grade B plate showed decreasing J-R curves with increased specimen thickness. This characteristic has not been observed in numerous tests made on the more recent production materials of A 533 grade B and A 508 class 2 pressure vessel steels. It was unknown if the departure from norm for the MEA material was a generic characteristic for all heats of A 302 grade B steels or just unique to that one particular plate. Seven heats of modified A 302 grade B steel and one heat of vintage A 533 grade B steel were provided to this project by the General Electric Company of San Jose, California. All plates were tested for chemical content, tensile properties, Charpy transition temperature curves, drop-weight nil-ductility transition (NDT) temperature, and J-R curves. Tensile tests were made in the three principal orientations and at four temperatures, ranging from room temperature to 550 degrees F (288 degrees C). Charpy V-notch transition temperature curves were obtained in longitudinal, transverse, and short transverse orientations. J-R curves were made using four specimen sizes (1/2T, IT, 2T, and 4T). None of the seven heats of modified A 302 grade showed size effects of any consequence on the J-R curve behavior. Crack orientation effects were present, but none were severe enough to be reported as atypical. A test temperature increase from 180 to 550 degrees F (82 to 288 degrees C) produced the usual loss in J-R curve fracture toughness. Generic J-R curves and mathematical curve fits to the same were generated to represent each heat of material. This volume is a compilation of all data developed

Newly designed anterolateral and posterolateral locking anatomic plates for lateral tibial plateau fractures: a finite element study.

Science.gov (United States)

Chen, Pengbo; Lu, Hua; Shen, Hao; Wang, Wei; Ni, Binbin; Chen, Jishizhan

2017-02-23

Lateral column tibial plateau fracture fixation with a locking screw plate has higher mechanical stability than other fixation methods. The objectives of the present study were to introduce two newly designed locking anatomic plates for lateral tibial plateau fracture and to demonstrate their characteristics of the fixation complexes under the axial loads. Three different 3D finite element models of the lateral tibial plateau fracture with the bone plates were created. Various axial forces (100, 500, 1000, and 1500 N) were applied to simulate the axial compressive load on an adult knee during daily life. The equivalent maps of displacement and stress were output, and relative displacement was calculated along the fracture lines. The displacement and stresses in the fixation complexes increased with the axial force. The equivalent displacement or stress map of each fixation under different axial forces showed similar distributing characteristics. The motion characteristics of the three models differed, and the max-shear stress of trabecula increased with the axial load. These two novel plates could fix lateral tibial plateau fractures involving anterolateral and posterolateral fragments. Motions after open reduction and stable internal fixation should be advised to decrease the risk of trabecular microfracture. The relative displacement of the posterolateral fragments is different when using anterolateral plate and posterolateral plate, which should be considered in choosing the implants for different posterolateral plateau fractures.

Locking internal fixator with minimally invasive plate osteosynthesis for the proximal and distal tibial fractures

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TONG Da-ke

2012-02-01

Full Text Available 【Abstract】Objective: To investigate the efficacy of the locking internal fixator (LIF, which includes the locking compression plate (LCP and the less invasive stable system (LISS, in the proximal and distal tibial fractures. Methods: We did a retrospective study on a total of 98 patients with either proximal or distal tibial fractures from January 2003 to January 2007, who had received the opera- tion with LIF by the minimally invasive plate osteosynthesis (MIPO technique. The data consisted of 43 proximal tibial fractures (type AO41C3 and 55 distal tibial fractures (type AO43C3. Results: No complications were observed in all patients after operation. The mean healing time was 8.4 months (range 5-14 months. Only two cases of delayed union occurred at postoperative 10 months. No infections were reported after the definitive surgery even in the cases of open fractures. All patients reached a full range of motion at postoperative 6 to 9 months and regained the normal functions of knee and ankle joints. Conclusion: Using LIF in MIPO technique is a reliable approach towards the proximal and distal tibial fractures that are not suitable for intramedullary nailing. Key words: Internal fixator; Tibial fractures; Fracture fixation, intramedullary; Bone plates

Indirect reduction with a condylar blade plate for osteosynthesis of subtrochanteric femoral fractures.

Science.gov (United States)

Siebenrock, K A; Müller, U; Ganz, R

1998-01-01

Subtrochanteric fractures frequently occur as high energy trauma usually in younger patients and may lead to severe comminution of the medial cortex. The medial cortex of the proximal femur is exposed to high compressive forces which make fracture stabilization a difficult problem. Bone healing may be seriously compromised due to extensive comminution and fragment devitalization. This requires reduction techniques which do not cause additional damage to the vitality of the bone. With indirect reduction techniques and the use of a condylar blade plate the results have been significantly improved in these fracture types in our department (1). In this report the essential aspects of indirect reduction for subtrochanteric fractures using a condylar blade plate and the treatment results from our department from earlier years (1) and from the last 2 1/2 years will be presented. In the latter period, fifteen patients with a mean age of 49 years (19-87 years) were treated with this method. Fractures resulted from traffic incidents or falls from a great height in 11 cases (73%). Union was achieved in 14 cases (93%) with full weight-bearing after a mean of 3 months (1-4 1/2 months). Malunion was seen in two cases (13%) without the need for further surgery. Non union occurred in one patient (7%) with a III B open injury due to early infection. After repeated debridements, bone grafting and decortication, the fracture was stabilized with a replacement condylar blade plate and healed uneventfully.

Comparative study of W-shaped angular plate and reconstruction plate in treating posterior wall fractures of the acetabulum.

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Qi Zhang

Full Text Available OBJECTIVE: This study aims to assess the medium-term results of the reconstruction of posterior wall fractures using a W-shaped acetabular angular plate (WAAP compared to those fixed using a reconstruction plate. METHODS: Between July 2006 and March 2009, we performed a retrospective study, which collected data for any patient treated for a posterior acetabular wall fracture. At the time of treatment, patients were either treated using a WAAP or a pelvic reconstruction plate. The intraoperative fluoroscopic images for both groups were compared. The quality of reduction and radiological grading were assessed according to the criteria developed by Matta. The clinical assessment was based on a modified Merle d'Aubigne and Postel scoring. RESULTS: 53 patients met the inclusion criteria and were followed up for an average of 38 months. 25 patients were treated with a WAAP (study group, and 28 patients were treated with a pelvic reconstruction plate (control group. The intraoperative fluoroscopic images of the study group confirmed extra-articular screw placement in all cases. In the control group, intra-articular screw placement was observed intraoperatively in 5 patients (17.86%, and the definitive location of the periarticular hardware could not be determined in 4 patients (14.29% during the operation. The differences between the two groups were statistically significant (p = 0.002. In contrast, the quality of fracture reduction, clinical outcomes, and radiological grading in the study group were not significantly different from those of the control group (p>0.05. The radiographic grade was strongly associated with the clinical outcomes in both the study and control groups (p<0.05. CONCLUSION: Reconstruction of posterior wall fractures of the acetabulum using a WAAP can help avoid screw penetration of the hip joint, provide a stable fixation of the posterior wall, and ensure good clinical outcomes.

Fracture assessment of HSST Plate 14 shallow-flaw cruciform bend specimens tested under biaxial loading conditions

Energy Technology Data Exchange (ETDEWEB)

Bass, B.R.; McAfee, W.J.; Williams, P.T.; Pennell, W.E.

1998-06-01

A technology to determine shallow-flaw fracture toughness of reactor pressure vessel (RPV) steels is being developed for application to the safety assessment of RPVs containing postulated shallow surface flaws. Matrices of cruciform beam tests were developed to investigate and quantify the effects of temperature, biaxial loading, and specimen size on fracture initiation toughness of two-dimensional (constant depth), shallow, surface flaws. The cruciform beam specimens were developed at Oak Ridge National Laboratory (ORNL) to introduce a far-field, out-of-plane biaxial stress component in the test section that approximates the nonlinear stresses resulting from pressurized-thermal-shock or pressure-temperature loading of an RPV. Tests were conducted under biaxial load ratios ranging from uniaxial to equibiaxial. These tests demonstrated that biaxial loading can have a pronounced effect on shallow-flaw fracture toughness in the lower transition temperature region for an RPV material. The cruciform fracture toughness data were used to evaluate fracture methodologies for predicting the observed effects of biaxial loading on shallow-flaw fracture toughness. Initial emphasis was placed on assessment of stress-based methodologies, namely, the J-Q formulation, the Dodds-Anderson toughness scaling model, and the Weibull approach. Applications of these methodologies based on the hydrostatic stress fracture criterion indicated an effect of loading-biaxiality on fracture toughness; the conventional maximum principal stress criterion indicated no effect. A three-parameter Weibull model based on the hydrostatic stress criterion is shown to correlate the experimentally observed biaxial effect on cleavage fracture toughness by providing a scaling mechanism between uniaxial and biaxial loading states.

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.

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

Science.gov (United States)

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

2010-04-01

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

Clavicle hook plate fixation for displaced lateral-third clavicle fractures (Neer type II): a functional outcome study.

LENUS (Irish Health Repository)

Good, Daniel W

2012-08-01

Controversy exists with the use of the acromioclavicular hook plate for the treatment of lateral-third clavicle fractures (Neer type II). This is thought to stem from problems associated with the hook plate causing impingement symptoms, which can cause long-term limitation of movement and pain. Our aim was to evaluate the functional outcomes of patients with lateral-third clavicle fractures treated with the hook plate.

Initial outcome and efficacy of S3 proximal humerus locking plate in the treatment of proximal humerus fractures

International Nuclear Information System (INIS)

Zhang Zhiming; Zhu Xuesong; Bao Zhaohua; Yang Huilin

2012-01-01

Objective: to explore the initial outcome and efficacy of S 3 proximal humerus locking plate in the treatment of proximal humerus fractures. Methods: Twenty-two patients with proximal humerus fracture were treated with the S 3 proximal humerus locking plate. Most of the fractures were complex, two-part (n=4), three-part (n=11) and four-part (n=7) fractures according to the Neer classification of the proximal humerus fractures. Results: All patients were followed up for 3∼15 months. There were no complications related to the implant including loosening or breakage of the plate. Good and excellent results were documented in 17 patients fair results in 4 patients according the Neer scores of shoulder. Conclusion: New design concepts of S 3 proximal humerus plate provide the subchondral support and the internal fixation support. With the addition of the proper exercise of the shoulder joint, the outcomes would be satisfied. (authors)

Ductile fracture toughness of modified A 302 Grade B Plate materials, data analysis. Volume 1

Energy Technology Data Exchange (ETDEWEB)

McCabe, D.E.; Manneschmidt, E.T.; Swain, R.L.

1997-01-01

The goal of this work was to develop ductile fracture toughness data in the form of J-R curves for modified A302 grade B plate materials typical of those used in reactor pressure vessels. A previous experimental study on one heat of A302 grade B plate showed decreasing J-R curves with increased specimen thickness. This characteristic has not been observed in tests made on recent production materials of A533 grade B and A508 class 2 pressure vessel steels. It was unknown if the departure from norm for the material was a generic characteristic for all heats of A302 grade B steels or unique to that particular plate. Seven heats of modified A302 grade B steel and one heat of vintage A533 grade B steel were tested for chemical content, tensile properties, Charpy transition temperature curves, drop-weight nil-ductility transition (NDT) temperature, and J-R curves. Tensile tests were made in the three principal orientations and at four temperatures, ranging from room temperature to 550F. Charpy V-notch transition temperature curves were obtained in longitudinal, transverse, and short transverse orientations. J-R curves were made using four specimen sizes (1/2T, 1T, 2T, and 4T). The fracture mechanics-based evaluation method covered three test orientations and three test temperatures (80, 400, and 550F). However, the coverage of these variables was contingent upon the amount of material provided. Drop-weight NDT temperature was determined for the T-L orientation only. None of the heats of modified A302 grade B showed size effects of any consequence on the J-R curve behavior. Crack orientation effects were present, but none were severe enough to be reported as atypical. A test temperature increase from 180 to 550F produced the usual loss in J-R curve fracture toughness. Generic J-R curves and curve fits were generated to represent each heat of material. This volume deals with the evaluation of data and the discussion of technical findings. 8 refs., 18 figs., 8 tabs.

Ductile fracture toughness of modified A 302 Grade B Plate materials, data analysis. Volume 1

International Nuclear Information System (INIS)

McCabe, D.E.; Manneschmidt, E.T.; Swain, R.L.

1997-01-01

The goal of this work was to develop ductile fracture toughness data in the form of J-R curves for modified A302 grade B plate materials typical of those used in reactor pressure vessels. A previous experimental study on one heat of A302 grade B plate showed decreasing J-R curves with increased specimen thickness. This characteristic has not been observed in tests made on recent production materials of A533 grade B and A508 class 2 pressure vessel steels. It was unknown if the departure from norm for the material was a generic characteristic for all heats of A302 grade B steels or unique to that particular plate. Seven heats of modified A302 grade B steel and one heat of vintage A533 grade B steel were tested for chemical content, tensile properties, Charpy transition temperature curves, drop-weight nil-ductility transition (NDT) temperature, and J-R curves. Tensile tests were made in the three principal orientations and at four temperatures, ranging from room temperature to 550F. Charpy V-notch transition temperature curves were obtained in longitudinal, transverse, and short transverse orientations. J-R curves were made using four specimen sizes (1/2T, 1T, 2T, and 4T). The fracture mechanics-based evaluation method covered three test orientations and three test temperatures (80, 400, and 550F). However, the coverage of these variables was contingent upon the amount of material provided. Drop-weight NDT temperature was determined for the T-L orientation only. None of the heats of modified A302 grade B showed size effects of any consequence on the J-R curve behavior. Crack orientation effects were present, but none were severe enough to be reported as atypical. A test temperature increase from 180 to 550F produced the usual loss in J-R curve fracture toughness. Generic J-R curves and curve fits were generated to represent each heat of material. This volume deals with the evaluation of data and the discussion of technical findings. 8 refs., 18 figs., 8 tabs

Fractures of the distal tibia treated with polyaxial locking plating.

Science.gov (United States)

Gao, Hong; Zhang, Chang-Qing; Luo, Cong-Feng; Zhou, Zu-Bin; Zeng, Bing-Fang

2009-03-01

We evaluated the healing rate, complications, and functional outcomes in 32 adult patients with very short metaphyseal fragments in fractures of the distal tibia treated with a polyaxial locking system. The average distance from the distal extent of the fracture to the tibial plafond was 11 mm. All fractures healed and the average time to union was 14 weeks. Six patients (19%) reported occasional local disturbance over the medial malleolus. There were two cases of postoperative superficial infections and evidence of delayed wound healing. Using the American Orthopaedic Foot and Ankle Society ankle score, the average functional score was 87.3 points (of 100 total possible points). Our results show the polyaxial locking plates, which offer more fixation versatility, may be a reasonable treatment option for distal tibia fractures with very short metaphyseal segments.

Minimally invasive treatment of pilon fractures with a low profile plate: preliminary results in 17 cases.

Science.gov (United States)

Borens, Olivier; Kloen, Peter; Richmond, Jeffrey; Roederer, Goetz; Levine, David S; Helfet, David L

2009-05-01

To determine the results of "biologic fixation" with a minimally invasive plating technique using a newly designed low profile "Scallop" plate in the treatment of pilon fractures. Retrospective case series. A tertiary referral center. Seventeen patients were treated between 1999 and 2001 for a tibial plafond fracture at the Hospital for Special Surgery with a newly designed low-profile plate. Eleven of the fractures (65%) were high-energy injuries. Two fractures were open. Staged surgical treatment with open reduction and fixation of the fibular fracture and application of an external fixator was performed in 12 cases. As soon as the soft tissues and swelling allowed, i.e. skin wrinkling, the articular surface was reconstructed and simply reduced, if necessary through an small incision, and the articular block was fixed to the diaphysis using a medially placed, percutaneously introduced flat scallop plate. In the remaining five cases the operation was performed in one session. Time to healing and complications including delayed union, non-union, instrument failure, loss of fixation, infection, quality of reduction and number of reoperations were evaluated. Quality of results and outcome were graded using the ankle-hindfoot-scale and a modified rating system. All patients went on to bony union at an average time of 14 weeks. There were no plate failures or loss of fixation/reduction. Two superficial wound-healing problems resolved with local wound care. At an average follow up of 17 months (range 6-29 months) eight patients (47%) had an excellent result; seven (41%) had a fair result whereas two (12%) had a poor result. The average ankle-hindfoot-score was 86.1 (range 61-100). Four patients have had the hardware removed and one of them is awaiting an ankle arthrodesis. Based on these initial results, it appears that a minimally invasive surgical technique including new low profile plate can decrease soft tissue problems while leading to fracture healing and

Comparison of Absorbable Mesh Plate versus Titanium-Dynamic Mesh Plate in Reconstruction of Blow-Out Fracture: An Analysis of Long-Term Outcomes

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Woon Il Baek

2014-07-01

Full Text Available Background A blow-out fracture is one of the most common facial injuries in midface trauma. Orbital wall reconstruction is extremely important because it can cause various functional and aesthetic sequelae. Although many materials are available, there are no uniformly accepted guidelines regarding material selection for orbital wall reconstruction. Methods From January 2007 to August 2012, a total of 78 patients with blow-out fractures were analyzed. 36 patients received absorbable mesh plates, and 42 patients received titanium-dynamic mesh plates. Both groups were retrospectively evaluated for therapeutic efficacy and safety according to the incidence of three different complications: enophthalmos, extraocular movement impairment, and diplopia. Results For all groups (inferior wall fracture group, medial wall fractrue group, and combined inferomedial wall fracture group, there were improvements in the incidence of each complication regardless of implant types. Moreover, a significant improvement of enophthalmos occurred for both types of implants in group 1 (inferior wall fracture group. However, we found no statistically significant differences of efficacy or complication rate in every groups between both implant types. Conclusions Both types of implants showed good results without significant differences in long-term follow up, even though we expected the higher recurrent enophthalmos rate in patients with absorbable plate. In conclusion, both types seem to be equally effective and safe for orbital wall reconstruction. In particular, both implant types significantly improve the incidence of enophthalmos in cases of inferior orbital wall fractures.

Functional Results of Unstable (Type 2 Distal Clavicle Fractures Treated with Superior Anterior Locking Plate

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Rajesh Govindasamy

2017-11-01

Full Text Available Background: The treatment of distal clavicle fracture is always a challenge, as it is mostly unstable and has higherrate of delayed union, malunion, non-union and associated acromioclavicular arthritis. So the management of thesefractures remains controversial. The purpose of this study is to evaluate the functional results of Type 2 distal endclavicle fractures treated with superior anterior locking plate.Methods: From June 2011 to August 2015 a retrospective study of12 male patients (mean age of 41.3 years 11 withunilateral and 1 with bilateral distal clavicle fractures treated with superior anterior locking plate was done. They wereevaluated at regular intervals with mean follow up of 14 months(12-18 months.Those with minimum one year followup were included in our study. All were evaluated for the functioning of the shoulder joint by both Oxford shoulder scoreand Quick DASH scores, rate of bone union, complications and earliest time for return to work.Results: All fractures union seen within 6-8 weeks (mean time: 7.1 weeks.All had good shoulder range of motion. Theaverage oxford shoulder and Quick DASH score were 46.2 and 6.5.There were no major complications in our studyviz. non-union, plate failure, secondary fracture. But one patient had superficial wound infection. All patients returned towork within 3 months of postoperative period.Conclusion: Displaced distal clavicle fractures treated with superior anterior locking plates achieved excellent resultsin terms of bony union with rarely any complications and demonstrate promising results with this novel technique.

Fracture healing using degradable magnesium fixation plates and screws.

Science.gov (United States)

Chaya, Amy; Yoshizawa, Sayuri; Verdelis, Kostas; Noorani, Sabrina; Costello, Bernard J; Sfeir, Charles

2015-02-01

Internal bone fixation devices made with permanent metals are associated with numerous long-term complications and may require removal. We hypothesized that fixation devices made with degradable magnesium alloys could provide an ideal combination of strength and degradation, facilitating fracture fixation and healing while eliminating the need for implant removal surgery. Fixation plates and screws were machined from 99.9% pure magnesium and compared with titanium devices in a rabbit ulnar fracture model. Magnesium device degradation and the effect on fracture healing and bone formation were assessed after 4 weeks. Fracture healing with magnesium device fixation was compared with that of titanium devices using qualitative histologic analysis and quantitative histomorphometry. Micro-computed tomography showed device degradation after 4 weeks in vivo. In addition, 2-dimensional micro-computed tomography slices and histologic staining showed that magnesium degradation did not inhibit fracture healing or bone formation. Histomorphology showed no difference in bone-bridging fractures fixed with magnesium and titanium devices. Interestingly, abundant new bone was formed around magnesium devices, suggesting a connection between magnesium degradation and bone formation. Our results show potential for magnesium fixation devices in a loaded fracture environment. Furthermore, these results suggest that magnesium fixation devices may enhance fracture healing by encouraging localized new bone formation. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

The Dynamic Locking Blade Plate : innovation in the treatment of femoral neck fractures

NARCIS (Netherlands)

Roerdink, W.H.

2011-01-01

The scope of this thesis was to describe the design and development of the Dynamic Locking Blade Plate (DLBP), an improved internal fixation (IF) device for intracapsular hip fractures. This thesis focuses on intracapsular hip fractures since the results of current surgical treatment of this type of

Plating versus wiring for fixation of traumatic rib and sternal fractures

Directory of Open Access Journals (Sweden)

Mostafa Kamel Abd-Elnaim

2017-12-01

Conclusions: Plating of rib and sternal fractures had better outcome than wiring, regarding better chest wall stability and restoration of chest contour; also it had shorter intensive care unit, hospital and ventilator days.

[Effectiveness of mini locking plate combined with Kirschner wire in treatment of comminuted Jones fracture].

Science.gov (United States)

Yan, Rongliang; Qu, Jiafu; Cao, Lihai; Liu, Hongda; Chen, Jianghua; Gao, Yan; Peng, Yi

2018-05-01

To summarize the effectiveness of mini locking plate combined with Kirschner wire in treatment of comminuted Jones fracture. Between January 2011 and October 2016, 25 cases with comminuted Jones fracture were treated with mini locking plate combined with Kirschner wire. There were 9 males and 16 females with an average age of 31.4 years (range, 16-66 years). The fractures located on the left side in 11 cases and on the right side in 14 cases. The causes of injury included spraining in 21 cases, falling down in 3 cases, and bruise in 1 case. The bone fragment of all cases was more than 3 pieces. The fracture line was mostly Y-shape or T-shape. Twelve of them were combined with other fractures. The time from injury to operation was 1-9 days (mean, 5 days). The mini locking plate and Kirschner wire were removed at 9-12 months postoperatively. At 12 months postoperatively, the pain was evaluated by the visual analogue scale (VAS) score, and the function by the American Orthopaedic Foot & Ankle Society (AOFAS) score. All incisions healed by first intention. All cases were followed up 12-36 months with an average of 21.7 months. Fracture union was observed in all patients without complications such as nonunion, delayed union, and malunion. The fracture union time was 8-12 weeks (mean, 9.4 weeks). At 12 months postoperatively, the VAS score was 1.15±0.87; the AOFAS score was 89.45±6.24, and the results were excellent in 14 cases, good in 9 cases, fair in 1 case, and poor in 1 case, with an excellent and good rate of 92%. The procedure of mini locking plate combined with Kirschner wire for comminuted Jones fracture has such advantages as convenient operation, more rigid fixation, high rate of fracture healing, and good functional recovery in foot.

Anterior Z-plate and titanic mesh fixation for acute burst thoracolumbar fracture.

Science.gov (United States)

Xu, Jian-Guang; Zeng, Bing-Fang; Zhou, Wei; Kong, Wei-Qing; Fu, Yi-Shan; Zhao, Bi-Zeng; Zhang, Tao; Lian, Xiao-Feng

2011-04-01

A retrospective study. To evaluate the clinical outcome, effectiveness, and security of the surgical management of acute thoracolumbar burst fracture with corpectomy, titanic mesh autograft, and Z-plate fixation by anterior approach. Many surgical methods were adopted to treat acute burst thoracolumbar fracture. But the optimal surgical management remains controversial. A retrospective review of a consecutive series of 48 patients with thoracolumbar burst fracture treated with anterior corpectomy, titanic mesh autograft, and Z-plate internal fixation was carried out. Preoperative clinical and radiographic data of all cases were originally collected. Surgical indications were motor neurologic deficit and thoracolumbar column instability. Twenty-two patients (45.8%) with acute thoracolumbar burst fractures presented with a neurologic deficit. The postoperative recovery of neural function, restoration of anterior cortex collapse, kyphotic angle, and spinal canal compromise were observed. The preoperative kyphotic angle was improved to a mean of 5.6°, radiographic height restored to 95.8% of the adjacent normal levels, and canal compromise was 0%. None of the patients had neurologic deterioration. Mean follow-up time was 32.4 months (range, 24-47 months). All 22 patients with neurologic deficit demonstrated at least one Frankel grade improvement on final observation, with 16 (73%) patients had accomplished complete neurologic recovery. Forty-six (96%) patients reported minimal or no pain at final follow-up observation, and 40 (83%) patients who had been working before injury returned to original work. The authors considered spinal cord decompression with anterior corpectomy and stability reconstruction with titanic mesh autograft and Z-plate fixation at same time in one incision as an effective technique for unstable thoracolumbar burst fracture with and without neurologic deficit.

Investigation of the ductile fracture properties of Type 304 stainless steel plate, welds, and 4-inch pipe

International Nuclear Information System (INIS)

Vassilaros, M.G.; Hays, R.A.; Gudas, J.P.

1985-01-01

J-integral fracture toughness tests were performed on welded 304 stainless steel 2-inch plate and 4-inch diameter pipe. The 2-inch plate was welded using a hot-wire automatic gas tungsten arc process. The tests were performed at 550 0 F, 300 0 F and room temperature. The results of the J-integral tests indicate that the Jsub(Ic) of the base plate ranged from 4400 to 6100 in lbs/in 2 at 550 0 F. The Jsub(Ic) values for the tests performed at 300 0 F and room temperature were beyond the measurement capacity of the specimens and appear to indicate that Jsub(Ic) was greater than 8000 in lb/in 2 . The J-integral tests performed on the weld metal specimens indicate that the Jsub(Ic) values ranged from 930 to 2150 in lbs/in 2 at 550 0 F. The Jsub(Ic) values of the weld metal specimens tested at 300 0 F and room temperature were 2300 and 3000 in lbs/in 2 respectively. One HAZ specimen was tested at 550 0 F and found to have a Jsub(Ic) value of 2980 in lbs/in 2 which indicates that the HAZ is an average of the base metal and weld metal toughness. These test results indicate that there is a significant reduction in the initiation fracture toughness as a result of welding. The second phase of this task dealt with the fracture toughness testing of 4-inch diameter 304 stainless steel pipes containing a gas tungsten arc weld. The pipes were tested at 550 0 F in four point bending. Three tests were performed, two with a through wall flaw growing circumferentially and the third pipe had a part through radial flaw in combination with the circumferential flaw. These tests were performed using unloading compliance and d.c. potential drop crack length estimate methods. The results of these tests indicate that the presence of a complex crack (radial and circumferential) reduces in the initiation toughness and the tearing modulus of the pipe material compared to a pipe with only a circumferentially growing crack. (orig.)

[APPLICATION OF BUTTERFLY SHAPED LOCKING COMPRESSION PLATE IN COMPLEX DISTAL RADIUS FRACTURES].

Science.gov (United States)

Jiang, Zongyuan; Ma, Tao; Xia, Jiang; Hu, Caizhi; Xu, Lei

2014-06-01

To investigate the effectiveness of butterfly shaped locking compression plate for the treatment of complex distal radius fractures. Between June 2011 and January 2013, 20 cases of complex distal radius fractures were treated with butterfly shaped locking compression plate fixation. There were 11 males and 9 females with an average age of 54 years (range, 25-75 years). Injury was caused by falling in 10 cases, by traffic accident in 7 cases, and by falling from height in 3 cases. All of fractures were closed. According to AO classification system, there were 8 cases of type C1, 8 cases of type C2, and 4 cases of type C3. Of them, 9 cases had radial styloid process fracture, 4 cases had sigmoid notch fracture, and 7 cases had both radial styloid process fracture and sigmoid notch fracture. The mean interval between injury and operation was 5.2 days (range, 3-15 days). All incisions healed by first intention; no complications of infection and necrosis occurred. All cases were followed up 14 months on average (range, 10-22 months). All factures healed after 9.3 weeks on average (range, 6-11 weeks). No complications such as displacement of fracture, joint surface subsidence, shortening of the radius, and carpal tunnel syndrome were found during follow-up. At last follow-up, the mean palmar tilt angle was 10.2° (range, 7-15°), and the mean ulnar deviation angle was 21.8° (range, 17-24°). The mean range of motion of the wrist was 45.3° (range, 35-68°) in dorsal extension, 53.5° (range, 40-78°) in palmar flexion, 19.8° (range, 12-27°) in radial inclination, 26.6° (range, 18-31°) in ulnar inclination, 70.2° (range, 45-90°) in pronation, and 68.4° (range, 25-88°) in supination. According to the Dienst scoring system, the results were excellent in 8 cases, good in 10 cases, and fair in 2 cases, and the excellent and good rate was 90%. Treatment of complex distal radius fractures with butterfly shaped locking compression plate can reconstruct normal anatomic

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.

The clinical application of absorbable intramedullary nail and claw plate on treating multiple rib fractures.

Science.gov (United States)

Chai, X; Lin, Q; Ruan, Z; Zheng, J; Zhou, J; Zhang, J

2013-08-01

The absorption intramedullary nail and claw plate indications and efficacy were investigated in the treatment of a life-threatening multiple rib fractures. A retrospective analysis of 248 surgically treated rib fracture patients was performed who admitted to our hospital from March 2007 to December 2012. Intramedullary nailing was performed in 28 cases, a claw-type bone plate was fixed in 141 cases, and a combination of both was fixed in 79 cases. All internal fixation patients were clinically cured except 1 patient died 14 days after a massive pulmonary embolism. The patients with flail chest and floating chest wall causing respiratory and circulatory disorders were promptly corrected. Routine follow-up was from 1 to 2 years, displaced fractures were in 2 cases, and there were 11 cases of internal fixation and extraction. Internal fixation is a simple and reliable method for the treatment of multiple rib fractures. Both internal fixation materials have their pros and cons but the claw bone plate is more robust. The actual selection of appropriate treatment options helps to improve the treatment efficacy.

Biomechanical properties of orthogonal plate configuration versus parallel plate configuration using the same locking plate system for intra-articular distal humeral fractures under radial or ulnar column axial load.

Science.gov (United States)

Kudo, Toshiya; Hara, Akira; Iwase, Hideaki; Ichihara, Satoshi; Nagao, Masashi; Maruyama, Yuichiro; Kaneko, Kazuo

2016-10-01

Previous reports have questioned whether an orthogonal or parallel configuration is superior for distal humeral articular fractures. In previous clinical and biomechanical studies, implant failure of the posterolateral plate has been reported with orthogonal configurations; however, the reason for screw loosening in the posterolateral plate is unclear. The purpose of this study was to evaluate biomechanical properties and to clarify the causes of posterolateral plate loosening using a humeral fracture model under axial compression on the radial or ulnar column separately. And we changed only the plate set up: parallel or orthogonal. We used artificial bone to create an Association for the Study of Internal Fixation type 13-C2.3 intra-articular fracture model with a 1-cm supracondylar gap. We used an anatomically-preshaped distal humerus locking compression plate system (Synthes GmbH, Solothurn, Switzerland). Although this is originally an orthogonal plate system, we designed a mediolateral parallel configuration to use the contralateral medial plate instead of the posterolateral plate in the system. We calculated the stiffness of the radial and ulnar columns and anterior movement of the condylar fragment in the lateral view. The parallel configuration was superior to the orthogonal configuration regarding the stiffness of the radial column axial compression. There were significant differences between the two configurations regarding anterior movement of the capitellum during axial loading of the radial column. The posterolateral plate tended to bend anteriorly under axial compression compared with the medial or lateral plate. We believe that in the orthogonal configuration axial compression induced more anterior displacement of the capitellum than the trochlea, which eventually induced secondary fragment or screw dislocation on the posterolateral plate, or nonunion at the supracondylar level. In the parallel configuration, anterior movement of the capitellum or

Lateral malleolus hook plate for comminuted Weber A and B fractures: A retrospective study

Directory of Open Access Journals (Sweden)

Fang Zhenhua

2013-01-01

Full Text Available Background: The goal of managing the comminuted fracture of lateral malleolus is to restore length, rotation and alignment which might be more challenging with extensive comminution around the area of the distal tip. The common osteosynthesis techniques such as the one-third tubular plate, tension band wiring, K-wires, screws, or intramedullary nail may be insufficient in cases with a comminuted lateral malleolus. The anatomical hook plate is an alternative implant in such cases. We present our results of the comminuted lateral malleolar fractures (Weber A, B, managed by open reduction and internal fixation (ORIF with an anatomical hook plate of lateral malleolus (Königsee Implant Company, Germany. Materials and Methods: We retrospectively reviewed 20 patients of comminuted fracture of distal lateral malleolus between 2008 and 2010. There were 12 males and 8 females, right side was involved in 18 patients and left in 2. The mean age was 51.9 years (range 18-75 years. The fractures were categorized by Denis-Weber classification type A (n=1, B1 (n=1, B2 (n=13 and B3 (n=5. Nineteen cases were of closed injury and one of open injury (Gustilo Anderson type II. These patients underwent ORIF with a lateral malleolus anatomical hook plate. Followup including radiographs and clinical examinations were performed. The American Orthopedic Foot and Ankle Society (AOFAS ankle hindfoot scores were documented at followups. Results: The mean followup was 21.4 months (range 16-27 months. The average AOFAS score was 94.3 (range 78-100 points. A stable anatomic reduction and bony union were obtained in all the cases. The average time was 3.1 months (range 2.5-4 months. Four cases had complications like posttraumatic osteoarthritis, hardware impingement and superficial wound infection. Conclusion: A reasonably good stability can be obtained in distal most comminuted fractures of lateral malleolus with a lateral malleolus anatomical hook plate. We believe this

Full title: Biomechanical comparison between stainless steel, titanium and carbon-fiber reinforced polyetheretherketone volar locking plates for distal radius fractures.

Science.gov (United States)

Mugnai, Raffaele; Tarallo, Luigi; Capra, Francesco; Catani, Fabio

2018-05-25

As the popularity of volar locked plate fixation for distal radius fractures has increased, so have the number and variety of implants, including variations in plate design, the size and angle of the screws, the locking screw mechanism, and the material of the plates. carbon-fiber reinforced polyetheretherketone (CFR-PEEK) plate features similar biomechanical properties to metallic plates, representing, therefore, an optimal alternative for the treatment of distal radius fractures. three different materials-composed plates were evaluated: stainless steel volar lateral column (Zimmer); titanium DVR (Hand Innovations); CFR-PEEK DiPHOS-RM (Lima Corporate). Six plates for each type were implanted in sawbones and an extra-articular rectangular osteotomy was created. Three plates for each material were tested for load to failure and bending stiffness in axial compression. Moreover, 3 constructs for each plate were evaluated after dynamically loading for 6000 cycles of fatigue. the mean bending stiffness pre-fatigue was significantly higher for the stainless steel plate. The titanium plate yielded the higher load to failure both pre and post fatigue. After cyclic loading, the bending stiffness increased by a mean of 24% for the stainless steel plate; 33% for the titanium; and 17% for the CFR-PEEK plate. The mean load to failure post-fatigue increased by a mean of 10% for the stainless steel and 14% for CFR-PEEK plates, whereas it decreased (-16%) for the titanium plate. Statistical analysis between groups reported significant values (p plastic deformation, and lower load to failure. N/A. Copyright © 2018. Published by Elsevier Masson SAS.

Stability of radial head and neck fractures: a biomechanical study of six fixation constructs with consideration of three locking plates.

Science.gov (United States)

Burkhart, Klaus Josef; Mueller, Lars P; Krezdorn, David; Appelmann, Philipp; Prommersberger, Karl J; Sternstein, Werner; Rommens, Pol M

2007-12-01

Open reduction and internal fixation of radial neck fractures can lead to secondary loss of reduction and nonunion due to insufficient stability. Nevertheless, there are only a few biomechanical studies about the stability achieved by different osteosynthesis constructs. Forty-eight formalin-fixed, human proximal radii were divided into 6 groups according to their bone density (measured by dual-energy x-ray absorptiometry). A 2.7-mm gap osteotomy was performed to simulate an unstable radial neck fracture, which was fixed with 3 nonlocking implants: a 2.4-mm T plate, a 2.4-mm blade plate, and 2.0-mm crossed screws, and 3 locking plates: a 2.0-mm LCP T plate, a 2.0-mm 6x2 grid plate, and a 2.0-mm radial head plate. Implants were tested under axial (N/mm) and torsional (Ncm/ degrees ) loads with a servohydraulic materials testing machine. The radial head plate was significantly stiffer than all other implants under axial as well as under torsional loads, with values of 36 N/mm and 13 Ncm/ degrees . The second-stiffest implant was the blade plate, with values of 20 N/mm and 6 Ncm/ degrees . The weakest implants were the 2.0-mm LCP, with values of 6 N/mm and 2 Ncm/ degrees , and the 2.0-mm crossed screws, with values of 18 N/mm and 2 Ncm/ degrees . The 2.4-mm T plate, with values of 14 N/mm and 4 Ncm/ degrees , and the 2.0-mm grid plate, with values of 8 N/mm and 4 Ncm/ degrees came to lie in the midfield. The 2.0-mm angle-stable plates-depending on their design-allow fixation with comparable or even higher stability than the bulky 2.4-mm nonlocking implants and 2.0-mm crossed screws.

Biomechanical and biological aspects of defect treatment in fractures using helical plates.

Science.gov (United States)

Perren, S M; Regazzoni, P; Fernandez, A A D

2014-01-01

The clinical case of figure 1 through figure 11 shows a series of impressive failures of plate fixation. The plates were repeatedly applied bridging a comminuted bone segment in a heavy patient. The biomechanical analysis elaborates why this happened and proposes an unconventional procedure to prevent this failure with a minimally invasive procedure. A plate bridging an open gap or a defect in a long bone diaphysis is exposed to full functional load. According to clinical observations such plate application often fails even without external load such as weight bearing. The plate risks to break through fatigue when exposed during a long time to cyclic loading. This type of failure has been observed even with broad plates as well in femoral as in tibiae. The first option to avoid such failure consists in protecting the plate by installing load sharing between plate and either bone or an additional implant. This reduces the load carried by the plate to a safe level. Load sharing with bone may be installed at surgery by establishing solid mechanical bridge between the two main fragments of the fractured bone. The optimal load sharing relies on a solid compressed contact between the main fragments. It can be established because the bone is able to take a large load which results in optimal protection of the plate. In the case of an extended comminuted bone segment it may be very difficult, traumatizing and inefficient to reconstruct the bone. In the present case it was impossible to establish load sharing through the bone. The second option protecting the plate is provided by callus bridging of the gap or defect. The formation of a solid callus bridge takes time but the fatigue failure of the plate also takes time. Therefore, the callus bridge may prevent a late fatigue failure. The surgeon may select one of several options: - Replacing the lack of bone support using a second plate which immediately alleviates plate loading. The drawback of application of a second

Tension band plating of a nonunion anterior tibial stress fracture in an athlete.

Science.gov (United States)

Merriman, Jarrad A; Villacis, Diego; Kephart, Curtis J; Rick Hatch, George F

2013-07-01

The authors present a rare technique of tension band plating of the anterior tibia in the setting of a nonunion stress fracture. Surgical management with an intramedullary nail is a viable and proven option for treating such injuries. However, in treating elite athletes, legitimate concerns exist regarding the surgical disruption of the extensor mechanism and the risk of anterior knee pain associated with intramedullary nail use. The described surgical technique demonstrates the use of tension band plating as an effective treatment of delayed union and nonunion anterior tibial stress fractures in athletes without the potential risks of intramedullary nail insertion. Copyright 2013, SLACK Incorporated.

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

Science.gov (United States)

Yao, Chen; Jin, Dongxu; Zhang, Changqing

2017-11-15

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

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.

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

Treatment of unstable fractures, dislocations and fracture-dislocations of the cervical spine with Senegas plate fixation

NARCIS (Netherlands)

Moerman, J.; Harth, A.; Trimpont, van I.; Uyttendaele, D.; Verdonk, R.; Claessens, H.A.; Verbeke, S.

1994-01-01

The results of the anterior approach to the cervical spine for the treatment of fractures and dislocations by arthrodesis and Senegas plate fixation are described. Twenty-two patients underwent a one- or two-level arthrodesis of the cervical spine. Their mean age was 42 years. The injuries were

Treatment of Middle Third Humeral Shaft Fractures with Anteromedial Plate Osteosynthesis through an Anterolateral Approach.

Science.gov (United States)

Kumar, B S; Soraganvi, P; Satyarup, D

2016-03-01

Background: Treatment of humeral shaft fractures has been a subject of debate for many decades. Even though a large majority of humeral shaft fractures can be treated by non operative methods, few conditions like open fractures, polytrauma, ipsilateral humeral shaft and forearm fractures require surgical intervention. The goal of treatment of humeral shaft fractures is to establish union with an acceptable humeral alignment and to restore the patient to pre-injury level of function. The objective was to assess the incidence of radial nerve palsy, non-union and mean time required for in anteromedial plate osteosynthesis with anterolateral approach and also to measure the functional outcome of this procedure. Method: A prospective study was conducted in the Department of Orthopaedics, PESIMSR, Kuppam, Andhra Pradesh, from August 2012 to August 2015 with a total of 54 patients who were operated with anteromedial plate osteosynthesis were included in the study. Rodriguez- Merchan criteria was used to grade the functional outcome. Results: Of the 54 patients, 28 (58.85%) were in the age group of 30-40 years. The most common fracture pattern identified was A3 type (48.14%).The mean (± SD) duration of surgery for anteromedial humeral plating was 53 ± 5.00 minutes. The time taken for the fracture to unite was less than 16 weeks in the majority or 50 patients (92.59%). Four (7.40%) patients had delayed union. There was no incidence of iatrogenic radial nerve palsy. Rodriguez - Merchan criteria showed that 37(68.51%) of the patients had good and 12 (22.22%) had excellent functional outcome.

[Curative efficacies of mini-invasive percutaneous osteosynthesis versus supercutaneous plating for distal tibial fractures].

Science.gov (United States)

He, Xianfeng; Zhu, Limei; Zhang, Jingwei; Li, Ming; Yu, Yihui

2014-12-30

To compare the clinical efficacies of mini-invasive percutaneous osteosynthesis (MIPO) versus supercutaneous plating with closed reduction in the treatment of distal tibial fractures. A total of 48 patients with close distal tibial fractures were treated between January 2010 and January 2012. The MIPO group included 16 males and 8 females with an average age of 36 years. And the types were A (n = 15), B (n = 6) and C (n = 3) according to the classification scheme of Association for the Study of Internal Fixation (AO/ASIF). The supercutaneous plating group also included 16 males and 8 females with an average age of 37 years. And the types were A (n = 15), B (n = 6) and C (n = 3). And the operative duration, hospital stay, union time, postoperative complications and function of ankle were compared between two groups. The mean follow-up period was 18.5 (12-26) months. There was no instance of nonunion, hardware breakdown or deep infection. Patients in supercutaneous plating group had significantly shorter mean operative duration, hospital stay and union time. Three patients and 1 patient in MIPO group presented with superficial infection and delayed union respectively while there was no occurrence in supercutaneous plating group. And the differences were not statistically significant. Fifteen patients (62.5%) complained of implant impingement or discomfort. And stripping occurred at an incidence of 15.6% during the removal time of locking screws in MIPO group. While in supercutaneous plating group, there as no complaint of skin irritation and removal of supercutaneous plate was easily performed without anesthesia. The mean AOFAS score was 90.7 ± 3.8 in supercutaneous plating group versus 88.9 ± 4.1 in MIPO group (P = 0.070). Distal tibia fractures may be treated successfully with MIPO or supercutaneous plating. However, supercutaneous plating offers multiple advantages in terms of mean operative duration, hospital stay, union time, skin irritation and implant

Distal tibial fracture treated by minimally invasive plate osteosynthesis after external fixation Retrospective clinical and radiographic assessment

Directory of Open Access Journals (Sweden)

Al. Șerban

2014-02-01

Full Text Available Fractures of the horizontal surface of the distal tibia are known commonly as pylon or plafond fractures, and represent 1-5% of lower extremity fractures, 7-10% of all tibial fractures. The protocol consisted of immediate (within eight to 24 hours open reduction and internal fixation of the fibula, using a fibular plate or one third tubular plate and application of an external fixator spanning the ankle joint. In the second stage, the treatment of proximal and distal tibial fractures with close reduction and MIPPO technique can preserve soft tissue, simplify operative procedure and decrease wound, obtain rigid internal fixation and guarantee early function exercises of ankle joint. In this study we evaluated 22 patients treated in Clinical Emergency Hospital Constanta between April 2012 - July 2013 diagnosed with multifragmentary fractures of the distal tibia. This study evaluates the treatment of complex fractures of distal tibia with locked plate after external fixation. There were 17 males and 5 females of mean age 51,7 years (31-68. The mean follow-up period was 14 weeks. (Ranging from 9-16 weeks. All patients were fully weight bearing at 16 weeks (ranging 9-16 weeks showing radiological union. There were no cases of failures of fixation, or rotational misalignment. No significant complication was observed in our patients. MIPO is an effective method of treatment for distal tibial fractures, reduce surgical trauma and maintain a more biologically favorable environment for fracture healing, reducing risks of infection and nonunion.

Osteosynthesis with long volar locking plates for meta- physeal-diaphyseal fractures of the distal radius

Directory of Open Access Journals (Sweden)

Gogna Paritosh

2013-12-01

Full Text Available 【Abstract】Objective: Metaphyseal-diaphyseal fractures of the distal radius are a major treatment dilemma and orthopaedic surgeons have to pay due consideration to restoration of anatomy of distal radius together with ro- tation of the radial shaft and maintenance of radial bow and interosseous space. We performed this study to evaluate the clinic-radiological outcome of metaphyseal-diaphyseal fractures of the distal radius treated with long volar locking plates. Methods: This prospective study involved 27 pa- tients (22 males and 5 females with metaphyseal-diaphy- seal fracture of the distal radius. Their mean age was (30.12± 11.48 years (range 19-52 years and the follow-up was 26.8 months (range 22-34 months. All patients underwent open reduction and internal fixation with a long volar locking plate. According to AO/OTA classification, there were 7 type A3, 13 type C2 and 7 type C3 fractures. Subjective assessment was done based on the disabilities of the arm, shoulder and hand (DASH questionnaire. Functional evaluation was done by measuring grip strength and range of motion around the wrist and the radiological determinants included radial angle, radial length, volar angle and ulnar variance. The final as- sessment was done according to Gartland and Werley scor- ing system. Results: Postoperative radiological parameters were well maintained throughout the trial, and there was signifi- cant improvement in the functional parameters from 6 weeks to final follow-up. The average DASH scores improved from 37.5 at 6 weeks to 4.2 at final follow-up. Final assessment using Gartland and Werley scoring system revealed 66.67% (n=18 excellent and 33.33% (n=9 good results. There was one case of superficial infection which responded to antibi- otics and another carpel tunnel syndrome which was ma- naged conservatively. Conclusion: Volar locking plate fixation for metaphy- seal-diaphyseal fractures of distal radius is associated with excellent to good

Resorbable triangular plate for osteosynthesis of fractures of the condylar neck.

Science.gov (United States)

Lauer, Günter; Pradel, Winnie; Leonhardt, Henry; Loukota, Richard; Eckelt, Uwe

2010-10-01

We describe a new design of resorbable plate for use in the treatment of fractures of the condylar neck, and report the outcome of initial treatment in two patients. Copyright © 2009 The British Association of Oral and Maxillofacial Surgeons. All rights reserved.

Comparison of circummandibular wiring with resorbable bone plates in pediatric mandibular fractures

OpenAIRE

Saikrishna, D.; Gupta, Nimish

2010-01-01

Pediatric patients present a unique challenge to maxillofacial surgeons in terms of their treatment planning as well as in their functional and nutritional needs which are different from that of adult patients. Early literature has advocated conservative closed management of pediatric fractures to prevent complications. However recent advances in maxillofacial surgery has enabled us to use biodegradable plates and screws, which overcomes the limitations of metallic plates. We present a compar...

Morphology Analysis of Cu Film Fractures in Sandwiched Methylmethacrylate Plates

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Cristiano Fidani

2015-06-01

Full Text Available Thin films of Cu were evaporated on solid plates of polymethylmethacrylate (PMMA. A polymerization process was made to realize sandwiched structure to protect the Cu films. Fracturing of the metal film surface was observed with several morphologies showing two different fracture systems. Surface film morphology was analysed in terms of the distribution area of the islands and contour fractal dimension. The island areas showed a maximum corresponding to 42 nm of the Cu thickness, it was also the threshold to observe the second fracture system. The fractures pattern resulted to be scale invariant with fractal dimensions between 1.55 and 1.7. The minimum fractal dimension also occurred at the film thickness corresponding to the maximum island area. The reported effects can be understood on the basis of different thermal expansion coefficients of the two materials and their thermally induced adhesion.DOI: http://dx.doi.org/10.5755/j01.ms.21.2.6518

Comparison of Internal Fixations for Distal Clavicular Fractures Based on Loading Tests and Finite Element Analyses

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Rina Sakai

2014-01-01

Full Text Available It is difficult to apply strong and stable internal fixation to a fracture of the distal end of the clavicle because it is unstable, the distal clavicle fragment is small, and the fractured region is near the acromioclavicular joint. In this study, to identify a superior internal fixation method for unstable distal clavicular fracture, we compared three types of internal fixation (tension band wiring, scorpion, and LCP clavicle hook plate. Firstly, loading tests were performed, in which fixations were evaluated using bending stiffness and torsional stiffness as indices, followed by finite element analysis to evaluate fixability using the stress and strain as indices. The bending and torsional stiffness were significantly higher in the artificial clavicles fixed with the two types of plate than in that fixed by tension band wiring (P<0.05. No marked stress concentration on the clavicle was noted in the scorpion because the arm plate did not interfere with the acromioclavicular joint, suggesting that favorable shoulder joint function can be achieved. The stability of fixation with the LCP clavicle hook plate and the scorpion was similar, and plate fixations were stronger than fixation by tension band wiring.

Angular-stable locking plate fixation of tibial plateau fractures-clinical and radiological midterm results in 101 patients

OpenAIRE

Sven Mardian; Felix Landmann; Florian Wichlas; Norbert P Haas; Klaus-Dieter Schaser; Philipp Schwabe

2015-01-01

Background: Articular reconstruction and stable fixation of tibial plateau fractures and its various subtypes continue to represent a surgical challenge. Only few trials have studied results following angular stable plate fixation. The present study aimed to investigate the clinical, radiological, functional and quality of life results following tibial plateau fractures using angular stable plate fixation. Materials and Methods: 101 patients were retrospectively studied using functional (...

A novel combined method of osteosynthesis in treatment of tibial fractures: a comparative study on sheep with application of rod-through-plate fixator and bone plating.

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Tralman, G; Andrianov, V; Arend, A; Männik, P; Kibur, R T; Nõupuu, K; Uksov, D; Aunapuu, M

2013-04-01

The study compares the efficiency of a new bone fixator combining periostal and intramedullary osteosynthesis to bone plating in treatment of tibial fractures in sheep. Experimental osteotomies were performed in the middle third of the left tibia. Animals were divided into two groups: in one group (four animals) combined osteosynthesis (rod-through-plate fixator, RTP fixator) was applied, and in the other group (three animals) bone plating was used. The experiments lasted for 10 weeks during which fracture union was followed by radiography, and the healing process was studied by blood serum markers reflecting bone turnover and by histological and immunohistochemical investigations. In the RTP fixator group, animals started to load body weight on the operated limbs the next day after the surgery, while in the bone plating group, this happened only on the seventh day. In the RTP fixator group, consolidation of fractures was also faster, as demonstrated by radiographical, histological, and immunohistochemical investigations and in part by blood serum markers for bone formation. It can be concluded that application of RTP fixation is more efficient than plate fixation in the treatment of experimental osteotomies of long bones in sheep. © 2012 Blackwell Verlag GmbH.

Treatment of Middle Third Humeral Shaft Fractures with Anteromedial Plate Osteosynthesis through an Anterolateral Approach

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Kumar BS

2016-03-01

Full Text Available Background: Treatment of humeral shaft fractures has been a subject of debate for many decades. Even though a large majority of humeral shaft fractures can be treated by non operative methods, few conditions like open fractures, polytrauma, ipsilateral humeral shaft and forearm fractures require surgical intervention. The goal of treatment of humeral shaft fractures is to establish union with an acceptable humeral alignment and to restore the patient to pre-injury level of function. The objective was to assess the incidence of radial nerve palsy, non-union and mean time required for in anteromedial plate osteosynthesis with anterolateral approach and also to measure the functional outcome of this procedure. Method: A prospective study was conducted in the Department of Orthopaedics, PESIMSR, Kuppam, Andhra Pradesh, from August 2012 to August 2015 with a total of 54 patients who were operated with anteromedial plate osteosynthesis were included in the study. RodriguezMerchan criteria was used to grade the functional outcome. Results: Of the 54 patients, 28 (58.85% were in the age group of 30-40 years. The most common fracture pattern identified was A3 type (48.14%.The mean (+ SD duration of surgery for anteromedial humeral plating was 53 ± 5.00 minutes. The time taken for the fracture to unite was less than 16 weeks in the majority or 50 patients (92.59%. Four (7.40% patients had delayed union. There was no incidence of iatrogenic radial nerve palsy. Rodriguez – Merchan criteria showed that 37(68.51% of the patients had good and 12 (22.22% had excellent functional outcome.

Use of tranexamic acid in dynamic hip screw plate fixation for trochanteric fractures.

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Baruah, Ranjit Kumar; Borah, Pranab Jyoti; Haque, Russel

2016-12-01

To evaluate perioperative blood loss and blood transfusion requirement in patients who underwent dynamic hip screw plate fixation for a stable trochanteric fracture with or without preoperative intravenous tranexamic acid (TXA). 49 men and 11 women (mean age, 56.5 years) who underwent open reduction and internal fixation with a dynamic hip screw plate for a stable trochanteric fracture by a single surgeon were equally randomised to receive either a single dose of intravenous TXA (15 mg/kg) 15 minutes prior to surgery or an equal volume of normal saline by slow infusion. Intra- and post-operative blood loss and the need for blood transfusion were assessed, as was any thromboembolic adverse event. The TXA and control groups were comparable in terms of age, gender, body mass index, blood pressure, pulse rate, time from injury to surgery, operating time, and preoperative haematological data. Blood loss was lower in the TXA than control group intraoperatively (320.3 vs. 403.33 ml, ptrochanteric fractures.

Treatment Results Of Diaphyseal Forearm Fractures With Dynamique Compression Plate A Retrospective study of 156 Cases.

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Hassan BOUSSAKRI

2015-12-01

Full Text Available This retrospective study addresses a series of 156 cases of forearm fractures. These 156 cases were managed in the trauma-orthopedic department (B4 of Fez University Hospital, Morocco, from May 2008 till January 2013. The purpose of this study is to analyze epidemiological and clinical factors of diaphyseal forearm fractures and the results of their treatment with dynamic compression plate (DCP, as well as the complications and therapeutic errors of this surgical technique. The frequency of hospitalization in the trauma-orthopedic department was 3,96%. Ages ranged between 16 and 83, the average age was 32. 132 patients were male (85%. 90% were managed at the day of trauma. Traffic accidents were the most frequent cause in 52% patients. The fracture was in the left forearm in 65% of patients. 53% of fracture lines were in the middle third of the forearm. 38 fractures were open, and 30 were admitted for polytrauma. Osteosynthesis was performed with dynamic compression plate for all patients. In comparison with the literature, our series shows the predominance of young male patients, with traffic accidents being the cause. Osteosynthesis with dynamic compression plate remains the treatment of choice that provides satisfactory results if the accuracy in this technique was respected.

Locking plate osteosynthesis in displaced 4-part fractures of the proximal humerus

DEFF Research Database (Denmark)

Brorson, Stig; Frich, Lars H; Winther, Annika

2011-01-01

There is considerable uncertainty about the optimal treatment of displaced 4-part fractures of the proximal humerus. Within the last decade, locking plate technology has been considered a breakthrough in the treatment of these complex injuries....

Optimization of geometrical characteristics of perforated plates

International Nuclear Information System (INIS)

Radisavljevic, Igor; Balos, Sebastian; Nikacevic, Milutin; Sidjanin, Leposava

2013-01-01

Highlights: ► Perforated plate are tested against 12.7 mm API projectile. ► Perforations similar to the projectile diameter offer more efficient core fracture. ► Larger perforations gave a more efficient core fragmentation. ► SEM microscopy analysis has shown a ductile fracture mode at impact point. - Abstract: In this paper, an attempt was made to design effective non-homogenous armor in form of perforated plate mounted at close distance from basic armor plate. Perforated plate with three perforation diameters: 9, 10 and 11 mm, two ligaments length: 3.5 and 4.5 mm ligaments, set at 0° and 28° angles, were combined to 13 mm basic plate and tested against 12.7 mm API ammunition. It has been shown that larger perforations gave a more efficient core fragmentation, while angled specimens were the only ones that offer full protection against five API shots when the perforated plate was placed at 100 mm from the basic plate. Perforations that are similar in size to the penetrating core diameter offer a more efficient core fracture, leading to a faster fragment separation. This may enable a smaller distance between the add-on perforated and basic plate to be used. Scanning electron microscopy analysis has shown a ductile fracture mode at impact point, with hardness values on plate basic level. On the other hand, a brittle fracture mode with a rise in local hardness measured near impact point is a result of intensive high speed plastic deformation produced by bending stresses. A drop in local hardness measured near impact point, may be the result of intensive cracking that occur due to repeated projectile impact

Splitting in Dual-Phase 590 high strength steel plates

International Nuclear Information System (INIS)

Yang Min; Chao, Yuh J.; Li Xiaodong; Tan Jinzhu

2008-01-01

Charpy V-notch impact tests on 5.5 mm thick, hot-rolled Dual-Phase 590 (DP590) steel plate were evaluated at temperatures ranging from 90 deg. C to -120 deg. C. Similar tests on 2.0 mm thick DP590 HDGI steel plate were also conducted at room temperature. Splitting or secondary cracks was observed on the fractured surfaces. The mechanisms of the splitting were then investigated. Fracture surfaces were analyzed by optical microscope (OM) and scanning electron microscope (SEM). Composition of the steel plates was determined by electron probe microanalysis (EPMA). Micro Vickers hardness of the steel plates was also surveyed. Results show that splitting occurred on the main fractured surfaces of hot-rolled steel specimens at various testing temperatures. At temperatures above the ductile-brittle-transition-temperature (DBTT), -95 deg. C, where the fracture is predominantly ductile, the length and amount of splitting decreased with increasing temperature. At temperatures lower than the DBTT, where the fracture is predominantly brittle, both the length and width of the splitting are insignificant. Splitting in HDGI steel plates only appeared in specimens of T-L direction. The analysis revealed that splitting in hot-rolled plate is caused by silicate and carbide inclusions while splitting in HDGI plate results from strip microstructure due to its high content of manganese and low content of silicon. The micro Vickers hardness of either the inclusions or the strip microstructures is higher than that of the respective base steel

Using external and internal locking plates in a two-stage protocol for treatment of segmental tibial fractures.

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Ma, Ching-Hou; Tu, Yuan-Kun; Yeh, Jih-Hsi; Yang, Shih-Chieh; Wu, Chin-Hsien

2011-09-01

The tibial segmental fractures usually follow high-energy trauma and are often associated with many complications. We designed a two-stage protocol for these complex injuries. The aim of this study was to assess the outcome of tibial segmental fractures treated according to this protocol. A prospective series of 25 consecutive segmental tibial fractures were treated using a two-stage procedure. In the first stage, a low-profile locking plate was applied as an external fixator to temporarily immobilize the fractures after anatomic reduction had been achieved followed by soft-tissue reconstruction. The second stage involved definitive internal fixation with a locking plate using a minimally invasive percutaneous plate osteosynthesis technique. The median follow-up was 32 months (range, 20-44 months). All fractures achieved union. The median time for the proximal fracture union was 23 weeks (range, 12-30 weeks) and that for distal fracture union was 27 weeks (range, 12-46 weeks; p = 0.08). Functional results were excellent in 21 patients and good in 4 patients. There were three cases of delayed union of distal fracture. Valgus malunion >5 degrees occurred in two patients, and length discrepancy >1 cm was observed in two patients. Pin tract infection occurred in three patients. Use of the two-stage procedure for treatment of segmental tibial fractures is recommended. Surgeons can achieve good reduction with stable temporary fixation, soft-tissue reconstruction, ease of subsequent definitive fixation, and high union rates. Our patients obtained excellent knee and ankle joint motion, good functional outcomes, and a comfortable clinical course.

In vivo study of magnesium plate and screw degradation and bone fracture healing.

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Chaya, Amy; Yoshizawa, Sayuri; Verdelis, Kostas; Myers, Nicole; Costello, Bernard J; Chou, Da-Tren; Pal, Siladitya; Maiti, Spandan; Kumta, Prashant N; Sfeir, Charles

2015-05-01

Each year, millions of Americans suffer bone fractures, often requiring internal fixation. Current devices, like plates and screws, are made with permanent metals or resorbable polymers. Permanent metals provide strength and biocompatibility, but cause long-term complications and may require removal. Resorbable polymers reduce long-term complications, but are unsuitable for many load-bearing applications. To mitigate complications, degradable magnesium (Mg) alloys are being developed for craniofacial and orthopedic applications. Their combination of strength and degradation make them ideal for bone fixation. Previously, we conducted a pilot study comparing Mg and titanium devices with a rabbit ulna fracture model. We observed Mg device degradation, with uninhibited healing. Interestingly, we observed bone formation around degrading Mg, but not titanium, devices. These results highlighted the potential for these fixation devices. To better assess their efficacy, we conducted a more thorough study assessing 99.9% Mg devices in a similar rabbit ulna fracture model. Device degradation, fracture healing, and bone formation were evaluated using microcomputed tomography, histology and biomechanical tests. We observed device degradation throughout, and calculated a corrosion rate of 0.40±0.04mm/year after 8 weeks. In addition, we observed fracture healing by 8 weeks, and maturation after 16 weeks. In accordance with our pilot study, we observed bone formation surrounding Mg devices, with complete overgrowth by 16 weeks. Bend tests revealed no difference in flexural load of healed ulnae with Mg devices compared to intact ulnae. These data suggest that Mg devices provide stabilization to facilitate healing, while degrading and stimulating new bone formation. Copyright © 2015 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.

Functional outcome of Schatzker type V and VI tibial plateau fractures treated with dual plates

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G Thiruvengita Prasad

2013-01-01

Full Text Available Background: Dual plate fixation in comminuted bicondylar tibial plateau fractures remains controversial. Open reduction and internal fixation, specifically through compromised soft tissues, has historically been associated with major wound complications. Alternate methods of treatment have been described, each with its own merits and demerits. We performed a retrospective study to evaluate the functional outcome of lateral and medial plate fixation of Schatzker type V and VI fractures through an anterolateral approach, and a medial minimally invasive approach or a posteromedial approach. Materials and Methods: We treated 46 tibial plateau fractures Schatzker type V and VI with lateral and medial plates through an anterolateral approach and a medial minimal invasive approach over an 8 years period. Six patients were lost to followup. Radiographs in two planes were taken in all cases. Immediate postoperative radiographs were assessed for quality of reduction and fixation. The functional outcome was evaluated according to the Oxford Knee Score criteria on followup. Results: Forty patients (33 men and 7 women who completed the followup were included in the study. There were 20 Schatzker type V fractures and 20 Schatzker type VI fractures. The mean duration of followup was 4 years (range 1-8 years. All patients had a satisfactory articular reduction defined as ≤2 mm step-off or gap as assessed on followup. All patients had a good coronal and sagittal plane alignment, and articular width as assessed on supine X-rays of the knee in the anteroposterior (AP and lateral views. The functional outcome, as assessed by the Oxford Knee Score, was excellent in 30 patients and good in 10 patients. All patients returned to their pre-injury level of activity and employment. There were no instances of deep infection. Conclusions: Dual plate fixation of severe bicondylar tibial plateau fractures is an excellent treatment option as it provides rigid fixation and

Water, oceanic fracture zones and the lubrication of subducting plate boundaries—insights from seismicity

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Schlaphorst, David; Kendall, J.-Michael; Collier, Jenny S.; Verdon, James P.; Blundy, Jon; Baptie, Brian; Latchman, Joan L.; Massin, Frederic; Bouin, Marie-Paule

2016-03-01

We investigate the relationship between subduction processes and related seismicity for the Lesser Antilles Arc using the Gutenberg-Richter law. This power law describes the earthquake-magnitude distribution, with the gradient of the cumulative magnitude distribution being commonly known as the b-value. The Lesser Antilles Arc was chosen because of its along-strike variability in sediment subduction and the transition from subduction to strike-slip movement towards its northern and southern ends. The data are derived from the seismicity catalogues from the Seismic Research Centre of The University of the West Indies and the Observatoires Volcanologiques et Sismologiques of the Institut de Physique du Globe de Paris and consist of subcrustal events primarily from the slab interface. The b-value is found using a Kolmogorov-Smirnov test for a maximum-likelihood straight line-fitting routine. We investigate spatial variations in b-values using a grid-search with circular cells as well as an along-arc projection. Tests with different algorithms and the two independent earthquake cataloges provide confidence in the robustness of our results. We observe a strong spatial variability of the b-value that cannot be explained by the uncertainties. Rather than obtaining a simple north-south b-value distribution suggestive of the dominant control on earthquake triggering being water released from the sedimentary cover on the incoming American Plates, or a b-value distribution that correlates with on the obliquity of subduction, we obtain a series of discrete, high b-value `bull's-eyes' along strike. These bull's-eyes, which indicate stress release through a higher fraction of small earthquakes, coincide with the locations of known incoming oceanic fracture zones on the American Plates. We interpret the results in terms of water being delivered to the Lesser Antilles subduction zone in the vicinity of fracture zones providing lubrication and thus changing the character of the

MINIMAL INVASIVE PLATE OSTEOSYNTHESIS- AN EFFECTIVE TREATMENT METHOD FOR DISTAL TIBIA INTRAARTICULAR (PILON FRACTURES- AN 18 MONTHS FOLLOW UP

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Saket Jati

2016-12-01

Full Text Available BACKGROUND Tibial pilon fracture though requires operative treatment is difficult to manage. Conventional osteosynthesis is not suitable, because distal tibia is subcutaneous bone with poor vascularity. Closed reduction and Minimally Invasive Plate Osteosynthesis (MIPO for distal tibia has emerged as an alternative treatment option because it respects fracture biology and haematoma and also provides biomechanically stable construct. The aim of the study is to evaluate the results of minimally invasive plate osteosynthesis using locking plates in treating tibial pilon fractures in terms of fracture union, restoration of ankle function and complications. MATERIALS AND METHODS 30 patients with closed tibial pilon fractures (Ruedi and Allgower type I (14, type II (13, type III (3 treated with MIPO with Locking Compression Plates (LCP were prospectively followed for average duration of 18 months. RESULTS Average duration of injury-hospital and injury-surgery interval was as 12.05 hrs. and 3.50 days, respectively. All fractures got united with an average duration of 20.8 weeks (range 14-28 weeks. Olerud and Molander score was used for evaluation at 3 months, 6 months and 18 months. One patient had union with valgus angulation of 15 degrees, but no nonunion was found. CONCLUSION The present study shows that MIPO with LCP is an effective treatment method in terms of union time and complications rate for tibial pilon fracture promoting early union and early weight bearing.

Adolescent Volar Barton Fracture with Open Physis treated with Volar Plating using Buttressing Principle

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Shah H

2015-07-01

Full Text Available Objective: The objective of the study was to assess the outcome of Salter- Harris type III distal radius fracture fixed using the principle of buttressing and avoiding screw insertion through the physis. Materials and Method: Eight school going children in the age group of 11-16 years with volar Barton fractures were treated with a volar plate using the buttress principle without inserting screws in the distal fragment. Patients were evaluated over a period of 18 months. Clinical evaluation was done using the Green O’Brien criteria and radiological evaluation using the Sarmiento criteria. Results: The average union time was two months. All the patients had good to excellent functional outcome with full extension and flexion. Conclusion: Buttress plating of volar Barton fractures in the adolescent age group is an excellent technique to achieve satisfactory outcome without violation of the physis.

A customized fixation plate with novel structure designed by topological optimization for mandibular angle fracture based on finite element analysis.

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Liu, Yun-Feng; Fan, Ying-Ying; Jiang, Xian-Feng; Baur, Dale A

2017-11-15

The purpose of this study was to design a customized fixation plate for mandibular angle fracture using topological optimization based on the biomechanical properties of the two conventional fixation systems, and compare the results of stress, strain and displacement distributions calculated by finite element analysis (FEA). A three-dimensional (3D) virtual mandible was reconstructed from CT images with a mimic angle fracture and a 1 mm gap between two bone segments, and then a FEA model, including volume mesh with inhomogeneous bone material properties, three loading conditions and constraints (muscles and condyles), was created to design a customized plate using topological optimization method, then the shape of the plate was referenced from the stress concentrated area on an initial part created from thickened bone surface for optimal calculation, and then the plate was formulated as "V" pattern according to dimensions of standard mini-plate finally. To compare the biomechanical behavior of the "V" plate and other conventional mini-plates for angle fracture fixation, two conventional fixation systems were used: type A, one standard mini-plate, and type B, two standard mini-plates, and the stress, strain and displacement distributions within the three fixation systems were compared and discussed. The stress, strain and displacement distributions to the angle fractured mandible with three different fixation modalities were collected, respectively, and the maximum stress for each model emerged at the mandibular ramus or screw holes. Under the same loading conditions, the maximum stress on the customized fixation system decreased 74.3, 75.6 and 70.6% compared to type A, and 34.9, 34.1, and 39.6% compared to type B. All maximum von Mises stresses of mandible were well below the allowable stress of human bone, as well as maximum principal strain. And the displacement diagram of bony segments indicated the effect of treatment with different fixation systems. The

Effect of stainless steel and titanium low-contact dynamic compression plate application on the vascularity and mechanical properties of cortical bone after fracture.

Science.gov (United States)

Jain, R; Podworny, N; Hearn, T; Anderson, G I; Schemitsch, E H

1997-10-01

Comparison of the effect of stainless steel and titanium low-contact dynamic compression plate application on the vascularity and mechanical properties of cortical bone after fracture. Randomized, prospective. Orthopaedic research laboratory. Ten large (greater than twenty-five kilogram) adult dogs. A short, midshaft spiral tibial fracture was created, followed by lag screw fixation and neutralization with an eight-hole, 3.5-millimeter, low-contact dynamic compression plate (LCDCP) made of either 316L stainless steel (n = five) or commercially pure titanium (n = five). After surgery, animals were kept with unrestricted weight-bearing in individual stalls for ten weeks. Cortical bone blood flow was assessed by laser Doppler flowmetry using a standard metalshafted probe (Periflux Pf303, Perimed, Jarfalla, Sweden) applied through holes in the custom-made LCDCPs at five sites. Bone blood flow was determined at four times: (a) prefracture, (b) postfracture, (c) postplating, and (d) ten weeks postplating. After the dogs were killed, the implant was removed and both the treated tibia and contralateral tibia were tested for bending stiffness and load to failure. Fracture creation decreased cortical perfusion in both groups at the fracture site (p = 0.02). The application of neither stainless steel nor titanium LCDCPs further decreased cortical bone blood flow after fracture creation. However, at ten weeks postplating, cortical perfusion significantly increased compared with acute postplating levels in the stainless steel (p = 0.003) and titanium (p = 0.001) groups. Cortical bone blood flow ten weeks postplating was not significantly different between the titanium group and the stainless steel group. Biomechanical tests performed on the tibiae with the plates removed did not reveal any differences in bending stiffness nor load required to cause failure between the two groups. Both titanium and stainless steel LCDCPs were equally effective in allowing revascularization, and

Diaphyseal Fractures of the Forearm in Adults, Plating Or Intramedullary Nailing Is a Better Option for the Treatment?

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Tabet A. Al-Sadek

2016-11-01

Full Text Available BACKGROUND: Fractures of the radius and ulna occupy a large field of the modern traumatology. Therefore, these fractures are a major subject in modern orthopaedics and traumatology. The study of the mechanisms of the trauma, and the pathophysiological changes that occur are of great importance for the development of ever more efficient and varied ways of the treatment and prophylactics of this type of fracture. AIM: The aim of this paper was to study the pattern of the diaphyseal fractures of the forearm in adults, to decide the modalities of surgical management, to observe the period of fracture healing clinically and radiologically, as well to study the rehabilitation of the patients. MATERIAL AND METHODS: The present study included 45 cases of diaphyseal fractures of both bones forearm in adults presenting to the orthopaedic outpatient department. For all the patients a detailed history was taken. A thorough clinical examination was carried out, required X-rays were taken, and initial treatment was given and admitted as in all patients. After careful pre-operative planning and evaluation for anaesthetic fitness, patients were operated for the fractures of both bone forearms. Twenty-three cases with 46 fractures were treated by open reduction and rigid fixation with DCP & Semi-tubular plates and 22 cases with 44 fractures were treated by closed reduction and fixation with “Talwarkar” intramedullary square nails. RESULTS: United results were found in 100% of plating group vs. 86% in the nailing group. Delayed and non-union results were found in 9% of the nailing group only. Average time to union in weeks was 9.4 weeks in the plating group vs. 10.2 weeks in the nailing group. CONCLUSION: Open reduction and internal fixation with compression plates with strict adherence to surgical technique is the gold standard method of treatment in both bones forearm fractures with excellent results than closed reduction, internal fixation with �

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

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

2010-12-01

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

Use of locking compression plates in ulnar fractures of 18 horses.

Science.gov (United States)

Jacobs, Carrie C; Levine, David G; Richardson, Dean W

2017-02-01

To describe the outcome, clinical findings, and complications associated with the use of the locking compression plate (LCP) for various types of ulnar fractures in horses. Retrospective case series. Client owned horses (n = 18). Medical records, radiographs, and follow-up for horses having an ulnar fracture repaired using at least 1 LCP were reviewed. Fifteen of 18 horses had fractures of the ulna only, and 3 horses had fractures of the ulna and proximal radius. All 18 horses were discharged from the hospital. Complications occurred in 5 horses; incisional infection (n = 4, 22%), implant-associated infection (n = 2, 11%), and colic (n = 1, 6%). Follow-up was available for all horses at a range of 13-120 months and 15 horses (83%) were sound for their intended purpose and 3 horses (17%) were euthanatized. One horse was euthanatized for complications associated with original injury and surgery. The LCP is a viable method of internal fixation for various types of ulnar fractures, with most horses in this series returning to soundness. © 2017 The American College of Veterinary Surgeons.

FUNCTIONAL OUTCOME OF SUPRACONDYLAR FRACTURES OF FEMUR MANAGED BY OPEN REDUCTION AND INTERNAL FIXATION WITH LOCKING COMPRESSION PLATE

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Madhusudhana

2015-10-01

Full Text Available INTRODUCTION : Incidence of distal femur fractures is approximately 37 per 1 , 00,000 person - years.¹Distal femoral fractures has two different injury mechanisms, high energy trauma and low energy trauma. In high - energy trauma, the problem of restoring the function in a destroyed knee joint persists. Complex knee ligament injuries frequently occur additionally to extensive cartilage injuries. In elderly patients, extreme osteoporosis represents a particular problem for anchoring the implant. 2 Supracondylar and inter condylar fractures often are unstable and comminuted and tend to occur in the elderly or those with multiple injuries. Treatment options are many with varied results. The final outcome would depend upon the type of fracture, stabilization of fixation and and perhaps patient general condition. 3 The options for operative treatment are traditional plating techniques that require compression of the implant to the femoral shaft (blade plate, Dynamic Condylar Screw, non - locking condylar buttress plate, antegrade nailing fixation, retrograde nailing, sub muscular locked internal fixation and external fixation. 4 However, as the complexity of fractures needing treatment has changed from simple extra - articular supra - condylar types to inter - condylar and metaphyseal comminuted types, these implants may not be ideal. Double plating, and more recently, locked plating techniques have been advocated 5 . However with double plating there is often extensive soft tissue stripping on both sides of the femur, resulting in reduced blood supply and potential non - union and failure of the implants 6 . The LCP is a single beam construct where the strength of its fixation is equal to the sum of all screw - bone interfaces rather than a single screw’s axial stiffness or pullout resistance as seen in unlocked plates 7,8 . Its unique biomechanical function is based on splinting rather than compression resulting in flexible stabilization

Early results for treatment of two- and three-part fractures of the proximal humerus using Contours PHP (proximal humeral plate).

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Biazzo, Alessio; Cardile, Carlo; Brunelli, Luca; Ragni, Paolo; Clementi, Daniele

2017-04-28

The management of displaced 2- and 3-part fractures of the proximal humerus is controversial, both in younger and in elderly patients. The purpose of this paper is to evaluate the functional results of the Contours Proximal Humerus Plate (OrthofixR, Bussolengo,Verona, Italy), for the treatment of displaced 2- and 3-part fractures of the proximal humerus. We retrospectively reviewed 55 patients with proximal humerus fractures, who underwent osteosynthesis with Contours Proximal Humerus Plate from December 2011 to March 2015. We had 21 patients with 2-part fractures and with an average age of 67.1 years and 34 patients with 3-part fractures, with average age of 63.6 years. The average union time was 3 months. The mean Constant score was 67 for 2-part fracture group and 64.9 for 3-part fracture group. The difference was not statistically significant (p = 0.18). The overall complication rate was 14.5 %. Six patients underwent additional surgery (10.9%). The most frequent major complication was secondary loss of reduction following varus collapse of the fracture (2 cases). In these patients, there was loss of medial hinge integrity due to impaction and osteoporosis. The placement of the main locking screw in the calcar area to provide inferomedial support is the rational of the Contours Proximal Humerus Plate. Osteosynthesis with Contours Proximal Humerus Plate is a safe system for treating displaced 2- and 3-part fractures of the proximal humerus, with good functional results and complication rates comparable to those reported in the literature.

Comparison and analysis of reoperations in two different treatment protocols for trochanteric hip fractures - postoperative technical complications with dynamic hip screw, intramedullary nail and Medoff sliding plate.

Science.gov (United States)

Paulsson, Johnny; Stig, Josefine Corin; Olsson, Ola

2017-08-24

In treatment of unstable trochanteric fractures dynamic hip screw and Medoff sliding plate devices are designed to allow secondary fracture impaction, whereas intramedullary nails aim to maintain fracture alignment. Different treatment protocols are used by two similar Swedish regional emergency care hospitals. Dynamic hip screw is used for fractures considered as stable within the respective treatment protocol, whereas one treatment protocol (Medoff sliding plate/dynamic hip screw) uses biaxial Medoff sliding plate for unstable pertrochanteric fractures and uniaxial Medoff sliding plate for subtrochanteric fractures, the second (intramedullary nail/dynamic hip screw) uses intramedullary nail for subtrochanteric fractures and for pertrochanteric fractures with intertrochanteric comminution or subtrochanteric extension. All orthopedic surgeries are registered in a regional database. All consecutive trochanteric fracture operations during 2011-2012 (n = 856) and subsequent technical reoperations (n = 40) were derived from the database. Reoperations were analysed and classified into the categories adjustment (percutaneous removal of the locking screw of the Medoff sliding plate or the intramedullary nail, followed by fracture healing) or minor, intermediate (reosteosynthesis) or major (hip joint replacement, Girdlestone or persistent nonunion) technical complications. The relative risk of intermediate or major technical complications was 4.2 (1.2-14) times higher in unstable pertrochanteric fractures and 4.6 (1.1-19) times higher in subtrochanteric fractures with treatment protocol: intramedullary nail/dynamic hip screw, compared to treatment protocol: Medoff sliding plate/dynamic hip screw. Overall rates of intermediate and major technical complications in unstable pertrochanteric and subtrochanteric fractures were with biaxial Medoff sliding plate 0.68%, with uniaxial Medoff sliding plate 1.4%, with dynamic hip screw 3.4% and with intramedullary nail 7.2%. The

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

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Christian Fang

2015-12-01

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

Use of a bone plate for treatment of middle phalangeal fractures in horses: seven cases (1979-1984)

International Nuclear Information System (INIS)

Doran, R.E.; White, N.A. II; Allen, D.

1987-01-01

Four adult horses and 3 foals with middle phalangeal fractures were treated by arthrodesis of the proximal interphalangeal joint, using a bone plate. Six of the 7 horses survived greater than 2 years; 2 of the 6 horses had intermittent lameness after hard work, and 4 horses didn't have evidence of lameness. The use of a bone plate for arthrodesis of the proximal interphalangeal joint was a successful treatment alternative for middle phalangeal fractures in horses

[Locked plating with minimally invasive percutaneous plate osteosynthesis versus intramedullary nailing of distal extra-articular tibial fracture: a retrospective study].

Science.gov (United States)

Yao, Qi; Ni, Jie; Peng, Li-bin; Yu, Da-xin; Yuan, Xiao-ming

2013-12-17

To compare the efficacies of minimally invasive plate osteosynthesis (MIPPO) and interlocking intramedullary nailing (IMN) in the treatment of extra-articular fractures of distal tibia. Retrospective reviews were conducted for 126 patients with extra-articular distal tibia fractures. Treatment was either MIPPO (n = 61) or IMN (n = 65). The outcomes were assessed by comparing operating duration, time to union, the last follow-up American Orthopedic Foot and Ankle Society (AOFAS) score and complication rate. The average follow-up period was 23.7 (12-53) months. In the minimally invasive plate osteosynthesis group, there were deep infections (n = 2), superficial infections (n = 5), delayed union (n = 2), malunion (n = 2) and knee joint pain (n = 10) were observed. In addition, the average operating duration (85.9 ± 18.9 min), average time to union (17.3 ± 3.8 weeks) and average AOFAS (83.2 ± 11.9) were analyzed. In the interlocking intramedullary nailing group, there were delayed union (n = 3), malunion (n = 12) and knee joint pain (n = 22). And the average operating duration (83.3 ± 15.7 min), average time to union (16.5 ± 3.1 weeks) and average AOFAS (84.9 ± 12.0) were analyzed. No statistical significance existed in operating duration, time to union and the last follow-up AOFAS between two groups (P > 0.05). However, the rates of malformation and knee joint pain were higher in the intramedullary nail group than those in the plate group. And the difference was statistically significant (P = 0.015, P = 0.025). Both MIPPO and IMN are effective for extra-articular fractures of distal tibia. However, the former has the advantage of lowers rate of malformation and knee joint pain. Therefore a surgeon should consider the degree of injury while managing extra-articular fracture of distal tibia.

Features of Three- and Four-Part Proximal Humeral Fractures and Outcome of Internal Fixation Using the Philos® Locking Plate

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Ali Sadighi

2017-03-01

Full Text Available Background: Proximal humeral fractures are among common types of fractures and remain a challenging issue for surgical management. This study aimed to assess the clinical outcomes and complication rates of three- vs. four-part proximal humeral fractures, treated with internal fixation using the Philos® plate. Material and Methods: In this cohort study, a total of 30 consecutive patients with three-part or four-part proximal humeral fractures based on the Neer classification were included. Surgical treatment was performed with open reduction and internal fixation using the Philos® plate. The constant score was evaluated 6 months later in follow-up. The P<0.05 was considered significant. Results: Four-part fractures were mainly caused by trauma from above, while insults of opposite direction were responsible for more than half of 3 part fractures (P=0.01. Open fractures were only observed in patients with a four-part fracture (P=0.018. No significant differences were noticed regarding gender, cause, and side of the fracture. The presence of other fractures, fracture of the implant, reduction loss, avascular necrosis (AVN of humerus head, rotator cuff injury, and revision surgery were significantly higher in patients with four-part fractures. The mean constant score was 81.40±11.61 and 65.09±16.09 for three-part and four-part fractures, respectively (P=0.006. Conclusion: Open reduction and internal fixation with Philos® plate yield acceptable results in both types of fractures, however, the prognosis of this intervention is poorer four-part fractures.

Biomechanical testing of a hybrid locking plate fixation of equine sesamoid osteotomies.

Science.gov (United States)

Almeida da Silveira, E; Levasseur, A; Lacourt, M; Elce, Y; Petit, Y

2014-01-01

To compare the biomechanical properties of a hybrid locking compression plate (LCP) construct with the compression screw technique as a treatment for transverse mid-body proximal sesamoid bone fractures. Ten paired forelimbs from abattoir horses were used. The medial proximal sesamoid bone of each limb was osteotomized transversely and randomly assigned, to either repair with a two-hole 3.5 mm LCP or a 4.5 mm cortical screw placed in lag fashion. Each limb was tested biomechanically by axial loading in single cycle until failure. The point of failure was evaluated from the load-displacement curves. Then a gross evaluation and radiographs were performed to identify the mode of failure. The loads to failure of limbs repaired with the hybrid LCP construct (4968 N ± 2167) and the limbs repaired with the screw technique (3009 N ± 1091) were significantly different (p fracture of the apical fragment of the proximal sesamoid bone. The LCP technique has potential to achieve a better fracture stability and healing when applied to mid-body fractures of the proximal sesamoid bone. Further testing, particularly fatigue resistance is required to corroborate its potential as a treatment option for mid-body fractures of the proximal sesamoid bone.

Acquirement of true stress-strain curve using true fracture strain obtained by tensile test and FE analysis

International Nuclear Information System (INIS)

Lee, Kyoung Yoon; Kim, Tae Hyung; Lee, Hyung Yil

2009-01-01

In this work, we predict a true fracture strain using load-displacement curves from tensile test and Finite Element Analysis (FEA), and suggest a method for acquiring true Stress-Strain (SS) curves by predicted fracture strain. We first derived the true SS curve up to necking point from load-displacement curve. As the beginning, the posterior necking part of true SS curve is linearly extrapolated with the slope at necking point. The whole SS curve is then adopted for FE simulation of tensile test. The Bridgman factor or suitable plate correction factors are applied to pre and post FEA. In the load-true strain curve from FEA, the true fracture strain is determined as the matching point to test fracture load. The determined true strain is validated by comparing with test fracture strain. Finally, we complete the true SS curve by combining the prior necking part and linear part, the latter of which connects necking and predicted fracture points.

Acquirement of true stress-strain curve using true fracture strain obtained by tensile test and FE analysis

Energy Technology Data Exchange (ETDEWEB)

Lee, Kyoung Yoon; Kim, Tae Hyung; Lee, Hyung Yil [Sogang University, Seoul (Korea, Republic of)

2009-07-01

In this work, we predict a true fracture strain using load-displacement curves from tensile test and Finite Element Analysis (FEA), and suggest a method for acquiring true Stress-Strain (SS) curves by predicted fracture strain. We first derived the true SS curve up to necking point from load-displacement curve. As the beginning, the posterior necking part of true SS curve is linearly extrapolated with the slope at necking point. The whole SS curve is then adopted for FE simulation of tensile test. The Bridgman factor or suitable plate correction factors are applied to pre and post FEA. In the load-true strain curve from FEA, the true fracture strain is determined as the matching point to test fracture load. The determined true strain is validated by comparing with test fracture strain. Finally, we complete the true SS curve by combining the prior necking part and linear part, the latter of which connects necking and predicted fracture points.

Acquirement of True Stress-strain Curve Using True Fracture Strain Obtained by Tensile Test and FE Analysis

Energy Technology Data Exchange (ETDEWEB)

Lee, Kyoung Yoon; Lee, Hyung Yil [Sogang University, Seoul (Korea, Republic of); Kim, Tae Hyung [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2009-10-15

In this work, we predict a true fracture strain using load-displacement curves from tensile test and finite element analysis (FEA), and suggest a method for acquiring true stress-strain (SS) curves by predicted fracture strain. We first derived the true SS curve up to necking point from load-displacement curve. As the beginning, the posterior necking part of true SS curve is linearly extrapolated with the slope at necking point. The whole SS curve is then adopted for FE simulation of tensile test. The Bridgman factor or suitable plate correction factors are applied to pre and post FEA. In the load-true strain curve from FEA, the true fracture strain is determined as the matching point to test fracture load. The determined true strain is validated by comparing with test fracture strain. Finally, we complete the true SS curve by combining the prior necking part and linear part, the latter of which connects necking and predicted fracture points.

Minimally invasive treatment of pilon fractures with a low profile plate: preliminary results in 17 cases

NARCIS (Netherlands)

Borens, Olivier; Kloen, Peter; Richmond, Jeffrey; Roederer, Goetz; Levine, David S.; Helfet, David L.

2009-01-01

To determine the results of "biologic fixation" with a minimally invasive plating technique using a newly designed low profile "Scallop" plate in the treatment of pilon fractures. Retrospective case series. A tertiary referral center. Seventeen patients were treated between 1999 and 2001 for a

Hook plate fixation of acute displaced lateral clavicle fractures: mid-term results and a brief literature overview

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Tiren Davut

2012-01-01

Full Text Available Abstract Background The clavicle hook plate achieves like most other operative techniques, a high percentage of union and a low percentage of complications however concerns about long term complications still exist, particularly the involvement of the acromioclavicular joint. Methods To evaluate the results and long term effects in use of this plate we performed a retrospective analysis with a mean follow up of 65 months (5.4 years of 28 consecutive patients with acute displaced lateral clavicle fractures, treated with the clavicle hook plate. Results Short term functional results in all patients were good to excellent. All but one patient had a united fracture (96%. Nine patients (32% developed impingement symptoms and in 7 patients (25% subacromial osteolysis was found. These findings resolved after plate removal. Twenty-four patients were re-evaluated at a mean follow-up period of 5.4 years. The Constant-Murley score was 97 and the DASH score was 3.5. Four patients (14% developed acromioclavicular joint arthrosis of which one was symptomatic. Three patients (11% had extra articular ossifications of which one was symptomatic. There was no relation between the impingement symptoms, subacromial osteolysis and development of acromioclavicular joint arthrosis or extra articular ossifications. Conclusions The clavicle hook plate is a good primary treatment option for the acute displaced lateral clavicle fracture with few complications. At mid term the results are excellent and no long term complications can be addressed to the use of the plate.

Theoretical and experimental study on unstable fracture for type 304 stainless steel plates with a soft tensile testing machine

International Nuclear Information System (INIS)

Yagawa, G.; Takahashi, Y.; Ando, Y.

1981-01-01

The object of this paper is to show experimental results on stable as well as unstable fractures for Type 304 stainless steel plates with a central crack using a soft tensile testing machine. The test machine was installed specially for the safety study of nuclear piping systems and its maximum loading capacity and maximum displacement are 600 ton and 500 mm, respectively. The compliance of the machine is 1.0 x 10 -4 (mm/N). The transition points from the stable to the unstable crack growth observed in the test were theoretically determined by using three methods. In the first method, the 'applied' value of T was calculated with the simple expression based on the dimensional analysis. In the second method, the fully-plastic solutions were used to calculate the nonlinear value of J, which was added to the linear value of J, thus the 'applied' values of T was determined by differentiating the total value of J, which was obtained for the material with the Ramberg-Osgood type stress-strain relation. In the final method, the finite element method was fully utilized to determine the 'applied' value of T. The value of J in the finite element method was obtained with the use of the path-integral. (orig./GL)

Benefits and harms of locking plate osteosynthesis in intraarticular (OTA Type C) fractures of the proximal humerus: A systematic review

DEFF Research Database (Denmark)

Brorson, Stig; Rasmussen, Jeppe Vejlgaard; Frich, Lars Henrik

2012-01-01

stable plates in AO/OTA Type C fractures of the proximal humerus. METHODS: We conducted an iterative search in PubMed, Embase, Cochrane Library, Web of Science, Cinahl, and PEDro in all languages from 1999 to November 2010. Eligible studies should study the outcome for Type C fractures after primary...... according to study type and synthesised qualitatively. No randomised clinical trials were identified. Two comparative, observational studies reported a mean CS of 71 (relative to contralateral shoulder) and 75 (non-adjusted Constant Score) for Type C fractures. For all studies mean non-adjusted CS ranged......INTRODUCTION: Locking plate osteosynthesis of proximal humeral fractures are widely recommended and used, even in complex intraarticular fracture patterns such as AO/OTA Type C fractures. We systematically reviewed clinical studies assessing the benefits and harms of osteosynthesis with angle...

[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.

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

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Rajendra Prasad

2013-01-01

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

Dual small fragment plating improves screw-to-screw load sharing for mid-diaphyseal humeral fracture fixation: a finite element study.

Science.gov (United States)

Kosmopoulos, Victor; Luedke, Colten; Nana, Arvind D

2015-01-01

A smaller humerus in some patients makes the use of a large fragment fixation plate difficult. Dual small fragment plate constructs have been suggested as an alternative. This study compares the biomechanical performance of three single and one dual plate construct for mid-diaphyseal humeral fracture fixation. Five humeral shaft finite element models (1 intact and 4 fixation) were loaded in torsion, compression, posterior-anterior (PA) bending, and lateral-medial (LM) bending. A comminuted fracture was simulated by a 1-cm gap. Fracture fixation was modelled by: (A) 4.5-mm 9-hole large fragment plate (wide), (B) 4.5-mm 9-hole large fragment plate (narrow), (C) 3.5-mm 9-hole small fragment plate, and (D) one 3.5-mm 9-hole small fragment plate and one 3.5-mm 7-hole small fragment plate. Model A showed the best outcomes in torsion and PA bending, whereas Model D outperformed the others in compression and LM bending. Stress concentrations were located near and around the unused screw holes for each of the single plate models and at the neck of the screws just below the plates for all the models studied. Other than in PA bending, Model D showed the best overall screw-to-screw load sharing characteristics. The results support using a dual small fragment locking plate construct as an alternative in cases where crutch weight-bearing (compression) tolerance may be important and where anatomy limits the size of the humerus bone segment available for large fragment plate fixation.

Anterior tension band plating for anterior tibial stress fractures in high-performance female athletes: a report of 4 cases

NARCIS (Netherlands)

Borens, Olivier; Sen, Milan K.; Huang, Russel C.; Richmond, Jeffrey; Kloen, Peter; Jupiter, Jesse B.; Helfet, David L.

2006-01-01

Stress fracture of the anterior tibial cortex is an extremely challenging fracture to treat, especially in the high-performance female athlete who requires rapid return to competition. Previous reports have not addressed treating these fractures in the world-class athlete with anterior plating. We

[Comparison of clinical effect on locking plate for proximal humeral fracture with or without application of inferomedial screws].

Science.gov (United States)

Guo, Xiu-wu; Fan, Jian; Yuan, Feng

2016-06-01

To compare clinical outcomes of locking plate for proximal humeral fracture whether application of inferomedial screws. From January 2012 to July 2013, 46 patients with proximal humeral fracture underwent locking plates were retrospectively analyzed. There were 25 males and 21 females aged from 29 to 80 years old with an average of 55.1 years old. Among them, 25 patients were treated with inferomedial screws (support group), including 13 males and 12 females aged from 38 to 80 years old with an average of (55.8 ± 11.8) years old; 8 cases were part two fracture,10 cases were part three fracture and 7 cases were part four fracture according to Neer classification. Twenty-one patients were treated without inferomedial screws (non-support group), including 12 males and 9 females aged from 29 to 79 years old with an average of (54.2 ± 14.8)years old; 6 cases were part two fracture, 9 cases were part three fracture and 6 cases were part four fracture according to Neer classification. Operative time, fracture healing time and complications were observed and compared, Neer scoring of shoulder joint were used to evaluate clinical effect. All patients were followed up from 12 to 41 months with an average of 15.6 months. Operative time and fracture healing time in support group was (1.6 ± 0.4) h and (3.0 ± 0.6) months, and (1.5 ± 0.4) h and (3.1 ± 0.6) months in non-support group, while there was no statistical difference in operative time and fracture healing time between two groups. There was significant differences in Neer score between support group (89.7± 4.9) and non-support group (83.1 ± 7.1). No complication occurred in support group,while 4 cases occurred complications in non-support group. Locking plate with inferomedial screws for proximal humeral fracture has advantages of stable fixation, less complications, quick recovery of function and satisfied clinical effect.

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

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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.

Periprosthetic Vancouver type B1 and C fractures treated by locking-plate osteosynthesis

DEFF Research Database (Denmark)

Froberg, Lonnie; Troelsen, Anders; Brix, Michael

2012-01-01

Historically, the treatment of periprosthetic femoral fractures (PFFs) has been associated with a high frequency of complications and reoperations. The preferred treatment is internal fixation, a revision of the femoral stem, or a combination of both. An improved understanding of plate use during...

The history, development and application of a uniformly applied load wide plate testing machine

International Nuclear Information System (INIS)

Quirk, A.; Bevitt, E.

1989-01-01

The paper describes early attempts to use a rigid end wide plate testing machine to investigate the behaviour of centre cracked flat plates. Confusing and inconsistent results arising from the above tests lead to a detailed investigation of the loading characteristics of rigid end machines in general and the difficulties which can arise in the interpretation of data obtained by the use of such machines. In order to overcome the above difficulties which stem largely from uneven load distribution, a versatile testing machine was designed which by use of cheap and easily obtainable components allows the application of a uniformly distributed applied load to a centre cracked test plate. The machine which was commissioned in its original form in 1975 was initially capable of testing plate of 820 mm width and 25 or 48 mm thickness up to maximum stress levels of 488 or 254 MPa respectively. The ease of adaptability of the machine has since permitted its capacity to be increased to handle plate up to 2032 mm wide and 76 mm thickness and by use of double-banked hydraulic jacks stress levels up to 350 MPa can be achieved on plate of these dimensions. The configuration of the machine allows adequate access for strain gauging, crack tip observation and measurements, and temperature control, tests having been conducted in the temperature range -40 0 C to 290 0 C. Advantages and potential for further development of the machine are given together with details of two of a number of fracture studies which have been conducted since its commissioning. (orig.)

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

Science.gov (United States)

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

2016-12-01

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

[Complications of treatment of acromioclavicular joint dislocation and unstable distal clavicular fracture with clavicular hook plate].

Science.gov (United States)

Zhu, Yi-Yong; Cui, Heng-Yan; Jiang, Pan-Qiang; Wang, Jian-Liang

2013-11-01

To investigate the causes and prevention of the complications about treatment of acromioclavicular joint dislocation (Tossy III) and unstable distal clavicular fracture (Neer II) with clavicular hook plate. From January 2001 to December 2011, 246 patients with acromioclavicular joint dislocation (Tossy III) and 222 patients with unstable distal clavicular fracture (Neer II) were treated with acromioclvicular hook plate fixation,including 348 males and 120 females with an average age of 45.4 years old ranging from 21 to 80 years old. The mean time from injury to operation was 30.8 hours (ranged from 1 h to 15 d). All patients had normal shoulder function before injury. According to Karlsson evaluation standard, the cases with excellent and good function of the shoulder joint were regarded as the normal group, and the cases with poor function of shoulder joint as the abnormal group. The comparison of the range of forward flexion,backward stretch, adduction, abduction and elevation of shoulder joints between two groups was performed. The data of impingement, subacromial osteolysis, acromioclavicular arthritis, clavicular stress fracture, downward acromioclavicular joint subluxation, hook cut-out and hook break were summarized. All patients were followed up from 8 to 48 months with an average of 12.5 months. The results were excellent in 308 cases,good in 76,and poor in 84 according to Karlsson evaluation. The excellent and good rate was 82.1%. The difference of the range of forward flexion, backward stretch, adduction, abduction and elevation of shoulder joints between two groups had a statistically significant difference (P acromioclavicular arthritis or painful shoulder caused by delayed dirigation,7 (1.50%) with clavicular stress fracture or interal plate upward, 6 (1.28%) with downward acromioclavicular joint subluxation, 5 (1.07%) with hook cut -out and 3 (0.64%) in hook break. The clavicular hook plate is useful for the treatment of acromioclavicular joint

A biomechanical comparison of proximal femoral nails and locking proximal anatomic femoral plates in femoral fracture fixation A study on synthetic bones

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Korhan Ozkan

2015-01-01

Conclusion: The proximal femoral intramedullary nail provides more stability and allows for earlier weight bearing than the locking plate when used for the treatment of unstable intertrochanteric fractures of the femur. Clinicians should be cautious for early weight bearing with locking plate for unstable intertrochanteric femur fractures.

Arthroscopy-assisted reduction of posteromedial tibial plateau fractures with buttress plate and cannulated screw construct.

Science.gov (United States)

Chiu, Chih-Hao; Cheng, Chun-Ying; Tsai, Min-Chain; Chang, Shih-Sheng; Chen, Alvin Chao-Yu; Chen, Yeung-Jen; Chan, Yi-Sheng

2013-08-01

To present the radiologic and clinical results of posteromedial fractures treated with arthroscopy-assisted reduction and buttress plate and cannulated screw fixation. Twenty-five patients with posteromedial tibial plateau fractures treated by the described technique were included in this study. According to the Schatzker classification, there were 5 type IV fractures (20%), 2 type V fractures (8%), and 18 type VI fractures (72%). The mean age at operation was 46 years (range, 21 to 79 years). The mean follow-up period was 86 months (range, 60 to 108 months). Clinical and radiologic outcomes were scored by the Rasmussen system. Subjective data were collected to assess swelling, difficulty climbing stairs, joint stability, ability to work and participate in sports, and overall patient satisfaction with recovery. Secondary osteoarthritis was diagnosed when radiographs showed a narrowed joint space in the injured knee at follow-up in comparison with the films taken at the time of injury. The mean postoperative Rasmussen clinical score was 25.9 (range, 18 to 29), and the mean radiologic score was 15.8 (range, 10 to 18). All 25 fractures achieved successful union, and 92% had good or excellent clinical and radiologic results. The 3 fracture types did not significantly differ in Rasmussen scores or rates of satisfactory results (P > .05). Secondary osteoarthritis was noted in 6 injured knees (24%). Arthroscopy-assisted reduction with buttress plate and cannulated screw fixation can restore posteromedial tibial plateau fractures of the knee with well-documented radiographic healing, good clinical outcomes, and low complication rates. Level IV, therapeutic case series. Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Well test analysis in fractured media

Energy Technology Data Exchange (ETDEWEB)

Karasaki, K.

1986-04-01

In this study the behavior of fracture systems under well test conditions and methods for analyzing well test data from fractured media are investigated. Several analytical models are developed to be used for analyzing well test data from fractured media. Numerical tools that may be used to simulate fluid flow in fractured media are also presented. Three types of composite models for constant flux tests are investigated. Several slug test models with different geometric conditions that may be present in fractured media are also investigated. A finite element model that can simulate transient fluid flow in fracture networks is used to study the behavior of various two-dimensional fracture systems under well test conditions. A mesh generator that can be used to model mass and heat flow in a fractured-porous media is presented. This model develops an explicit solution in the porous matrix as well as in the discrete fractures. Because the model does not require the assumptions of the conventional double porosity approach, it may be used to simulate cases where double porosity models fail.

COMPARATIVE STUDY BETWEEN TITANIUM ELASTIC NAILING (TENS AND DYNAMIC COMPRESSION PLATING (DCP IN THE TREATMENT OF FEMORAL DIAPHYSEAL FRACTURES IN CHILDREN

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Ramasubba Reddy

2015-08-01

Full Text Available BACKGROUND : Orthopaedic surgeons have long maintained that all children who have sustained a diaphyseal fracture of femur recover with c onservative treatment, given the excellent remodeling ability of immature bone in children. Angulations, shortenings and malrotations are not always corrected by conservative treatment. Of many surgical options, titanium elastic nailing has been the newer implant which is being used regularly. Although good results have been reported with elastic intramedullary nails, plate fixation continues to be a viable alternative in surgical treatment of femoral shaft fractures. However there are not many studies comp aring the efficiency of titanium elastic nailing and plating for femoral diaphyseal fractures in pediatric age group. AIM : The present study aims to compare the surgical management of diaphyseal fractures of femur in children with Dynamic Compression Plati ng versus Titanium Elastic Nailing. DESIGN : This is a prospective study . MATERIALS AND METHODS : This prospective study was conducted in a tertiary hospital. Patients who presented to the out - patient department and casualty of the hospital with femoral diap hyseal fractures during April 2012 to June 2014 were considered for the study. Subjects fulfilling the predetermined inclusion and exclusion criteria were included in the study. STATISTICAL METHODS : Fisher Exact test, Chi - Square Test, Student t test (Two t ailed, independent . RESULTS : Patients in the age group of 6 - 14 years were considered for the study, Patients were divided into two groups and treated with DCP/TENS. The duration of surgery, hospital stay, and, amount of blood loss was minimal in TENS grou p. Callus was seen early in TENS group. Radiological union was early in TENS group by 2 - 3 weeks. Outcome was better in patients treated with TENS (Excellent - 70%; Satisfactory – 30%; Poor - 0% in comparison to DCP (Excellent - 70%; Satisfactory - 25%; Poor - 5%. CO NCLUSION : TENS

Well test analysis in fractured media

Energy Technology Data Exchange (ETDEWEB)

Karasaki, K.

1987-04-01

The behavior of fracture systems under well test conditions and methods for analyzing well test data from fractured media are investigated. Several analytical models are developed to be used for analyzing well test data from fractured media. Numerical tools that may be used to simulate fluid flow in fractured media are also presented. Three types of composite models for constant flux tests are investigated. These models are based on the assumption that a fracture system under well test conditions may be represented by two concentric regions, one representing a small number of fractures that dominates flow near the well, and the other representing average conditions farther away from the well. Type curves are presented that can be used to find the flow parameters of these two regions and the extent of the inner concentric region. Several slug test models with different geometric conditions that may be present in fractured media are also investigated. A finite element model that can simulate transient fluid flow in fracture networks is used to study the behavior of various two-dimensional fracture systems under well test conditions. A mesh generator that can be used to model mass and heat flow in a fractured-porous media is presented.

The Evolution of Plate and Extruded Products with High Strength and Fracture Toughness

Science.gov (United States)

Denzer, D. K.; Rioja, R. J.; Bray, G. H.; Venema, G. B.; Colvin, E. L.

From the first use of 2017-T74 on the Junkers F13, improvements have been made to plate and extruded products for applications requiring the highest attainable strength and adequate fracture toughness. One such application is the upper wing of large aircraft. The progression of these product improvements achieved through the development of alloys that include 7075-(T6 & T76), 7150-(T6 & T77) and 7055-(T77 & T79) and most recently 7255-(T77 & T79) is reviewed. The most current advancements include aluminum-copper-lithium, alloy 2055 plate and extruded products that can attain strength equivalent to that of 7055-T77 with higher modulus, similar fracture toughness and improved fatigue, fatigue crack growth and corrosion performance. The achievement of these properties is explained in terms of the several alloy design principles. The highly desired and balanced characteristics make these products ideal for upper wing applications.

A comparative study of intramedullary interlocking nailing and minimally invasive plate osteosynthesis in extra articular distal tibial fractures.

Science.gov (United States)

Daolagupu, Arup K; Mudgal, Ashwani; Agarwala, Vikash; Dutta, Kaushik K

2017-01-01

Extraarticular distal tibial fractures are among the most challenging fractures encountered by an orthopedician for treatment because of its subcutaneous location, poor blood supply and decreased muscular cover anteriorly, complications such as delayed union, nonunion, wound infection, and wound dehiscence are often seen as a great challenge to the surgeon. Minimally invasive plate osteosynthesis (MIPO) and intramedullary interlocking nail (IMLN) are two well-accepted and effective methods, but each has been historically related to complications. This study compares clinical and radiological outcome in extraarticular distal tibia fractures treated by intramedullary interlocking nail (IMLN) and minimally invasive plate osteosynthesis (MIPO). 42 patients included in this study, 21 underwent IMLN and 21 were treated with MIPO who met the inclusion criteria and operated between June 2014 and May 2015. Patients were followed up for clinical and radiological evaluation. In IMLN group, average union time was 18.26 weeks compared to 21.70 weeks in plating group which was significant ( P ankle stiffness, and infection, were seen in interlocking group as compared to plating group. Average functional outcome according to American Orthopedic Foot and Ankle Society score was measured which came out to be 96.67. IMLN group was associated with lesser duration of surgery, earlier weight bearing and union rate, lesser incidence of infection and implant irritation which makes it a preferable choice for fixation of extra-articular distal tibial fractures. However, larger randomized controlled trials are required for confirming the results.

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

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Dema Rajaiah

2016-08-01

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

Staged minimally invasive plate osteosynthesis of proximal tibial fractures with acute compartment syndrome.

Science.gov (United States)

Kim, Joon-Woo; Oh, Chang-Wug; Oh, Jong-Keon; Kyung, Hee-Soo; Park, Kyeong-Hyeon; Kim, Hee-June; Jung, Jae-Wook; Jung, Young-Soo

2017-06-01

High-energy proximal tibial fractures often accompany compartment syndrome and are usually treated by fasciotomy with external fixation followed by secondary plating. However, the initial soft tissue injury may affect bony union, the fasciotomy incision or external fixator pin sites may lead to postoperative wound infections, and the staged procedure itself may adversely affect lower limb function. We assess the results of staged minimally invasive plate osteosynthesis (MIPO) for proximal tibial fractures with acute compartment syndrome. Twenty-eight patients with proximal tibial fractures accompanied by acute compartment syndrome who underwent staged MIPO and had a minimum of 12 months follow-up were enrolled. According to the AO/OTA classification, 6 were 41-A, 15 were 41-C, 2 were 42-A and 5 were 42-C fractures; this included 6 cases of open fractures. Immediate fasciotomy was performed once compartment syndrome was diagnosed and stabilization of the fracture followed using external fixation. After the soft tissue condition normalized, internal conversion with MIPO was done on an average of 37 days (range, 9-158) after index trauma. At the time of internal conversion, the external fixator pin site grades were 0 in 3 cases, 1 in 12 cases, 2 in 10 cases and 3 in 3 cases, as described by Dahl. Radiographic assessment of bony union and alignment and a functional assessment using the Knee Society Score and American Orthopedic Foot and Ankle Society (AOFAS) score were carried out. Twenty-six cases achieved primary bony union at an average of 18.5 weeks. Two cases of nonunion healed after autogenous bone grafting. The mean Knee Society Score and the AOFAS score were 95 and 95.3 respectively, at last follow-up. Complications included 1 case of osteomyelitis in a patient with a grade IIIC open fracture and 1 case of malunion caused by delayed MIPO due to poor wound conditions. Duration of external fixation and the external fixator pin site grade were not related to the

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

Science.gov (United States)

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

2017-06-01

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

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

Science.gov (United States)

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

2017-06-01

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

Greenland Fracture Zone-East Greenland Ridge(s) revisited: Indications of a C22-change in plate motion?

DEFF Research Database (Denmark)

Døssing, Arne; Funck, T.

2012-01-01

a reinterpretation of the Greenland Fracture Zone -East Greenland Ridge based on new and existing geophysical data. Evidence is shown for two overstepping ridge segments (Segments A and B) of which Segment A corresponds to the already known East Greenland Ridge while Segment B was not detected previously......Changes in the lithospheric stress field, causing axial rift migration and reorientation of the transform, are generally proposed as an explanation for anomalously old crust and/or major aseismic valleys in oceanic ridge-transform-ridge settings. Similarly, transform migration of the Greenland...... Fracture Zone and separation of the 200-km-long, fracture-zone-parallel continental East Greenland Ridge from the Eurasia plate is thought to be related to a major change in relative plate motions between Greenland and Eurasia during the earliest Oligocene (Chron 13 time). This study presents...

Wedge splitting test method: quantification of influence of glued marble plates by two-parameter fracture mechanics

Czech Academy of Sciences Publication Activity Database

Seitl, Stanislav; Nieto Garcia, B.; Merta, I.

2014-01-01

Roč. 30, OCT (2014), s. 174-181 ISSN 1971-8993 R&D Projects: GA MŠk(CZ) 7AMB14AT012 Institutional support: RVO:68081723 Keywords : Wedge splitting test * T-stress * K-calibration curves * Stress intensity factor * Concrete fracture test Subject RIV: JL - Materials Fatigue, Friction Mechanics

The Use of the String of Pearls Locking Plate System in the Stabilisation of a Comminuted Calcaneal Fracture in a Giant Breed Dog

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A. B. Scrimgeour

2011-01-01

Full Text Available An eight-year-old male Pyrenean mountain dog was presented with a comminuted fracture of the right calcaneus following motor vehicle trauma. The fracture was stabilised with a plate-rod construct, using the String of Pearls locking plate system and an intramedullary pin. Healing was uncomplicated.

Compartment syndrome like picture in metaphyseal comminuted fracture of tibia treated by locking plate due to tight closure

Directory of Open Access Journals (Sweden)

Prafulla Herode

2013-01-01

Full Text Available A 22-year-old male came to casualty on 5 th May 2012 after a fall from motorcycle. He complained of excruciating pain and swelling over right knee. There was an open wound of 7 × 2 cm over supra-patellar region and diffuse swelling over knee joint with severe tenderness over proximal aspect of right tibia. X-ray showed intra-articular fracture of proximal tibia extending to diaphysis classified as type 6 by Schatzker classification for proximal tibia, with fibula shaft transverse fracture. The skin over the fracture was contused. Debridement with primary wound closure was done in emergency. Skeletal traction was applied through a lower tibial Steinman pin. Patient was operated after 15 days when wound healed and swelling subsided. Locking plate was applied on medial aspect using Minimally invasive percutaneous plate osteosysthesis (MIPPO technique. Post-operatively over 4 hours patient developed severe pain and swelling in operated leg which mimicked compartment syndrome. Suture removal was done immediately in the ward from the distal aspect, which relieved the symptoms but lead to exposure of the plate. A rotational flap was done to cover the plate in coordination with a plastic surgeon on the next day.

Management of pediatric mandibular fractures using bioresorbable plating system - Efficacy, stability, and clinical outcomes: Our experiences and literature review.

Science.gov (United States)

Singh, Mahinder; Singh, R K; Passi, Deepak; Aggarwal, Mohit; Kaur, Guneet

2016-01-01

The purpose of this study was to determine the efficacy and stability of the biodegradable fixation system for treatment of mandible fractures in pediatric patients by measuring the bite force. Sixty pediatric patients with mandibular fractures (36 males, 24 females) were included in this study. The 2.5-mm resorbable plates were adapted along Champy's line of ideal osteosynthesis and secured with four 2.5 mm diameter monocortical resorbable screws, 8 mm in length. All patients were followed for 10 months. Clinical parameters, such as soft tissue infection, nonunion, malunion, implant exposure, malocclusion, nerve injury, and bite force for stability, were prospectively assessed. Adequate fixation and primary bone healing was achieved in 100% of the cases. Six minor complications (10%) were observed: 2 soft tissue infections (3%), 1 plate dehiscence (2%), 1 malocclusion (2%), and 2 paresthesia (3%). 2.5-mm resorbable plating system along Champy's line of ideal osteosynthesis is a good treatment modality for mandible fractures in pediatric patients.

A prospective, randomised trial comparing closed intramedullary nailing with percutaneous plating in the treatment of distal metaphyseal fractures of the tibia.

Science.gov (United States)

Guo, J J; Tang, N; Yang, H L; Tang, T S

2010-07-01

We compared the outcome of closed intramedullary nailing with minimally invasive plate osteosynthesis using a percutaneous locked compression plate in patients with a distal metaphyseal fracture in a prospective study. A total of 85 patients were randomised to operative stabilisation either by a closed intramedullary nail (44) or by minimally invasive osteosynthesis with a compression plate (41). Pre-operative variables included the patients' age and the side and pattern of the fracture. Peri-operative variables were the operating time and the radiation time. Postoperative variables were wound problems, the time to union of the fracture, the functional American Orthopaedic Foot and Ankle surgery score and removal of hardware. We found no significant difference in the pre-operative variables or in the time to union in the two groups. However, the mean radiation time and operating time were significantly longer in the locked compression plate group (3.0 vs 2.12 minutes, p fractures had united. Patients who had intramedullary nailing had a higher mean pain score (40 = no pain, 0 = severe pain), [corrected] but better function, alignment and total American Orthopaedic Foot and Ankle surgery scores, although the differences were not statistically significant (p = 0.234, p = 0.157, p = 0.897, p = 0.177 respectively). Three (6.8%) patients in the intramedullary nailing group and six (14.6%) in the locked compression plate group showed delayed wound healing, and 37 (84.1%) in the former group and 38 (92.7%) in the latter group expressed a wish to have the implant removed. We conclude that both closed intramedullary nailing and a percutaneous locked compression plate can be used safely to treat Orthopaedic Trauma Association type-43A distal metaphyseal fractures of the tibia. However, closed intramedullary nailing has the advantage of a shorter operating and radiation time and easier removal of the implant. We therefore prefer closed intramedullary nailing for patients with

[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.

Anatomically contoured plates for fixation of rib fractures.

Science.gov (United States)

Bottlang, Michael; Helzel, Inga; Long, William B; Madey, Steven

2010-03-01

: Intraoperative contouring of long bridging plates for stabilization of flail chest injuries is difficult and time consuming. This study implemented for the first time biometric parameters to derive anatomically contoured rib plates. These plates were tested on a range of cadaveric ribs to quantify plate fit and to extract a best-fit plating configuration. : Three left and three right rib plates were designed, which accounted for anatomic parameters required when conforming a plate to the rib surface. The length lP over which each plate could trace the rib surface was evaluated on 109 cadaveric ribs. For each rib level 3-9, the plate design with the highest lP value was extracted to determine a best-fit plating configuration. Furthermore, the characteristic twist of rib surfaces was measured on 49 ribs to determine the surface congruency of anatomic plates with a constant twist. : The tracing length lP of the best-fit plating configuration ranged from 12.5 cm to 14.7 cm for ribs 3-9. The corresponding range for standard plates was 7.1-13.7 cm. The average twist of ribs over 8-cm, 12-cm, and 16-cm segments was 8.3 degrees, 20.6 degrees, and 32.7 degrees, respectively. The constant twist of anatomic rib plates was not significantly different from the average rib twist. : A small set of anatomic rib plates can minimize the need for intraoperative plate contouring for fixation of ribs 3-9. Anatomic rib plates can therefore reduce the time and complexity of flail chest stabilization and facilitate spanning of flail segments with long plates.

Fracture assessment for a dissimilar metal weld of low alloy steel and Ni-base alloy

Energy Technology Data Exchange (ETDEWEB)

Ogawa, Takuya, E-mail: takuya4.ogawa@toshiba.co.jp [Toshiba Corporation Power Systems Company, Power and Industrial Systems Research and Development Center, 8, Shinsugita-cho, Isogo-ku, Yokohama 235-8523 (Japan); Itatani, Masao; Saito, Toshiyuki; Hayashi, Takahiro; Narazaki, Chihiro; Tsuchihashi, Kentaro [Toshiba Corporation Power Systems Company, Power and Industrial Systems Research and Development Center, 8, Shinsugita-cho, Isogo-ku, Yokohama 235-8523 (Japan)

2012-02-15

Recently, instances of SCC in Ni-base alloy weld metal of light water reactor components have been reported. Despite the possibility of propagation of SCC crack to the fusion line between low alloy steel (LAS) of pressure vessel and Ni-base alloy of internal structure, a fracture assessment method of dissimilar metal welded joint has not been established. The objective of this study is to investigate a fracture mode of dissimilar metal weld of LAS and Ni-base alloy for development of a fracture assessment method for dissimilar metal weld. Fracture tests were conducted using two types of dissimilar metal weld test plates with semi-elliptical surface crack. In one of the test plates, the fusion line lies around the surface points of the surface crack and the crack tips at the surface points have intruded into LAS. Material ahead of the crack tip at the deepest point is Ni-base alloy. In the other, the fusion line lies around the deepest point of the surface crack and the crack tip at the deepest point has intruded into LAS. Material ahead of the crack tip at the deepest point is LAS. The results of fracture tests using the former type of test plate reveal that the collapse load considering the proportion of ligament area of each material gives a good estimation for fracture load. That is, fracture assessment based on plastic collapse mode is applicable to the former type of test plate. It is also understood that a fracture assessment method based on the elastic-plastic fracture mode is suitable for the latter type of test plate.

High failure rate of trochanteric fracture osteosynthesis with proximal femoral locking compression plate.

Science.gov (United States)

Wirtz, C; Abbassi, F; Evangelopoulos, D S; Kohl, S; Siebenrock, K A; Krüger, A

2013-06-01

Stable reconstruction of proximal femoral (PF) fractures is especially challenging due to the peculiarity of the injury patterns and the high load-bearing requirement. Since its introduction in 2007, the PF-locking compression plate (LCP) 4.5/5.0 has improved osteosynthesis for intertrochanteric and subtrochanteric fractures of the femur. This study reports our early results with this implant. Between January 2008 and June 2010, 19 of 52 patients (12 males, 7 females; mean age 59 years, range 19-96 years) presenting with fractures of the trochanteric region were treated at the authors' level 1 trauma centre with open reduction and internal fixation using PF-LCP. Postoperatively, partial weight bearing was allowed for all 19 patients. Follow-up included a thorough clinical and radiological evaluation at 1.5, 3, 6, 12, 24, 36 and 48 months. Failure analysis was based on conventional radiological and clinical assessment regarding the type of fracture, postoperative repositioning, secondary fracture dislocation in relation to the fracture constellation and postoperative clinical function (Merle d'Aubigné score). In 18 patients surgery achieved adequate reduction and stable fixation without intra-operative complications. In one patient an ad latus displacement was observed on postoperative X-rays. At the third month follow-up four patients presented with secondary varus collapse and at the sixth month follow-up two patients had 'cut-outs' of the proximal fragment, with one patient having implant failure due to a broken proximal screw. Revision surgeries were performed in eight patients, one patient receiving a change of one screw, three patients undergoing reosteosynthesis with implantation of a condylar plate and one patient undergoing hardware removal with secondary implantation of a total hip prosthesis. Eight patients suffered from persistent trochanteric pain and three patients underwent hardware removal. Early results for PF-LCP osteosynthesis show major

Locking plate fixation provides superior fixation of humerus split type greater tuberosity fractures than tension bands and double row suture bridges.

Science.gov (United States)

Gaudelli, Cinzia; Ménard, Jérémie; Mutch, Jennifer; Laflamme, G-Yves; Petit, Yvan; Rouleau, Dominique M

2014-11-01

This paper aims to determine the strongest fixation method for split type greater tuberosity fractures of the proximal humerus by testing and comparing three fixation methods: a tension band with No. 2 wire suture, a double-row suture bridge with suture anchors, and a manually contoured calcaneal locking plate. Each method was tested on eight porcine humeri. A osteotomy of the greater tuberosity was performed 50° to the humeral shaft and then fixed according to one of three methods. The humeri were then placed in a testing apparatus and tension was applied along the supraspinatus tendon using a thermoelectric cooling clamp. The load required to produce 3mm and 5mm of displacement, as well as complete failure, was recorded using an axial load cell. The average load required to produce 3mm and 5mm of displacement was 658N and 1112N for the locking plate, 199N and 247N for the double row, and 75N and 105N for the tension band. The difference between the three groups was significant (Prow (456N) and tension band (279N) (Prow (71N/mm) and tension band (33N/mm) (Pbiomechanical fixation for split type greater tuberosity fractures. Copyright © 2014 Elsevier Ltd. All rights reserved.

Determination of Fracture Parameters for Multiple Cracks of Laminated Composite Finite Plate

Science.gov (United States)

Srivastava, Amit Kumar; Arora, P. K.; Srivastava, Sharad Chandra; Kumar, Harish; Lohumi, M. K.

2018-04-01

A predictive method for estimation of stress state at zone of crack tip and assessment of remaining component lifetime depend on the stress intensity factor (SIF). This paper discusses the numerical approach for prediction of first ply failure load (FL), progressive failure load, SIF and critical SIF for multiple cracks configurations of laminated composite finite plate using finite element method (FEM). The Hashin and Chang failure criterion are incorporated in ABAQUS using subroutine approach user defined field variables (USDFLD) for prediction of progressive fracture response of laminated composite finite plate, which is not directly available in the software. A tensile experiment on laminated composite finite plate with stress concentration is performed to validate the numerically predicted subroutine results, shows excellent agreement. The typical results are presented to examine effect of changing the crack tip distance (S), crack offset distance (H), and stacking fiber angle (θ) on FL, and SIF .

Studies on mechanical properties, microstructure and fracture morphology details of laser beam welded thick SS304L plates for fusion reactor applications

Energy Technology Data Exchange (ETDEWEB)

Buddu, Ramesh Kumar, E-mail: buddu@ipr.res.in [Fusion Reactor Materials Development and Characterization Division, Institute for Plasma Research, Bhat, Gandhinagar 382428 (India); Chauhan, N.; Raole, P.M. [Fusion Reactor Materials Development and Characterization Division, Institute for Plasma Research, Bhat, Gandhinagar 382428 (India); Natu, Harshad [Magod Laser Machining Pvt. Ltd, Jigani, Bengaluru 560105 (India)

2015-06-15

Highlights: • CO{sub 2} laser welding of 8 mm thick SS304L plates has been carried out and full penetration welds fabricated and characterized for mechanical properties and microstructure details. • Welded samples have shown tensile properties comparable to base indicating good weld quality joints. • Impact fracture tests of weld zone and heat affected zone samples have shown poor toughness compared to the base metal. • SEM analysis of fracture samples of tensile and impact specimens indicated the complex microstructure features in weld zone and combined ductile and brittle fracture features. • Combined features of dendrite and cellular structures are observed in weld microstructures with narrow HAZ and delta ferrite is found in the welds and further confirmed by higher Ferrite Number data. - Abstract: Austenitic stainless steel is widely used structural material for the fabrication of the fusion reactor components. Laser welding is high power density process which offers several advantages over the other conventional processes like Tungsten Inert Gas welding. The features like low distortion, narrow heat affected zone, deep penetration in single pass, good mechanical properties are some of the advantages of laser welding process. The laser weld process parameters optimization has several challenges in terms of overcoming the weld defects like voids due to lack of penetration over depth, undercuts and porosity. The present paper reports the studies carried out with CO{sub 2} laser welding of 8 mm thick austenitic stainless steel SS304L plates and their characterization of mechanical properties, microstructure and fracture morphology details. The weld process parameter optimization towards defect free welds with full penetration welding has been carried out. The welded samples have shown tensile properties comparable to base metal, bend tests are successfully passed. The hardness measurements have shown slightly higher for weld zone compared to base metal

Studies on mechanical properties, microstructure and fracture morphology details of laser beam welded thick SS304L plates for fusion reactor applications

International Nuclear Information System (INIS)

Buddu, Ramesh Kumar; Chauhan, N.; Raole, P.M.; Natu, Harshad

2015-01-01

Highlights: • CO 2 laser welding of 8 mm thick SS304L plates has been carried out and full penetration welds fabricated and characterized for mechanical properties and microstructure details. • Welded samples have shown tensile properties comparable to base indicating good weld quality joints. • Impact fracture tests of weld zone and heat affected zone samples have shown poor toughness compared to the base metal. • SEM analysis of fracture samples of tensile and impact specimens indicated the complex microstructure features in weld zone and combined ductile and brittle fracture features. • Combined features of dendrite and cellular structures are observed in weld microstructures with narrow HAZ and delta ferrite is found in the welds and further confirmed by higher Ferrite Number data. - Abstract: Austenitic stainless steel is widely used structural material for the fabrication of the fusion reactor components. Laser welding is high power density process which offers several advantages over the other conventional processes like Tungsten Inert Gas welding. The features like low distortion, narrow heat affected zone, deep penetration in single pass, good mechanical properties are some of the advantages of laser welding process. The laser weld process parameters optimization has several challenges in terms of overcoming the weld defects like voids due to lack of penetration over depth, undercuts and porosity. The present paper reports the studies carried out with CO 2 laser welding of 8 mm thick austenitic stainless steel SS304L plates and their characterization of mechanical properties, microstructure and fracture morphology details. The weld process parameter optimization towards defect free welds with full penetration welding has been carried out. The welded samples have shown tensile properties comparable to base metal, bend tests are successfully passed. The hardness measurements have shown slightly higher for weld zone compared to base metal and the

Facial Fractures.

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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.

Analysis of clinical efficacy and complications of titanium mini plate internal fixation and reconstructive surgery for patients with orbital fracture

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Yang Liu

2016-07-01

Full Text Available AIM: To analyze the clinical efficacy and complications of titanium mini plate internal fixation and reconstructive surgery for patients with orbital fracture. METHODS: Fifty-seven cases(60 eyeswith orbital fracture from March 2013 to April 2014 in our hospital were researched. According to the random number table method, the patients were divided into observation group(29 cases with 30 eyesand control group(28 cases with 30 eyes. The control group was treated with hydroxyapatite artificial bone plate for internal fixation, and the observation group with titanium mini plate internal fixation and reconstructive surgery. The diplopia grading, grading of ocular movement disorder before and at 1, 3mo after treatment and postoperative complications(prolapse, dislocation, infectionwere compared between the two groups. RESULTS: In both group, all the 60 eyes were healed without scar formation. The rate of diplopia grading as grade 0 1mo postoperatively of observation group and the control groups were 63% and 40%(PPPCONCLUSION: The clinical curative effect of titanium mini plate internal fixation and reconstructive surgery has a good effect for orbital fractures, which can improve the therapeutic effect and reduce the incidence of adverse reactions.

Application of Minimally Invasive Treatment of Locking Compression Plate in Schatzker Ⅰ-Ⅲ Tibial Plateau Fracture

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Guohui Zhao

2014-06-01

Full Text Available Objective: To investigate the clinical effect of minimally invasive treatment of locking compression plate (LCP in Schatzker Ⅰ-Ⅲ tibial plateau fracture. Methods: Thirty-eight patients with Schatzker Ⅰ-Ⅲ tibial plateau fracture in our hospital were given minimally invasive treatment of LCP, and the artificial bone was transplanted to the depressed bone. Adverse responses, wound healing time and clinical efficacy were observed. Results: All patients were followed-up for 14- 20 months, and the mean duration was 16 months. Within 1 week after operation, 1 patient suffered from short-term rejection reaction to artificial bone, but he healed after corresponding measures were taken. There were no complications like skin necrosis and externally-exposed steel plate among the patients. In addition, all fractures were recovered, and the recovery time was 2.6 - 4.1 months, with the mean duration being 3.4 months. The recovery of knee function was favorable, in which 20 cases were excellent, 14 were good, and 4 were general. The excellent and good rate was 89.5%. Conclusion: Minimally invasive treatment of LCP for Schatzker Ⅰ - Ⅲ tibial plateau fracture can reduce the postoperative relocation loss, and has small trauma and stable fixation.

Unstable metacarpal and phalangeal fractures: treatment by internal fixation using AO mini-fragment plates and screws.

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Mumtaz, Mohammad Umar; Farooq, Muneer Ahmad; Rasool, Altaf Ahmad; Kawoosa, Altaf Ahmad; Badoo, Abdul Rashid; Dhar, Shabir Ahmad

2010-07-01

Accurate open reduction and internal fixation for metacarpal and phalangeal fractures of the hand is required in less than 5% of the patients; otherwise, closed treatment techniques offer satisfactory results in most of these cases as these fractures are stable either before or after closed reduction. AO mini-fragment screws and plates, when used in properly selected cases, can provide rigid fixation, allowing early mobilization of joints and hence good functional results while avoiding problems associated with protruding K-wires and immobilization. The advantages of such internal fixation urged us to undertake such a study in our state where such hand injuries are commonly seen. Forty patients with 42 unstable metacarpal and phalangeal fractures were treated with open reduction and internal fixation using AO mini-fragment screws and plates over a period of three years in a prospective manner. The overall results were good in 78.5% of cases, fair in 19% of cases and poor in 2.5% of cases, as judged according to the criteria of the American Society for Surgery of the Hand. This technique is a reasonable option for treating unstable metacarpal and phalangeal fractures as it provides a highly rigid fixation, which is sufficient to allow early mobilization of the adjacent joints, thus helping to achieve good functional results.

History of internal fixation with plates (part 2): new developments after World War II; compressing plates and locked plates.

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Hernigou, Philippe; Pariat, Jacques

2017-07-01

The first techniques of operative fracture with plates were developed in the 19th century. In fact, at the beginning these methods consisted of an open reduction of the fracture usually followed by a very unstable fixation. As a consequence, the fracture had to be opened with a real risk of (sometimes lethal) infection, and due to unstable fixation, protection with a cast was often necessary. During the period between World Wars I and II, plates for fracture fixation developed with great variety. It became increasingly recognised that, because a fracture of a long bone normally heals with minimal resorption at the bone ends, this may result in slight shortening and collapse, so a very rigid plate might prevent such collapse. However, as a consequence, delayed healing was observed unless the patient was lucky enough to have the plate break. One way of dealing with this was to use a slotted plate in which the screws could move axially, but the really important advance was recognition of the role of compression. After the first description of compression by Danis with a "coapteur", Bagby and Müller with the AO improved the technique of compression. The classic dynamic compression plates from the 1970s were the key to a very rigid fixation, leading to primary bone healing. Nevertheless, the use of strong plates resulted in delayed union and the osteoporosis, cancellous bone, comminution, and/or pathological bone resulted in some failures due to insufficient stability. Finally, new devices represented by locking plates increased the stability, contributing to the principles of a more biological osteosynthesis while giving enough stability to allow immediate full weight bearing in some patients.

Application of Minimally Invasive Treatment of Locking Compression Plate in Schatzker Ⅰ-Ⅲ Tibial Plateau Fracture

OpenAIRE

Guohui Zhao

2014-01-01

Objective: To investigate the clinical effect of minimally invasive treatment of locking compression plate (LCP) in Schatzker Ⅰ-Ⅲ tibial plateau fracture. Methods: Thirty-eight patients with Schatzker Ⅰ-Ⅲ tibial plateau fracture in our hospital were given minimally invasive treatment of LCP, and the artificial bone was transplanted to the depressed bone. Adverse responses, wound healing time and clinical efficacy were observed. Results: All patients were followed-up for 14- 20 months, and the...

Viscoplastic-dynamic analyses of small-scale fracture tests to obtain crack arrest toughness values for PTS conditions

International Nuclear Information System (INIS)

Kanninen, M.F.; Hudak, S.J. Jr; Dexter, R.J.; Couque, H.; O'Donoghue, P.E.; Polch, E.Z.

1988-01-01

Reliable predictions of crack arrest at the high upper shelf toughness conditions involved in postulated pressurized thermal shock (PTS) events require procedures beyond those utilized in conventional fracture mechanics treatments. To develop such a procedure, viscoplastic-dynamic fracture mechanics finite element analyses, viscoplastic material characterization testing, and small-scale crack propagation and arrest experimentation are being combines in this research. The approach couples SwRI's viscoplastic-dynamic fracture mechanics finite element code VISCRK with experiments using duplex 4340/A533B steel compact specimens. The experiments are simulated by VISCRK computations employing the Bodner-Partom viscoplastic constitutive relation and the nonlinear fracture mechanics parameter T. The goal is to develop temperature-dependent crack arrest toughness values for A533B steel. While only room temperature K Ia values have been obtained so far, these have been found to agree closely with those obtained from wide plate tests. (author)

Middle-term follow-up results of Pipkin type IV femoral head fracture patients treated by reconstruction plate and bioabsorbable screws

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Shan-Xi Wang

2018-06-01

Full Text Available Purpose: To investigate the mid-term curative effects of the treatment of Pipkin type IV femoral head fractures using a reconstruction plate and bioabsorbable screws and provide the evidence for clinical practice. Methods: From February 2010 to September 2014, 21 patients with Pipkin type IV femoral head fractures were treated surgically. There were 13 males and 8 females with an average age of 41.1 years (range, 20–65 years. The causes of the fractures included traffic accidents (13 cases, falls from a height (four cases, heavy lifting injuries (three cases, and sport injury (one case. All patients were followed up with radiography and three-dimensional reconstruction computed tomography and other checks and any complications were actively managed. Closed reduction of fracture-dislocation of the hip was attempted under general anesthesia using the Kocher-Langenbeck approach. Femoral head fractures were treated with internal fixation or excision based on the size of the fracture fragments, whereas acetabular fractures were fixed with a reconstruction plate and screws following anatomic reduction. Results: The incisions healed by primary intention in all patients after surgery, without any infection, deep venous thrombosis, or other complications. All 21 patients were followed up for 36–76 months, with an average follow-up duration of 49 months. Postoperative imaging data showed that all dislocations and fractures were anatomically reduced, and bony union of the fractures was achieved. Heterotopic ossification was found in four patients, post-traumatic osteoarthritis in three, and avascular necrosis of the femoral head in two. At the final follow-up, the assessment of hip joint function according to the Thompson-Epstein scoring scale was excellent in 10 cases, good in six cases, fair in three cases, and poor in two cases. The rate of excellent and good functional outcomes was 76.1%. Conclusion: The mid-term curative effects of a

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

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Ali Andalib

2017-09-01

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

Close Intramedullary Interlocking Nailing Versus Locking Compression Plating In the Treatment of Closed Fracture Shaft of the Tibia.

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Kundu, I K; Datta, N K; Chowdhury, A Z; Das, K P; Tarik, M M; Faisal, M A

2016-07-01

Fracture of tibial shaft is the commonest site of long bone fractures due to its superficial location involving young or middle-age people. Proper management is an important issue regarding the future effective movements. In this study patients were grouped in closed Intra medullary interlocking nailing and locking compression plating. Post-operative follow up at 2 weeks, 6 weeks, 12 weeks and 3 months thereafter up to 6 months were done. Each of the patients was evaluated clinically and radiologically by tucker criteria of Tuker et al. Patients were assessed for pain on full weight bearing and kneeling, shortening and range of motion of knee and ankle joints. Radiological assessment for union of fracture, alignment of fracture and angulations and position of nail and screws and infection were observed during follow up. A total number of 32 patients were selected but only 27 patients were available for follow up for a period of 6 months. They were grouped into Group A, consisting of 15 patients who took the treatment in the form of closed intramedullary interlocking nailing and Group B, consisting of 12 patients those underwent ORIF with locking compression plating. In both of the groups Motor Vehicle Accident was the main mechanism of trauma. Fracture involving the middle 3rd of the tibia is common in both the groups. During post-operative follow up, four patients in Group A complained anterior knee pain, one patient in Group B had superficial infection, most of the patients had no restriction of movement in the ankle and knee joints and a single patient in Group B showed 1.5cm shortening of the lower limb. Period of hospital stay and fracture union time were less in Group A, which was statistically significant. Both groups showed excellent result with minimum complications. So this study permits to conclude that close IM interlocking nailing and open reduction and internal fixation by locking compression plating is equally effective for the management of close

[Effectiveness comparison of suspension fixation plus hinged external fixator and double plate internal fixation in treatment of type C humeral intercondylar fractures].

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Zhang, Jian; Lin, Xu; Zhong, Zeli; Wu, Chao; Tan, Lun

2017-07-01

To compare the effectiveness of suspension fixation plus hinged external fixator with double plate internal fixation in the treatment of type C humeral intercondylar fractures. Between January 2014 and April 2016, 30 patients with type C (Association for the Study of Internal Fixation, AO/ASIF) humeral intercondylar fractures were treated. Kirschner wire suspension fixation plus hinged external fixator was used in 14 cases (group A), and double plate internal fixation in 16 cases (group B). There was no significant difference in gender, age, injury cause, disease duration, injury side, and type of fracture between 2 groups ( P >0.05). There was no significant difference in operation time and hospitalization stay between 2 groups ( P >0.05). But the intraoperative blood loss in group A was significantly less than that in group B ( P internal fixation removal, the intraoperative blood loss, and VAS score at 1 day and 3 days after operation in group A were significant better than those in group B ( P external fixator and double plate internal fixation for the treatment of type C humeral intercondylar fractures have ideal outcome in elbow function. But the suspension fixation plus hinged external fixator is better than double plate internal fixation in intraoperative blood loss, postoperative VAS score, and time of internal fixation removal.

Treatment of Unstable Trochanteric Femur Fractures: Proximal Femur Nail Versus Proximal Femur Locking Compression Plate.

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Singh, Ashutosh Kumar; Narsaria, Nidi; G R, Arun; Srivastava, Vivek

Unstable trochanteric femur fractures are common fractures that are difficult to manage. We conducted a prospective study to compare functional outcomes and complications of 2 different implant designs, proximal femur nail (PFN) and proximal femur locking compression plate (PFLCP), used in internal fixation of unstable trochanteric femur fractures. On hospital admission, 48 patients with unstable trochanteric fractures were randomly assigned (using a sealed envelope method) to treatment with either PFN (24 patients) or PFLCP (24 patients). Perioperative data and complications were recorded. All cases were followed up for 2 years. The groups did not differ significantly (P > .05) in operative time, reduction quality, complications, hospital length of stay, union rate, or time to union. Compared with the PFLCP group, the PFN group had shorter incisions and less blood loss. Regarding functional outcomes, there was no significant difference in mean Harris Hip Score (P = .48) or Palmer and Parker mobility score (P = .58). Both PFN and PFLCP are effective in internal fixation of unstable trochanteric femur fractures.

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

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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.

Unusual proximal femur fracture in children treated with PHILOS plate and review of literature

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Mukesh Kumar

2017-01-01

Full Text Available Fractures of the hip are uncommon in children with incidence is less than 1% in all paediatrics fracture. It requires careful attention because of the incidence of complications is high. There is no consensus over ideal treatment of each group, but there are different options for each group has been described in literature, we report a case of unusual proximal femur fracture in ten-year-old girl which is not described in literature in best of our knowledge. A 10 years old girl was brought to us with pain in right hip joint and inability to bear weight on right lower limb after road traffic accident (child was hit by a car while walking on the road. Evaluated and found to have fracture of proximal femur. fracture was fixed with long PHILOS plate, which united in eight weeks duration, implant was removed at 10 month. At present after 14 months, she is able to perform her routine activities comfortably. and her Harris hip score is 95. We propose to add this type of fracture as 5th type of Delbet's classification as the fracture pattern in my patient was not fitting in any group of Delbet's classification and it belongs to proximal femur group and anatomically this fracture pattern was next to type IV fracture. Uncommon fracture of hip in children can be expected, this type of fracture can be added as 5th type in Delbet's classification. Long term outcome and ideal treatment yet to be described.

Mini-plate versus Kirschner wire internal fixation for treatment of metacarpal and phalangeal fractures in Chinese Han population: a meta-analysis.

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Xu, Jiaming; Zhang, Changqing

2014-04-11

This meta-analysis aimed to compare the therapeutic effect of mini-plate versus Kirschner wire (K-wire) internal fixation on the treatment of metacarpal and phalangeal fractures among Chinese Han population. Databases of China National Knowledge Infrastructure (CNKI), Wanfang, Chinese VIP, PubMed, and Embase were retrieved for studies on mini-plate (case group) versus K-wire (control group) internal fixation for the treatment of metacarpal and phalangeal fractures among Chinese Han population. The odds ratio (OR) and standardized mean difference (SMD) at 95% confidence interval (CI) were used for estimating the effects of dichotomous data and continuous data, respectively. All statistical analyses were performed by Review Manager 5.2 software. A total of 18 studies involving 1,375 metacarpal or phalangeal fracture patients (709 cases and 666 controls) were included in the meta-analysis. There were significant differences in fracture healing time (SMD = -1.28; 95% CI: -1.81, -0.76), postoperative infection rate (OR = 0.25; 95% CI: 0.16, 0.39), complication incidence (OR = 0.24; 95% CI: 0.15, 0.38), and surgery time (SMD = 1.57; 95% CI: 0.76, 2.37) between the case and the control group, while no significant difference was found in hospital stays between these two groups (SMD = 0.43; 95% CI: -0.34, 1.20; P = 0.27). For the treatment of metacarpal or phalangeal fracture among Chinese Han population, mini-plate has advantages of shorter healing time and lower infection rate and complication incidence compared with K-wire internal fixation, while a longer surgery time than K-wire. In conclusion, mini-plate is prior than K-wire internal fixation for the treatment of metacarpal or phalangeal fracture among Chinese Han population.

Delayed Foreign Body Reaction Caused by Bioabsorbable Plates Used for Maxillofacial Fractures

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Hong Bae Jeon

2016-01-01

Full Text Available BackgroundBioabsorbable plates and screws are commonly used to reduce maxillofacial bones, particularly in pediatric patients because they degrade completely without complications after bone healing. In this study, we encountered eight cases of a delayed foreign body reaction after surgical fixation with bioabsorbable plates and screws.MethodsA total of 234 patients with a maxillofacial fracture underwent surgical treatment from March 2006 to October 2013, in which rigid fixation was achieved with the Inion CPS (Inion, Tampere, Finland plating system in 173 patients and Rapidsorb (Synthes, West Chester, PA, USA in 61 patients. Their mean age was 35.2 years (range, 15-84 years. Most patients were stabilized with two- or three-point fixation at the frontozygomatic suture, infraorbital rim, and anterior wall of the maxilla.ResultsComplications occurred in eight (3.4% of 234 patients, including palpable, fixed masses in six patients and focal swelling in two patients. The period from surgical fixation to the onset of symptoms was 9-23 months. Six patients with a mass underwent secondary surgery for mass removal. The masses contained fibrous tissue with a yellow, grainy, cloudy fluid and remnants of an incompletely degraded bioabsorbable plate and screws. Their histological findings demonstrated a foreign body reaction.ConclusionsInadequate degradation of bioabsorbable plates caused a delayed inflammatory foreign body reaction requiring secondary surgery. Therefore, it is prudent to consider the possibility of delayed complications when using bioabsorbable plates and surgeons must conduct longer and closer follow-up observations.

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

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

2013-04-01

The aim of our study is to analyse the results of our surgical technique for the treatment of proximal humeral fractures and fracture dislocations using locking plates in conjunction with calcium sulphate bone-substitute augmentation and tuberosity repair using high-strength sutures. We used the extended deltoid-splitting approach for fracture patterns involving displacement of both lesser and greater tuberosities and for fracture-dislocations. Optimal surgical management of proximal humeral fractures remains controversial. Locking plates have become a popular method of fixation. However, failure of fixation may occur if they are used as the sole method of fixation in comminuted fractures, especially in osteopenic bone. We retrospectively analysed 22 proximal humeral fractures in 21 patients; 10 were male and 11 female with an average age of 64.6 years (range 37-77). Average follow-up was 24 months. Eleven of these fractures were exposed by the extended deltoid-splitting approach. Fractures were classified according to Neer and Hertel systems. Preoperative radiographs and computed tomography (CT) scans in three- and four-part fractures were done to assess the displacement and medial calcar length for predicting the humeral head vascularity. According to the Neer classification, there were five two-part, six three-part, five four-part fractures and six fracture-dislocations (two anterior and four posterior). Results were assessed clinically with disabilities of the arm, shoulder and hand (DASH) scores, modified Constant and Murley scores and serial postoperative radiographs. The mean DASH score was 16.18 and the modified Constant and Murley score was 64.04 at the last follow-up. Eighteen out of twenty-two cases achieved good clinical outcome. All the fractures united with no evidence of infection, failure of fixation, malunion, tuberosity failure, avascular necrosis or adverse reaction to calcium sulphate bone substitute. There was no evidence of axillary nerve

[Effectiveness of arthroscopic treatment of anterior cruciate ligament tibial eminence avulsion fracture with non-absorbable suture fixation combined with mini-plate].

Science.gov (United States)

Wang, Suiyuan; Xiao, Yang; Tong, Zuoming; Li, Guiqiu; Jiang, Juhua; Yao, Jinghui; Wu, Zhiyong; Li, Tengfei; Wu, Qun

2013-09-01

To evaluate the surgical techniques and effectiveness of arthroscopic treatment of anterior cruciate ligament (ACL) tibial eminence avulsion fracture with non-absorbable suture fixation combined with the miniplate. Between January 2009 and March 2012, 32 patients with ACL tibial eminence avulsion fractures were treated. There were 18 males and 14 females, aged 12-40 years (mean, 17.5 years). The injury causes included traffic accident injury in 15 cases, sport injury in 6 cases, and falling injury in 11 cases. The time from injury to operation ranged 7-18 days with an average of 9.5 days. Before operation, the results of Lachman test were all positive; the Lysholm score was 52.13 +/- 4.22 and the International Knee Documentation Committee (IKDC) score was 44.82 +/- 2.44. According to Meyers-McKeever classification criteria, there were 12 cases of type II and 20 cases of type III. After arthroscopic poking reduction of fracture, tibial eminence avulsion fractures were fixed with the Ethibond non-absorbable sutures bypass figure-of-eight tibial tunnel combined with the metacarpal and phalangeal mini-plate. Primary healing was obtained in all incisions; no joint infection or skin necrosis occurred after operation. All patients were followed up with an average time of 22.4 months (range, 12-50 months). The patients showed negative Lachman test at 12 weeks after operation. Except 3 patients having knee extension limitation at last follow-up, the knee extension range of motion (ROM) was normal in the other patients; the knee flexion ROM was normal in all patients. The Lysholm score and IKDC score were significantly improved to 94.19 +/- 0.93 and 94.35 +/- 1.22 at last follow-up, showing significant differences when compared with preoperative values (t = 55.080, P = 0.000; t = 101.715, P = 0.000). The arthroscopic treatment of ACL tibial eminence avulsion fracture with Ethibond non-absorbable suture fixation combined with mini-plate is an effective procedure with the

Test techniques for fracture mechanics testing

International Nuclear Information System (INIS)

Schwalbe, K.H.

1980-01-01

Test methods for fracture mechanics tests are described. Two groups of techniques are distinguished: Those for measurement of stable crack growth and those for determination of the loading parameters. (orig.) [de

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

Science.gov (United States)

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

2014-10-01

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

Management of pediatric mandibular fractures using bioresorbable plating system – Efficacy, stability, and clinical outcomes: Our experiences and literature review

Science.gov (United States)

Singh, Mahinder; Singh, R.K.; Passi, Deepak; Aggarwal, Mohit; Kaur, Guneet

2015-01-01

Aims The purpose of this study was to determine the efficacy and stability of the biodegradable fixation system for treatment of mandible fractures in pediatric patients by measuring the bite force. Methods Sixty pediatric patients with mandibular fractures (36 males, 24 females) were included in this study. The 2.5-mm resorbable plates were adapted along Champy's line of ideal osteosynthesis and secured with four 2.5 mm diameter monocortical resorbable screws, 8 mm in length. All patients were followed for 10 months. Clinical parameters, such as soft tissue infection, nonunion, malunion, implant exposure, malocclusion, nerve injury, and bite force for stability, were prospectively assessed. Results Adequate fixation and primary bone healing was achieved in 100% of the cases. Six minor complications (10%) were observed: 2 soft tissue infections (3%), 1 plate dehiscence (2%), 1 malocclusion (2%), and 2 paresthesia (3%). Conclusion 2.5-mm resorbable plating system along Champy's line of ideal osteosynthesis is a good treatment modality for mandible fractures in pediatric patients. PMID:27195206

Defect nonunion of a metatarsal bone fracture in a cow: successful management with bone plating and autogenous cancellous bone graft.

Science.gov (United States)

Raghunath, M; Singh, N; Singh, T; Gopinathan, A; Mohindroo, J; Atri, K

2013-01-01

A two-and-half-year-old cow was presented with a defect nonunion of the right metatarsal III/IV bone following a severely comminuted open fracture two months previously. The animal underwent open fixation using a 4.5 mm, broad, 10-hole, dynamic compression plate and autogenous cancellous bone graft collected from the contralateral iliac shaft. The animal started partial weight bearing after the third postoperative day and resumed complete weight bearing after the 10th day. Fracture healing was complete and the implants were removed after the 120th postoperative day. Stable fixation by means of a bone plate in conjunction with a cancellous bone graft facilitated complete healing and restoration of the bone column of the defect and the metatarsal fracture. The animal made a complete recovery.

Combined finite element and multibody musculoskeletal investigation of a fractured clavicle with reconstruction plate

DEFF Research Database (Denmark)

Cronskar, Marie; Rasmussen, John; Tinnsten, Mats

2015-01-01

This paper addresses the various treatment options for clavicle fractures by means of computational models, more precisely cases with a need for internal fixation: non-unions and certain complex fractures. The motivation for the work is that treatment can be enhanced by a better understanding...... of the loading of the clavicle and fixation device. This study aimed to develop a method for realistic simulation of stresses in the bone and fixation device in the case of a fractured clavicle. A finite element (FE) mesh of the clavicle geometry was created from computer tomography (CT) data and imported...... into the FE solver where the model was subjected to muscle forces and other boundary conditions from a multibody musculoskeletal model performing a typical activity of daily life. A reconstruction plate and screws were also imported into the model. The combination models returned stresses and displacements...

Failure analysis of stainless steel femur fixation plate.

Science.gov (United States)

Hussain, P B; Mohammad, M

2004-05-01

Failure analysis was performed to investigate the failure of the femur fixation plate which was previously fixed on the femur of a girl. Radiography, metallography, fractography and mechanical testing were conducted in this study. The results show that the failure was due to the formation of notches on the femur plate. These notches act as stress raisers from where the cracks start to propagate. Finally fracture occurred on the femur plate and subsequently, the plate failed.

Salvage of tibial pilon fractures using fusion of the ankle with a 90 degrees cannulated blade-plate: a preliminary report.

Science.gov (United States)

Morgan, S J; Thordarson, D B; Shepherd, L E

1999-06-01

Six patients with ankle joint destruction and delayed metaphyseal union after tibial plafond fracture were surgically treated with tibiotalar arthrodesis and metaphyseal reconstruction, using a fixed-angle cannulated blade-plate. The procedure was performed through a posterior approach in five cases and a lateral approach in one case. The subtalar joint was preserved in all cases. Metaphyseal union and a stable arthrodesis were obtained in all cases without loss of fixation and with no mechanical failure of the blade-plate. Union was obtained in an average of 26 weeks. No secondary procedures were required to obtain union. All six patients were ambulatory at last follow-up. Stable internal fixation for simultaneous tibiotalar fusion and metaphyseal reconstruction can be achieved with a cannulated blade-plate while preserving the subtalar joint in complex plafond fractures.

[Experimental study on carbon fiber reinforced plastic plate--analysis of stabilizing force required for plate].

Science.gov (United States)

Iizuka, H

1990-11-01

Plates currently in use for the management of bone fracture made of metal present with various problems. We manufactured carbon fiber reinforced plastic (CFRP) plates from Pyrofil T/530 puriplegs overlaid at cross angles of +/- 10 degrees, +/- 20 degrees, and +/- 30 degrees for trial and carried out an experimental study on rabbit tibiofibular bones using 316L stainless steel plates of comparable shape and size as controls. The results indicate the influence of CFRP plate upon cortical bone was milder than that of stainless steel plate, with an adequate stabilizing force for the repair of fractured rabbit tibiofibular bones. CFRP has the advantages over metals of being virtually free from corrosion and fatigue, reasonably radiolucent and able to meet a wide range of mechanical requirements. This would make CFRP plate quite promising as a new devices of treating fracture of bones.

Estimation of Fracture Porosity in an Unsaturated Fractured Welded Tuff Using Gas Tracer Testing

International Nuclear Information System (INIS)

B.M. Freifeild

2001-01-01

Kinematic fracture porosity is an important hydrologic transport parameter for predicting the potential of rapid contaminant migration through fractured rock. The transport velocity of a solute moving within a fracture network is inversely related to the fracture porosity. Since fracture porosity is often one or two orders of magnitude smaller than matrix porosity, and fracture permeability is often orders of magnitude greater than matrix permeability, solutes may travel significantly faster in the fracture network than in the surrounding matrix. This dissertation introduces a new methodology for conducting gas tracer tests using a field portable mass spectrometer along with analytical tools for estimating fracture porosity using the measured tracer concentration breakthrough curves. Field experiments were conducted at Yucca Mountain, Nevada, consisting of air-permeability transient testing and gas-tracer-transport tests. The experiments were conducted from boreholes drilled within an underground tunnel as part of an investigation of rock mass hydrological behavior. Air-permeability pressure transients, recorded during constant mass flux injections, have been analyzed using a numerical inversion procedure to identify fracture permeability and porosity. Dipole gas tracer tests have also been conducted from the same boreholes used for air-permeability testing. Mass breakthrough data has been analyzed using a random walk particle-tracking model, with a dispersivity that is a function of the advective velocity. The estimated fracture porosity using the tracer test and air-injection test data ranges from .001 to .015. These values are an order of magnitude greater than the values estimated by others using hydraulically estimated fracture apertures. The estimates of porosity made using air-permeability test data are shown to be highly sensitive to formation heterogeneity. Uncertainty analyses performed on the gas tracer test results show high confidence in the parameter

Estimation of Fracture Porosity in an Unsaturated Fractured Welded Tuff Using Gas Tracer Testing

Energy Technology Data Exchange (ETDEWEB)

B.M. Freifeild

2001-10-18

Kinematic fracture porosity is an important hydrologic transport parameter for predicting the potential of rapid contaminant migration through fractured rock. The transport velocity of a solute moving within a fracture network is inversely related to the fracture porosity. Since fracture porosity is often one or two orders of magnitude smaller than matrix porosity, and fracture permeability is often orders of magnitude greater than matrix permeability, solutes may travel significantly faster in the fracture network than in the surrounding matrix. This dissertation introduces a new methodology for conducting gas tracer tests using a field portable mass spectrometer along with analytical tools for estimating fracture porosity using the measured tracer concentration breakthrough curves. Field experiments were conducted at Yucca Mountain, Nevada, consisting of air-permeability transient testing and gas-tracer-transport tests. The experiments were conducted from boreholes drilled within an underground tunnel as part of an investigation of rock mass hydrological behavior. Air-permeability pressure transients, recorded during constant mass flux injections, have been analyzed using a numerical inversion procedure to identify fracture permeability and porosity. Dipole gas tracer tests have also been conducted from the same boreholes used for air-permeability testing. Mass breakthrough data has been analyzed using a random walk particle-tracking model, with a dispersivity that is a function of the advective velocity. The estimated fracture porosity using the tracer test and air-injection test data ranges from .001 to .015. These values are an order of magnitude greater than the values estimated by others using hydraulically estimated fracture apertures. The estimates of porosity made using air-permeability test data are shown to be highly sensitive to formation heterogeneity. Uncertainty analyses performed on the gas tracer test results show high confidence in the parameter

Estimation of fracture porosity in an unsaturated fractured welded tuff using gas tracer testing

Energy Technology Data Exchange (ETDEWEB)

Freifeld, Barry Mark [Univ. of California, Berkeley, CA (United States)

2001-12-01

Kinematic fracture porosity is an important hydrologic transport parameter for predicting the potential of rapid contaminant migration through fractured rock. The transport velocity of a solute moving within a fracture network is inversely related to the fracture porosity. Since fracture porosity is often one or two orders of magnitude smaller than matrix porosity, and fracture permeability is often orders of magnitude greater than matrix permeability, solutes may travel significantly faster in the fracture network than in the surrounding matrix. This dissertation introduces a new methodology for conducting gas tracer tests using a field portable mass spectrometer along with analytical tools for estimating fracture porosity using the measured tracer concentration breakthrough curves. Field experiments were conducted at Yucca Mountain, Nevada, consisting of air-permeability transient testing and gas-tracer-transport tests. The experiments were conducted from boreholes drilled within an underground tunnel as part of an investigation of rock mass hydrological behavior. Air-permeability pressure transients, recorded during constant mass flux injections, have been analyzed using a numerical inversion procedure to identify fracture permeability and porosity. Dipole gas tracer tests have also been conducted from the same boreholes used for air-permeability testing. Mass breakthrough data has been analyzed using a random walk particle-tracking model, with a dispersivity that is a function of the advective velocity. The estimated fracture porosity using the tracer test and air-injection test data ranges from .001 to .015. These values are an order of magnitude greater than the values estimated by others using hydraulically estimated fracture apertures. The estimates of porosity made using air-permeability test data are shown to be highly sensitive to formation heterogeneity. Uncertainty analyses performed on the gas tracer test results show high confidence in the parameter

Fixation via dorsal for complex fractures of radius distal with plate P

International Nuclear Information System (INIS)

Rojas, Sandra; Bocanegra, Sergio; Suarez, Fabio

2002-01-01

The existence of multiple alternatives in the handling of the complex fractures of the radius distal it constitutes a reflection of the challenge that these they represent as for the possibility of recovering an appropriate consistency to articulate and orientation and radial height. This prospective study included 13 patients assisted in the hospital military of Bogota, by means of internal fixation with plate π. This treatment alternative, it solves many present inconveniences with other methods and it allows the precocious postoperative rehabilitation

Ultrasonic Testing of NIF Amplifier FAU Top Plates

International Nuclear Information System (INIS)

Chinn, D.J.; Huber, R.D.; Haskins, J.J.; Rodriguez, J.A.; Souza, P.R.; Le, T.V.

2002-01-01

A key component in the National Ignition Facility (NIF) laser optic system is the amplifier frame assembly unit (FAU). The cast aluminum top plate that supports the FAU is required to withstand loads that would occur during an earthquake with a recurrence period of 1000 years. The stringent seismic requirements placed on the FAU top plate induced a study of the cast aluminum material used in the top plate. Ultrasonic testing was used to aid in characterizing the aluminum material used in the plates. This report documents the work performed using contact ultrasonic testing to characterize the FAU top plate material. The ultrasonic work reported here had 3 objectives: (1) inspect the plate material before cyclic testing conducted at the Pacific Earthquake Engineering Research Center (PEER); (2) determine the overall quality of individual plates; and (3) detect large defects in critical areas of individual plates. Section III, ''Pre-cyclic test inspection'', describes work performed in support of Objective 1. Section IV, ''Ultrasonic field measurements'', describes work performed in support of Objectives 2 and 3

Difference between radiological and functional outcome with deltoid-splitting approach versus deltopectoral approach for the management of proximal humeral fractures with philos plate

Directory of Open Access Journals (Sweden)

Shah Waliullah

2013-01-01

Full Text Available Background: Proximal humeral fractures are one of the common fractures of upper extremity. Good results by various studies have been reported for proximal humeral locking plate (PHILOS fixation in proximal humeral fractures. We want to evaluate whether it is only the implant which has given good results or different surgical approach utilized for fixation of plate also affects result. Materials and Methods: A total of 57 patients with proximal humeral fractures were divided in two groups, in Group A, patient′s classical deltopectoral approach utilized, while in Group B deltoid-splitting approach was used. All patients were managed by PHILOS plate fixation. Cases were followed up clinically as well as radiologically at 4-6 weeks after operation and thereafter at 10-12 weeks and then at 6 monthly for long-term complications. Functional outcomes of patient were accessed in terms Constant Scoring System, while radiological evaluation was done by taking x-rays to access quality of reduction and union of fracture. Results: All patients were followed for a minimum of 18 months. In Group B, reduction of tuberosities was better in 3 part and 4 part fractures. Mean Constant score in Group A at the end of 3 months was 56, while in Group B it was 62 and statistically significant (P = 0.02. At the end of 18 months, mean Constant score in Group A was 79, while in Group B it was 81 and statistically insignificant (P = 0.72. One patient in Group B showed axillary nerve paresis in postoperative period and recovered at the end of 3 months. Conclusion: We recommend that deltoid-splitting approach can be used in 3 part and 4 part complex proximal humeral fractures and in posterior fracture dislocation shoulder, which are difficult to approach with deltopectoral approach; however, care should be taken while inserting calcar screw in PHILOS plate fixation to avoid iatrogenic axillary nerve injury.

Irradiated dynamic fracture toughness of ASTM A533, Grade B, Class 1 steel plate and submerged arc weldment. Heavy section steel technology program technical report No. 41

International Nuclear Information System (INIS)

Davidson, J.A.; Ceschini, L.J.; Shogan, R.P.; Rao, G.V.

1976-10-01

As a result of the Heavy Section Steel Technology Program (HSST), sponsored by the Nuclear Regulatory Commission, Westinghouse Electric Corporation conducted dynamic fracture toughness tests on irradiated HSST Plate 02 and submerged arc weldment material. Testing performed at the Westinghouse Research and Development Laboratory in Pittsburgh, Pennsylvania, included 0.394T compact tension, 1.9T compact tension, and 4T compact tension specimens. This data showed that, in the transition region, dynamic test procedures resulted in lower (compared to static) fracture toughness results, and that weak direction (WR) oriented specimen data were lower than the strong direction (RW) oriented specimen results. Irradiated lower-bound fracture toughness results of the HSST Program material were well above the adjusted ASME Section III K/sub IR/ curve. An irradiated and nonirradiated 4T-CT specimen was tested during a fracture toughness test as a preliminary study to determine the effect of irradiation on the acoustic emission-stress intensity factor relation in pressure vessel grade steel. The results indicated higher levels of acoustic emission activity from the irradiated sample as compared to the unirradiated one at a given stress intensity factor (K) level

Operational test of bonded magnetocaloric plates

DEFF Research Database (Denmark)

Bahl, Christian; Navickaité, Kristina; Neves Bez, Henrique

2017-01-01

Bonded plates made by hot pressing La0.85Ce0.15Fe11.25Mn0.25Si1.5Hy particles and resin have been tested as active magnetic regenerators in a small scale magnetocaloric device. Firstly the plates were carefully characterised magnetically and thermally. The plates were prepared with 5 wt% resin...

Laboratory tests of hydraulic fracturing and swell healing

DEFF Research Database (Denmark)

Thunbo, Christensen Claes; Foged, Christensen Helle; Foged, Niels

1998-01-01

New laboratory test set-ups and test procedures are described - for testing the formation of hydraulically induced fractures as well as the potential for subsequent fracture closurefrom the relase of a swelling potential. The main purpose with the tests is to provide information on fracturing str...

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)

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...

Comparison of accuracy of lag screw placement in cephalocondylic nails and sliding hip screw plate fixation for extracapsular fractures of the neck of femur

OpenAIRE

Shyam Kumar, A. J.; Parmar, V.; Bankart, J.; Williams, S. C.; Harper, W. M.

2006-01-01

This study compared the accuracy of lag screw placement between extracapsular femoral fractures fixed with sliding hip screw plate systems and those fixed with cephalocondylic nails. It involved 75 retrospective radiographs of fractures fixed with either a cephalocondylic nail (32) or a sliding hip screw plate system (43). Postoperative anteroposterior and lateral radiographs of the hip were scanned using a digital X-ray scanner and measured using computer software. Measurements were conducte...

46 CFR 57.06-2 - Production test plate interval of testing.

Science.gov (United States)

2010-10-01

... WELDING AND BRAZING Production Tests § 57.06-2 Production test plate interval of testing. (a) At least one... 46 Shipping 2 2010-10-01 2010-10-01 false Production test plate interval of testing. 57.06-2... follows: (1) When the extent of welding on a single vessel exceeds 50 lineal feet of either or both...

Determination of Fracture System Geometry from Well Testing

International Nuclear Information System (INIS)

Doe, T.W.

1994-01-01

In this paper, the research and development for the description of the hydraulic geometry of fracture networks are discussed. The studies on fracture networks have developed on the premise that the structural geological information on fracture geometries could be used to develop the realistic models of flow. It has been widely recognized that a relatively small portion of natural fracture networks controls a major portion of groundwater flow. The key to efficient network modeling is to identify that portion of networks. It is the main purpose of this paper to discuss the methods for characterizing the hydraulic geometry of fracture flow systems. The methods described in this paper cover three approaches for defining the hydraulic geometry of fracture networks, that is, the determination of conductive fracture frequency in boreholes, the use of transient pressure and flow responses in single holes, and the use of cross hole test to assess connectivity. The information which can be obtained by each test is shown. Flow logging, well test distribution and conductive fracture frequency are discussed. The transient analysis of single hole well test and the cross hole analysis of well test for fracture network geometry are reported. The data taken by various methods together can provide network characterization. (K.I.)

Postirradiation fracture toughness tests of ESR alloy HT-9 and modified 9Cr-1Mo alloy from UBR reactor experiments

International Nuclear Information System (INIS)

Hawthorne, J.R.; Reed, J.R.; Sprague, J.A.

1984-01-01

Alloy HT-9 and Modified 9Cr-1Mo are being evaluated for potential applications as first wall materials in magnetic fusion reactors. Objectives of the current research task were to test fatigue-precracked Charpy-V (PCC/sub v/) specimens from representative plates irradiated in the UBR reactor at 149 0 C or 300 0 C, and, to compare the results against postirradiation notch ductility data developed previously for the materials. Both plates represent electroslag refined (ESR) melt processing. PCC/sub v/ specimens of Alloy HT-9 and Modified 9Cr-1Mo alloy were irradiated at 300 0 C and 149 0 C, respectively, to approx.0.8 X 10 20 n/cm 2 , E > 0.1 MeV. During this period, postirradiation tests for fracture toughness were completed and results compared to notch ductility determinations from standard Charpy-V (C/sub v/) specimens irradiated in the same reactor experiments. Fracture surface examinations by SEM are also reported

Locking screw-plate interface stability in carbon-fibre reinforced polyetheretherketone proximal humerus plates.

Science.gov (United States)

Hak, David J; Fader, Ryan; Baldini, Todd; Chadayammuri, Vivek B S

2017-09-01

Carbon-fibre reinforced polyetheretherketone (CFR-PEEK) plates have recently been introduced for proximal humerus fracture treatment. The purpose of this study was to compare the locking screw-plate interface stability in CFR-PEEK versus stainless steel (SS) proximal humerus plates. Locking screw mechanical stability was evaluated independently in proximal and shaft plate holes. Stiffness and load to failure were tested for three conditions: (1) on-axis locking screw insertion in CFR-PEEK versus SS plates, (2) on-axis locking screw insertion, removal, and reinsertion in CFR-PEEK plates, and (3) 10-degree off-axis locking screw insertion in CFR-PEEK plates. Cantilever bending at a rate of 1 mm/minute was produced by an Instron machine and load-displacement data recorded. Shaft locking screw load to failure was significantly greater in CFR-PEEK plates compared to SS plates (746.4 ± 89.7 N versus 596.5 ± 32.6 N, p PEEK plates (p PEEK plates. The mechanical stability of locking screws in CFR-PEEK plates is comparable or superior to locking screws in SS plates.

The anterolateral supra-fibular-head approach for plating posterolateral tibial plateau fractures: A novel surgical technique.

Science.gov (United States)

Hu, Sun-Jun; Chang, Shi-Min; Zhang, Ying-Qi; Ma, Zhuo; Du, Shou-Chao; Zhang, Kai

2016-02-01

The posterolateral (PL) tibial plateau quadrant is laterally covered by the fibular head and posteriorly covered by a mass of muscle ligament and important neurovascular structures. There are several limitations in exposing and fixing the PL tibial plateau fractures using a posterior approach. The aim of this study is to present a novel anterolateral supra-fibular-head approach for plating PL tibial plateau fractures. Five fresh and ten preserved knee specimens were dissected to measure the following parameters:1) the vertical distance from the apex of the fibular head to the lateral plateau surface, 2) the transverse distance between the PL platform and fibula collateral ligament (FCL), and 3) the tension of the FCL in different knee flexion positions. Clinically, isolated PL quadrant tibial plateau fractures were treated via an anterolateral supra-fibular-head approach and lateral rafting plate fixation. The outcome of the patients was assessed after a short to medium follow-up period. The distance from the apex of the fibular head to the lateral condylar surface was 12.2 ± 1.6 mm on average. With the knee extended and the FCL tensioned, the transverse distance between the PL platform and the FCL was 6.7 ± 1.1 mm. With the knee flexed to 60° and the FCL was in the most relaxed position, the distance increased to 21.1 ± 3.0 mm. Clinically, a series of 7 cases of PL tibial plateau fractures were treated via this anterolateral supra-fibular-head approach. The patient was placed in a lateral decubitus position with the knee flexed to approximately 60 degrees. After the posterior retraction of the FCL, the plate was placed more posteriorly to provide a raft or horizontal belt fixation of the PL tibial plateau fragment. After an average of 14.3 months of follow up, the knee range of motion(ROM) was 121.4° ± 8.8° (range: 105°-135°), the HSS score was 96.7 ± 2.6 (range: 90-100), and the SMFA dysfunction score was 22.4 ± 3.8 (range: 16-28) points. The

Locking plate versus external fixation for type C distal radius fractures: A meta-analysis of randomized controlled trials

Directory of Open Access Journals (Sweden)

Dong Wang

2018-04-01

Full Text Available Purpose: Distal radial fracture is one of the most common fractures. Up to now, locking plates (LP and external fixation (EF are two conventional surgical approaches to type C radius fracture. Which method is superior has not yet reached a consensus. We try to assess the clinical effectiveness of the two interventions by this meta-analysis. Methods: We used network to search the PubMed, Embase, and Cochrane Medical Library of randomized controlled clinical trials about the type C distal radius fractures performed according to the search strategy mentioned in Cochrane Handbook 5.1.0 from Jan. 2005 to Jan. 2016. Patients in the experimental group were used LP, in the control group were included EF and other surgical approaches. Publication language was restricted to English. Studies that patient population and surgical indication did not define had been excluded. Studies must report at least one of the outcomes as follow: radial inclination, palmar tilt, ulnar variance, range of wrist flexion and extension, and range of wrist supination and pronation. The trials in which participants included children were excluded. We used Jadad study scores to appraise the study. Results: Seven studies included 162 patients (LP group and 190 patients (EF group. We compared the radial inclination, palmar tilt, ulnar variance, range of wrist flexion and extension, and range of wrist supination and pronation. The radial inclination were revealed a difference favoring LP over EF [WMD = 1.84, 95% CI (0.17, 3.50, p = 0.03] and the palmar tilt and ulnar variance was no significant difference between the two groups [(WMD = 3.61, 95% CI (0.00, 7.23, p = 0.05; WMD = 0.05, 95% CI (−0.99, 1.09, p = 0.93]. The functional activities of range of flexion and extension and range of supination and pronation between the two groups was no difference [WMD = 10.04, 95% CI (−6.88, 26.96, p = 0.24; WMD = 12.53, 95% CI (−9.99, 35.06, p = 0.28]. Conclusion

Fracture-toughness variations in Alloy 718

International Nuclear Information System (INIS)

Mills, W.J.; Blackburn, L.D.

1983-04-01

The effect of product-form variations within a single heat on the J Ic fracture toughness behavior of Alloy 718 was examined at 24, 427 and 538 degree C using the multiple-specimen J R -curve method. Three product forms (plate, round bar and upset forging) were tested in both the conventional and modified heat-treatment (CHT and MHT) conditions. In CHT material, the fracture toughness response was different for the three product forms -- plate having the highest toughness, bar the lowest. The MHT was found to improve the overall fracture resistance for each product form. In this condition, plate and forging had very similar toughness values, but J Ic levels for the bar were considerably lower. These results and WHC data previously reported for four other Alloy 718 heats were unalloyed statistically to establish minimum-expected J Ic values based on tolerance limits bracketing 90% of a total population at a 95% confidence level. Metallographic and fractographic examinations of the seven material lots were performed to relate key microstructural features and operative fracture mechanisms to macroscopic properties. Generally, coarse δ precipitates controlled fracture properties in CHT material by initiating secondary dimples that pre-empted growth of the primary dimples nucleated by broken carbide inclusions. The MHT dissolved the coarse δ particles and thereby suppressed secondary microvoid coalescence. This generally enhanced the fracture resistance of Alloy 718, except when alternate secondary fracture mechanism, such as channel fracture and dimple rupture at δ-phase remnants, prematurely interrupted primary microvoid growth. 25 refs., 12 figs., 12 tabs

[The Extended Deltoid-Split Approach for Plating Four-Part Proximal Humeral Fractures].

Science.gov (United States)

Schiffer, G; Sayar, A; Thelen, U

2016-08-01

The deltoideopectoral approach is established as the gold standard in the surgical treatment of proximal humeral fractures. As an alternative, we demonstrate the extended deltoid approach with an intraoperative video. A direct lateral incision is performed and the anterior parts of the axillary nerve are identified and preserved. In our experience, this approach allows improved visualisation of the greater tuberosity and easier positioning of locking plates. Clinically relevant neurological injuries cannot be seen in our patients or in the literature. Georg Thieme Verlag KG Stuttgart · New York.

Evaluation of locked plate in the osteosynthesis of fractures in osteoporotic bones.

Science.gov (United States)

Oboirien, Muhammad; Agbo, Stephen Patrick; Ajiboye, Lukman Olalekan

2017-01-01

The use of conventional dynamic compression plates (DCPs) in osteoporotic bones is associated with higher chances of implant failure. The advent and use of locking combi-plates have ensured a stable construct during osteosynthesis of fractures in osteoporotic bones. The study aims to assess the outcome of use of locking combi-plates in the management of fractures in osteoporotic bones in our environment. Cases of patients with nonunion and localized osteoporosis from January 2014 to December 2014 that were managed with locked combi-plates were reviewed. Outcome was assessed by time to healing, stability of implant construct after 6 and 12 months. There were 10 patients with mean age of 47.4 ± 12.63 years. There were 9 males and 1 female, and road traffic crashes were the mechanism of injury in 90% (n = 9) and gunshot injuries in 10% (n = 1). Atrophic nonunion was the most common indication for osteosynthesis with 80%, followed by fibrous nonunion with 10.0%. The humerus was the most common long bone involved with 50%. Locked broad DCP was used in 62.5%, and the duration between initial injury and surgery was 6 and 48 months, with an average of 17.5 months. The outcome was such that 90% healed after 12 months on follow-up while one case had the implant backing out and delay union at 6 months. The use of locked plate in the management of nonunion in the presence of osteoporosis ensures stable fixation construct and healing. Contexte: L'utilisation de plaques de compression dynamiques conventionnelles dans les os ostéoporotiques est associée à des chances plus élevées de défaillance de l'implant. L'avènement et l'utilisation de combi-plaques de verrouillage ont assuré une construction stable lors de l'ostéosyntheis de fractures dans les os ostéoporotiques. Objectifs: L'étude vise à évaluer le résultat de l'utilisation de combi-plaques de verrouillage dans la gestion des fractures dans les os ostéoporotiques dans notre environnement. Méthodologie: Les

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

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Colin Murphy

2016-04-01

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

Reoperative surgical stabilization of a painful nonunited rib fracture using bone grafting and a metal plate.

Science.gov (United States)

Cho, Yang Hyun; Kim, Hyun Koo; Kang, Du-Young; Choi, Young Ho

2009-09-01

We report a case of a nonunited sixth rib in a patient with multiple rib fractures who underwent internal fixation using a wire and Judet strut 3 times. During the following 3 years, the patient continued to complain of pain and instability. At surgery, a pseudarthrosis between the ends of the sixth rib was excised. A longitudinal gutter crossing the fracture site was fashioned and splinted with an inlay block of cancellous bone grafted from the iliac crest; stabilization was accomplished with a reconstruction plate and screws. The following 2 years of follow-up demonstrated no instability or pain.

Stress and stability of plate-screw fixation and screw fixation in the treatment of Schatzker type IV medial tibial plateau fracture: a comparative finite element study.

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Huang, Xiaowei; Zhi, Zhongzheng; Yu, Baoqing; Chen, Fancheng

2015-11-25

The purpose of this study is to compare the stress and stability of plate-screw fixation and screw fixation in the treatment of Schatzker type IV medial tibial plateau fracture. A three-dimensional (3D) finite element model of the medial tibial plateau fracture (Schatzker type IV fracture) was created. An axial force of 2500 N with a distribution of 60% to the medial compartment was applied to simulate the axial compressive load on an adult knee during single-limb stance. The equivalent von Mises stress, displacement of the model relative to the distal tibia, and displacement of the implants were used as the output measures. The mean stress value of the plate-screw fixation system was 18.78 MPa, which was significantly (P stress value of the triangular fragment in the plate-screw fixation system model was 42.04 MPa, which was higher than that in the screw fixation model (24.18 MPa). But the mean stress of the triangular fractured fragment in the screw fixation model was significantly higher in terms of equivalent von Mises stress (EVMS), x-axis, and z-axis (P < 0.001). This study demonstrated that the load transmission mechanism between plate-screw fixation system and screw fixation system was different and the stability provided by the plate-screw fixation system was superior to the screw fixation system.

The metallogenic role of east-west fracture zones in South America with regard to the motion of lithospheric plates (with an example from Brazil)

Science.gov (United States)

Kutina, J.; Carter, William D.; Lopez, F.X.

1978-01-01

The role of east-west fracture zones in South America is discussed with regard to global fracturing and the motion of lithospheric plates. A set of major NW-trending lineaments has been derived which show a tendency to be spaced equidistantly and may correspond to a set of east-west fractures in the "pre-drift" position of the South American plate. Statistical analysis of linears in the ERTS-mosaics shows that NW-fractures are also among the most important ones in the Andes region, suggesting that the above major lineaments extend into the basement of the Andes. Some of the old major fractures, trending east-west in the present orientation of South America, are discussed and their NE orientation in the pre-drift position of the plate is considered. An example of structural control of ore deposition in the Brazilian Shield is presented, using the maps of the RADAM Project. It is concluded that the small tin-bearing granitic bodies concentrated in the region of Sao Felix do Xingu in the state of Para represent upper parts of an unexposed granitoid massif which is controlled by the intersection of a major east-west fracture zone probably represents westward extension of the Patos Lineament of the easternmost part of Brazil, connected with the east-west fracture zone of the Para state through the basement of the Maranhao Basin (Sineclise do Maranhao-Piaui). It is expected that the proposed "Patos-Para Lineament" extends further westward and may similarly control, at intersections with fractures of other trends, some mineralization centers in the western part of the state of Para and in the state of Amazonas.

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

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

2014-07-24

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

[Osteosynthesis and cup revision in periprosthetic acetabulum fractures using a Kocher-Langenbeck approach].

Science.gov (United States)

Schwabe, P; Märdian, S; Perka, C; Schaser, K-D

2016-04-01

Reconstruction/stable fixation of the acetabular columns to create an adequate periacetabular requirement for the implantation of a revision cup. Displaced/nondisplaced fractures with involvement of the posterior column. Resulting instability of the cup in an adequate bone stock situation. Periprosthetic acetabulum fractures with inadequate bone stock. Extended periacetabular defects with loss of anchorage options. Isolated periprosthetic fractures of the anterior column. Septic loosening. Dorsal approach. Dislocation of hip. Mechanical testing of inlaying acetabular cup. With unstable cup situation explantation of the cup, fracture fixation of acetabulum with dorsal double plate osteosynthesis along the posterior column. Cup revision. Hip joint reposition. Early mobilization; partial weight bearing for 12 weeks. Thrombosis prophylaxis. Clinical and radiological follow-ups. Periprosthetic acetabular fracture in 17 patients with 9 fractures after primary total hip replacement (THR), 8 after revision THR. Fractures: 12 due to trauma, 5 spontaneously; 7 anterior column fractures, 5 transverse fractures, 4 posterior column fractures, 1 two column fracture after hemiendoprosthesis. 5 type 1 fractures and 12 type 2 fractures. Operatively treated cases (10/17) received 3 reinforcement ring, 2 pedestal cup, 1 standard revision cup, cup-1 cage construct, 1 ventral plate osteosynthesis, 1 dorsal plate osteosynthesis, and 1 dorsal plate osteosynthesis plus cup revision (10-month Harris Hip Score 78 points). Radiological follow-up for 10 patients: consolidation of fractures without dislocation and a fixed acetabular cup. No revision surgeries during follow-up; 2 hip dislocations, 1 transient sciatic nerve palsy.

Required grades of hull steel plates in consideration of fracture toughness; Hakai jinsei wo koryoshita sentaiyo koban shiyo kubun ni kansuru ichikosatsu

Energy Technology Data Exchange (ETDEWEB)

Yajima, H; Yamamoto, M; Ogaki, Y [Hiroshima University, Hiroshima (Japan). Faculty of Engineering

1997-10-01

This paper discusses the required grades of hull steel plates based on the steel ship rule of Nippon Kaiji Kyokai (NK). The minimum value of the allowable crack length in NK rule (critical safety crack length at 0degC just before brittle unstable crack causing fatal fracture) was estimated. In the case where the estimated crack tip exists in a matrix, the crack length was a minimum of 200-210mm, while nearly 60mm in a fusion line at high-heat-input welded joint. The allowable crack lengths estimated from a specified value in the NK rule were fairly different. The allowable crack length at 0degC was also estimated from the minimum value in V-notch Charpy impact test. The private proposal on the required grades of hull steel plates in consideration of fracture toughness was discussed. Thirty-five percent of crack lengths found in real ships is 100mm or less, however, cracks of 250-400mm long are frequently found suggesting the allowable crack length of 400mm. The required grade integrally considering required values and design conditions is demanded to secure the reliability of hull strength. 5 refs., 5 figs., 2 tabs.

Surgical Management of a Mandible Subcondylar Fracture

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Dong Hee Kang

2012-07-01

Full Text Available Open reduction and anatomic reduction can create better function for the temporomandibular joint, compared with closed treatment in mandible fracture surgery. Therefore, the double miniplate fixation technique via mini-retromandibular incision was used in order to make the most stable fixation when performing subcondylar fracture surgery. Those approaches provide good visualization of the subcondyle from the posterior edge of the ramus, allow the surgeon to work perpendicularly to the fracture, and enable direct fracture management. Understanding the biomechanical load in the fixation of subcondylar fractures is also necessary in order to optimize fixation methods. Therefore, we measured the biomechanical loads of four different plate fixation techniques in the experimental model regarding mandibular subcondylar fractures. It was found that the loads measured in the two-plate fixation group with one dynamic compression plate (DCP and one adaption plate showed the highest deformation and failure loads among the four fixation groups. The loads measured in the one DCP plate fixation group showed higher deformation and failure loads than the loads measured in the two adaption plate fixation group. Therefore, we conclude that the selection of the high profile plate (DCP is also important in order to create a stable load in the subcondylar fracture.

[Efficacy of Sacroiliac Joint Anterior Approach with Double Reconstruction Plate and Computer Assisted Navigation Percutaneous Sacroiliac Screw for Treating Tile C1 Pelvic Fractures].

Science.gov (United States)

Tan, Zhen; Fang, Yue; Zhang, Hui; Liu, Lei; Xiang, Zhou; Zhong, Gang; Huang, Fu-Guo; Wang, Guang-Lin

2017-09-01

To compare the efficacy of sacroiliac joint anterior approach with double reconstruction plate and computer assisted navigation percutaneous sacroiliac screw for treating Tile C1 pelvic fractures. Fifty patients with pelvic Tile C1 fractures were randomly divided into two groups ( n =25 for each) in the orthopedic department of West China Hospital of Sichuan University from December 2012 to November 2014. Patients in group A were treated by sacroiliac joint dislocation with anterior plate fixation. Patients in group B were treated with computerized navigation for percutaneous sacroiliac screw. The operation duration,intraoperative blood loss,incision length,and postoperative complications (nausea,vomiting,pulmonary infection,wound complications,etc.) were compared between the two groups. The postoperative fracture healing time,postoperative patient satisfaction,and postoperative fractures MATTA scores (to evaluate fracture reduction),postoperative MAJEED function scores,and SF36 scores of the patients were also recorded and compared. No significant differences in baseline characteristics were found between the two groups of patients. All of the patients in both groups had their operations successfully completed. Patients in group B had significantly shorter operations and lower intraoperative blood loss,incision length and postoperative complications than those in group A ( P 0.05). Sacroiliac joint anterior approach with double reconstruction plate and computer assisted navigation percutaneous sacroiliac screws are both effective for treating Tile C1type pelvic fractures,with similar longterm efficacies. However,computer assisted navigation percutaneous sacroiliac screw has the advantages of less trauma,less bleeding,and quicker.

Surgical Management of a Mandible Subcondylar Fracture

Directory of Open Access Journals (Sweden)

Dong Hee Kang

2012-07-01

Full Text Available Open reduction and anatomic reduction can create better function for the temporomandibularjoint, compared with closed treatment in mandible fracture surgery. Therefore, the doubleminiplate fixation technique via mini-retromandibular incision was used in order to makethe most stable fixation when performing subcondylar fracture surgery. Those approachesprovide good visualization of the subcondyle from the posterior edge of the ramus, allow thesurgeon to work perpendicularly to the fracture, and enable direct fracture management.Understanding the biomechanical load in the fixation of subcondylar fractures is alsonecessary in order to optimize fixation methods. Therefore, we measured the biomechanicalloads of four different plate fixation techniques in the experimental model regardingmandibular subcondylar fractures. It was found that the loads measured in the two-platefixation group with one dynamic compression plate (DCP and one adaption plate showed thehighest deformation and failure loads among the four fixation groups. The loads measuredin the one DCP plate fixation group showed higher deformation and failure loads than theloads measured in the two adaption plate fixation group. Therefore, we conclude that theselection of the high profile plate (DCP is also important in order to create a stable load in thesubcondylar fracture.

[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

Conclusions regarding fracture mechanics testing and evaluation of small specimens - As evidenced by the finnish contribution to the IAEA CRP3 programme

Energy Technology Data Exchange (ETDEWEB)

Wallin, K; Valo, M; Rintamaa, R; Torronen, K [Technical Research Centre of Finland, Espoo (Finland); Ahlstrand, R [Imatran Voima Oy (IVO), Helsinki (Finland)

1994-12-31

An extensive mechanical property evaluation has been carried out on various specimens (a Japanese steel plate (JRQ), a French forging material (FFA) and a Japanese forging material (JFL)) in the as-received and irradiated conditions. The mechanical properties measured at different temperatures include Charpy-V notch and instrumented pre-cracked Charpy data and static and dynamic elastic-plastic fracture toughness based on the J-integral, with various specimen size and geometry. Test analysis lead to conclusions regarding the use of small specimen fracture mechanical tests for investigating irradiation effects: CVN{sub pc} and RCT type specimens are suitable for determining the materials fracture toughness even in the ductile/brittle transition region provided the elastic-plastic parameter K{sub JC} is applied together with a statistical size correction. These two specimen types yield equivalent results for the fracture toughness transition shift. Charpy-V appears not to be suitable for estimating the static fracture toughness transition shift. 8 refs., 11 figs.

Surgical plate fixation of multiple rib fractures: a case report.

Science.gov (United States)

Mitev, Konstantin; Neziri, Dashurie; Stoicovski, Emil; Mitrev, Zan

2018-05-29

The healthcare system in developing countries is limited; particularly, medical specialties such as emergency and trauma medicine are underdeveloped. Consequently, trauma injuries sustained in traffic accidents result in chronic morbidity more often than similar cases in developed countries. Multiple rib fractures induce significant patient morbidity. Current international guidelines recommend a multidisciplinary, surgery-based treatment approach to achieve optimal clinical benefit. We admitted a 41-year-old Albanian man to our emergency department following a pedestrian-vehicle accident 5 days earlier. He presented with severe upper thoracic pain, chest deformity, dyspnea, tachycardia, subcutaneous emphysema, and hematoma. Chest radiography pointed to hypoventilated lung fields and a minor pleural effusion. Computed tomographic scans indicated displaced fractures of right lateral ribs 5 -11, hyperdensity regions from bone fragments, and pulmonary contusion. The treatment consisted of surgical fixation of ribs 7-10 using titanium reconstruction plates and cortical locking screws. The patient's clinical condition rapidly improved postoperatively. Follow-up at 6 weeks confirmed a full return to preoperative daily activities and a high quality of life. In this case report, we present a novel and promising development in the field of trauma medicine in the Republic of Macedonia. Trauma injuries can be treated via advanced multidisciplinary medical care according to international standards, allowing optimal health recovery.

Crack-arrest behavior in SEN wide plates of low-upper-shelf base metal tested under nonisothermal conditions: WP-2 series

International Nuclear Information System (INIS)

Naus, D.J.; Keeney-Walker, J.; Bass, B.R.; Robinson, G.C. Jr.; Iskander, S.K.; Alexander, D.J.; Fields, R.J.; deWit, R.; Low, S.R.; Schwartz, C.W.

1990-08-01

The Heavy-Section Steel Technology (HSST) Program at the Oak Ridge National Laboratory under the sponsorship of the Nuclear Regulatory Commission is conducting analytical and experimental studies aimed at understanding the circumstances that would initiate the growth of an existing crack in a reactor pressure vessel (RPV) and the conditions leading to arrest of a propagating crack. Objectives of these studies are to determine (1) if the material will exhibit crack-arrest behavior when the driving force on a crack exceeds the ASME limit, (2) the relationship between K Ia and temperature, and (3) the interaction of fracture modes (arrest, stable crack growth, unstable crack growth, and tensile instability) when arrest occurs at high temperatures. In meeting these objectives, crack-arrest data are being developed over an expanded temperature range through tests involving large thermally shocked cylinders, pressurized thermally shocked vessels, and wide-plate specimens. The wide-plate specimens provide the opportunity for a significant number of data points to be obtained at relatively affordable costs. These tests are designed to provide fracture-toughness measurements approaching or above the onset of the Charpy upper-shelf regime in a rising toughness region and with an increasing driving force. This document discusses test methodology and results. 23 refs., 92 figs., 25 tabs

[Case-control study on minimally invasive percutaneous locking compression plate internal fixation for the treatment of type II and III pilon fractures].

Science.gov (United States)

Zhang, Zhi-Da; Ye, Xiu-Yi; Shang, Li-Yong; Xu, Rong-Ming; Zhu, Yan-Zhao

2011-12-01

To explore the clinical efficacy of delayed open reduction and internal fixation with minimally invasive percutaneous locking compression plate for the treatment of type II and III Pilon fractures. From January 2007 to September 2009, 32 patients with type II and III Pilon fractures were treated with open reduction and anatomic plate fixation (AP group) and minimally invasive percutaneous locking compression plate osteosynthesis (LCP group). There were 11 males and 6 females in AP group, with an average age of (37.4 +/- 13.3) years (ranged, 19 to 55 years). And there were 10 males and 5 females in LCP group, with an average age of (34.6 +/- 11.3) years(ranged, 21 to 56 years). The operating time, fracture healing time, aligned angulation and ankle function were compared between the two groups. All the patients were followed up, and the during ranged from 12 to 25 months, with a mean of (15.0 +/- 1.7) months. The average operation time was (76.5 +/- 8.3) min for AP group and (58.3 +/- 3.4) min for LCP group; the average time of fracture healing was (20.5 +/- 0.4) weeks for AP group and (15.7 +/- 0.2) weeks for LCP group; the total angulation between anterior posterior film and lateral film was averaged (6.6 +/- 0.5) degrees for AP group and (3.6 +/- 0.2) degrees for LCP group. As to above index, the results of LCP group were better than those of AP group (P ankle joint, the results of LCP group were better than those of AP group in ankle joint pain, wakling and ankle joint function (P fracture with less invasion, faster bone union, more stabilized fixation, quicker recovery of ankle function and fewer complications, which is more advantaged for type II and III Pilon fractures.

Hydroxyapatite coatings of fracture fixation plates for orthopedic applications

International Nuclear Information System (INIS)

Omar, M.A.; Abdullah, N.S.; Yahya, N.M.; Subuki, I.; Hassan, N.; Mohamad, S.M.

2007-01-01

The plasma sprayed hydroxyapatite (HA) coatings are used on metallic implants to improve their adhesion to bone. The present study investigates the plasma sprayed process of HA on the fracture fixation plates fabricated by metal injection moulding process. The phase and microstructure of the coatings were studied and their microhardness measured. The phase composition of coatings was analyzed by the use of X-ray diffraction method. The homogeneity of the deposit and coating thickness were evaluated using scanning electron microscope (SEM). The results suggest that the nature of the coating morphology, phase and crystallinity changes with respect to the plasma sprayed processing parameters. The XRD revealed the presence of both amorphous and crystalline phases. In addition, the powder particles also melt partially in some region and coating microstructure varied from a porous structure to a smooth glassy structure or a typical lamellar structure. (author)

Application of ISRM testing methods to fracture toughness testing of graphite

International Nuclear Information System (INIS)

Hashida, T.; Fukasawa, T.; Takahashi, H.; Ishiyama, S.; Oku, T.

1987-01-01

Fracture toughness measurements of nuclear grade graphites, IG11 and PGX, were made by means of AE technique. Tests were conducted on edge-notched round bend bar, edge-notched short bar and round compact tension specimens. These round-shaped specimens used in this study have been proposed for standard fracture toughness tests of rock as a draft of testing standard of International Society for Rock Mechanics (ISRM). Taking the observed nonlinear deformation behavior into account, J-integral approach was utilized to determine the fracture toughness of the graphites. It is shown that the critical J integral determined by AE technique, J iAE , is independent of specimen geometry. Based on this experimental results, the fracture toughness K IC of the graphites was determined from the J iAE values. K IC value of IG11 was 1.04 MPa√m, and 0.77 MPa√m for PGX respectively. Furthermore, the specimen size effect of the fracture toughness determined by the J-integral/AE method is discussed. (author)

Investigation of Hot Rolling Influence on the Explosive-Welded Clad Plate

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Guanghui ZHAO

2016-11-01

Full Text Available The microstructure, the shear strength and tensile strength of stainless steel explosive-welded clad plate at different rolling reduction were studied. The mechanical properties of the explosive-welded and explosive-rolled clad plates were experimentally measured. Simultaneously, the microstructures of the clad plate were investigated by the Ultra deep microscope and the tensile fracture surface were observed by the scan electron microscope (SEM. It was observed that the tensile strength has been increased considerably, whereas the elongation percentage has been reduced with the increase of hot rolling reduction. In the tensile shear test, the bond strength is higher than the strength of the ferritic stainless steel layer and meets the relevant known standard criterion. Microstructural evaluations showed that the grain of the stainless steel and steel refined with the increase of thickness reduction. Examination of the tensile fracture surfaces reveal that, after hot rolling, the fracture in the low alloy steel and ferritic stainless steel clad plates is of the ductile type.DOI: http://dx.doi.org/10.5755/j01.ms.22.4.12409

[Application of lateral malleolus hook-plate in treatment of stage II supination-adduction type medial malleolus fracture].

Science.gov (United States)

Chen, Yu; Zhang, Hui; Huang, Fuguo; Xiang, Zhuo; Fang, Yue; Liu, Lei; Cen, Shiqiang

2014-09-01

To investigate the application of lateral malleolus hook-plate for the treatment of stage II supination-adduction type medial malleolus fractures. Between January 2011 and June 2013, 21 patients with stage II supination-adduction type ankle fractures were treated with lateral malleolus hook-plate, including 12 males and 9 females with an average age of 55.5 years (range, 27-65 years). The injury causes were sprain in 17 cases and traffic accident in 4 cases. The mean time between injury and admission was 12.4 hours (range, 2-72 hours). The tibial distal medial articular surface collapse was found in 7 cases by CT examination and in 3 cases by X-ray film. Of 21 cases, there were 12 cases of low transverse fractures of lateral malleolus, 7 cases of short oblique fractures of lateral malleolus, and 2 cases of ankle joint lateral collateral ligament injury without fractures of lateral malleolus. After operation, the clinical outcome was evaluated according to the talus-leg angle, the recovery of Coin-sign continuity, inside-outside and top ankle gap, talus slope, American Orthopedic Foot and Ankle Society (AOFAS) score, Olerud-Molander score, Kofoed evaluation standards, and patient satisfaction. Seventeen cases were followed up 18.7 months on average (range, 12-25 months). Primary healing was obtained in 16 cases except 1 case of delayed healing. Fracture healed at an average of 14.6 weeks (range, 12-16 weeks). All cases achieved anatomical reduction, the continuity of Coin-sign, and consistency of inside and outside joint gap; no talus tilt occurred. There was no complication of reduction loss, loosening or breakage of internal fixation, or osteoarthritis during follow-up. The talus-leg angle of the affected side was significantly improved to (83.4 ± 1.8)° at 1 week after operation from preoperative (74.8 ± 7.1)° (t = 5.370, P = 0.000), but no significant difference was found when compared with normal side (83.8 ± 2.3)° (t = 0.676, P = 0.509). The AOFAS score

Uncertainty in hydraulic tests in fractured rock

International Nuclear Information System (INIS)

Ji, Sung-Hoon; Koh, Yong-Kwon

2014-01-01

Interpretation of hydraulic tests in fractured rock has uncertainty because of the different hydraulic properties of a fractured rock to a porous medium. In this study, we reviewed several interesting phenomena which show uncertainty in a hydraulic test at a fractured rock and discussed their origins and the how they should be considered during site characterisation. Our results show that the estimated hydraulic parameters of a fractured rock from a hydraulic test are associated with uncertainty due to the changed aperture and non-linear groundwater flow during the test. Although the magnitude of these two uncertainties is site-dependent, the results suggest that it is recommended to conduct a hydraulic test with a little disturbance from the natural groundwater flow to consider their uncertainty. Other effects reported from laboratory and numerical experiments such as the trapping zone effect (Boutt, 2006) and the slip condition effect (Lee, 2014) can also introduce uncertainty to a hydraulic test, which should be evaluated in a field test. It is necessary to consider the way how to evaluate the uncertainty in the hydraulic property during the site characterisation and how to apply it to the safety assessment of a subsurface repository. (authors)

[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.

A COMPARATIVE STUDY OF PROXIMAL FEMUR LOCKING COMPRESSION PLATE VERSUS PROXIMAL FEMORAL NAILING IN THE MANAGEMENT OF COMMINUTED TROCHANTERIC AND SUBTROCHANTERIC FRACTURE

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Satish Koti

2016-11-01

Full Text Available BACKGROUND Fractures of proximal femur and hip are relatively common injuries in elderly individuals constituting 11.6% of total fractures. The latest implant for management of intertrochanteric fracture is Proximal Femoral Locking Compression Plate (PF-LCP. In this study, we compare the clinical outcome of fractures treated by proximal femoral nail with that of proximal femur locking compression plate. MATERIALS AND METHODS The present study consists of 24 elderly patients of peritrochanteric factures of femur satisfying the inclusion criteria who were treated with PF-LCP or PFN in Department of Orthopaedics, S.V.R.R.G.G.H, Tirupati, during a period between December 2013 to October 2015. RESULTS 24 cases were treated with PF-LCP or PFN in a randomised pattern who satisfied inclusion criteria. Intraoperative complication were found to be more with PF-LCP in contrast to PFN. Postoperative rehabilitation was easier with PFN though not statistically significant functional and anatomical outcomes were found to be better with PFN. CONCLUSION Both PFN and PF-LCP have good effectiveness in the treatment of intertrochanteric fractures with the lateral unsubstantial femoral wall in the elderly patients. Each has its own advantages and disadvantages. Further studies with large number of patients and long-term follow up is needed to determine the optimal implant for the internal fixation of comminuted pertrochanteric femoral fractures.

Calibration and use of filter test facility orifice plates

Science.gov (United States)

Fain, D. E.; Selby, T. W.

1984-07-01

There are three official DOE filter test facilities. These test facilities are used by the DOE, and others, to test nuclear grade HEPA filters to provide Quality Assurance that the filters meet the required specifications. The filters are tested for both filter efficiency and pressure drop. In the test equipment, standard orifice plates are used to set the specified flow rates for the tests. There has existed a need to calibrate the orifice plates from the three facilities with a common calibration source to assure that the facilities have comparable tests. A project has been undertaken to calibrate these orifice plates. In addition to reporting the results of the calibrations of the orifice plates, the means for using the calibration results will be discussed. A comparison of the orifice discharge coefficients for the orifice plates used at the seven facilities will be given. The pros and cons for the use of mass flow or volume flow rates for testing will be discussed. It is recommended that volume flow rates be used as a more practical and comparable means of testing filters. The rationale for this recommendation will be discussed.

Fixation of supraglenoid tubercle fractures using distal femoral locking plates in three Warmblood horses.

Science.gov (United States)

Frei, Sina; Fürst, Anton E; Sacks, Murielle; Bischofberger, Andrea S

2016-05-18

Three horses that were presented with supraglenoid tubercle fractures were treated with open reduction and internal fixation using distal femoral locking plates (DFLP). Placing the DFLP caudal to the scapular spine in order to preserve the suprascapular nerve led to a stable fixation, however, it resulted in infraspinatus muscle atrophy and mild scapulohumeral joint instability (case 1). Placing the DFLP cranial to the scapular spine and under the suprascapular nerve resulted in a stable fixation, however, it resulted in severe atrophy of the supraspinatus and infraspinatus muscles and scapulohumeral joint instability (case 2). Placing the DFLP cranial to the scapular spine and slightly overbending it at the suprascapular nerve passage site resulted in the best outcome (case 3). Only a mild degree of supraspinatus and infraspinatus muscle atrophy was apparent, which resolved quickly and with no effect on scapulohumeral joint stability. In all cases, fixation of supraglenoid tubercle fractures using DFLP in slightly different techniques led to stable fixations with good long-term outcome. One case suffered from a mild incisional infection and plates were removed in two horses. Placement of the DFLP cranial to the scapular spine and slightly overbending it at the suprascapular nerve passage prevented major nerve damage. Further cases investigating the degree of muscle atrophy following the use of the DFLP placed in the above-described technique are justified to improve patient outcome.

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.

Biomechanical properties of an advanced new carbon/flax/epoxy composite material for bone plate applications.

Science.gov (United States)

Bagheri, Zahra S; El Sawi, Ihab; Schemitsch, Emil H; Zdero, Rad; Bougherara, Habiba

2013-04-01

This work is part of an ongoing program to develop a new carbon fiber/flax/epoxy (CF/flax/epoxy) hybrid composite material for use as an orthopaedic long bone fracture plate, instead of a metal plate. The purpose of this study was to evaluate the mechanical properties of this new novel composite material. The composite material had a "sandwich structure", in which two thin sheets of CF/epoxy were attached to each outer surface of the flax/epoxy core, which resulted in a unique structure compared to other composite plates for bone plate applications. Mechanical properties were determined using tension, three-point bending, and Rockwell hardness tests. Also, scanning electron microscopy (SEM) was used to characterize the failure mechanism of specimens in tension and three-point bending tests. The results of mechanical tests revealed a considerably high ultimate strength in both tension (399.8MPa) and flexural loading (510.6MPa), with a higher elastic modulus in bending tests (57.4GPa) compared to tension tests (41.7GPa). The composite material experienced brittle catastrophic failure in both tension and bending tests. The SEM images, consistent with brittle failure, showed mostly fiber breakage and fiber pull-out at the fractured surfaces with perfect bonding at carbon fibers and flax plies. Compared to clinically-used orthopaedic metal plates, current CF/flax/epoxy results were closer to human cortical bone, making the material a potential candidate for use in long bone fracture fixation. Copyright © 2013 Elsevier Ltd. All rights reserved.

Thermal shock fracture of graphite armor plate under the heat load of plasma disruption

International Nuclear Information System (INIS)

Horie, Tomoyoshi; Seki, Masahiro; Ohmori, Junji

1989-01-01

Experiments on the thermal shock brittle fracture of graphite plates were performed. Thermal loading which simulated a plasma disruption was produced by an electron beam facility. Pre-cracks produced on the surface propagated to the inside of the specimen even if the thermal stress on the surface was compressive. Two mechanisms are possible to produce tensile stress around the crack tip under thermal shock conditions. Temperature, thermal stress, and the stress intensity factor for the specimen were analyzed based on the finite element method for various heating conditions. The trend of experimental results under the asymmetric heating agrees qualitatively with the analytical results. This phenomenon is important for the design of plasma facing components made of graphite. Establishment of a lifetime prediction procedure including fatigue, fatigue crack growth, and brittle fracture is needed for graphite armors. (orig.)

Treatment of displaced talar neck fractures using delayed procedures of plate fixation through dual approaches.

Science.gov (United States)

Xue, Youdi; Zhang, Hui; Pei, Fuxing; Tu, Chongqi; Song, Yueming; Fang, Yue; Liu, Lei

2014-01-01

Treatment of talar neck fractures is challenging. Various surgical approaches and fixation methods have been documented. Clinical outcomes are often dissatisfying due to inadequate reduction and fixation with high rates of complications. Obtaining satisfactory clinical outcomes with minimum complications remains a hard task for orthopaedic surgeons. In the period from May 2007 to September 2010, a total of 31 cases with closed displaced talar neck fractures were treated surgically in our department. Injuries were classified according to the Hawkins classification modified by Canale and Kelly. Under general anaesthesia with sufficient muscle relaxation, urgent closed reduction was initiated once the patients were admitted; if the procedure failed, open reduction and provisional stabilisation with Kirschner wires through an anteromedial approach with tibiometatarsal external fixation were performed. When the soft tissue had recovered, definitive fixation was performed with plate and screws through dual approaches. The final follow-up examination included radiological analysis, clinical evaluation and functional outcomes which were carried out according to the Ankle-Hindfoot Scale of the American Orthopaedic Foot and Ankle Society (AOFAS), patient satisfaction and SF-36. Twenty-eight patients were followed up for an average of 25 months (range 18-50 months) after the injury. Only two patients had soft tissue complications, and recovery was satisfactory with conservative treatment. All of the fractures healed anatomically without malunion and nonunion, and the average union time was 14 weeks (range 12-24 weeks). Post-traumatic arthritis developed in ten cases, while six patients suffered from avascular necrosis of the talus. Secondary procedures included three cases of subtalar arthrodesis, one case of ankle arthrodesis and one case of total ankle replacement. The mean AOFAS hindfoot score was 78 (range 65-91). According to the SF-36, the average score of the

Fragment-Specific Fixation Versus Volar Locking Plates in Primarily Nonreducible or Secondarily Redisplaced Distal Radius Fractures: A Randomized Controlled Study.

Science.gov (United States)

Landgren, Marcus; Abramo, Antonio; Geijer, Mats; Kopylov, Philippe; Tägil, Magnus

2017-03-01

To compare the patient-reported, clinical, and radiographic outcome of 2 methods of internal fixation in distal radius fractures. Fifty patients, mean age 56 years (range, 21-69 years) with primarily nonreducible or secondarily redisplaced distal radius fractures were randomized to open reduction internal fixation using volar locking plates (n = 25) or fragment-specific fixation (n = 25). The patients were assessed on grip strength, range of motion, patient-reported outcome (Quick Disabilities of the Arm, Shoulder, and Hand), pain (visual analog scale), health-related quality of life (Short Form-12 [SF-12]), and radiographic evaluation. Grip strength at 12 months was the primary outcome measure. At 12 months, no difference was found in grip strength, which was 90% of the uninjured side in the volar plate group and 87% in the fragment-specific fixation group. No differences were found in range of motion and the median Quick Disabilities of the Arm, Shoulder, and Hand score was 5 in both groups. The overall complication rate was significant, 21% in the volar locking plate group, compared with 52% in the fragment-specific group. In treatment of primarily nonreducible or secondarily redisplaced distal radius fractures, volar locking plates and fragment-specific fixation both achieve good and similar patient-reported outcomes, although more complications were recorded in the fragment-specific group. Therapeutic II. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Statistical test for the distribution of galaxies on plates

International Nuclear Information System (INIS)

Garcia Lambas, D.

1985-01-01

A statistical test for the distribution of galaxies on plates is presented. We apply the test to synthetic astronomical plates obtained by means of numerical simulation (Garcia Lambas and Sersic 1983) with three different models for the 3-dimensional distribution, comparison with an observational plate, suggest the presence of filamentary structure. (author)

Periodic Hydraulic Testing for Discerning Fracture Network Connections

Science.gov (United States)

Becker, M.; Le Borgne, T.; Bour, O.; Guihéneuf, N.; Cole, M.

2015-12-01

Discrete fracture network (DFN) models often predict highly variable hydraulic connections between injection and pumping wells used for enhanced oil recovery, geothermal energy extraction, and groundwater remediation. Such connections can be difficult to verify in fractured rock systems because standard pumping or pulse interference tests interrogate too large a volume to pinpoint specific connections. Three field examples are presented in which periodic hydraulic tests were used to obtain information about hydraulic connectivity in fractured bedrock. The first site, a sandstone in New York State, involves only a single fracture at a scale of about 10 m. The second site, a granite in Brittany, France, involves a fracture network at about the same scale. The third site, a granite/schist in the U.S. State of New Hampshire, involves a complex network at scale of 30-60 m. In each case periodic testing provided an enhanced view of hydraulic connectivity over previous constant rate tests. Periodic testing is particularly adept at measuring hydraulic diffusivity, which is a more effective parameter than permeability for identify the complexity of flow pathways between measurement locations. Periodic tests were also conducted at multiple frequencies which provides a range in the radius of hydraulic penetration away from the oscillating well. By varying the radius of penetration, we attempt to interrogate the structure of the fracture network. Periodic tests, therefore, may be uniquely suited for verifying and/or calibrating DFN models.

[Close reduction combined with minimally invasive percutaneous plate osteosynthesis for proximal and distal tibial fractures: a report of 56 patients].

Science.gov (United States)

Liu, Yin-Wen; Kuang, Yong; Gu, Xin-Feng; Zheng, Yu-Xin; Li, Zhi-Qiang; Wei, Xiao-En; Zhang, Ming-Cai; Zhan, Hong-Sheng; Shi, Yin-yu

2013-03-01

To evaluate the clinical effects of close reduction combined with minimally invasive percutanous plate osteosynthesis (MIPPO) for proximal and distal tibial fractures. From March 2007 to December 2010, 56 patients with proximal and distal tibial fractures were treated with close reduction combined with MIPPO technique. There were 39 males and 17 females,aged from 22 to 67 years with an average of 41.3 years. Left fracture was in 25 cases and right fracture was in 31 cases; proximal tibial fracture was in 15 cases and distal tibial fractures was in 41 cases; 34 cases caused by fall down and 22 cases caused by road accident. The mean time from injury to operation was 1.7 d. Clinical manifestation included pain, swelling of leg with limitation of activity. According to the standard of Johner-Wruhs, clinical effects were evaluated. The mean operative time was 46 min in 56 patients. All fractures obtained satisfactory reduction and the location of plate was good. Incisions healed with one-stage and no superficial or deep infection was found. All the patients were followed up from 8 to 23 months with an average of 14.2 months. Only one fracture complication with delayed union,and after auto grafting with ilium bone,the fracture got union. Other 55 cases obtained bone healing in 15 to 20 weeks after operation and no internal fixation failure was found. The time of walking was 4-6 months after operation,without limping at 7 months after operation. Both lower extremities were symmetrical and the function of knee and ankle got complete recovery. According to the criteria of Johner-Wruhs score,46 cases obtained excellent results,9 good and 2 fair. Treatment of proximal and distal tibial fractures with close reduction and MIPPO technique can not only preserve soft tissue,simplify operative procedure and decrease wound, but also can obtain rigid internal fixation and guarantee early function exercises of knee and ankle joints. The method has the advantages of less soft tissue

[Treatment type C fracture of the distal radius with locking compression plate and external fixators].

Science.gov (United States)

Yang, Xiang; Zhao, You-ming; Chen, Lin; Ye, Cong-cong; Guo, Wei-jun; Wang, Bo

2013-12-01

To compare efficacy of unilateral external fixators and locking compression plates in treating type C fractures of the distal radius. From January 2009 to June 2010, 76 patients with distal radius fracture were treated with LCP and external fixators, 54 patients were followed up. Among them, 29 cases were male and 25 cases were female with an average age of 45.31 (ranged, 24 to 68) years old. There were 29 patients in LCP group. According to AO classification, 8 cases were type C1, 7 cases were type C2 and 14 cases were type C3. There were 25 cases in external fixators group. According to AO classification, 6 cases were type C1, 8 cases were type C2 and 11 cases were type C3. Radial height, volar tilt and radial inclination were compared, advanced Gartland-Werley scoring were used to assessed wrist joint function after 6 and 12 months' following up. Two cases were suffered from nail infection in external fixators group. Fifty-four patients were followed up from 12 to 24 months with an average of 21.3 months. Radial height was (9.60 +/- 0.72) mm, volar tilt was (9.55 +/- 0.80) degrees and radial inclination was (21.40 +/- 0.78) degrees in LCP group,while those were (9.40 +/- 0.70) mm, (9.47 +/- 0.71) degrees and (21.20 +/- 0.73) degrees in external fixtors group, and with no statistical significance (P>0.05). Advanced Gartland-Werley score after 6 months' following up was 3.31 +/- 1.17 in LCP group, 5.56 +/- 1.58 in external fixtors group, and with significant difference (t=-5.99,Pmeaning (t=-1.55, P>0.05). LCP and external fixtors can receive good curative effects in treating type C distal radius fracture, and LCP can obtain obviously short-term efficacy, while there is no significant difference between two groups in long-term results. For serious distal radius comminuted fracture which unable to plate internal fixation, external fixators is a better choice.

Fracture toughness of welded joints of ASTM A543 steel plate

International Nuclear Information System (INIS)

Susukida, H.; Uebayashi, T.; Yoshida, K.; Ando, Y.

1977-01-01

Fracture toughness and weldability tests have been performed on a high strength steel which is a modification of ASTM A543 Grade B Class 1 steel, with a view to using it for nuclear reactor containment vessels. The results showed that fracture toughness of welded joints of ASTM A543 modified high strength steel is superior and the steel is suitable for manufacturing the containment vessels

The influence of composition, annealing treatment, and texture on the fracture toughness of Ti-5Al-2.5Sn plate at cryogenic temperatures

Science.gov (United States)

Vanstone, R. H.; Shannon, J. L., Jr.; Pierce, W. S.; Low, J. R., Jr.

1977-01-01

The plane strain fracture toughness K sub Ic and conventional tensile properties of two commercially produced one-inch thick Ti-5Al-2.5Sn plates were determined at cryogenic temperatures. One plate was extra-low interstitial (ELI) grade, the other normal interstitial. Portions of each plate were mill annealed at 1088 K (1500 F) followed by either air cooling or furnace cooling. The tensile properties, flow curves, and K sub Ic of these plates were determined at 295 K (room temperature), 77 K (liquid nitrogen temperature), and 20 K (liquid hydrogen temperature).

Customized a Ti6Al4V Bone Plate for Complex Pelvic Fracture by Selective Laser Melting

Directory of Open Access Journals (Sweden)

Di Wang

2017-01-01

Full Text Available In pelvic fracture operations, bone plate shaping is challenging and the operation time is long. To address this issue, a customized bone plate was designed and produced using selective laser melting (SLM technology. The key steps of this study included designing the customized bone plate, metal 3D printing, vacuum heat treatment, surface post-processing, operation rehearsal, and clinical application and evaluation. The joint surface of the bone plate was placed upwards with respect to the build platform to keep it away from the support and to improve the quality of the joint surface. Heat conduction was enhanced by adding a cone-type support beneath the bone plate to prevent low-quality fabrication due to poor heat conductivity of the Ti-6Al-4V powder. The residual stress was eliminated by exposing the SLM-fabricated titanium-alloy bone plate to a vacuum heat treatment. Results indicated that the bone plate has a hardness of HV1 360–HV1 390, an ultimate tensile strength of 1000–1100 MPa, yield strength of 900–950 MPa, and an elongation of 8%–10%. Pre-operative experiments and operation rehearsal were performed using the customized bone plate and the ABC-made pelvic model. Finally, the customized bone plate was clinically applied. The intraoperative C-arm and postoperative X-ray imaging results indicated that the customized bone plate matched well to the damaged pelvis. The customized bone plate fixed the broken bone and guides pelvis restoration while reducing operation time to about two hours. The customized bone plate eliminated the need for preoperative titanium plate pre-bending, thereby greatly reducing surgical wounds and operation time.

Customized a Ti6Al4V Bone Plate for Complex Pelvic Fracture by Selective Laser Melting.

Science.gov (United States)

Wang, Di; Wang, Yimeng; Wu, Shibiao; Lin, Hui; Yang, Yongqiang; Fan, Shicai; Gu, Cheng; Wang, Jianhua; Song, Changhui

2017-01-04

In pelvic fracture operations, bone plate shaping is challenging and the operation time is long. To address this issue, a customized bone plate was designed and produced using selective laser melting (SLM) technology. The key steps of this study included designing the customized bone plate, metal 3D printing, vacuum heat treatment, surface post-processing, operation rehearsal, and clinical application and evaluation. The joint surface of the bone plate was placed upwards with respect to the build platform to keep it away from the support and to improve the quality of the joint surface. Heat conduction was enhanced by adding a cone-type support beneath the bone plate to prevent low-quality fabrication due to poor heat conductivity of the Ti-6Al-4V powder. The residual stress was eliminated by exposing the SLM-fabricated titanium-alloy bone plate to a vacuum heat treatment. Results indicated that the bone plate has a hardness of HV1 360-HV1 390, an ultimate tensile strength of 1000-1100 MPa, yield strength of 900-950 MPa, and an elongation of 8%-10%. Pre-operative experiments and operation rehearsal were performed using the customized bone plate and the ABC-made pelvic model. Finally, the customized bone plate was clinically applied. The intraoperative C-arm and postoperative X-ray imaging results indicated that the customized bone plate matched well to the damaged pelvis. The customized bone plate fixed the broken bone and guides pelvis restoration while reducing operation time to about two hours. The customized bone plate eliminated the need for preoperative titanium plate pre-bending, thereby greatly reducing surgical wounds and operation time.

Applicability and interpretation of fracture test methods for metals

International Nuclear Information System (INIS)

Langford, W.J.

1978-05-01

Fracture tests are conducted usually out of a conviction (sometimes only vaguely defined) that they will guarantee a certain level of protecton from metal failure. Qualitative tests, such as the Charpy V-notch, produce results which cannot be rigorously related to a measure of fracture tolerance: rather, they indicate metal quality so that fracture tolerance may be inferred. Quantitative tests on the other hand provide parameters which may be used directly in equations to determine the likelihood of fracture. Both types of tests have limitations which should be understood: the paper tries to provide guidance on the relative merits of either approach for a particular purpose, and gives an insight into near-future test methods which will extend the range of usefullness of quantitative tests. (author)

Effect of screw position on single cycle to failure in bending and torsion of a locking plate-rod construct in a synthetic feline femoral gap model.

Science.gov (United States)

Niederhäuser, Simone K; Tepic, Slobodan; Weber, Urs T

2015-05-01

To evaluate the effect of screw position on strength and stiffness of a combination locking plate-rod construct in a synthetic feline femoral gap model. 30 synthetic long-bone models derived from beechwood and balsa wood. 3 constructs (2 locking plate-rod constructs and 1 locking plate construct; 10 specimens/construct) were tested in a diaphyseal bridge plating configuration by use of 4-point bending and torsion. Variables included screw position (near the fracture gap and far from the fracture gap) and application of an intramedullary pin. Constructs were tested to failure in each loading mode to determine strength and stiffness. Failure was defined as plastic deformation of the plate or breakage of the bone model or plate. Strength, yield angle, and stiffness were compared by use of a Wilcoxon test. Placement of screws near the fracture gap did not increase bending or torsional stiffness in the locking plate-rod constructs, assuming the plate was placed on the tension side of the bone. Addition of an intramedullary pin resulted in a significant increase in bending strength of the construct. Screw positioning did not have a significant effect on any torsion variables. Results of this study suggested that, in the investigated plate-rod construct, screw insertion adjacent to the fracture lacked mechanical advantages over screw insertion at the plate ends. For surgeons attempting to minimize soft tissue dissection, the decision to make additional incisions for screw placement should be considered with even more caution.

Seafloor spreading on the Southeast Indian Ridge over the last one million years: a test of the Capricorn plate hypothesis

Science.gov (United States)

Conder, James A.; Forsyth, Donald W.

2001-05-01

Plate motions in the Indian Ocean are inconsistent with a rigid Indo-Australian plate. An equatorial, diffuse boundary dividing the plate into separate Indian and Australian plates significantly improves the fit of kinematic plate models to the spreading rates, transform azimuths, and earthquake slip vectors on the spreading center boundaries. An additional boundary, further dividing the Australian plate into Australian and Capricorn plates has been proposed to account for much of the remaining inconsistency and the pattern of intraplate earthquakes [J.-Y. Royer, R.G. Gordon, Science 277 (1997) 1268-1274]. The proposed boundary is ˜2000 km wide where it intersects the Southeast Indian Ridge. Several recent geophysical cruises to the Southeast Indian Ridge, including a cruise within the proposed boundary, provide many new data for investigating the validity of the Capricorn plate model. These new observations strongly support the hypothesis that the Capricorn plate exists. Statistical tests of the data from the Southeast Indian Ridge alone are not sufficient to confirm it, but motion about the Rodriguez Triple Junction (RTJ) suggests some non-rigidity in the Antarctica-Australia-Somalia circuit. Inferred deformation with enforced closure about the RTJ leads to an estimate of plate motion consistent with the Capricorn plate model. However, the diffuse Capricorn-Australia boundary does not extend south of the St. Paul Fracture Zone, 800 km narrower than the previously proposed boundary.

Minimally invasive plate osteosynthesis for humeral shaft fracture: a reproducible technique with the assistance of an external fixator.

Science.gov (United States)

Lee, Hyun-Joo; Oh, Chang-Wug; Oh, Jong-Keon; Apivatthakakul, Theerachai; Kim, Joon-Woo; Yoon, Jong-Pil; Lee, Dong-Joo; Jung, Jae-Wook

2013-05-01

Minimally invasive plate osteosynthesis (MIPO) has become a popular option for treatment of humeral shaft fractures. However, indirect reduction might risk unpromising results, with mal-alignment/mal-union or nonunion. The purpose of this study was to describe a reproducible MIPO technique that used an external fixator during the procedure as a tool for reduction and maintenance, and to assess the outcomes in patients with humeral shaft fracture. Of 31 consecutive cases of humeral shaft fracture in 30 patients, 29 were included in this study. There were seven simple (type A) and 22 comminuted (type B or C) fractures. After the insertion of one Schanz pin on each proximal and distal humerus, a provisional reduction was achieved by connecting the pins with a monolateral external fixator. The MIPO procedure was then performed over the anterior aspect of the humerus. To evaluate the efficacy of the provisional reduction by external fixator, coronal and sagittal alignments were assessed. We also assessed bony and functional results, including complications, from this technique. There was no case of mal-union >10°, and mean angulation was 1.3° (range 0°-9°) in the coronal plane and 1.2° (range 0°-8°) in the sagittal plane. Twenty-eight of 29 fractures were united, including three delayed unions, with a mean union time of 19.1 weeks (range 12.3-38.4 weeks) and a mean follow-up of 20.8 months (range 13.5-31.0 months). There was one hypertrophic nonunion that healed after fixing with two additional screws. Except one patient with associated injury in the elbow, all patients recovered to pre-injury joint motion. There were two cases of postoperative radial nerve palsy that both recovered completely. We attributed them to manipulation, and not to the Schanz pins or plate fixation. Surgical treatment of humeral shaft fractures with external fixator-assisted reduction and MIPO resulted in excellent reductions and high union rates.

EVALUATION OF RESULTS IN FRACTURES OF BOTH BONES FOREARM TREATED WITH DYNAMIC COMPRESSION PLATING

Directory of Open Access Journals (Sweden)

Sindhuja G

2017-06-01

incisions for radius and ulna and preservation of the natural curves of radius will lessen the rate of complications. Rigid fixation of fractures after perfect anatomical reduction with 3.5 mm DCP and screws allows early mobilisation, prevents soft tissue contracture, muscular tethering and improves vascularity. A minimum of 6 cortices have to be fixed in each fracture fragment and the nearest screw to the fracture line should be at least 1 cm away. It minimises vascular damage to the plated bone segment.

Novel management of distal tibial and fibular fractures with Acumed fibular nail and minimally invasive plating osteosynthesis technique: A case report.

Science.gov (United States)

Wang, Tie-Jun; Ju, Wei-Na; Qi, Bao-Chang

2017-03-01

Anatomical characteristics, such as subcutaneous position and minimal muscle cover, contribute to the complexity of fractures of the distal third of the tibia and fibula. Severe damage to soft tissue and instability ensure high risk of delayed bone union and wound complications such as nonunion, infection, and necrosis. This case report discusses management in a 54-year-old woman who sustained fractures of the distal third of the left tibia and fibula, with damage to overlying soft tissue (swelling and blisters). Plating is accepted as the first choice for this type of fracture as it ensures accurate reduction and rigid fixation, but it increases the risk of complications. Closed fracture of the distal third of the left tibia and fibula (AO: 43-A3). After the swelling was alleviated, the patient underwent closed reduction and fixation with an Acumed fibular nail and minimally invasive plating osteosynthesis (MIPO), ensuring a smaller incision and minimal soft-tissue dissection. At the 1-year follow-up, the patient had recovered well and had regained satisfactory function in the treated limb. The Kofoed score of the left ankle was 95. Based on the experience from this case, the operation can be undertaken safely when the swelling has been alleviated. The minimal invasive technique represents the best approach. Considering the merits and good outcome in this case, we recommend the Acumed fibular nail and MIPO technique for treatment of distal tibial and fibular fractures.

Novel use of hand fracture fixation plates in the surgical stabilisation of flail chest.

LENUS (Irish Health Repository)

Dunlop, Rebecca L E

2010-01-01

Plastic surgeons specialize in working closely with other surgical colleagues to help solve clinical problems. In this case, we performed surgical stabilisation of a large flail chest fragment in conjunction with the cardiothoracic surgical team, using the mini-plating set more commonly used for hand fracture fixation. The use of this fixation system for flail chest has not previously been described, but offers advantages over other reported methods, primarily by dispensing with the need for an extensive thoracotomy incision and by providing robust stabilisation without the presence of prominent hardware.

Implant Material, Type of Fixation at the Shaft, and Position of Plate Modify Biomechanics of Distal Femur Plate Osteosynthesis.

Science.gov (United States)

Kandemir, Utku; Augat, Peter; Konowalczyk, Stefanie; Wipf, Felix; von Oldenburg, Geert; Schmidt, Ulf

2017-08-01

To investigate whether (1) the type of fixation at the shaft (hybrid vs. locking), (2) the position of the plate (offset vs. contact) and (3) the implant material has a significant effect on (a) construct stiffness and (b) fatigue life in a distal femur extraarticular comminuted fracture model using the same design of distal femur periarticular locking plate. An extraarticular severely comminuted distal femoral fracture pattern (OTA/AO 33-A3) was simulated using artificial bone substitutes. Ten-hole distal lateral femur locking plates were used for fixation per the recommended surgical technique. At the distal metaphyseal fragment, all possible locking screws were placed. For the proximal diaphyseal fragment, different types of screws were used to create 4 different fixation constructs: (1) stainless steel hybrid (SSH), (2) stainless steel locked (SSL), (3) titanium locked (TiL), and (4) stainless steel locked with 5-mm offset at the diaphysis (SSLO). Six specimens of each construct configuration were tested. First, each specimen was nondestructively loaded axially to determine the stiffness. Then, each specimen was cyclically loaded with increasing load levels until failure. Construct Stiffness: The fixation construct with a stainless steel plate and hybrid fixation (SSH) had the highest stiffness followed by the construct with a stainless steel plate and locking screws (SSL) and were not statistically different from each other. Offset placement (SSLO) and using a titanium implant (TiL) significantly reduced construct stiffness. Fatigue Failure: The stainless steel with hybrid fixation group (SSH) withstood the most number of cycles to failure and higher loads, followed by the stainless steel plate and locking screw group (SSL), stainless steel plate with locking screws and offset group (SSLO), and the titanium plate and locking screws group (TiL) consecutively. Offset placement (SSLO) as well as using a titanium implant (TiL) reduced cycles to failure. Using the

Interpretation of fracture system geometry using well test data

International Nuclear Information System (INIS)

Doe, T.W.; Geier, J.E.

1990-11-01

This report presents three methods of determining fracture geometry and interconnection from well test information. Method 1 uses evidence for boundary effects in the well test to determine the distance to and type of fracture boundary. Method 2 uses the spatial dimension of the well test to infer the geometry of the fracture-conduit system. Method 3 obtains information of the spacing and transmissivity distribution of individual conductive fractures from fixed-interval-length (FIL) well tests. The three methods are applied to data from the Site Characterization and Validation (SCV) at the 360 m level of the Stripa Mine. The focus of the technology development is the constant-pressure welltest, although the general approaches apply to constant-rate well test, and to a much lesser extent slug or pulse test, which are relatively insensitive to boundaries and spatial dimension. Application of the techniques to the N and W holes in the SCV area shows that there is little evidence for boundary effects in the well test results. There is, on the other hand, considerable variation in the spatial dimension of the well test data ranging from sub-linear (fractures which decrease in conductivity with distance from the hole) to spherical, for three-dimensional fracture systems. The absence of boundary effects suggest that the rock mass in the SCV area contains a well connected fracture system. Major uncertainties in the analysis of well test data limit the use of single borehole measurements. Without assuming the value of specific storage, one can reliably determine only the spatial dimension, and, for two dimensional flow only, the transmissivity. Among the uncertainties are the effective well radius, the degree to which the fracture conduits fill the n-dimensional space in which flow occurs, and the cross-sectional area of the conduits at the wellbore. This report presents a complete development of constant-pressure well test methods for cylindrical flow and flow of arbitrary

Open reduction and internal fixation of osteoporotic acetabular fractures through the ilio-inguinal approach: use of buttress plates to control medial displacement of the quadrilateral surface.

Science.gov (United States)

Peter, Robin E

2015-01-01

The number of acetabular fractures in the geriatric population requiring open reduction and internal fixation is increasing. Fractures with medial or anterior displacement are the most frequent types, and via the ilio-inguinal approach buttress plates have proved helpful to maintain the quadrilateral surface or medial acetabular wall. Seven to ten hole 3.5 mm reconstruction plates may be used as buttress plates, placed underneath the usual pelvic brim plate. This retrospective study presents our results with this technique in 13 patients at a minimum follow-up of 12 months (average, 31 months). 85% of the patients had a good result. The early onset of post-traumatic osteoarthritis necessitated total hip arthroplasty in two patients (15%) at 12 and 18 months follow-up, respectively. This treatment option should be considered in the surgeon's armamentarium when fixing these challenging cases. Copyright © 2015 Elsevier Ltd. All rights reserved.

Ipsilateral humeral neck and shaft fractures

Directory of Open Access Journals (Sweden)

Zhu Bin

2017-01-01

Full Text Available Background/Aim. Fractures of the proximal humerus or shaft are common, however, ipsilateral neck and shaft humerus fracture is a rare phenomenon. This combination injury is challenging for orthopaedic surgeons because of its complex treatment options at present. The purpose of this study was to review a series of ipsilateral humeral neck and shaft fractures to study the fracture pattern, complications and treatment outcomes of each treatment options used. Methods. A total of six patients (four female and two male with the average age of 42.8 years (range: 36–49 years was collected and reviewed retrospectively. Two of them were treated with double plates and four with antegrade intramedullary nail. According to the Neer’s classification, all proximal fractures were two-part surgical neck fractures. All humeral shaft fractures were located at the middle of one third. Five fractures were simple transverse (A3, one fragmented wedge fracture (B3. One patient had associated radial nerve palsy. Results. All surgical neck fractures except one united uneventfully in the average time span of 8.7 weeks. Four humeral shaft fractures healed in near anatomic alignment. The remaining two patients had the nonunion with no radiological signs of fracture healing. The average University of California, Los Angeles End-Results (UCLA score was 23.1. On the contrary, the average American Shoulder and Elbow Surgeon's (ASES score was 73.3. The patients treated with antegrade intramedullary nails presented 70.5 points. The ASES scores were 79 in the double plates group. Conclusions. Ipsilateral humeral shaft and neck fracture is extremely rare. Both antegrade intramedullar nailing and double plates result in healing of fractures. However the risk of complication is lower in the double plating group.

Fracture mechanisms of aluminium alloy AA7075-T651 under various loading conditions

International Nuclear Information System (INIS)

Pedersen, Ketill O.; Borvik, Tore; Hopperstad, Odd Sture

2011-01-01

The fracture behaviour of the aluminium alloy AA7075-T651 is investigated for quasi-static and dynamic loading conditions and different stress states. The fracture surfaces obtained in tensile tests on smooth and notched axisymmetric specimens and compression tests on cylindrical specimens are compared to the fracture surfaces that occur when a projectile, having either a blunt or an ogival nose shape, strikes a 20 mm thick plate of the aluminium alloy. The stress state in the impact tests is much more complex and the strain rate significantly higher than in the tensile and compression tests. Optical and scanning electron microscopes are used in the investigation. The fracture surface obtained in tests with smooth axisymmetric specimens indicates that the crack growth is partly intergranular along the grain boundaries or precipitation free zones and partly transgranular by void formation around fine and coarse intermetallic particles. When the stress triaxiality is increased through the introduction of a notch in the tensile specimen, delamination along the grain boundaries in the rolling plane is observed perpendicular to the primary crack. In through-thickness compression tests, the crack propagates within an intense shear band that has orientation about 45 o with respect to the load axis. The primary failure modes of the target plate during impact were adiabatic shear banding when struck by a blunt projectile and ductile hole-enlargement when struck by an ogival projectile. Delamination and fragmentation of the plates occurred for both loading cases, but was stronger for the ogival projectile. The delamination in the rolling plane was attributed to intergranular fracture caused by tensile stresses occurring during the penetration event.

Comparative endurance testing of the Biomet Matthews Nail and the Dynamic Compression Screw, in simulated condylar and supracondylar femoral fractures

Directory of Open Access Journals (Sweden)

Davies Benjamin M

2008-01-01

Full Text Available Abstract Background The dynamic compression screw is a plate and screws implant used to treat fractures of the distal femur. The Biomet Matthews Nail is a new retrograde intramedullary nail designed as an alternative surgical option to treat these fractures. The objective of this study was to assess the comparative endurance of both devices. Method The dynamic compression screw (DCS and Biomet Matthews Nail (BMN were implanted into composite femurs, which were subsequently cyclically loaded using a materials testing machine. Simulated fractures were applied to each femur prior to the application of load. Either a Y type fracture or a transverse osteotomy was prepared on each composite femur using a jig to enable consistent positioning of cuts. Results The Biomet Matthews Nail demonstrated a greater endurance limit load over the dynamic compression screw in both fracture configurations. Conclusion The distal locking screws pass through the Biomet Matthews Nail in a unique "cruciate" orientation. This allows for greater purchase in the bone of the femoral condyle and potentially improves the stability of the fracture fixation. As these fractures are usually in weak osteoporotic bone, the Biomet Matthews Nail represents a favourable surgical option in these patients.

Clinical comparative analysis on unstable pelvic fractures in the treatment with percutaneous sacroiliac screws and sacroiliac joint anterior plate fixation.

Science.gov (United States)

Li, C-L

2014-01-01

To investigate clinical efficacy of unstable pelvic fractures in the treatment with percutaneous sacroiliac screws and sacroiliac joint anterior plate fixation. 64 patients with unstable pelvic fractures were selected in the hospital from January 2008 to June 2011, and were randomly divided into two groups.(32 patients with sacroiliac anterior plate fixation as the control group, and another 32 patients with percutaneous sacroiliac screw internal fixation as the observation group). The perioperative period clinical indicators, postoperative Matta score, postoperative Majeed function score of all patients were compared and analyzed. The operation time, intraoperative blood loss, wound total length, postoperative fever time, duration of hospitalization in the observation group were significantly less than those in the control group. The complication rate (3.1%) in the observation group was lower than that in the control group (21.9%). The rate of Matta score excellent (96.9%) in the observation group was higher than that in the control group (81.2%) after the treatment. The rate of Majeed function score excellent (93.8%) in the observation group was significantly higher than that in the control group (75%) after the treatment. Percutaneous sacroiliac screw internal fixation in the treatment of unstable pelvic fractures has less injury, less bleeding, less pain and rapid recovery which is a safe and effective minimally invasive operation method. The clinical curative effect of percutaneous sacroiliac screw internal fixation is better than anterior plate fixation for the treatment of sacroiliac joint. The full preparation before the surgery and patients with positive can substantially reduce the occurrence of complications rate.

Fracture Testing with Surface Crack Specimens. [especially the residual tensile strength test

Science.gov (United States)

Orange, T. W.

1974-01-01

Recommendations are given for the design, preparation, and static fracture testing of surface crack specimens. The recommendations are preceded by background information including discussions of stress intensity factors, crack opening displacements, and fracture toughness values associated with surface crack specimens. Cyclic load and sustained load tests are discussed briefly.

Multi-Scale Thermal Heat Tracer Tests for Characterizing Transport Processes and Flow Channelling in Fractured Media: Theory and Field Experiments

Science.gov (United States)

de La Bernardie, J.; Klepikova, M.; Bour, O.; Le Borgne, T.; Dentz, M.; Guihéneuf, N.; Gerard, M. F.; Lavenant, N.

2017-12-01

The characterization of flow and transport in fractured media is particularly challenging because hydraulic conductivity and transport properties are often strongly dependent on the geometric structure of the fracture surfaces. Here we show how thermal tracer tests may be an excellent complement to conservative solute tracer tests to infer fracture geometry and flow channeling. We performed a series of thermal tracer tests at different scales in a crystalline rock aquifer at the experimental site of Ploemeur (H+ observatory network). The first type of thermal tracer tests are push-pull tracer tests at different scales. The temporal and spatial scaling of heat recovery, measured from thermal breakthrough curves, shows a clear signature of flow channeling. In particular, the late time tailing of heat recovery under channeled flow is shown to diverge from the T(t) α t-1,5 behavior expected for the classical parallel plate model and follow the scaling T(t) α 1/t(logt)2 for a simple channel modeled as a tube. Flow channeling is also manifested on the spatial scaling of heat recovery as flow channeling affects the decay of the thermal breakthrough peak amplitude and the increase of the peak time with scale. The second type of thermal tracer tests are flow-through tracer tests where a pulse of hot water was injected in a fracture isolated by a double straddle packer while pumping at the same flow rate in another fracture at a distance of about 10 meters to create a dipole flow field. Comparison with a solute tracer test performed under the same conditions also present a clear signature of flow channeling. We derive analytical expressions for the retardation and decay of the thermal breakthrough peak amplitude for different fracture geometries and show that the observed differences between thermal and solute breakthrough can be explained only by channelized flow. These results suggest that heat transport is much more sensitive to fracture heterogeneity and flow

A Passive and Wireless Sensor for Bone Plate Strain Monitoring.

Science.gov (United States)

Tan, Yisong; Hu, Jiale; Ren, Limin; Zhu, Jianhua; Yang, Jiaqi; Liu, Di

2017-11-16

This paper reports on a sensor for monitoring bone plate strain in real time. The detected bone plate strain could be used for judging the healing state of fractures in patients. The sensor consists of a magnetoelastic material, which can be wirelessly connected and passively embedded. In order to verify the effectiveness of the sensor, a tibia-bone plate-screw (TBS) model was established using the finite element analysis method. A variation of the bone plate strain was obtained via this model. A goat hindquarter tibia was selected as the bone fracture model in the experiment. The tibia was fixed on a high precision load platform and an external force was applied. Bone plate strain variation during the bone fracture healing process was acquired with sensing coils. Simulation results indicated that bone plate strain decreases as the bone gradually heals, which is consistent with the finite element analysis results. This validated the soundness of the sensor reported here. This sensor has wireless connections, no in vivo battery requirement, and long-term embedding. These results can be used not only for clinical practices of bone fracture healing, but also for bone fracture treatment and rehabilitation equipment design.

Test plan: Hydraulic fracturing and hydrologic tests in Marker Beds 139 and 140

International Nuclear Information System (INIS)

Wawersik, W.R.; Beauheim, R.L.

1991-03-01

Combined hydraulic fracturing and hydrological measurements in this test plan are designed to evaluate the potential influence of fracture formation in anhydrite Marker Beds 139 and 140 on gas pressure in and gas flow from the disposal rooms in the Waste Isolation Pilot Plant with time. The tests have the further purpose of providing comparisons of permeabilities of anhydrite interbeds in an undisturbed (virgin) state and after fracture development and/or opening and dilation of preexisting partially healed fractures. Three sets of combined hydraulic fracturing and hydrological measurements are planned. A set of trial measurements is expected to last four to six weeks. The duration of each subsequent experiment is anticipated to be six to eight weeks

Flaw behavior in mechanically loaded clad plates

International Nuclear Information System (INIS)

Iskander, S.K.; Robinson, G.C.; Oland, C.B.

1989-01-01

A small crack near the inner surface of clad nuclear reactor pressure vessels is an important consideration in the safety assessment of the structural integrity of the vessel. Four-point bend tests on large plate specimens, conforming to ASTM specification for pressure vessel plates, alloy steels, quenched and tempered, Mn-Mo and Mn-Mo-Ni (A533) grade B six clad and two unclad with stainless steels 308, 309 and 312 weld wires, were performed to determine the effect of cladding upon the propagation of small surface cracks subjected to stress states. Results indicated that the tough surface layer composed of cladding and/or heat-affected zone has enhanced the load-bearing capacity of plates under conditions where unclad plates have ruptured. The results are interpreted in terms of fracture mechanics. The behavior of flaws in clad reactor pressure vessels is examined in the light of the test results. 11 refs., 8 figs., 2 tabs

Role of Appositional Screw Fixation in Minimally Invasive Plate Osteosynthesis for Distal Tibial Fracture.

Science.gov (United States)

Yang, Kyu-Hyun; Won, Yougun; Kang, Dong-Hyun; Oh, Jin-Cheol; Kim, Sung-Jun

2015-09-01

To determine the effect of interfragmentary appositional (gap-closing) screw fixation in minimally invasive plate osteosynthesis (MIPO) for distal tibial fractures on the clinical and radiologic results. Prospective nonrandomized study. Level I trauma center. Sixty patients who were diagnosed as distal metadiaphyseal oblique or spiral tibial fracture without displaced articular fragment. Thirty patients (group A) of the 60 patients were treated with MIPO without appositional screw fixation, and the other 30 (group B) were treated with the screw. Radiologic union, clinical union, clinical functional score [American Orthopaedic Foot and Ankle Society (AOFAS) score], and complications. The time for initial callus formation and radiologic union was significantly longer in group A than those in group B (76.8 vs. 58.0 days, P = 0.044; 409 vs. 258.7 days, P = 0.002, respectively). The rate of clinical union during 1 year was significantly higher in group B than in group A (P = 0.0063). Four nonunion patients in group A achieved bone union after placement of an additional bone graft. None of the patients in group B diagnosed with delayed union or nonunion (P fracture promoted callus formation and union rate compared with MIPO without appositional screw fixation. Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

Ilizarov external fixation versus plate osteosynthesis in the management of extra-articular fractures of the distal tibia.

Science.gov (United States)

Fadel, Mohamed; Ahmed, Mohamed Ali; Al-Dars, Ahmed Mounir; Maabed, Mustafa Ahmed; Shawki, Hashem

2015-03-01

The purpose of this study was to evaluate the outcome of Ilizarov external fixation (IE) versus dynamic compression plate (PO) in the management of extra-articular distal tibial fractures. Between 2010 and 2011, extra-articular distal tibial fractures in 40 consecutive patients met the inclusion criteria. They were classified according to AO classification fracture type A (A1, A2, and A3). In a randomized method, two equal groups were managed using either IE or PO. PO was performed using open reduction and internal fixation (ORIF) and DCP through anterolateral approach. IE was done using Ilizarov frame. For the PO group, non-weight bearing ambulation was permitted on the second postoperative day but partial weight bearing was permitted according to the progression in union criteria clinically and radiologically. For the IE group, weight bearing started as tolerated from the first postoperative day. Physiotherapy and pin-site care was performed by the patient themselves. Modified Mazur ankle score was applied to IE (excellent 10, good 10) and in PO (excellent 2, good 8, poor 6). Data were statically analysed using (Mann-Whitney test). The rate of healing in the IE group (average 130) was higher than the PO (average 196.5); plus, there were no cases of delayed union or nonunion in the IE group (p value 0.003). It was found that IE compared with PO provides provision of immediate weight bearing as tolerated following postoperative recovery, irrespective of radiological or clinical healing with no infection, deformity or non-union.

[Treatment of complex tibial plateau fractures with bilateral locking plate and bone graft].

Science.gov (United States)

Yan, Ying-Jie; Cheng, Zhan-Wei; Feng, Kai; Yan, Shao-Hua

2012-07-01

To explore the effective methods for the treatment of complex tibial plateau fractures. From May 2008 to April 2011, 28 patients with complex tibial plateau fractures were treated indirect reduction techniques, bilateral locking plate fixation combined with autologous bone grafts. There were 21 males and 7 females, with an average age of 43 years ranging from 21 to 65. There were 11 cases in Schatzker type V, 17 in VI. The effect was evaluated by Rasmussen standard on clinical and radiological. All patients were followed-up for 7 to 36 months (averaged of 21.5 months). Healing time of fracture was from 3 to 8 months (averaged 5.5 months). The results of Rasmussen scores in clinical was 4.50 +/- 1.32 in pain, 4.32 +/- 1.63 in walking ability, 4.07 +/- 1.34 in knee activity, 4.78 +/- 1.27 in stability of the knee, 4.85 +/- 1.12 in stretch knee; the results in radiation was 5.07 +/- 0.92 in articular surface collapse, 5.00 +/- 0.98 in platform widened, 5.14 +/- 0.85 in knee external varus. The effect result was excellent in 8 cases, good in 15, fair in 3 and poor in 2. The key for the treatment of complex tibial plateau fractures was to fully assess the damage as much as possible to protect the soft tissue, select the appropriate timing of surgery and surgical incision, application of indirect reduction techniques, limited incision and effective internal fixation to restore joint surface smooth and good limb alignment, early exercise, in order to achieve maximum recovery of joint function.

Comparative study of fracture mechanical test methods for concrete

DEFF Research Database (Denmark)

Østergaard, Lennart; Olesen, John Forbes

2004-01-01

and the interpretation, i.e. the analysis needed to extract the stress-crack opening relationship, the fracture energy etc. Experiments are carried out with each test configuration using mature, high performance concrete. The results show that the UTT is a highly complicated test, which only under very well controlled...... circumstances will yield the true fracture mechanical properties. It is also shown that both the three point bending test and the WST are well-suited substitutes for the uniaxial tension test.......This paper describes and compares three different fracture mechanical test methods; the uniaxial tension test (UTT), the three point bending test (TPBT) and the wedge splitting test (WST). Potentials and problems with the test methods will be described with regard to the experiment...

Permeability testing of fractures in climax stock granite at the Nevada Test Site

International Nuclear Information System (INIS)

Murray, W.A.

1980-01-01

Permeability tests conducted in the Climax stock granitic rock mass indicate that the bulk rock permeability can be highly variable. If moderately to highly fractured zones are encountered, the permeability values may lie in the range of 10 -4 to 10 -1 darcies. If, on the other hand, only intact rock or healed fractures are encountered, the permeability is found to be less than 10 -9 darcies. In order to assess the thermomechanical effect on fracture permeability, discrete fractures will be packed off and tested periodically throughout the thermal cycle caused by the emplacement of spent nuclear fuel in the Climax stock

Biomechanical investigation of an alternative concept to angular stable plating using conventional fixation hardware

Directory of Open Access Journals (Sweden)

Radtke Roman

2010-05-01

Full Text Available Abstract Background Angle-stable locking plates have improved the surgical management of fractures. However, locking implants are costly and removal can be difficult. The aim of this in vitro study was to evaluate the biomechanical performance of a newly proposed crossed-screw concept ("Fence" utilizing conventional (non-locked implants in comparison to conventional LC-DCP (limited contact dynamic compression plate and LCP (locking compression plate stabilization, in a human cadaveric diaphyseal gap model. Methods In eight pairs of human cadaveric femora, one femur per pair was randomly assigned to receive a Fence construct with either elevated or non-elevated plate, while the contralateral femur received either an LCP or LC-DCP instrumentation. Fracture gap motion and fatigue performance under cyclic loading was evaluated successively in axial compression and in torsion. Results were statistically compared in a pairwise setting. Results The elevated Fence constructs allowed significantly higher gap motion compared to the LCP instrumentations (axial compression: p ≤ 0.011, torsion p ≤ 0.015 but revealed similar performance under cyclic loading (p = 0.43. The Fence instrumentation with established bone-plate contact revealed larger fracture gap motion under axial compression compared to the conventional LC-DCP osteosynthesis (p ≤ 0.017. However, all contact Fence specimens survived the cyclic test, whereas all LC-DCP constructs failed early during torsion testing (p Conclusions Even though accentuated fracture gap motion became obvious, the "Fence" technique is considered an alternative to cost-intensive locking-head devices. The concept can be of interest in cases were angle-stable implants are unavailable and can lead to new strategies in implant design.

A COMPARATIVE STUDY OF FUNCTIONAL OUTCOMES OF FRACTURE SHAFT HUMERUS IN ADULTS TREATED WITH DYNAMIC COMPRESSION PLATING AND INTERLOCKING NAILING

Directory of Open Access Journals (Sweden)

Nagesh Desai

2015-02-01

Full Text Available INTRODUCTION: Opti m al m ethod of hu m eral shaft f r acture f i xation remains in debate till date. Two techniq u es under study include i n tra m edullary nailing and dyna m ic co m pression plate fixation. Plating provides satisfactory results but requires extensive dissection and m eticulous radial nerve protection. Theoretical advantage of intra m ed u llary nailing included less invasive surgery, undisturbed fractu r e hemato m a and use of load sharing device support. Purpose of this study is to co m p are o u tco m es of each m ethod of fixation for fracture shaft of humerus. MATERIALS AND METHODS: P atients with diaphyseal fractures of the hu m erus were divided in two groups of 20 treated with dynam i c co m pression plate or w i th i n tra m edullary interlocking nail. Postoperatively both groups received sa m e type of physiotherapy. They were followed up regularly . T i me taken for radiological union in two groups was co m pared. After satisfactory radiological un i on, functional out c o m e was assessed by “Disabilities of Hand, Shoulder and Elbow (DASH Questionnaire”. RESULTS: F unctional outco m e was better in DCP group co m pared to int e rloc ki ng nailing group which was statistically significant ( P = 0.062. Rate of healing was marginally better in DCP group as compared to I.M nail. CONCLUSION: W e are of opi n i on that when s u r ge r y is opted as a c h oice of treat m ent, both modalities of treat m ent i.e. dyn a m i c co m pression plating and interlocking nailing are good as far as union of fracture is concerned, but considering number of co m plications and functional outco m e, we opine that d y na m i c co m p ression plating o f f ers bett e r result than anteg r ade i n te r l ocking nailing with respect to pain and function of shoulder joint

Plate Fixation With Autogenous Calcaneal Dowel Grafting Proximal Fourth and Fifth Metatarsal Fractures: Technique and Case Series.

Science.gov (United States)

Seidenstricker, Chad L; Blahous, Edward G; Bouché, Richard T; Saxena, Amol

Metaphyseal and proximal diaphyseal fractures of the lateral column metatarsals can have problems with healing. In particular, those involving the fifth metatarsal have been associated with a high nonunion rate with nonoperative treatment. Although intramedullary screw fixation results in a high union rate, delayed healing and complications can occur. We describe an innovative technique to treat both acute and chronic injuries involving the metatarsal base from the metaphysis to the proximal diaphyseal bone of the fourth and fifth metatarsals. The surgical technique involves evacuation of sclerotic bone at the fracture site, packing the fracture site with compact cancellous bone, and plate fixation. In our preliminary results, 4 patients displayed 100% radiographic union at a mean of 4.75 (range 4 to 6) weeks with no incidence of refracture, at a mean follow-up point of 3.5 (range 1 to 5) years. The early results with our small series suggest that this technique is a useful treatment choice for metaphyseal and proximal diaphyseal fractures of the fourth and fifth metatarsals. Copyright © 2017 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

Effect of inherited structures on strike-slip plate boundaries: insight from analogue modelling of the central Levant Fracture System, Lebanon

Science.gov (United States)

Ghalayini, Ramadan; Daniel, Jean-Marc; Homberg, Catherine; Nader, Fadi

2015-04-01

Analogue sandbox modeling is a tool to simulate deformation style and structural evolution of sedimentary basins. The initial goal is to test what is the effect of inherited and crustal structures on the propagation, evolution, and final geometry of major strike-slip faults at the boundary between two tectonic plates. For this purpose, we have undertaken a series of analogue models to validate and reproduce the structures of the Levant Fracture System, a major NNE-SSW sinistral strike-slip fault forming the boundary between the Arabian and African plates. Onshore observations and recent high quality 3D seismic data in the Levant Basin offshore Lebanon demonstrated that Mesozoic ENE striking normal faults were reactivated into dextral strike-slip faults during the Late Miocene till present day activity of the plate boundary which shows a major restraining bend in Lebanon with a ~ 30°clockwise rotation in its trend. Experimental parameters consisted of a silicone layer at the base simulating the ductile crust, overlain by intercalated quartz sand and glass sand layers. Pre-existing structures were simulated by creating a graben in the silicone below the sand at an oblique (>60°) angle to the main throughgoing strike-slip fault. The latter contains a small stepover at depth to create transpression during sinistral strike-slip movement and consequently result in mountain building similarly to modern day Lebanon. Strike-slip movement and compression were regulated by steady-speed computer-controlled engines and the model was scanned using a CT-scanner continuously while deforming to have a final 4D model of the system. Results showed that existing normal faults were reactivated into dextral strike-slip faults as the sinistral movement between the two plates accumulated. Notably, the resulting restraining bend is asymmetric and segmented into two different compartments with differing geometries. One compartment shows a box fold anticline, while the second shows an

J-R Fracture Resistance of SA533 Gr.B-Cl.1 Steel for Reactor Pressure Vessel

Energy Technology Data Exchange (ETDEWEB)

Yoon, Ji-Hyun; Hong, Seokmin; Lee, Bong-Sang [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

2016-10-15

A rolled plate might show different mechanical behaviors from a forging, even though they contain same chemical compositions. Furthermore, it is known that the fracture behavior of a rolled plate is very sensitive to material orientation comparing to a forging. In this study, the J-R fracture resistances of SA533 Gr.B-Cl.1 plate were measured at reactor operating temperature and the material orientation sensitivity was discussed. The decrease of fracture resistance of this kind of low alloy steel at an elevated temperature is known as the effect of dynamic strain aging (DSA). It was attributed to that the carbides and grains elongated to primary rolling direction, so that the aspect ratio of carbides and grains in the specimen with T-L orientation is larger. Generally, the hard second phase could take a roll of trigger point of unstable fracture. It is needed that the fracture surfaces of the tested specimens to be examined profoundly.

Computerized detection of vertebral compression fractures on lateral chest radiographs: Preliminary results with a tool for early detection of osteoporosis

International Nuclear Information System (INIS)

Kasai, Satoshi; Li Feng; Shiraishi, Junji; Li Qiang; Doi, Kunio

2006-01-01

-positive fractures per image. The accuracy of identifying vertebral end plates, marked by radiologists in a morphometric study, was 76.6% (400/522) and 70.9% (420/592) for cases used for training and those for testing, respectively. We prepared 32 additional fracture cases for a validation test, and we examined the detection accuracy of our computerized method. The sensitivity for these cases was 75% (24/32) at 1.03 (33/32) false-positive fractures per image. Our preliminary results show that the automated computerized scheme for detecting vertebral fractures on lateral chest radiographs has the potential to assist radiologists in detecting vertebral fractures

Finite Element Simulation of Fracture Toughness Test

International Nuclear Information System (INIS)

Chu, Seok Jae; Liu, Cong Hao

2013-01-01

Finite element simulations of tensile tests were performed to determine the equivalent stress - equivalent plastic strain curves, critical equivalent stresses, and critical equivalent plastic strains. Then, the curves were used as inputs to finite element simulations of fracture toughness tests to determine the plane strain fracture toughness. The critical COD was taken as the COD when the equivalent plastic strain at the crack tip reached a critical value, and it was used as a crack growth criterion. The relationship between the critical COD and the critical equivalent plastic strain or the reduction of area was found. The relationship between the plane strain fracture toughness and the product of the critical equivalent stress and the critical equivalent plastic strain was also found

Comparison of surgical techniques of 111 medial malleolar fractures classified by fracture geometry.

Science.gov (United States)

Ebraheim, Nabil A; Ludwig, Todd; Weston, John T; Carroll, Trevor; Liu, Jiayong

2014-05-01

Evaluation of operative techniques used for medial malleolar fractures by classifying fracture geometry has not been well documented. One hundred eleven patients with medial malleolar fractures (transverse n = 63, oblique n = 29, vertical n = 7, comminuted n = 12) were included in this study. Seventy-two patients had complicating comorbidities. All patients were treated with buttress plate, lag screw, tension band, or K-wire fixation. Treatment outcomes were evaluated on the basis of radiological outcome (union, malunion, delayed union, or nonunion), need for operative revision, presence of postoperative complications, and AOFAS Ankle-Hindfoot score. For transverse fractures, tension band fixation showed the highest rate of union (79%), highest average AOFAS score (86), lowest revision rate (5%), and lowest complication rate (16%). For oblique fractures, lag screws showed the highest rate of union (71%), highest average AOFAS score (80), lowest revision rate (19%), and lowest complication rate (33%) of the commonly used fixation techniques. For vertical fractures, buttress plating was used in every case but 1, achieving union (whether normal or delayed) in all cases with an average AOFAS score of 84, no revisions, and a 17% complication rate. Comminuted fractures had relatively poor outcomes regardless of fixation method. The results of this study suggest that both tension bands and lag screws result in similar rates of union for transverse fractures of the medial malleolus, but that tension band constructs are associated with less need for revision surgery and fewer complications. In addition, our data demonstrate that oblique fractures were most effectively treated with lag screws and that vertical fractures attained superior outcomes with buttress plating. Level III, retrospective comparative series.

Segmentation along the Queen Charlotte Fault: The long-lived influence of plate-motion rotation and Explorer Ridge fracture zones

Science.gov (United States)

Miller, N. C.; Walton, M. A. L.; Brothers, D. S.; Haeussler, P. J.; Ten Brink, U. S.; Conrad, J. E.; Kluesner, J.; Andrews, B. D.

2017-12-01

The Queen Charlotte Fault (QCF) generally tracks the flow line for Pacific/North America (Pa/NA) relative motion since 20 Ma, indicating that the plate boundary localized along an optimally oriented small circle geometry. Rotation in Pa/NA motion at 10—12 Ma caused the QCF south of 53 N to be oblique to plate motion by 10—20. This oblique convergence appears to be accommodated in part by underthrusting of the Pacific Plate beneath Haida Gwaii and in part by slip on faults west of the QCF. On the west side of the QCF, a series of ridges and small basins oriented subparallel to either the QCF or relative plate motion form a 40-km-wide terrace. New high-resolution seismic reflection data image the seaward edge of the ridges as a vertical contact between horizontal or sometimes downwarped deep-sea sediments and west-vergent anticlinal structures within the ridges, supporting earlier interpretations that these ridges have accommodated some component of oblique motion. We argue that the ridges originated as step overs from fracture zones on Explorer Ridge, analogous to the current fault geometry at the southernmost end of the QCF. There, the Revere-Dellwood Fracture Zone (RDFZ) overlaps the QCF for 120 km and connects to the QCF via a more-optimally oriented extensional right step. 3.9—6.4 Mw strike-slip earthquakes along the RDFZ and a lack of contractional seafloor morphologies along the QCF south of the RDFZ-QCF right step suggest that the step over and reactivation along the RDFZ accommodates a majority of plate motion in this region. Kinematic reconstruction of ridges from 54—56 N indicates that they also originated in a similar location, potentially as right steps from either the RDFZ or Sovanco Fracture Zone. Similarly, the RDFZ flow path is coincident with a truncation of seafloor magnetic anomalies and the outer edge of the ridge-bounded terrace, which both parallel the QCF since at least the onset of Explorer Ridge spreading at 8 Ma. The RDFZ-QCF right

Development of a fixation device for robot assisted fracture reduction of femoral shaft fractures: a biomechanical study.

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Weber-Spickschen, T S; Oszwald, M; Westphal, R; Krettek, C; Wahl, F; Gosling, T

2010-01-01

Robot assisted fracture reduction of femoral shaft fractures provides precise alignment while reducing the amount of intraoperative imaging. The connection between the robot and the fracture fragment should allow conventional intramedullary nailing, be minimally invasive and provide interim fracture stability. In our study we tested three different reduction tools: a conventional External Fixator, a Reposition-Plate and a Three-Point-Device with two variations (a 40 degrees and a 90 degrees version). We measured relative movements between the tools and the bone fragments in all translation and rotation planes. The Three-Point-Device 90 degrees showed the smallest average relative displacement and was the only device able to withstand the maximum applied load of 70 Nm without failure of any bone fragment. The Three-Point-Device 90 degrees complies with all the stipulated requirements and is a suitable interface for robot assisted fracture reduction of femoral shaft fractures.

Investigation on impact resistance of steel plate reinforced concrete barriers against aircraft impact. Pt.2: Simulation analysis of scale model impact tests

International Nuclear Information System (INIS)

Jun Mizuno; Norihide Koshika; Hiroshi Morikawa; Kentaro Wakimoto; Ryusuke Fukuda

2005-01-01

Steel plate reinforced concrete (SC) structure is one in which the rebars of conventional reinforced concrete (RC) structures are replaced with external steel plates attached to inner concrete with headed studs. SC structures are considered to be more effective than RC structures against aircraft impact, so their application to outer walls and roofs of risk-sensitive structures such as nuclear-related structures is expected to mitigate damage to critical components. The objective of this study was to investigate the fracture behavior and perforation thickness of SC panels against aircraft impact through impact tests and simulation analyses. Objectives of this paper are to analytically investigate the protection performance of SC panels against aircraft model impact through simulation analyses of 1/7.5 scale aircraft model impact tests presented in Part 1 of this study using a discrete element method (DEM), and to examine the applicability and validity of the DEM. Simulation analyses by a finite element method (FEM) were also performed to evaluate its applicability. The fracture process and damage to the SC test panels as well as the aircraft models are closely simulated by the discrete element analyses. The various impact responses and failure mechanisms, such as deceleration curves of projectile, velocity of debris from rear face and deformation mode of SC panels, are also simulated closely by the DEM analyses. The results of analyses confirm the shock-proof performance of SC panels against aircraft impact, and the applicability and validity of DEM for evaluating the complex phenomena of an aircraft impact against an SC panel. The finite element analysis closely simulates the deformation of the SC test panel and strains of rear steel plate where the global bending deformation mode is dominant. (authors)

EVALUATION OF FUNCTIONAL OUTCOME AFTER OPEN REDUCTION AND INTERNAL FIXATION OF DISTAL FEMUR FRACTURES BY LOCKING COMPRESSION PLATE

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L. Lokanadha Rao

2016-09-01

Full Text Available BACKGROUND In the supra and intercondylar fractures of femur particularly with intra articular extension, patient may develop stiffness of knee, shortening, rotational deformities, internal derangement of knee with instability, varus and valgus deformities which affect patient’s routine lifestyle. If these cases were treated with locking compression plate, the results obtained were successful, superior, timesaving providing early ambulation and least disability improving the functional outcome. MATERIALS AND METHODS This is a prospective interventional study. This study includes 25 supracondylar and intercondylar fractures of femur (both Muller’s Type ‘A’, Type B and Type ‘C’ fractures treated with open reduction and internal fixation by Locking Compression Plate in the Department of Orthopaedics, King George Hospital, Visakhapatnam from September 2013 to September 2015. There are 16 males and 9 females with age ranging from 20 to 80 years with an average of 44.6 years. Average age for males is 28.9 years and average age for females is 25 years. 18 fractures were due to road traffic accidents and 6 cases are due to fall from significant heights, 1 case due to simple fall from standing (osteoporosis. 15 cases were in right femur (60% and 10 cases were in left femur (40%. RESULTS 25 cases were included in the study. There is an increase in the rate of union, decreased time taken for union, increased knee range of motion, decreased time for weight-bearing, postoperative complications and duration for hospital stay. CONCLUSION LCP proved to be a good implant which could take the challenges like poor bone stock, severe comminution both metaphyseal and articular and prove successful. The locking head screws distally have prevented varus collapse, even in cases of osteoporosis. The Condylar LCP can be used in either an open or a minimally invasive manner.

Dynamic compression plate (DCP) fixation of propagating medial condylar fractures of the third metacarpal/metatarsal bone in 30 racehorses: retrospective analysis (1990-2005).

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Goodrich, L R; Nixon, A J; Conway, J D; Morley, P S; Bladon, B M; Hogan, P M

2014-11-01

An in-depth review of dynamic compression plate (DCP) fixation of propagating medial condyle fractures of the third metacarpus or metatarsus has not been previously reported. To describe the technique, evaluate short-term outcome and long-term race performance of racehorses that underwent DCP fixation for repair of propagating or spiralling medial condylar fractures of the third metacarpal (McIII) or metatarsal (MtIII) bone. Retrospective case series. The surgical case records of 30 horses with propagating fractures of the medial condyle of McIII or MtIII were reviewed. Medical information included: age, breed, sex, presentation, how injury occurred (racing or training), surgical treatment and post operative complications. Racing information included: starts, top 3 placing and career earnings. Long propagating fractures of the medial condyle of Mc/tIII were identified in 23 Thoroughbred (TB) and 7 Standardbred (STB) racehorses. The fracture spiralled proximally in 22 of 30 cases (73%). Standardbreds had a higher propensity for hindlimb involvement (71%), whereas TBs tended to have more front limb involvement (61%). Twelve of 30 (40%) horses raced post surgery. Career earnings were significantly lower for TB horses with medial condylar fractures; $34,916 when compared with the national average of $60,841 (P≤0.03). Overall, horses having DCP fixation for medial condylar fractures had less starts post surgery (3.1 TBs and 5.8 STBs) compared with the national average (7 TBs and 17.3 STBs) and decreased lifetime starts 13.4 (TBs) compared with 17.3 nationally. Propagating medial condyle fractures can be repaired with plate fixation to potentially lessen the risk of catastrophic fracture destabilisation and return to racing can be expected in 40% of horses. Further prospective studies are warranted comparing lag screw fixation with DCP fixation for repair of severe medial condylar fractures of the metacarpus/metatarsus. © 2013 The Authors. Equine Veterinary Journal

Fuel performance analysis for the HAMP-1 mini plate test

Energy Technology Data Exchange (ETDEWEB)

Cho, Byoung Jin; Tahka, Y. W.; Yim, J. S.; Lee, B. H. [KAERI, Daejeon (Korea, Republic of)

2016-05-15

U-7wt%Mo/Al- 5wt%Si dispersion fuel with 8gU/cm{sup 3} is chosen to achieve more efficiency and higher performance than the conventional U{sub 3}Si{sub 2} fuel. As part of the fuel qualification program for the KiJang research reactor (KJRR), three irradiation tests with mini-plates are on the way at the High-flux Advanced Neutron Application Reactor (HANARO). The first test among three HANARO Mini-Plate Irradiation tests (HAMP-1, 2, 3) has completed. PLATE code has been initially developed to analyze the thermal performance of high density U-Mo/Al dispersion fuel plates during irradiation [1]. We upgraded the PLATE code with the latest irradiation results which were implemented by corrosion, thermal conductivity and swelling model. Fuel performance analysis for HAMP-1 was conducted with updated PLATE. This paper presents results of performance evaluation of the HAMP-1. Maximum fuel temperature was obtained 136 .deg., which is far below the preset limit of 200 .deg. for the irradiation test. The meat swelling and corrosion thickness was also confirmed that the developed fuel would behave as anticipated.

Open reduction and cranial bone plate fixation of fractures involving the distal aspect of the radius and ulna in miniature- and toy-breed dogs: 102 cases (2008-2015).

Science.gov (United States)

De Arburn Parent, Rebecca; Benamou, Jérôme; Gatineau, Matthieu; Clerfond, Pierre; Planté, Jérôme

2017-06-15

OBJECTIVE To determine outcomes and complication rates of open reduction and cranial bone plate fixation of fractures involving the distal aspect of the radius and ulna in miniature- and toy-breed dogs. DESIGN Retrospective case series. ANIMALS 102 miniature- and toy-breed dogs (105 fractures) weighing ≤ 7 kg (15.4 lb) that had undergone open reduction and cranial bone plate fixation of a fracture involving the distal aspect of the radius and ulna from 2008 through 2015. PROCEDURES Medical records were reviewed and information extracted regarding dog and fracture characteristics, surgical variables, and follow-up examination data (including postoperative complications). Postoperative radiographs were examined for distal fragment size, implant placement, apposition, alignment, and healing stage. A long-term follow-up questionnaire was completed by telephone interview with dog owners at least 6 months after surgery. RESULTS Mean length of the distal bone fragment in all fractures was 19.2 mm, with a mean distal-to-total radial length ratio of 0.21. At last follow-up examination (typically 6 weeks after surgery), 97 (95%) dogs had no signs of lameness; minor lameness was identified in 5 (5%) dogs. Complications developed in 26 (25%) fractures (23 [22%] minor and 3 [3%] major complications). Sixty-eight of 71 (96%) owners rated the overall and long-term outcome as excellent and 3 (4%) as good; 68 of 71 (96%) dogs reportedly had no signs of residual lameness. CONCLUSIONS AND CLINICAL RELEVANCE Open reduction and cranial bone plate fixation for the treatment of radius-ulna fractures in miniature- and toy-breed dogs provided an excellent outcome with a low complication rate.

Study on elastic-plastic fracture toughness test in high temperature water

International Nuclear Information System (INIS)

Miura, Yasufumi

2016-01-01

Structural integrity of internal components in light water reactors is important for the safety of operation and service lifetime. Fracture toughness is important parameter for structural integrity assessment of nuclear power plant. In general, fracture toughness of materials which compose the components in light water reactor is obtained with fracture toughness tests in air although some components are subjected to high temperature water because of the difficulty of fracture toughness test in high temperature water. However, the effects of high temperature water and hydrogen on fracture behavior of the structural materials in nuclear power plant such as low alloy steel, cast austenitic stainless steel, and Ni base alloy are concerned recently. In this study, elastic-plastic fracture toughness test of low alloy steel in simulated BWR water environment was studied. Fracture toughness test in high temperature water with original clip gage and normalization data reduction technique was established. The difference of fracture toughness J_Q tested in air between using elastic unload compliance method and normalization data reduction technique was also discussed. As a result, obtained value with normalization data reduction technique tended to be higher than the value with elastic unload compliance. (author)

Finite element analysis of intramedullary nailing and double locking plate for treating extra-articular proximal tibial fractures.

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Chen, Fancheng; Huang, Xiaowei; Ya, Yingsun; Ma, Fenfen; Qian, Zhi; Shi, Jifei; Guo, Shuolei; Yu, Baoqing

2018-01-16

Proximal tibia fractures are one of the most familiar fractures. Surgical approaches are usually needed for anatomical reduction. However, no single treatment method has been widely established as the standard care. Our present study aims to compare the stress and stability of intramedullary nails (IMN) fixation and double locking plate (DLP) fixation in the treatment of extra-articular proximal tibial fractures. A three-dimensional (3D) finite element model of the extra-articular proximal tibial fracture, whose 2-cm bone gap began 7 cm from the tibial plateau articular surface, was created fixed by different fixation implants. The axial compressive load on an adult knee during single-limb stance was imitated by an axial force of 2500 N with a distribution of 60% to the medial compartment, while the distal end was fixed effectively. The equivalent von Mises stress and displacement of the model was used as the output measures for analysis. The maximal equivalent von Mises stress value of the system in the IMN model was 293.23 MPa, which was higher comparing against that in the DLP fixation model (147.04 MPa). And the mean stress of the model in the IMN model (9.25 MPa) was higher than that of the DLP fixation system in terms of equivalent von Mises stress (EVMS) (P tibial fractures of young patients.

The Role of Minimally Invasive Plate Osteosynthesis in Rib Fixation: A Review

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Michael Bemelman

2016-02-01

Full Text Available More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950’s, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has becomeavailable suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation.

The Role of Minimally Invasive Plate Osteosynthesis in Rib Fixation: A Review

Science.gov (United States)

Bemelman, Michael; van Baal, Mark; Yuan, Jian Zhang; Leenen, Luke

2016-01-01

More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950’s, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft für osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO) technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has become available suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation. PMID:26889439

Advantage and limitations of a minimally-invasive approach and early weight bearing in the treatment of tibial shaft fractures with locking plates.

Science.gov (United States)

Adam, P; Bonnomet, F; Ehlinger, M

2012-09-01

Intramedullary nailing is a common method of treating tibial shaft fractures. However, precise control of reduction at the proximal and distal quarters is difficult to achieve. The purpose of this study was to assess the results of plating using locking screws and the feasibility of a minimally-invasive approach. All patients with tibial shaft fracture treated by means of locking plates from January 2004 to October 2006. Thirty-two fractures were treated in 32 patients with a mean age of 43.8 years. Internal fixation with a locking plate and screw construct, using a minimally-invasive or standard approach. Surgical approach, time to weight bearing, complications and their type, time to bone union, alignment in the frontal and sagittal planes on anteroposterior and lateral radiographs. The minimally-invasive approach was performed in 28 cases and immediate full weight bearing allowed in 25 cases. At a mean follow-up of 27 months, two patients had died and two patients were lost to follow-up. The mean time to bone union was 9.1 weeks. Four cases had a complicated course: one infection, one compartment syndrome, one hardware breakage and one pseudarthrosis. Six cases ended up with valgus malunion exceeding 5° in the frontal plane, already present at the time of surgery. Where a minimally-invasive approach can be performed, immediate pain-free weight bearing can be allowed without further displacement at follow-up. The observed rate of malunion underlines the need for adequate reduction and shows that the rationale for success does not solely depend on the plate anatomic design but also on the skills of the operating surgeon. Level I university regional hospital Cohort study. Copyright © 2012. Published by Elsevier Masson SAS.

Biologic fixation through bridge plating for comminuted shaft fracture of the clavicle: technical aspects and prospective clinical experience with a minimum of 12-month follow-up.

Science.gov (United States)

Jung, Gu Hee; Park, Chang-Min; Kim, Jae-Do

2013-12-01

For comminuted shaft fracture of clavicle, the operative goal, aside from sound bone healing without complications of direct reduction, is maintenance of the original length in order to maintain the normal biomechanics of adjacent joint. Our bridge plating technique utilizing distraction through a lumbar spreader was expected to be effective for restoring clavicular length with soft tissue preservation. However, there are two disadvantages. First, there is more exposure to radiation compared to conventional plating; and second, it is difficult to control the rotational alignment. Despite these disadvantages, our technique has important benefits, in particular, the ability to preserve clavicular length without soft tissue injury around the fracture site.

Stabilization of multiple rib fractures in a canine model.

Science.gov (United States)

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

2014-12-01

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

[Double-plate fixation via combined approaches for the treatment of old tibial plateau fractures of Schatzker type IV].

Science.gov (United States)

Tan, Hong-Lue; Dai, Peng-Yi; Liu, Wei-Feng; Yuan, Yan-Hao

2017-10-25

To explore the clinical efficacy of double-plate fixation for the treatment of old tibial plateau fractures with Schatzker type IV through anterior midline and posteromedial approaches. From July 2013 to July 2015, 15 patients with old tibial plateau fractures were treated with internal fixation using locking reconstructive plate for the posteromedial fragment and anatomical locking plate for anteromedial fragment through antero midline and posteromedial approaches. There were 9 males and 6 females, with an average age of 49.2 years old (ranged, 21 to 61 years old). Eight patients had injured in the left side and 7 in the right side. According to Schatzker classification, all patients were type IV. The mean interval from injury to operation was 26.5 days (ranged, 21 to 65 days). The main clinical symptoms before operation were knee joint swelling, pain, deformity and limitation of motion. The X-ray and CT confirmed the fracture type. The indexes such as tibial plateau tibial shaft angle (TPA), femoral tibial angle (FTA) and posterior slope angle (PSA) were compared between immediate postoperation and final follow-up using postoperative X-ray film. The knee functions were evaluated using the HSS (Hospital for Special Surgery) knee score system. Two patients had incision complications which healed by correct treatment, 1 patient had traumatic arthritis. All patients were followed up for mean 16.6 months (ranged, 13 to 24 months). No infections, deep venous thrombosis, implant loosening and breakage, fragment displacement, plateau surface collapse and bone nonunion found. The bone union time ranged from 3 to 8 months (mean 6.07 months) after operation. The average immediate postoperative value of TPA, FTA and PSA were(86.81±1.67)°, (168.00±3.29)° and(10.20±1.47)° respectively; and(86.47±1.67)°, (168.53±3.03)° and (10.54±1.21)° respectively at the final follow-up evaluation, showing no statistical differences( P >0.05). According to the HSS score system, 26

Fracture analysis of one-dimensional hexagonal quasicrystals: Researches of a finite dimension rectangular plate by boundary collocation method

Energy Technology Data Exchange (ETDEWEB)

Jiaxing, Cheng; Dongfa, Sheng [Southwest Forestry University, Yunnan (China)

2017-05-15

As an important supplement and development to crystallography, the applications about quasicrystal materials have played a core role in many fields, such as manufacturing and the space industry. Due to the sensitivity of quasicrystals to defects, the research on the fracture problem of quasicrystals has attracted a great deal of attention. We present a boundary collocation method to research fracture problems for a finite dimension rectangular one-dimensional hexagonal quasicrystal plate. Because mode I and mode II problems for one- dimensional hexagonal quasicrystals are like that for the classical elastic materials, only the anti-plane problem is discussed in this paper. The correctness of the present numerical method is verified through a comparison of the present results and the existing results. And then, the size effects on stress field, stress intensity factor and energy release rate are discussed in detail. The obtained results can provide valuable references for the fracture behavior of quasicrystals.

Modification of the Rappaport rapid test in large-scale testing for syphilis. Evaluation of the rapid plate and rapid card tests.

Science.gov (United States)

Ghinsberg, R; Meir, E; Blumstein, G; Kafeman, R

1975-11-01

The Rappaport rapid (RR) plate and card tests were developed as modifications of the RR tube test to permit rapid and inexpensive screening of large numbers of subjects for the diagnosis of syphilis. More than 2,000 sera were examined in parallel by the Venereal Disease Research Laboratory (VDRL) slide test, the rapid plasma reagin (RPR) card test and the RR plate and card tests. There was complete agreement between the RR plate and card tests and the VDRL slide and RPR card tests in 96.6% of sera. In a selected group of 1,530 sera examined, in addition, by the fluorescent treponemal antibody absorption (FTA-ABS) test, there was agreement between the RR plate and card tests and the FTA-ABS test in 74.3% of sera and between the VDRL and RPR tests and the FTA-ABS test in 73.7% of sera. The RR plate test was found to be sufficiently sensitive and specific for the diagnosis of syphilis, although the VDRL slide test is perhaps more sensitive in primary and late latent syphilis. Since the antigen used in the RR tests is colored and stable and the sera do not require inactivation before the test, the tests are easier to perform than the VDRL slide test: the RR plate and card tests could therefore replace the VDRL test as a screening test, with hardly any loss of accuracy.

Laboratory testing on infiltration in single synthetic fractures

Science.gov (United States)

Cherubini, Claudia; Pastore, Nicola; Li, Jiawei; Giasi, Concetta I.; Li, Ling

2017-04-01

An understanding of infiltration phenomena in unsaturated rock fractures is extremely important in many branches of engineering for numerous reasons. Sectors such as the oil, gas and water industries are regularly interacting with water seepage through rock fractures, yet the understanding of the mechanics and behaviour associated with this sort of flow is still incomplete. An apparatus has been set up to test infiltration in single synthetic fractures in both dry and wet conditions. To simulate the two fracture planes, concrete fractures have been moulded from 3D printed fractures with varying geometrical configurations, in order to analyse the influence of aperture and roughness on infiltration. Water flows through the single fractures by means of a hydraulic system composed by an upstream and a downstream reservoir, the latter being subdivided into five equal sections in order to measure the flow rate in each part to detect zones of preferential flow. The fractures have been set at various angles of inclination to investigate the effect of this parameter on infiltration dynamics. The results obtained identified that altering certain fracture parameters and conditions produces relevant effects on the infiltration process through the fractures. The main variables influencing the formation of preferential flow are: the inclination angle of the fracture, the saturation level of the fracture and the mismatch wavelength of the fracture.

Pie technique of LWR fuel cladding fracture toughness test

International Nuclear Information System (INIS)

Endo, Shinya; Usami, Koji; Nakata, Masahito; Fukuda, Takuji; Numata, Masami; Kizaki, Minoru; Nishino, Yasuharu

2006-01-01

Remote-handling techniques were developed by cooperative research between the Department of Hot Laboratories in the Japan Atomic Energy Research Institute (JAERI) and the Nuclear Fuel Industries Ltd. (NFI) for evaluating the fracture toughness on irradiated LWR fuel cladding. The developed techniques, sample machining by using the electrical discharge machine (EDM), pre-cracking by fatigue tester, sample assembling to the compact tension (CT) shaped test fixture gave a satisfied result for a fracture toughness test developed by NFL. And post-irradiation examination (PIE) using the remote-handling techniques were carried out to evaluate the fracture toughness on BWR spent fuel cladding in the Waste Safety Testing Facility (WASTEF). (author)

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

Science.gov (United States)

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

2016-10-01

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

Risk of symptomatic heterotopic ossification following plate osteosynthesis in multiple trauma patients: an analysis in a level-1 trauma centre

Directory of Open Access Journals (Sweden)

Pape Hans-Christoph

2009-10-01

Full Text Available Abstract Background Symptomatic heterotopic ossification (HO in multiple trauma patients may lead to follow up surgery, furthermore the long-term outcome can be restricted. Knowledge of the effect of surgical treatment on formation of symptomatic heterotopic ossification in polytrauma is sparse. Therefore, we test the effects of surgical treatment (plate osteosynthesis or intramedullary nailing on the formation of heterotopic ossification in the multiple trauma patient. Methods We retrospectively analysed prospectively documented data of blunt multiple trauma patients with long bone fractures which were treated at our level-1 trauma centre between 1997 and 2005. Patients were distributed to 2 groups: Patients treated by intramedullary nails (group IMN or plate osteosynthesis (group PLATE were compared. The expression and extension of symptomatic heterotopic ossifications on 3-6 months follow-up x-rays in antero-posterior (ap and lateral views were classified radiologically and the maximum expansion was measured in millimeter (mm. Additionally, ventilation time, prophylactic medication like indomethacine and incidence and correlation of head injuries were analysed. Results 101 patients were included in our study, 79 men and 22 women. The fractures were treated by intramedullary nails (group IMN n = 50 or plate osteosynthesis (group PLATE n = 51. Significantly higher radiologic ossification classes were detected in group PLATE (2.9 ± 1.3 as compared to IMN (2.2 ± 1.1; p = 0.013. HO size in mm ap and lateral showed a tendency towards larger HOs in the PLATE group. Additionally PLATE group showed a higher rate of articular fractures (63% vs. 28% in IMN while IMN demonstrated a higher rate of diaphyseal fractures (72% vs. 37% in PLATE; p = 0.003. Ventilation time, indomethacine and incidence of head injuries showed no significant difference between groups. Conclusion Fracture care with plate osteosynthesis in polytrauma patients is associated with

Evaluation of plate type fuel elements by eddy current test method

International Nuclear Information System (INIS)

Frade, Rangel Teixeira

2015-01-01

Plate type fuel elements are used in MTR research nuclear reactors. The fuel plates are manufactured by assembling a briquette containing the fissile material inserted in a frame, with metal plates in both sides of the set, to act as a cladding. This set is rolled under controlled conditions in order to obtain the fuel plate. In Brazil, this type of fuel is manufactured by IPEN and used in the IEA-R1 reactor. After fabrication of three batches of fuel plates, 24 plates, one of them is taken, in order to verify the thickness of the cladding. For this purpose, the plate is sectioned and the thickness measurements are carried out by using optical microscopy. This procedure implies in damage of the plate, with the consequent cost. Besides, the process of sample preparation for optical microscopy analysis is time consuming, it is necessary an infrastructure for handling radioactive materials and there is a generation of radioactive residues during the process. The objective of this study was verify the applicability of eddy current test method for nondestructive measurement of cladding thickness in plate type nuclear fuels, enabling the inspection of all manufactured fuel plates. For this purpose, reference standards, representative of the cladding of the fuel plates, were manufactured using thermomechanical processing conditions similar to those used for plates manufacturing. Due to no availability of fuel plates for performing the experiments, the presence of the plate’s core was simulated using materials with different electrical conductivities, fixed to the thickness reference standards. Probes of eddy current testing were designed and manufactured. They showed high sensitivity to thickness variations, being able to separate small thickness changes. The sensitivity was higher in tests performed on the reference standards and samples without the presence of the materials simulating the core. For examination of the cladding with influence of materials simulating the

Applications of probabilistic fracture mechanics to FBR components

International Nuclear Information System (INIS)

Yagawa, Genki; Yoshimura, Shinobu; Takenaka, Makoto; Hojo, Kiminobu; Kaguchi, Hitoshi.

1991-01-01

A probabilistic fracture mechanics code PCCF which could analyze half-elliptical crack behavior in a plate under creep-fatigue condition using nonlinear fracture mechanics parameters was developed. The effects of bending stress level on failure probability was studied using the PCCF as test analyses. As the results, failure mode was leakage not break in all cases analyzed in this study. It is shown that leak probability is sensitive to stress level and increase rapidly around yield stress of materials. (J.P.N.)

An experimental study on the deformation and fracture modes of steel projectiles during impact

International Nuclear Information System (INIS)

Rakvåg, K.G.; Børvik, T.; Westermann, I.; Hopperstad, O.S.

2013-01-01

Highlights: • The fracture process is ductile for the unhardened projectiles. • A combined ductile–brittle fracture process is obtained for the HRC 40 projectiles. • The fragmentation of HRC 52 projectiles has cleavage as the main mechanism. • The fracture modes were confirmed in a metallurgical study. • The hardened materials have a stochastic variation of the mechanical properties. - Abstract: Previous investigations of the penetration and perforation of high-strength steel plates struck by hardened steel projectiles have shown that under certain test conditions the projectile may fracture or even fragment upon impact. Simulations without an accurate failure description for the projectile material will then predict perforation of the target instead of fragmentation of the projectile, and thus underestimate the ballistic limit velocity of the target plate. This paper presents an experimental investigation of the various deformation and fracture modes that may occur in steel projectiles during impact. This is studied by conducting Taylor bar impact tests using 20 mm diameter, 80 mm long, tool steel projectiles with three different hardness values (HRC 19, 40 and 52). A gas gun was used to fire the projectiles into a rigid wall at impact velocities ranging from 100 to 350 m/s, and the deformation and fracture processes were captured by a high-speed video camera. From the tests, several different deformation and fracture modes were registered for each hardness value. To investigate the influence of material on the deformation and fracture modes, several series of tensile tests on smooth axisymmetric specimens were carried out to characterise the mechanical properties of the three materials. To gain a deeper understanding of the various processes causing fracture and fragmentation during impact, a metallurgical investigation was conducted. The fracture surfaces of the failed projectiles of different hardness were investigated, and the microstructure was

[Development and clinical application of a new type of anatomical locking plate for sternoclavicular joint fracture and dislocation].

Science.gov (United States)

Sun, Yuanlin; Yang, Yunkang; Ge, Jianhua; Yang, Kun; Xiang, Feifan; Zhou, Ju; Liang, Jie

2018-03-01

To report a new type of anatomical locking plate for sternocalvicular joint, and investigate its effectiveness in treatment of sternoclavicular joint fracture and dislocation. A new type of anatomical locking plate for sternoclavicular joint was developed, which accorded with the anatomical features and biomechanical characteristics of Chinese sternoclavicular joint. By adopting the method of clinical randomized controlled study, 32 patients with the sternoclavicular joint fracture and dislocation who met the selection criteria between June 2008 and May 2015 were randomly divided into groups A and B ( n =16), and the patients were treated with new anatomic locking plate and distal radial T locking plate internal fixation, respectively. There was no significant difference between 2 groups in gender, age, injured side, body mass index, cause of injury, type of injury, the time from injury to operation, and preoperative Rockwood grading score ( P >0.05). The operation time, intraoperative blood loss, incision length, hospitalization time, and postoperative complications in 2 groups were recorded, and the effectiveness was evaluated by Rockwood grading score. The operations of 2 groups completed successfully. The operation time, intraoperative blood loss, and hospitalization time in group A were significantly less than those in group B ( P case of sternoclavicular joint pain and 2 cases of wound infection; in group B, there were 1 case of sternoclavicular joint pain, 1 case of internal fixation loosening, and 1 case of sternoclavicular joint re-dislocation; there was no significant difference in complication incidence between 2 groups ( P =1.000). The Rockwood grading scores at each time point after operation in 2 groups were significantly higher than those before operation. At 1 month after operation, the Rockwood grading score in group A was significantly higher than that in group B ( t= 2.270, P =0.031); but there was no significant difference in the Rockwood

Clinic research on the treatment for humeral shaft fracture with minimal invasive plate osteosynthesis: a retrospective study of 128 cases.

Science.gov (United States)

Chen, H; Hu, X; Yang, G; Xiang, M

2017-04-01

Minimal invasive plate osteosynthesis (MIPO) is one of the most important techniques in the treatment for humeral shaft fractures. This study was performed to evaluate the efficacy of MIPO technique for the treatment for humeral shaft fractures. We retrospectively evaluated 128 cases with humeral shaft fractures that were treated with MIPO technique from March 2005 to August 2008. All the patients were followed up by routine radiological imaging and clinical examinations. Constant-Murley score and HSS elbow joint score were used to evaluate the treatment outcome. The average duration of the surgery was 60 min (range 40-95 min) without blood transfusion. All fractures healed without infection. All cases recovered carrying angle except four cases with 10°-15° cubitus varus. After the average follow-up of 23 (13-38) months, satisfactory function was achieved according to Constant-Murley score and HSS elbow joint score. Constant-Murley score was 80 on average (range 68-91). According to HSS elbow joint score, there were 123 cases of excellent clinical outcome and five cases of effective outcome. It seems to be a safe and effective method for managing humeral shaft fractures with MIPO technique.

Fracture toughness testing of a reactor grade graphite

Energy Technology Data Exchange (ETDEWEB)

Roeding, M.; Klein, G.; Schiffers, H.; Nickel, H.

1976-03-15

Fracture mechanics is a well established tool for the assessment of brittle fracture in metallic structural materials. In this paper an attempt is made to apply fracture mechanics to a reactor-grade graphite. The effect of several test parameters on the stress intensity factor was measured; this was found to lie in the range 25 and 50 N/mm/sup -3/2/. The results are discussed in terms of the well known mechanical characteristics of graphite.

Metallographic examination of a failed Jewett nail-plate from a human femur

International Nuclear Information System (INIS)

Gray, R.J.; Zirkel, L.G. Jr.

1976-01-01

A type 316L wrought stainless steel Jewett nail-plate is one of several implant designs for bridging fractures in the proximal end of the femur. A soldier received a high velocity projectile in the trochanteric region of the femur. He was treated for a subtrochanteric fracture and greater trochanteric bone loss. After 9 months, hip varus angulation was progressively increasing. A Jewett nail-plate was inserted after valgus osteotomy and bone grafting of the unhealed fracture. The nail-plate fractured three weeks after surgery. Optical and scanning electron microscopy related the origin of failure to an impactor failure and subsequent microscopic scoring of the nail-plate during insertion into the abnormally hard femoral head. Photomicrographs showing the implant failure and evidences of corrosion after the short time in the body are presented. 12 figs

Interlaminar fracture toughness for composite materials

International Nuclear Information System (INIS)

Lee, Kang Yong; Kwon, Soon Man

1991-01-01

The new equation of energy release rate for a double cantilever beam specimen is proposed within the framework of the higher order shear deformable plate theory. The interlaminar fracture toughnesses by present theory, ASTM round robin test method and acoustic emission method are compared for thermoset Graphite/Epoxy and thermoplastic AS4/PEEK composites. As a result, the interlaminar fracture toughness values by present theory show good agreement within 5% when compared with ones by ASTM method and it is shown that ones by acoustic emission method yield the lower values than ones by ASTM method. It is observed that the interlaminar fracture toughness of thermoplastic AS4/PEEK composite is about ten times larger than one of thermoset Graphite/Epoxy composite. (Author)

Fracture toughness of 6.4 mm (0.25 inch) Arc-Cast molybdenum and molybdenum-TZM plate at room temperature and 300 oC

International Nuclear Information System (INIS)

Shields, J.A. jr.; Lipetzky, P.; Mueller, A.J.

2001-01-01