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Sample records for plate fracture tests

  1. Growth Plate Fractures

    Science.gov (United States)

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

  2. Results of fracture mechanics tests on PNC SUS 304 plate

    Energy Technology Data Exchange (ETDEWEB)

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

    1985-08-01

    PNC provided SUS 304 plate to be irradiated in FFTF at about 400/sup 0/C to a target fluence of 5 x 10/sup 21/ n/cm/sup 2/ (E > 0.1 MeV). The actual irradiation included two basically different exposure levels to assure that information would be available for the exposure of interest. After irradiation, tensile properties, fatigue-crack growth rates and J-integral fracture toughness response were determined. These same properties were also measured for the unirradiated material so radiation damage effects could be characterized. This report presents the results of this program. It is expected that these results would be applicable for detailed fracture analysis of reactor components. Recent advances in elastic-plastic fracture mechanics enable reasonably accurate predictions of failure conditions for flawed stainless steel components. Extensive research has focused on the development of J-integral-based engineering approach for assessing the load carrying capacity of low-strength, high-toughness structural materials. Furthermore, Kanninen, et al., have demonstrated that J-integral concepts can accurately predict the fracture response for full-scale cracked structures manufactured from Type 304 stainless steel.

  3. Locking plates in proximal humerus fractures.

    Science.gov (United States)

    Strohm, P C; Helwig, P; Konrad, G; Südkamp, N P

    2007-12-01

    It is well known that proximal humerus fractures are among the three most frequent fracture types. Epidemiological invetsigations show that in people elder than 60 years the fracture of the proximal humerus is more frequent than fractures of the hip region (17). Over the last decades several techniques have been applied for treatment of proximal humerus fractures. Widely accepted is the initiation of a conservative treatment regimen for undisplaced fractures, however, the standard treatment for displaced fractures, especially three and four part fractures, is still the center of scientific debate. Many different implants have been tested and investigated, thus demonstrating lack of sufficient results. Over the last years the development of angle stable, locking implants started and clinical studies demonstrated encouraging results. In our clinic the locking proximal humerus plate and the PHILOS plate advanced to the implant of choice for treatment of displaced proximal humerus fractures. There are still cases of implant failure and humerus head necrosis, but most of these complications were caused by the fracture type and not an implant specific problem. However the overall results with these new implants are encouraging. Key words: locking plates, proximal humerus fracture, humerus, humerus fracture, PHILOS, PHP.

  4. Development of a Titanium Plate for Mandibular Angle Fractures with a Bone Defect in the Lower Border: Finite Element Analysis and Mechanical Test

    Directory of Open Access Journals (Sweden)

    Douglas Rangel Goulart

    2015-09-01

    Full Text Available Objectives: The aim of the present study was to develop a plate to treat mandibular angle fractures using the finite element method and mechanical testing. Material and Methods: A three-dimensional model of a fractured mandible was generated using Rhinoceros 4.0 software. The models were exported to ANSYS®, in which a static application of displacement (3 mm was performed in the first molar region. Three groups were assessed according to the method of internal fixation (2 mm system: two non-locking plates; two locking plates and a new design locking plate. The computational model was transferred to an in vitro experiment with polyurethane mandibles. Each group contained five samples and was subjected to a linear loading test in a universal testing machine. Results: A balanced distribution of stress was associated with the new plate design. This plate modified the mechanical behavior of the fractured region, with less displacement between the fractured segments. In the mechanical test, the group with two locking plates exhibited greater resistance to the 3 mm displacement, with a statistically significant difference when compared with the new plate group (ANOVA, P = 0.016. Conclusions: The new plate exhibited a more balanced distribution of stress. However, the group with two locking plates exhibited greater mechanical resistance.

  5. Plating of proximal humeral fractures.

    Science.gov (United States)

    Martetschläger, Frank; Siebenlist, Sebastian; Weier, Michael; Sandmann, Gunther; Ahrens, Philipp; Braun, Karl; Elser, Florian; Stöckle, Ulrich; Freude, Thomas

    2012-11-01

    The optimal treatment for proximal humeral fractures is controversial. Few data exist concerning the influence of the surgical approach on the outcome. The purpose of this study was to evaluate the clinical and radiological outcomes of proximal humeral fractures treated with locking plate fixation through a deltopectoral vs an anterolateral deltoid-splitting approach. Of 86 patients who met the inclusion criteria, 70 were available for follow-up examination. Thirty-three patients were treated through a deltopectoral approach and 37 through an anterolateral deltoid-splitting approach. In all cases, open reduction and internal fixation with a PHILOS locking plate (Synthes, Umkirch, Germany) was performed. Clinical follow-up included evaluation of pain, shoulder mobility, and strength. Constant score and Disabilities of the Arm, Shoulder and Hand (DASH) score were assessed. A clinical neurological examination of the axillary nerve was also performed. Consolidation, reduction, and appearance of head necrosis were evaluated radiographically. After a mean follow-up of 33 months, Constant scores, DASH scores, and American Shoulder and Elbow Surgeons scores showed no significant differences between the groups. Clinical neurologic examination of the axillary nerve revealed no obvious damage to the nerve in either group. Deltopectoral and anterolateral detoid-splitting approaches for plate fixation of proximal humeral fractures are safe and provide similar clinical outcomes. The results of this study suggest that the approach can be chosen according to surgeon preference.

  6. Plate osteosynthesis of simple forearm fractures : LCP versus DC plates

    NARCIS (Netherlands)

    Stevens, Charles Tjerk; Ten Duis, Henk Jan

    2008-01-01

    The aim of this study was to compare the time to radiological bony union of simple A-type fractures of the forearm, treated with either a locking compression plate (LCP) or a dynamic compression plate (DCP). For each fracture, the relation between the use of compression and radiological healing time

  7. Plate osteosynthesis of simple forearm fractures : LCP versus DC plates

    NARCIS (Netherlands)

    Stevens, Charles Tjerk; Ten Duis, Henk Jan

    The aim of this study was to compare the time to radiological bony union of simple A-type fractures of the forearm, treated with either a locking compression plate (LCP) or a dynamic compression plate (DCP). For each fracture, the relation between the use of compression and radiological healing time

  8. Locking plate osteosynthesis of clavicle fractures

    DEFF Research Database (Denmark)

    Fridberg, Marie; Ban, Ilija; Issa, Zaid

    2013-01-01

    PURPOSE: Locking plate osteosynthesis has become the preferred method for operative treatment of clavicle fractures. The method offers stable fixation, and would theoretically be associated with a low rate of fracture-related complications and reoperations. However, this remains to be explored...... in a large cohort, and our purpose was to assess the overall rates of complications and reoperations following locking plate osteosynthesis of mid-shaft clavicle fractures. METHODS: We identified all locking plate osteosynthesis of mid-shaft clavicle fractures operated upon in our department from January...... 2008 to November 2010 (n = 114). Nine patients did not attend the follow-up at our institution. The study group of 105 fractures (104 patients, 86 males) had a median age of 36 years (14-75 years). Follow-up ranged from 0.5 to 3.5 years. No patients were allowed to load the upper extremity for six...

  9. Outcome Analysis of Locking Plate Fixation in Proximal Humerus Fracture

    Science.gov (United States)

    Pathak, Abhishek; Gaur, Sanjiv

    2016-01-01

    Introduction Proximal humerus fractures account for approximately 5% of all fractures. Stable minimally displaced fractures can be treated nonoperatively but the management of displaced fractures remain controversial with various modalities of treatment available. Locking plates provide stable fixation and enable early postoperative mobilization specially in osteoporotic proximal humerus fracture. Aim To evaluate the functional outcome of locking plate fixation and to compare the results of two approaches used for fixation. Materials and Methods This prospective study was conducted at a tertiary level hospital between September 2011 to December 2013. PHILOS plates were used for internal fixation of displaced proximal humerus fractures Neer’s type 2 part, 3 part and 4 part fractures on 26 patients (M/F ratio 1.36:1; mean age 46 years). According to Neer classification, 5,12 and 9 patients had displaced 2, 3 and 4 part fractures respectively. Deltopectoral and deltoid splitting approaches were used for fixation on 13 patients each. Functional outcome was assessed using Constant-Murley shoulder score. Graphpad software version 6.0 was used with Chi-square test and Fisher-exact test are used to compare data. The p-value .05) and all fractures were united. Conclusion Our study demonstrates that locking plate fixation gives good functional outcomes in treatment of proximal humerus fractures. There was no significant difference in the two approaches used for exposure. Our results are comparable to various studies conducted by other authors which states that locking plates provide better functional and radiological outcomes as compared to other fixation methods like Tension band wiring, percutaneous K-wire fixation, non-locking plates, intramedullary nails. PMID:27656515

  10. Biological Plating in Comminuted Subtrochanteric Fractures

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    MR Aghamirsalim

    2012-05-01

    Full Text Available Background: Comminuted subtrochanteric fractures have been a challenge for orthopedic surgeons in terms of appropriate reduction and stable fixation. Numerous methods have been used for the fixation of comminuted subtrochanteric fractures among which some are accompanied with technical difficulties and complications of their own. Regarding the results of previous studies, we decided to evaluate the biological fixation method in comminuted subtrochanteric fractures. Methods: In this prospective study, we evaluated 20 men with comminuted subtrochanteric femoral fractures. The patients underwent indirect reduction with dynamic hip screw (DHS or dynamic condylar screw (DCS fixation within one week of injury. The patients were evaluated clinically for pain, hip and knee range of motion, leg-length discrepancy and angular and rotational deformities, in addition the radiographic assessment of the union. Results: According to Seinsheimer's classification of subtrochanteric fractures, four patients had type III, nine had type IV and seven had type V fractures. Fracture fixation was performed by DCS in eight and by DHS in 12 cases. The average time of the operations was 79.4 (ranging from 60-125 minutes. Mean blood loss was 634 (ranging from 340-1160 milliliters. Uneventfully, union occurred in all patients with no clinical pain or dysfunction. Conclusion: Submuscular plating with either DCS or DHS is a viable option to treat comminuted subtrochanteric fractures. The results of this study highly suggest use of submuscular plating in the treatment of comminuted subtrochanteric fractures, especially in the third world countries.

  11. Plating of patella fractures: techniques and outcomes.

    Science.gov (United States)

    Taylor, Benjamin C; Mehta, Sanjay; Castaneda, Joaquin; French, Bruce G; Blanchard, Chris

    2014-09-01

    Operative treatment of displaced patella fractures with tension band fixation remains the gold standard, but is associated with a significant rate of complications and symptomatic implants. Despite the evolution of tension band fixation to include cannulated screws, surprisingly little other development has been made to improve overall patient outcomes. In this article, we present the techniques and outcomes of patella plating for displaced patella fractures and patella nonunions.

  12. Double Plating of Distal Fibula Fractures.

    Science.gov (United States)

    Vance, Danica D; Vosseller, J Turner

    2017-02-01

    Distal fibula fractures are common orthopaedic injuries that often require open reduction internal fixation (ORIF) to anatomically reduce the fracture and minimize the risk of posttraumatic arthritis. In certain clinical situations, stouter fixation may be advantageous to decrease the risk of fixation failure. In this study, the authors report on 12 patients who underwent distal fibula ORIF with 2 one-third tubular plates. Twelve consecutive patients who underwent distal fibula ORIF with 2 one-third tubular plates were retrospectively reviewed. Clinical and radiographic outcomes were reviewed, and functional outcomes were obtained using the Foot and Ankle Outcome Score (FAOS). Institutional review board approval was obtained. All 12 fractures healed clinically and radiographically. One patient was lost to follow-up after healing of the fracture. One patient had removal of fibular hardware at 15 months after surgery. Ten patients had no hardware related pain and good ankle function. FAOS scores were obtained at a mean of 25.6 months after surgery and were as follows: pain (87.6, SD = 9.5), activities of daily living (90.4, SD = 14.5), symptoms (93.3, SD = 9.5), sports (89.5, SD = 18.1), and quality of life (57.4, SD = 21.3). Double plating of distal fibula fractures is a viable technique for problem fractures that potentially provides a readily accessible, low-cost alternative to other means of enhancing fixation. Level IV.

  13. A STUDY ON PROXIMAL HUMERAL FRACTURES STABILISED WITH PHILOS PLATE

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    Praveen Sivakumar K

    2017-02-01

    Full Text Available BACKGROUND Techniques for treating complex proximal humeral fractures vary and include fixations using tension bands, percutaneous pins, bone suture, T-plates, intramedullary nails, double tubular plates, hemiarthroplasty, plant tan humerus fixator plates, Polaris nails and blade plates. Complications of these techniques include cutout or back out of the screws and plates, avascular necrosis, nonunion, malunion, nail migration, rotator cuff impairment and impingement syndromes. Insufficient anchorage from conventional implants may lead to early loosening and failure, especially in osteoporotic bones. In general, nonoperative treatment of displaced three and four-part fractures of the proximal humerus leads to poor outcome due to intraarticular nature of injury and inherent instability of the fragments. Comminuted fractures of the proximal humerus are at risk of fixation failure, screw loosening and fracture displacement. Open reduction and internal fixation with conventional plate and screws has been associated with unacceptably high incidence of screw pull out. PHILOS (the proximal humeral internal locking system plate is an internal fixation system that enables angled stabilisation with multiple interlocking screws for fractures of the proximal humerus. MATERIALS AND METHODS 30 patients with proximal humerus fractures who were admitted in the Department of Orthopaedics, Government General Hospital, Kakinada, during the period November 2014 - November 2016 were taken up for study according to inclusion criteria. All patients were treated with PHILOS plate. These proximal humerus fractures were classified according to Neer’s classification. Patients were followed up at 6 weeks, 12 weeks and 6 months’ interval. Functional outcomes for pain, range of motion and muscle power and function were assessed using the Constant-Murley scoring system. Collected data analysed with independent t-test and ANNOVA test. RESULTS The outcome of the study was 1

  14. 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.

  15. Biomechanical Study of the Fixation Strength of Anteromedial Plating for Humeral Shaft Fractures

    Directory of Open Access Journals (Sweden)

    Yin-Feng Zheng

    2016-01-01

    Conclusions: Anteromedial plating was superior to anterolateral or posterior plating in all mechanical tests except in AP four-point bending fatigue tests compared to the anterolateral plating group. We can suggest that anteromedial plating is a clinically safe and effective way for humeral shaft fractures.

  16. Anterolateral Versus Medial Plating of Distal Extra-articular Tibia Fractures: A Biomechanical Model.

    Science.gov (United States)

    Pirolo, Joseph M; Behn, Anthony W; Abrams, Geoffrey D; Bishop, Julius A

    2015-09-01

    Both medial and anterolateral plate applications have been described for the treatment of distal tibia fractures, each with distinct advantages and disadvantages. The objective of this study was to compare the biomechanical properties of medial and anterolateral plating constructs used to stabilize simulated varus and valgus fracture patterns of the distal tibia. In 16 synthetic tibia models, a 45° oblique cut was made to model an Orthopedic Trauma Association type 43-A1.2 distal tibia fracture in either a varus or valgus injury pattern. Each fracture was then reduced and plated with a precontoured medial or anterolateral distal tibia plate. The specimens were biomechanically tested in axial and torsional loading, cyclic axial loading, and load to failure. For the varus fracture pattern, medial plating showed less fracture site displacement and rotation and was stiffer in both axial and torsional loading (Ptibia fractures.

  17. A Novel Computer-Aided Approach for Parametric Investigation of Custom Design of Fracture Fixation Plates.

    Science.gov (United States)

    Chen, Xiaozhong; He, Kunjin; Chen, Zhengming

    2017-01-01

    The present study proposes an integrated computer-aided approach combining femur surface modeling, fracture evidence recover plate creation, and plate modification in order to conduct a parametric investigation of the design of custom plate for a specific patient. The study allows for improving the design efficiency of specific plates on the patients' femur parameters and the fracture information. Furthermore, the present approach will lead to exploration of plate modification and optimization. The three-dimensional (3D) surface model of a detailed femur and the corresponding fixation plate were represented with high-level feature parameters, and the shape of the specific plate was recursively modified in order to obtain the optimal plate for a specific patient. The proposed approach was tested and verified on a case study, and it could be helpful for orthopedic surgeons to design and modify the plate in order to fit the specific femur anatomy and the fracture information.

  18. A Novel Computer-Aided Approach for Parametric Investigation of Custom Design of Fracture Fixation Plates

    Science.gov (United States)

    2017-01-01

    The present study proposes an integrated computer-aided approach combining femur surface modeling, fracture evidence recover plate creation, and plate modification in order to conduct a parametric investigation of the design of custom plate for a specific patient. The study allows for improving the design efficiency of specific plates on the patients' femur parameters and the fracture information. Furthermore, the present approach will lead to exploration of plate modification and optimization. The three-dimensional (3D) surface model of a detailed femur and the corresponding fixation plate were represented with high-level feature parameters, and the shape of the specific plate was recursively modified in order to obtain the optimal plate for a specific patient. The proposed approach was tested and verified on a case study, and it could be helpful for orthopedic surgeons to design and modify the plate in order to fit the specific femur anatomy and the fracture information. PMID:28203270

  19. Quadrilateral plate fractures of the acetabulum: an update.

    Science.gov (United States)

    White, Grace; Kanakaris, Nikolaos K; Faour, Omar; Valverde, Jose Antonio; Martin, Miguel Angel; Giannoudis, Peter V

    2013-02-01

    Acetabular fractures with quadrilateral plate involvement form a heterogeneous group of fractures, which are not specifically defined by any current classification system. Their incidence is increasing due to the rising number of elderly osteoporotic fractures. They have always been notoriously difficult fractures to treat. We present a systematic review of conservative and operative management and their respective outcomes over the last century.

  20. PHILOS humerus plate for a distal tibial fracture.

    Science.gov (United States)

    Twaij, Haider; Damany, Dev

    2013-01-04

    This report discusses the use of an alternative implant in the emergency fixation of a distal tibial fracture. We planned to fix the shear-type medial malleolar fracture in a closed, tri-malleolar fracture with a locking distal tibial plate. Intra-operatively, it was noted that the required plate was unavailable. A PHILOS humeral plate seemed to fit the contours of the distal tibia. The broad end of the PHILOS, when placed distally, gave options to place locking screws in the medial malleolar fragment. The fracture was stable after fixation. The patient made a full post-operative recovery and follow-up at 4 months was satisfactory. Despite adequate planning, there will be instances where one has to improvise. An understanding of the principles of fracture management can aid in finding solutions. PHILOS humeral plate may be used to stabilize a distal tibial fracture if an appropriate distal tibial locking plate is not available.

  1. Dynamic plate osteosynthesis for fracture stabilization: how to do it

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    Juerg Sonderegger

    2010-01-01

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

  2. Minimally Invasive Plate Osteosynthesis with Conventional Compression Plate for Diaphyseal Tibia Fracture

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    IM Anuar-Ramdhan

    2014-11-01

    Full Text Available The diaphyseal tibia fracture is best treated with intramedullary nail but in some cases where the nail is not applicable, plate fixation will be the next option of fixation. The extensile anterior approach is normally used for conventional compression plate fixation in tibia shaft fractures. The extensive surgical dissection may devitalizes the bony fragments and interfere with the fracture union as well as soft tissue healing. Minimally Invasive Plate Osteosynthesis (MIPO provides good preservation of blood supply and fracture hematoma at the fracture site thus promotes biological bone healing. The use of indirect reduction techniques and small skin incisions to introduce the plate is technically demanding and requires fluoroscopy exposures throughout the surgery, being some of its drawbacks. We recommend MIPO for conventional compression plate fixation in tibial shaft fractures in view of the reduced surgical trauma to the surrounding soft tissue and good functional outcome.

  3. Fixation of multifragmentary patella fractures using a bilateral fixed-angle plate.

    Science.gov (United States)

    Thelen, Simon; Betsch, Marcel; Schneppendahl, Johannes; Grassmann, Jan; Hakimi, Mohssen; Eichler, Christian; Windolf, Joachim; Wild, Michael

    2013-11-01

    This biomechanical study is the first to compare 3 fixation methods-bilateral fixed-angle plate, modified anterior tension wiring, and cannulated lag screws with anterior tension wiring-in multifragmentary distal patella fractures. A T-shaped 3-part fracture simulating a multifragmentary articular distal patella fracture (AO/OTA 34-C2.2) was created in 18 human cadaver knee specimens. Three groups were created using homogenous ages and bone mineral densities based on the fixation method received. Repetitive testing over 100 cycles was performed by moving the knee against gravity from 90° flexion to full extension. Failure was defined as fracture displacement greater than 2 mm. In all patellae using fixed-angle plates, an anatomical fracture reduction could be maintained throughout cyclic testing, whereas anterior tension wiring and lag screws with tension wiring showed significant fracture displacement after 100 cycles, with mean fracture gaps of 2.0±1.3 and 1.9±1.6 mm, respectively. The differences in fracture gaps between the fixed-angle plate group and the other 2 groups were statistically significant. In both groups using tension wiring, half of the constructs (3 of 6 in each group) failed due to a fracture displacement greater than 2 mm. The bilateral fixed-angle plate was the only fixation method that sustainably stabilized a multifragmentary articular distal patella fracture during cyclic loading when compared with modified anterior tension wiring and cannulated lag screws with anterior tension wiring.

  4. Experimental study and clinical observation of minimum-contact plate in long bone fracture

    Institute of Scientific and Technical Information of China (English)

    YANG Xin-jian; FEI Jun; WANG Zheng-guo; YU Hong-jun; SUN Jun

    2005-01-01

    Objective: To sutdy the mechanical properties and the clinical results of minimum-contact plate in the treatment of fractures. Methods: Four-point bending and torsion tests were conducted to compare the new minimum contact plate (MCP) with dynamic compression plate (DCP) and limited contact dynamic compression plate (LC-DCP). The fracture healing time and growth of bony callus were observed in 29 cases of long bone fracture fixed with MCP to evaluate the advantages of this kind of plate. Results: The 29 patients who underwent MCP were followed up from 6 to 14 months. The average healing time for femoral, tibial and humeral fractures was 12, 13 and 10 weeks, respectively. All fractures were healed. No displacement of fracture, screw pullout, deformation or break of the plate were found. Conclusions: The bending stiffness of MCP is significantly greater than that of DCP and LC-DCP (P<0.05). MCP can protect the periosteal blood supply against avascular osseous necrosis and accelerate bone healing. It is a kind of reliable and effective plate in treatment of fractures.

  5. Plate on Plate Osteosynthesis for the Treatment of Nonhealed Periplate Fractures

    OpenAIRE

    Georgios Arealis; Nikolaou, Vassilios S.; Andrew Lacon; Neil Ashwood; Mark Hamlet

    2014-01-01

    Purpose. The purpose of this paper is to present our technique for the treatment of periplate fractures. Methods. From 2009 to 2012 we treated three patients. In all cases the existing plate was left and the new one placed over the existing. Locking screws were placed through both plates. The other screws in the new plate were used as best suited the fracture. Results. In all cases less than 6 months had passed between fractures. None of the original fractures had healed. Mean followup was 2 ...

  6. Operative Cost Comparison: Plating Versus Intramedullary Fixation for Clavicle Fractures.

    Science.gov (United States)

    Hanselman, Andrew E; Murphy, Timothy R; Bal, George K; McDonough, E Barry

    2016-09-01

    Although clavicle fractures often heal well with nonoperative management, current literature has shown improved outcomes with operative intervention for specific fracture patterns in specific patient types. The 2 most common methods of midshaft clavicle fracture fixation are intramedullary and plate devices. Through retrospective analysis, this study performed a direct cost comparison of these 2 types of fixation at a single institution over a 5-year period. Outcome measures included operative costs for initial surgery and any hardware removal surgeries. This study reviewed 154 patients (157 fractures), and of these, 99 had intramedullary fixation and 58 had plate fixation. A total of 80% (79 of 99) of intramedullary devices and 3% (2 of 58) of plates were removed. Average cost for initial intramedullary placement was $2955 (US dollars) less than that for initial plate placement (Pcost for removal was $1874 less than that for plate removal surgery (P=.2). Average total cost for all intramedullary surgeries was $1392 less than the average cost for all plating surgeries (Pcost for all intramedullary surgeries requiring plate placement and removal was $653 less than the average cost for all plating surgeries that involved only placement (P=.04). Intramedullary fixation of clavicle fractures resulted in a statistically significant cost reduction compared with plate fixation, despite the incidence of more frequent removal surgeries. [Orthopedics.2016; 39(5):e877-e882.].

  7. COMPARATIVE STUDY OF FOREARM FRACTURES TREATED WITH LOCKING COMPRESSION PLATE LIMITED CONTACT DYNAMIC COMPRESSION PLATE

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    Jayachandra Reddy

    2015-02-01

    Full Text Available OBJECTIVES: This study has been carried out to compare the functional outcome of fracture fixation in diaphyseal forearm fractures by using Locking Compression Plate versus Limited contact dynamic compression Plate. To study the difference in the duration of union & complications with LCP & LC - DCP. METHODOLOGY: It is a prospective randomised comparative study which was carried out from December 2012 to December 2014 in our In stitution. In Group I, 20 patients were subjected to open reduction and internal fixation with 3.5 mm stainless steel LCP and locking head/nonlocking screws. In Group II, 20 patients were managed by 3.5mm LCDCP and non - locking screws. Clinical assessments regarding pain and function, radiological assessments were undertaken at the final follow - up. RESULTS - The time required for LCP fixation (mean 93.5 min, range 75 - 120 min was found to be more than that required for LC - DCP (mean 81.94 min, range 60 - 110 mi n. But this time difference was not significant (P=0.07, unpaired t test. The mean time of union for the forearm fixed with LCP was found to be 18 weeks (range 14 - 26 weeks in comparison to 16 weeks (range 10 - 22 weeks for the LC - DCP group. CONCLUSION - LC plating is an effective treatment option for fractures shaft of forearm. The present study could not prove the superiority of LCP over LC - DCP. It is the proper application of the principles of plating and not the type of plate which decides the outco me. Further long - term multicentric study is required to prove behaviors of the implant.

  8. Complications of the locking plate for displaced proximal humeral fractures

    Institute of Scientific and Technical Information of China (English)

    LU Yi; WANG Man-yi; ZHU Yi-ming; JIANG Chun-yan

    2010-01-01

    Background Although the locking plate has become popular for treating displaced proximal humeral fractures in recent years, the complications of this method are still underestimated. We tried to evaluate the factors that have an influence on the complications experienced after proximal humeral fractures fixed by locking plates and compare the results from patients having complications with those having no complications.Methods From September 2004 to September 2007, 92 out of 111 displaced proximal humeral fractures treated by open reduction and internal fixation with a locking plate were available for follow-up, with an average time of 15.2months (12-36 months). The range of motion, Visual Analog Score (VAS) for pain, American Shoulder and Elbow Surgeons' Form (ASES), Constant-Murley, University of California-Los Angles scoring system (UCLA) score, and Simple Shoulder Test (SST) for function evaluation was all recorded at the latest follow-up. The results from patients with complications were evaluated according to the indices listed above and compared with those patients without any complications.Results There were 17 patients with complications, an 18.5% complication rate. Among them, the forward flexion,external rotation and internal rotation were 139.1°±24.3°, 24.1°±19.6°, and up to T10 level on average. The mean VAS score was 1.0±1.1, the ASES score was 82.9±13.8, the Constant 82.1±11.8, the UCLA 28.5±4.1 and the mean SST 9.5on average. There was no significant difference of complication rate among different age, sex, and injured side, fresh or delayed fracture, combined with other injury or not groups. Compared with the group without complications, patients with complications showed significantly less external rotation and lower Constant-Murley and UCLA functional scores (P <0.05). A significant difference in results was seen between patients with complications and those without complications.Conclusion The indication control and appropriate

  9. Impact Delamination and Fracture in Aluminum/Acrylic Sandwich Plates

    Science.gov (United States)

    Liaw, Benjamin; Zeichner, Glenn; Liu, Yanxiong; Bowles, Kenneth J. (Technical Monitor)

    2000-01-01

    Impact-induced delamination and fracture in 6061-T6 aluminum/cast acrylic sandwich plates adhered by epoxy were generated in an instrumented drop-weight impact machine. Although only a small dent was produced on the aluminum side when a hemispherical penetrator tup was dropped onto it from a couple of inches, a large ring of delamination at the interface was observed. The delamination damage was often accompanied by severe shattering in the acrylic substratum. Damage patterns in the acrylic layer include radial and ring cracks and, together with delamination at the interface, may cause peeling-off of acrylic material from the sandwich plate. Theory of stress-wave propagation can be used to explain these damage patterns. The impact tests were conducted at various temperatures. The results also show clearly that temperature effect is very important in impact damage. For pure cast acrylic nil-ductile transition (NDT) occurs between 185-195 F. Excessive impact energy was dissipated into fracture energy when tested at temperature below this range or through plastic deformation when tested at temperature above the NDT temperature. Results from this study will be used as baseline data for studying fiber-metal laminates, such as GLARE and ARALL for advanced aeronautical and astronautical applications.

  10. Interface contact profiles of a novel locking plate and its effect on fracture healing in goat

    Institute of Scientific and Technical Information of China (English)

    WEI Da-cheng; ZHAO Yu-feng; XING Shu-xing; WANG Ai-min

    2010-01-01

    Objective: To evaluate the interface characteristics of the new-designed locking plate (LP) and limited contact-dynamic compression plate (LC-DCP) and compare the fracture healing between LP and LC-DCP in a goat tibia fracture model.Methods: Eight-hole LP and LC-DCP were applied to fix flesh goat tibiae in a reproducible manner. The average pressure, force and interface contact area were calculated using Fuji prescale pressure sensitive film interposed among the plate and the bone and image analysis system. Eighthole LP and LC-DCP were applied to each tibia in a goat tibia fracture model. The fracture healing was evaluated by X-ray photography at postoperative 8 weeks. The goats were sacrificed at postoperative 12 weeks. Three-point bending test was conducted in the tibiae.Results: The interface contact of LP system was smaller than that ofLC-DCP (P<0.05), while interface contact force of LP system was higher than that of LC-DCP (P<0.05). Radiographs revealed that the fracture line disappeared in the LP group, while the fracture line was visible in DCP group at postoperative 8 weeks. At postoperative 12 weeks, the bending strength and bending load of fractured tibia were higher in LP group than in DCP group, respectively.Conclusion: The new-designed locking plate can significantly decrease the contact area on the bone interface,which further provides better fracture healing than conventional plates.

  11. OUTCOME OF LOCKING PLATES IN DISTAL TIBIA FRACTURES TREATMENT

    Directory of Open Access Journals (Sweden)

    Lokesh

    2016-05-01

    Full Text Available 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-articular fractures are fixed with these plates with minimally invasive percutaneous plate osteosynthesis method, these plates have given excellent result 4 . But again these plates have some disadvantages 5 . This study is done to see the outcome of locking plates in distal tibia fracture. METHODS This study is done in the Department of Orthopaedics, Bangalore Medical College, Bangalore. This study is done from 2013 to 2015. 30 patients who came to outpatient department were treated with locking plates. All patients above 16 years having distal third tibia fracture are included. All open fractures except type 1 and elderly above 60 years and pathological fractures are excluded in our study. All patients were followed up for initial 5 months, thereafter, once in 3 months, for clinical and radiological evaluation of union status, knee range of motion, ankle range of motion and other complications. Assessment of the patient with functional recovery was done with American Orthopaedic Foot and Ankle Surgery(AOFAS 6 minimum 5 months after injury. RESULTS Majority of the patients are from age group 18-29 years (50%. Average age group was 30 years. Majority of the patients were males 80.6% (25. All fractures were closed fractures except 2 cases which are type 1. There were 12 cases of AO type A, 8 patients were AO type B and 10 patients were type C. Majority of the patients had fracture due to road traffic accidents, 74%. All fractures were united by the end of 20 weeks. There was delayed union in

  12. Reverse LISS plating for intertrochanteric Hip Fractures in elderly patients

    Directory of Open Access Journals (Sweden)

    Chen SB

    2010-07-01

    Full Text Available Abstract Background Fractures of the intertrochanteric hip are common and the treatment of unstable fractures generally requires an operative approach. In elderly patients, osteoporosis makes internal fixation problematic and frequently contributes to failed fixation and poor clinical results. We have attempted to apply the Less Invasive Stabilization System (LISS in reverse position for the repair of intertrochanteric hip fractures in elderly patients with osteoporotic bones. A retrospective review is presented of the cases of 28 elderly patients with stable and unstable fractures of the intertrochanteric hip treated using the reverse LISS. Methods We treated 28 elderly patients with a mean age of 82.3 years. According to the Evens classification, there were 2 Type I fractures, 2 Type II fractures, 3 Type III fractures, 13 Type IV fractures, 6 Type V fractures and 2 Type R fractures. All fractures were treated using the reverse LISS. Radiographic and clinical evidence of functional outcome and complications were evaluated. Results Mean perioperative blood loss was 92.4 milliliters (range 35 to 245 milliliters, and the mean postoperative hospital stay was 8.7 days (range 3 to 14 days. Complications included one minor wound hematoma. Radiographically, no collapses, screw cutouts, or head penetrations were seen. All surviving patients (28 of 28; 100 percent had uneventful fracture healing with union achieved by six months in all patients. Conclusions Use of the Reverse LISS plating for intertrochanteric hip fractures resulted in event-free fracture healing.

  13. Treatment of middle-third clavicle fractures using anterior plating with a dynamic compression plate (DCP).

    Science.gov (United States)

    Subramanian, Padmanabhan; Joshi, Meera; Shilston, Sophie; Wallace, Donald; Pearce, Oliver J

    2013-03-01

    Significantly displaced midshaft clavicle fractures can be managed operatively to restore anatomy and allow early mobilization. Several techniques have described using precontoured anatomically designed plates placed on the superior surface of the bone or reconstruction plates contoured by the surgeon placed either superiorly or anteriorly. We describe the use of the dynamic compression plate placed anteriorly on the clavicle in treating these fractures and discuss the relative advantages of this technique. We have a case series of 8 patients over a 2-year period, who were followed up and all went on to successful fracture union.

  14. Reconstruction plate fixation of subtrochanteric femoral fractures in children.

    Science.gov (United States)

    El-Sayed, Moustafa; Abulsaad, Mazen; El-Hadidi, Mahmoud; El-Adl, Wael; El-Batouty, Magdy

    2007-08-01

    Pediatric subtrochanteric femoral fractures are rare and have received limited attention in the literature Treatment is controversial. Different treatment options are used: skin traction, 90/90 skeletal traction, spica casting, cast bracing, internal fixation and external fixation. The aim of this study is to present our results with internal fixation of subtrochanteric femoral fractures in children using a reconstruction plate. Between 2000 and 2004, eighteen patients with closed subtrochanteric femoral fractures were treated in the Mansoura Emergency Hospital. The average age at the time of injury was 8.2 years (range 5.3 years to 11.5 years). Pathological fractures and fractures associated with neuromuscular diseases were excluded from this study. Eight patients had head injuries and/or multiple injuries. In all cases a single 4.5 mm contoured reconstruction plate was used and a 6.5 mm cancellous screw was inserted through the plate into the femoral neck. Average follow-up was 38 months (range, 12 to 47 months). All fractures united with anatomical alignment within an average of 8 weeks (range 6 to 12 weeks). There were no deep infections and no significant limb length discrepancies. At the latest follow-up, no patient had any restriction of activities. Internal fixation with a reconstruction plate appears as a good treatment option for children with subtrochanteric femoral fractures.

  15. Biomechanical Assessment of Locked Plating for the Fixation of Patella Fractures.

    Science.gov (United States)

    Wurm, Simone; Augat, Peter; Bühren, Volker

    2015-09-01

    To analyze the mechanical stability of locked plating in comparison with tension-band wiring for the fixation of fractures of the patella. Biomechanical tests were performed on artificial foam patella specimens comparing an angular stable plate and monocortical screws with tension-band wiring. Tests were performed under combined tension and bending until failure simulating physiological loading of the tibia during walking. Tension-band wiring failed at 66% of the failure load of plating (1052 N, P = 0.002) and had 5 times larger fracture gap displacements (P = 0.002). Based on the biomechanical advantages, locked plating of the patella may constitute a reasonable alternative in the treatment of patella fractures.

  16. Buttress plating for a rare case of comminuted medial condylar Hoffa fracture associated with patellar fracture

    Institute of Scientific and Technical Information of China (English)

    Ashwani Soni; Ramesh K Sen; Uttam Chand Saini; Dajjit Singh; Sushil Chaudhary

    2012-01-01

    Hoffa fracture is an uncommon injury.In the literature,lateral condylar Hoffa fracture is mentioned as a more common injury pattern than medial condylar Hoffa fracture.The mechanism of injury and method of treatment is not very well described in the literature.We are presenting a rare case of comminuted medial condylar Hoffa fracture with ipsitateral patellar fracture.The mechanism of injury has not been described in the literature.Lag screw fixation,which is the most acceptable method of treatment,is not possible due to comminution.We explain the possible mechanism of injury and fix the fracture with L-buttress plate.

  17. Development of site-specific locking plates for acetabular fractures.

    Science.gov (United States)

    Xu, Meng; Zhang, Li-Hai; Zhang, Ying-Ze; He, Chun-Qing; Zhang, Li-Cheng; Wang, Yan; Tang, Pei-Fu

    2013-05-01

    Site-specific locking plates have gained popularity for the treatment of fractures. However, the clinical use of a site-specific locking plate for acetabular fractures remains untested due to production limits. To design a universal site-specific locking plate for acetabular fractures, the 3-dimensional (3D) photographic records of 171 pelvises were retrospectively studied to generate a universal posterior innominate bone surface. Using 3D photographical processing software, the 3D coordinate system was reset according to bony landmarks and was scaled based on the acetabular diameter to allow a direct comparison between surfaces. The measured surface was separated into measurement units. At each measurement unit, the authors calculated the average z-axis values in all samples and obtained the 3D coordinate values of the point cloud that could be reconstructed into the universal surface. A plate was subsequently designed in 3D photographical processing software, and the orientation and distribution of locking screws was included. To manufacture a plate, the data were entered into Unigraphics NX version 6.0 software (Siemens PLM Software, Co, Ltd, Plano, Texas) and a CNC digital milling machine (FANUC Co, Ltd, Yamanashi, Japan). The resulting locking plate fit excellently with the reduced bone surface intraoperatively. Plate contouring was avoided intraoperatively. Universal 3.5-mm locking screws locked successfully into the plate, and their orientations were consistent with the design. No screw yielded to acetabular penetration. This method of designing a site-specific acetabular locking plate is practical, and the plates are suitable for clinical use. These site-specific locking plates may be an option for the treatment of acetabular fractures, particularly in elderly patients.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. 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.

  20. Reasons Analysis on Laminated Fracture of DH36 Hull Plate During Tensile Test%DH36船板钢拉伸断口分层的原因分析

    Institute of Scientific and Technical Information of China (English)

    张鑫; 郭汉杰; 李宏亮; 吴建中; 刘锦强

    2012-01-01

    The reasons for the laminated fracture tinder tensile test of DH36 hull plate were researched by metallurgical observation and SEM observation. The results show that the main reasons are the aggregation of MnS as well as the martensite and bainite banded structure in the center of plate.%采用金相检验、扫描电镜检验等手段对DH36船板钢拉伸断口分层缺陷进行了分析.结果表明:DH36船板钢拉伸断口分层缺陷主要是由钢板厚度中心条状MnS夹杂和宽大的贝氏体、马氏体带状组织引起的.

  1. Proximal humeral fractures: a biomechanical comparison of locking plate constructs in a cadaveric 3-part fracture model.

    Science.gov (United States)

    Rose, David M; Sutter, Edward G; Mears, Simon C; Gupta, Rohit R; Belkoff, Stephen M

    2010-11-01

    The purpose of our study was to biomechanically compare, under cyclic loading conditions, fracture site motion, humeral head collapse, and intra-articular hardware penetration in simulated 3-part osteoporotic proximal humeral fractures stabilized with 1 of 2 locking-plate constructs. We performed fixation on simulated 3-part proximal humeral fractures in 10 pairs of cadaveric osteoporotic humeri with a Hand Innovations S3 Proximal Humerus Plate (S3 plate) or an LCP Proximal Humerus Plate (LCP plate; 1 each for each pair). The specimens were potted, mounted on a materials testing machine, and subjected to 5000 cycles of abduction in the scapular plane, loading through the supraspinatus tendon. Interfragmentary displacement at 2 virtual points (the most medial aspect of the calcar and the most superior aspect of the osteotomy line between the greater tuberosity and humeral head) was measured using an optical tracking system. Humeral head rotation was also measured. We used a generalized linear latent and mixed model to check for an effect of cyclic loading and treatment on the parameters of interest (significance, P fracture site motion, it is unknown whether the magnitude of the motion is clinically significant.

  2. Unstable Distal Radius Fractures Treated by Volar Locking Anatomical Plates

    Science.gov (United States)

    Jose, Anto; Deniese, Pascal Noel; Babu, Abey Thomas; Rengasamy, Kanagasabai; Najimudeen, Syed

    2017-01-01

    Introduction Fracture of the distal end of radius represents the most common fracture of the upper extremity accounting for 16-20% of all fractures. Plating is now emerging as the gold standard for management of distal radius fractures due to increased rate of complications such as malunion, subluxation/dislocation of distal radio-ulnar joint or late collapse of fracture. Procedures such as closed reduction and cast immobilization, ligamentotaxis with external fixator and percutaneous pin fixation are no longer acceptable. Aim The purpose of the study was to evaluate the functional and radiological outcome of unstable distal radius fractures treated with the volar locking plate. Materials and Methods We reviewed 53 patients from January 2011 to December 2015, treated for unstable distal radius fractures using a volar locking compression plate. Standard radiographic and clinical assessment after 12 months (range 12-16 months) were measured and final functional and radiological outcome were assessed using the Modified Mayo wrist scoring system and Sarmiento’s modification of Lindstorm criteria respectively. Results There were 42 males and 11 females with an average age of 39.12±31.78 years (18-71 years). At the end of 12 months, 36 patients had an excellent radiological outcome and 10 patients had good radiological outcome as per Sarmiento’s modification of Lindstorm criteria. Eleven patients had an excellent functional outcome and 26 patients had a good functional outcome as per modified Mayo wrist scoring system. There was one case of superficial wound infection which subsided with intravenous antibiotics. Conclusion The volar locking plate fixation helps in early mobilization of the wrist, restores anatomy, allows early return to function, prevents secondary loss of reduction and hence is an effective treatment for unstable fractures of the distal radius. PMID:28274009

  3. A method for designing plates in treatments of proximal humeral fracture and distal radial fracture

    Directory of Open Access Journals (Sweden)

    Lin Wang

    2016-11-01

    Full Text Available The purpose of this paper was to quickly design fixation plates for fractured proximal humerus and distal radius according to the requirements of surgical treatment. Therefore, a new method to quickly design cloverleaf plate appropriate for proximal humerus and volar plate appropriate for distal radius is put forward. First, three-dimensional (3D reconstruction models of fractured proximal humerus and distal radius were generated based on deforming mean parametric models of proximal humerus and distal radius, respectively. Second, based on region-of-interest marked on the 3D reconstruction model of proximal humerus and distal radius, abutted surfaces of cloverleaf plate and volar plate were established, respectively. Then, parametric abutted surface was established after setting rational parameters for the surface of the cloverleaf plate. Parametric abutted surface of volar plate was established using the same method. Finally, parametric cloverleaf plate and volar plate are generated through thickening their respective parametric abutted surfaces. The parametric plates, acting as templates, accelerate and simplify the design process and therefore allow users to construct plate with editing valid parameters easily. Group of cloverleaf plates and volar plates with different sizes were generated quickly, showing that the proposed method is feasible and effective.

  4. Displaced proximal humeral fractures: an Indian experience with locking plates

    Directory of Open Access Journals (Sweden)

    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.

  5. [ANATOMICAL PLATE COMBINED WITH CORTICAL BONE PLATE ALLOGRAFTS FOR TREATMENT OF COMMINUTED FRACTURES OF FEMORAL CONDYLES].

    Science.gov (United States)

    Guo, Zhimin; Gong, Xingxing; Li, Yanwei; Qiu, Xiaochun; Zhang, Meng; Shangguan, Tiancheng; Ao, Qingfang; Liu, Qiang

    2015-01-01

    To summarize the effectiveness of anatomical plate combined with cortical bone plate allografts in the treatment of comminuted fractures of the femoral condyles. Between January 2008 and December 2012, 18 patients with comminuted fractures of the femoral condyles were treated, including 13 males and 5 females with an average age of 45 years (range, 23-65 years). Fractures were caused by traffic accident in 11 cases, by falling from height in 4 cases, and by the other in 3 cases. The locations were the left side in 7 cases and the right side in 11 cases. Of 18 fractures, 12 were open fractures and 6 were closed fractures. The mean time from injury to operation was 6 days (range, 4-15 days). The fixation was performed by anatomical plate combined with cortical bone plate allografts, and autograft bone or allogeneic bone grafting were used. Superficial local skin necrosis occurred in 1 case, and was cured after skin graft, and other incisions achieved primary healing. All patients were followed up 12-36 months (mean, 23 months). X-ray films showed that bone union was achieved within 3-12 months (5.6 months on average). No related complication occurred, such as fixation loosening, refracture, infection, or immunological rejection. According to Merchan et al. criteria for knee joint function evaluation, the results were excellent in 7 cases, good in 9 cases, fair in 1 case, and poor in 1 case at last follow-up; the excellent and good rate was 88.9%. Anatomical plate combined with cortical bone plate allograft fixation is a good method to treat comminuted fractures of the femoral condyles. This method can effectively achieve complete cortical bone on the inside of the femur as well as provide rigid fixation.

  6. Does plate type influence the clinical outcomes and implant removal in midclavicular fractures fixed with 2.7-mm anteroinferior plates? A retrospective cohort study.

    Science.gov (United States)

    Gilde, Alex K; Jones, Clifford B; Sietsema, Debra L; Hoffmann, Martin F

    2014-07-04

    The purpose of this study was to evaluate surgical healing rates, implant failure, implant removal, and the need for surgical revision with regards to plate type in midshaft clavicle fractures fixed with 2.7-mm anteroinferior plates utilizing modern plating techniques. This retrospective exploratory cohort review took place at a level I teaching trauma center and a single large private practice office. A total of 155 skeletally mature individuals with 156 midshaft clavicle fractures between March 2002 and March 2012 were included in the final results. Fractures were identified by mechanism of injury and classified based on OTA/AO criteria. All fractures were fixed with 2.7-mm anteroinferior plates. Primary outcome measurements included implant failure, malunion, nonunion, and implant removal. Secondary outcome measurements included pain with the visual analog scale and range of motion. Statistically significant testing was set at 0.05, and testing was performed using chi-square, Fisher's exact, Mann-Whitney U, and Kruskall-Wallis. Implant failure occurred more often in reconstruction plates as compared to dynamic compression plates (p = 0.029). Malunions and nonunions occurred more often in fractures fixed with reconstruction plates as compared to dynamic compression plates, but it was not statistically significant. Implant removal attributed to irritation or implant prominence was observed in 14 patients. Statistically significant levels of pain were seen in patients requiring implant removal (p = 0.001) but were not associated with the plate type. Anteroinferior clavicular fracture fixation with 2.7-mm dynamic compression plates results in excellent healing rates with low removal rates in accordance with the published literature. Given higher rates of failure, 2.7-mm reconstruction plates should be discouraged in comparison to stiffer and more reliable 2.7-mm dynamic compression plates.

  7. Biomechanical Study of the Fixation Strength of Anteromedial Plating for Humeral Shaft Fractures

    Institute of Scientific and Technical Information of China (English)

    Yin-Feng Zheng; Jun-Lin Zhou; Xiao-Hong Wang; Lei Shan; Yang Liu

    2016-01-01

    Background:Open reduction and internal fixation with plate and screws are the gold standard for the surgical treatment of humeral shaft fractures,this study was to compare the mechanical properties of anteromedial,anterolateral,and posterior plating for humeral shaft fractures.Methods:A distal third humeral shaft fracture model was constructed using fourth-generation sawbones (#3404,composite bone).Atotal of 24 sawbones with a distal third humeral shaft fracture was randomly divided into three Groups:A,B,and C (n =8 in each group) for anteromedial,anterolateral,and posterior plating,respectively.All sawbones were subjected to horizontal torsional fatigue tests,horizontal torsional and axial compressive fatigue tests,four-point bending fatigue tests in anteroposterior (AP) and mediolateral (ML) directions and horizontal torsional destructive tests.Results:In the horizontal torsional fatigue tests,the mean torsional angle amplitude in Groups A,B,and C were 6.12°,6.53°,and 6.81°.In horizontal torsional and axial compressive fatigue tests,the mean torsional angle amplitude in Groups A,B,and C were 5.66°,5.67°,and 6.36°.The mean plate displacement amplitude was 0.05 mm,0.08 mm,and 0.10 mm.Group A was smaller than Group C (P < 0.05).In AP four-point bending fatigue tests,the mean plate displacement amplitude was 0.16 mm,0.13 mm,and 0.20 mm.Group B was smaller than Group C (P < 0.05).In ML four-point bending fatigue tests,the mean plate displacement amplitude were 0.16 mm,0.19 mm,and 0.17 mm.In horizontal torsional destructive tests,the mean torsional rigidity in Groups A,B,and C was 0.82,0.75,and 0.76 N.m/deg.The yielding torsional angle was 24.50°,25.70°,and 23.86°.The mean yielding torque was 18.46,18.05,and 16.83 N·m,respectively.Conclusions:Anteromedial plating was superior to anterolateral or posterior plating in all mechanical tests except in AP four-point bending fatigue tests compared to the anterolateral plating group.We can suggest that

  8. Caspar plate fixation for the treatment of complex hangman's fractures.

    Science.gov (United States)

    Tuite, G F; Papadopoulos, S M; Sonntag, V K

    1992-05-01

    This report details our recent experience with the surgical treatment of complex hangman's fractures after failure of closed reduction and immobilization in external orthosis. We have successfully treated hangman's fractures in 5 patients with anterior Caspar plate stabilization and C2-C3 interbody fusion. The specific anatomical features of these fractures were complex, rendering the spines of the patients highly unstable. The patients were considered surgical candidates when reduction could not be achieved or maintained with axial traction or halo immobilization. Each patient underwent anterior C2-C3 interbody bone fusion and Caspar plating from C2 to C3. All patients achieved adequate intraoperative reduction and were immobilized postoperatively with a halo vest. The follow-up period ranged from 3 to 28 months and provided a 100% fusion rate with no complications related to plating or nonunion. Our initial experience indicates that anterior C2-C3 interbody bone fusion and Caspar plate fixation is a suitable treatment option for patients with complex hangman's fractures who are not successfully managed nonoperatively.

  9. Plate fixation or intramedullary fixation of humeral shaft fractures

    NARCIS (Netherlands)

    Heineman, D.J.; Poolman, R.W.; Sean, S.E.N.; Ponsen, K.J.; Bhandari, M.

    2010-01-01

    Methods We performed a literature search from 1967 to November 2007 in the main medical search engines and selected 4 randomized trials that compared nails and plates in patients with humeral shaft fractures and that reported on complications due to surgery. We statistically pooled patient data

  10. Proximal Humeral Fractures: A Biomechanical Comparison of Locking Plate Constructs in a Cadaveric 3-Part Fracture Model

    OpenAIRE

    2010-01-01

    The purpose of our study was to biomechanically compare, under cyclic loading conditions, fracture site motion, humeral head collapse, and intra-articular hardware penetration in simulated 3-part osteoporotic proximal humeral fractures stabilized with 1 of 2 locking-plate constructs. We performed fixation on simulated 3-part proximal humeral fractures in 10 pairs of cadaveric osteoporotic humeri with a Hand Innovations S3 Proximal Humerus Plate (S3 plate) or an LCP Proximal Humerus Plate (LCP...

  11. Locking plates in distal humerus fractures: study of 43 patients

    Directory of Open Access Journals (Sweden)

    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

  12. Posterior coronal plating for tibial fractures: technique and advantages

    Directory of Open Access Journals (Sweden)

    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

  13. FUNCTIONAL OUTCOME OF PHILOS PLATE FIXATION FOR PROXIMAL HUMERUS FRACTURES

    Directory of Open Access Journals (Sweden)

    Ch. Venkateswarlu

    2016-01-01

    Full Text Available INTRODUCTION Treating a proximal humerus fracture remained a challenging problem until proximal humeral internal locking system has been developed. Our study aims at evaluating the functional outcome of 30 consecutive patients with proximal humeral fracture treated by Philos plate fixation; 30 patients with proximal humeral fractures who attended our hospital between December 2013 and December 2015 were included in the study; 18 women and 12 men with a mean age of 47.5years (30-60 years are included. Data was collected prospectively and outcomes were assessed using constant shoulder score. The mean follow-up period was 12 months (6-18 months. Mean union time of all the fractures was 11.4 weeks (8-20 weeks. The mean constant shoulder score at final review was 70.5 (52-92. Philos plate provides stable fracture fixation for proximal humerus fracture in both young and elderly patients, which enables for early mobilisation and achieves acceptable functional results.

  14. VOL AR PLATING OF DISTAL RADIUS FRACTURE : A RETROSPECTIVE ANALYSIS

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    Victor

    2015-06-01

    Full Text Available BACKGROUND: Treatment of distal radius has undergone remarkable changes since the time of Abraham colles. Conservative treatment with cast application has given way to operative techniques for better o utcome in high demand young individuals. Volar plating fo r distal end radius fractures is an effective technique which allows early mobilisation with re storation of r adial inclination , radial length , articular congruity and palmar tilt. MATERIALS AND METHODS: T his study was performed in chettinad hospital and research institute between January 2013 and M arch 2014. 24 patients with closed isolated distal end radius fractures treated with open reduction and internal fixation with plates and screws by volar approach were followed up retrospectively for a minimum period of one year . There were 17 men and 7 women. Mean age was 44 years (Range, 22 - 75 years. The fractures were classified based on the AO system. There were 4 A2, 12 B3, 5 C1, 3 C2 fracture types. RESULTS : All the patients were evaluated with standard anteroposterior and lateral radiographs and CT scans in c ase of intraarticular fractures . In all patie nts plating of distal end radius done by volar approach. Patients were followed postoperatively for one y ear radiologically and clinically by modified clinical scoring system by Green and O Brien. Five patients had excellent results, thirteen patients had good results with twenty five percent restriction of wrist function . Five patients had fair results. One patient had postop wound infection which required implant removal and external fixator application . CONCLUSION: With proper patient selection a nd accurate surgical techniques , volar plating continues to be a useful method of treatment for distal end radius fractures with minimal complications and allowing early return of patients to normal activities.

  15. Minimally invasive plate internal fixation for calcaneal fractures

    Institute of Scientific and Technical Information of China (English)

    SHAN Shu-lan; XU Jun-ling; YAO Shu-zhang; YU Guo-sheng; LIU Yu-qin

    2010-01-01

    Objective: To assess the clinical efficacy of minimally invasive plate internal fixation for the treatment of calcaneal fractures.Methods: Manual reduction, rectification of deformity,and cold compress with traditional Chinese medicine were used preoperatively to relieve swelling and pain. A small incision was made to expose the articular facet and to perform anatomic reduction and plate fixation. Self-made traditional Chinese pharmaceutics were applied postoperatively on the surface of the wound to accelerate bony union.Results: All the 40 patients were followed up for at least 1 year postoperatively. According to the Maryland scoring system, the excellent and good rate was 87.5%.Conclusion: Minimally invasive plate internal fixation has the advantages of relatively mild injury, reliable fixation,good recovery, and rare complications in the treatment of intraarticular fractures.

  16. 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.

  17. 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

  18. FRACTURE CALCULATION OF BENDING PLATES BY BOUNDARY COLLOCATION METHOD

    Institute of Scientific and Technical Information of China (English)

    王元汉; 伍佑伦; 余飞

    2003-01-01

    Fracture of Kirchhoff plates is analyzed by the theory of complex variables and boundary collocation method. The deflections, moments and shearing forces of the plates are assumed to be the functions of complex variables. The functions can satisfy a series of basic equations and governing conditions, such as the equilibrium equations in the domain, the boundary conditions on the crack surfaces and stress singularity at the crack tips. Thus, it ts only necessary to consider the boundary conditions on the external boundaries of the plate, which can be approximately satisfied by the collocation method and least square technique. Different boundary conditions and loading cases of the cracked plates are analyzed and calculated. Compared to other methods, the numerical examples show that the present method has many advantages such as good accuracy and less computer time This is an effective semi-analytical and semi-numerical method.

  19. Reducing Postoperative Fracture Displacement After Locked Plating of Proximal Humerus Fractures: Current Concepts.

    Science.gov (United States)

    Newman, Jared; Kahn, Mani; Gruson, Konrad I

    2015-07-01

    The incidence of proximal humerus fractures in the elderly has been rising. Concomitantly, operative fixation with use of locking plates has been increasing. Postoperative complications of locking plate fixation, particularly in the setting of osteoporotic bone, include screw penetration of the articular surface, progressive fracture displacement, and avascular necrosis. Intraoperative techniques to enhance the fixation construct and reduce complications include use of rotator cuff sutures, bone void fillers (fibular strut allograft, cancellous allograft, autograft, bone cement), appropriate placement of divergent and shorter locking screws, and medial calcar reduction and support. More recent clinical and biomechanical studies suggest that use of these strategies may reduce complications after locked plating of osteoporotic proximal humerus fractures. Furthermore, a multidisciplinary approach to the evaluation and treatment of osteoporosis may be beneficial in these patients.

  20. Outcomes of pin and plaster versus locking plate in distal radius intraarticular fractures.

    Science.gov (United States)

    Bahari-Kashani, Mahmoud; Taraz-Jamshidy, Mohammad Hosein; Rahimi, Hassan; Ashraf, Hami; Mirkazemy, Masoud; Fatehi, Amirreza; Asadian, Mariam; Rezazade, Jafar

    2013-01-01

    Distal radius fractures are among the most prevalent fractures predictive of probable occurrence of other osteoporotic fractures. They are treated via a variety of methods, but the best treatment has not been defined yet. This study was performed to compare the results of open reduction and internal fixation with locking plates versus the pin and plaster method. In this prospective study, 114 patients aged 40 to 60 years with Fernandez type III fracture referring to Imam-Reza and Mehr hospitals of Mashhad from 2009 to 2011, were selected randomly; after obtaining informed consent, they were treated with pin and plaster fixation (n = 57) or internal fixation with the volar locking plate (n = 57). They were compared at the one year follow up. Demographic features and standard radiographic indices were recorded and MAYO, DASH and SF - 36 tests were performed. Data was analyzed by SPSS software version 13, with descriptive indices, Mann-Whitney and Chi-square tests. SF-36 test demonstrated a better general health (P plaster group. Also, in the LCP group mean MAYO score (P plaster group. Mean DASH score was not different between the groups (P = 0.218). The rate of acceptable results of radiographic indices (P plaster method. In treatment of intra-articular distal radius fractures in middle-aged patients internal fixation with locking plates may be prefered to pin and plaster as the treatment of choice.

  1. 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

  2. Minimally invasive percutaneous plate osteosynthesis through fracture site approach for fracture of both tibia and fibula

    Institute of Scientific and Technical Information of China (English)

    QI Feng; XIAO Lu-wei

    2007-01-01

    Objective:To introduce the experience of treating fracture of both tibia and fibula with micro-invasive percutaneous plate internal fixation through fracture site approach.Methods : The data of 15 patients ( 11 males and 4 females) , including 14 adults ( aged 22-73 years, mean =40 years) and 1 child (aged 10 years) , with fracture of both tibia and fibula were studied retrospectively in this study. A small incision was made at the fracture site of tibia. Then reposition was made under direct vision, and internal fixation was employed with steel plates inserting through the small incision.Results: Anatomical reduction was obtained. No complication was found. Union occurred on time in 14 patients. One case healed after a second operation.Conclusions: Micro-invasive percutaneous plate internal fixation is beneficial to the healing of bone and soft tissues. Without X-ray examination, it is also easy to reach anatomical reduction and make tibial internal fixation with both plates with micro-invasive percutaneous plate internal fixation.

  3. Biomechanical Evaluation of a Mandibular Spanning Plate Technique Compared to Standard Plating Techniques to Treat Mandibular Symphyseal Fractures

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    Matthew Richardson

    2015-01-01

    Full Text Available Purpose. The purpose of this study is to compare the biomechanical behavior of the spanning reconstruction plate compared to standard plating techniques for mandibular symphyseal fractures. Materials and Methods. Twenty-five human mandible replicas were used. Five unaltered synthetic mandibles were used as controls. Four experimental groups of different reconstruction techniques with five in each group were tested. Each synthetic mandible was subjected to a splaying force applied to the mandibular angle by a mechanical testing unit until the construct failed. Peak load and stiffness were recorded. The peak load and stiffness were analyzed using ANOVA and the Tukey test at a confidence level of 95% (P<0.05. Results. The two parallel plates’ group showed statistically significant lower values for peak load and stiffness compared to all other groups. No statistically significant difference was found for peak load and stiffness between the control (C group, lag screw (LS group, and the spanning plate (SP1 group. Conclusions. The spanning reconstruction plate technique for fixation of mandibular symphyseal fractures showed similar mechanical behavior to the lag screw technique when subjected to splaying forces between the mandibular gonial angles and may be considered as an alternative technique when increased reconstructive strength is needed.

  4. Intramedullary osteosynthesis versus plate osteosynthesis in subtrochanteric fractures.

    Science.gov (United States)

    Burnei, C; Popescu, Gh; Barbu, D; Capraru, F

    2011-11-14

    Due to an ever-aging population and a growing prevalence of osteoporosis and motor vehicle accidents, the number of subtrochanteric fractures is increasing worldwide. The choice of the appropriate implant continues to be critical for fixation of unstable hip fractures. The subtrochanteric region has certain anatomical and biomechanical features that can make fractures in this region difficult to treat. The preferred type of device is a matter of debate. Increased understandings of biomechanical characteristics of the hip and improvement of the implant materials have reduced the incidence of complications. The surgeons choose between the two methods according to Seinsheimer's classification and also to their personal preferences. As a general principle, the open reduction and internal fixation were performed in stable fractures, and the closed reduction and internal fixation were performed in unstable fractures. The advantages of intramedullary nailing consist in a small skin incision, lower operating times, preservation of fracture hematoma and the possibility of early weight bearing. The disadvantages consist in a difficult closed reduction due to important muscular forces, although the nail can be used as a reduction instrument, and higher implant cost. In open reduction internal fixation techniques, the advantage is represented by anatomical reduction which, in our opinion, is not necessary. The disadvantages are represented by: higher operating time, demanding surgery, large devascularization, higher infection rates, late weight bearing, medial instability, refracture after plate removal and inesthetic approach.

  5. Locking plates in distal humerus fractures: study of 43 patients

    Institute of Scientific and Technical Information of China (English)

    Rakesh Kumar Gupta; Vinay Gupta; Dickey Richard Marak

    2013-01-01

    Objective:The treatment of multifragmentary,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 humerns fractures.Methods:Forty-three consecutive patients with articular 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 radiological 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 patient 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 plate system is useful in providing stable fixation for complex

  6. Biomechanical Evaluation of the Fixation Methods for Transcondylar Fracture of the Humerus:ONI Plate Versus Conventional Plates and Screws

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    Shimamura,Yasunori

    2010-04-01

    Full Text Available

    We biomechanically evaluated the bone fixation rigidity of an ONI plate (Group I during fixation of experimentally created transcondylar humerus fractures in cadaveric elbows, which are the most frequently observed humeral fractures in the elderly, and compared it with the rigidity achieved by 3 conventional fixation methods:an LCP reconstruction plate 3.5 using a locking mechanism (Group II, a conventional reconstruction plate 3.5 (CRP with a cannulated cancellous screw (Group III, and a CRP with 2 cannulated cancellous screws (CS in a crisscross orientation (Group IV. In the axial loading test, the mean failure loads were:Group I, 98.9+/-32.6;Group II, 108.5+/-27.2;Group III, 50.0+/-7.5;and Group IV, 34.5+/-12.2 (N. Group I fixations failed at a significantly higher load than those of Groups III and IV (p0.05. In the extension loading test, the mean failure loads were:Group I, 34.0+/-12.4;Group II, 51.0+/-14.8;Group III, 19.3+/-6.0;and Group IV, 14.7+/-3.1 (N. Group IV fixations showed a significantly lower failure load than those of Group I (p0.05. The fixation rigidities against mechanical loading by the ONI plate and LCP plate were comparable. These results suggested that an ONI system might be superior to the CRP and CS method, and comparable to the LCP method in terms of fixation rigidity for distal humerus fractures.

  7. Comminuted supracondylar femoral fractures: a biomechanical analysis comparing the stability of medial versus lateral plating in axial loading

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    Nikolai Briffa

    2016-10-01

    Full Text Available Abstract The aim of this study was to compare the biomechanical properties of medial and lateral plating of a medially comminuted supracondylar femoral fracture. A supracondylar femoral fracture model comparing two fixation methods was tested cyclically in axial loading. One-centimetre supracondylar gap osteotomies were created in six synthetic femurs approximately 6 cm proximal to the knee joint. There were two constructs investigated: group 1 and group 2 were stabilized with an 8-hole LC-DCP, medially and laterally, respectively. Both construct groups were axially loaded. Global displacement (total length, wedge displacement, bending moment and strain were measured. Medial plating showed a significantly decreased displacement, bending moment and strain at the fracture site in axial loading. Medial plating of a comminuted supracondylar femur fracture is more stable than lateral plating.

  8. 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

  9. Comparison of 2-Dimensional and 3-Dimensional Metacarpal Fracture Plating Constructs Under Cyclic Loading.

    Science.gov (United States)

    Tannenbaum, Eric P; Burns, Geoffrey T; Oak, Nikhil R; Lawton, Jeffrey N

    2017-03-01

    Metacarpal fractures are commonly treated by a variety of means including casting or open reduction internal fixation when unacceptable alignment is present following attempted closed reduction. Dorsal plating with either single-row 2-dimensional or double-row 3-dimensional plates has been proposed. This study's purpose was to determine if there are any differences in fixation construct stability under cyclic loading and subsequent load to failure between the lower profile 3-dimensional and the larger 2-dimensional plates in a metacarpal fracture gap sawbone model. Thirty metacarpal cortico-cancellous synthetic bones were cut with a 1.75-mm gap between the 2 fragments simulating mid-diaphyseal fracture comminution. Half of the metacarpals were plated with 2.0-mm locking 2-dimensional plates and half with 1.5-mm locking 3-dimensional plates. The plated metacarpals were mounted into a materials testing apparatus and cyclically loaded under cantilever bending for 2,000 cycles at 70 N, then 2,000 cycles at 120 N, and finally monotonically loaded to failure. Throughout testing, fracture gap sizes were measured, failure modes were recorded, and construct strength and stiffness values were calculated. All 3-dimensional constructs survived both cyclic loading conditions. Ten (67%) 2-dimensional constructs survived both loading conditions, whereas 5 (33%) failed the 120-N loading at 1377 ± 363 cycles. When loaded to failure, the 3-dimensional constructs failed at 265 N ± 21 N, whereas the 2-dimensional constructs surviving cyclic loading failed at 190 N ± 17 N. The shorter, thinner 3-dimensional metacarpal plates demonstrated increased resistance to failure in a cyclic loading model and increased load to failure compared with the relatively longer, thicker 2-dimensional metacarpal plates. The lower-profile 3-dimensional metacarpal plate fixation demonstrated greater stability for early postoperative resistance than the thicker 2-dimensional fixation, whereas the smaller

  10. Surgical treatment of proximal humerus fractures using PHILOS plate

    Institute of Scientific and Technical Information of China (English)

    GN Kiran Kumar; Gaurav Sharma; Vijay Sharma; Vaibhav Jain; Kamran Farooque; Vivek Morey

    2014-01-01

    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 patients 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 fixation 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.

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

    Science.gov (United States)

    2011-01-01

    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 advantages over the established

  12. A Biomechanical Comparison of Locking Versus Conventional Plate Fixation for Distal Fibula Fractures in Trimalleolar Ankle Injuries.

    Science.gov (United States)

    Nguyentat, Annie; Camisa, William; Patel, Sandeep; Lagaay, Pieter

    2016-01-01

    Previous biomechanical studies have advocated the use of locking plates for isolated distal fibula fractures in osteoporotic bone. Complex rotational ankle injuries involve an increased number of fractures, which can result in instability, potentially requiring the same fixed angle properties afforded by locking plates. However, the mechanical indication for locking plate technology has not been tested in this fracture model. The purpose of the present study was to compare the biomechanical properties of locking and conventional plate fixation for distal fibula fractures in trimalleolar ankle injuries. Fourteen (7 matched pairs) fresh-frozen cadaver leg specimens were used. The bone mineral density of each was obtained using dual x-ray absorptiometry scans. The fracture model simulated an OTA 44-B3.3 fracture. The syndesmosis was not disrupted. Each fracture was fixated in the same fashion, except for the distal fibula plate construct: locking (n = 7) and one-third tubular (n = 7). The specimens underwent axial and torsional cyclic loading, followed by torsional loading to failure. No statistically significant differences were found between the locking and conventional plate constructs during both fatigue and torque to failure testing (p > .05). Our specimen bone mineral density averages did not represent poor bone quality. The clinical implication of the present study is that distal fibular locking plates do not provide a mechanical advantage for trimalleolar ankle injuries in individuals with normal bone density and in the absence of fracture comminution. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  13. Minimally invasive plate osteosynthesis for distal radius fractures

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    Xu-ming Wei

    2014-01-01

    Full Text Available Background: Fractures of distal radius are common injury in all age groups. Cast treatment with or without close reduction is a viable option. However, the results are often unsatisfactory with restricted function. The open reduction and internal fixation often results in extensive soft tissue dissection and associated high rates of infection and delayed/nonunion. The distractor/external fixator have reported good functional and anatomical results but the incidence of pin traction infection nerve injury and cosmedic deformity are high. We introduced a modified operative technique for minimally invasive plate osteosynthesis (MIPO for distal radial fracture and evaluated the functional outcomes and complications. Materials and Methods: 22 distal radial fractures (10 left, 12 right were treated using the MIPO technique and two small incisions with a palmar locking plate from August 2009 to August 2010. The wrist function was assessed according to Dienst wrist rating system, and postoperative complications were recorded. Results: According to Dienst wrist rating system, 13 patients showed excellent results, 6 cases showed good results and 3 patients had moderate results. No patient had poor results. Thus, the excellent and good rate was 86.4%. One patient had anesthesia in the thenar eminence and this symptom disappeared after 3 months. One patient had delayed healing in the proximal wrist crease. Two patients had mild pain on the ulnar side of the wrist and two patients had limited wrist joint function. Conclusion: The MIPO technique by using two small palmar incisions is safe and effective for treatment of distal radial fractures.

  14. Functional results of osteosynthesis with mini-plate and screws in metacarpal fractures

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    Hakan Başar

    2014-01-01

    Conclusions: Mini-plate and screws fixation of unstable metacarpal fractures produces anatomical reduction of fractures with stabilization that is rigid enough to allow early mobilization, thereby preventing stiffness and hence good functional results.

  15. Fracture analysis of cracked metallic plate repaired with adhesive bonding composite patch

    Institute of Scientific and Technical Information of China (English)

    Su Weiguo; Mu Zhitao

    2014-01-01

    Fatigue crack growth test of cracked metallic plate repaired with adhesive bonding composite patch was conducted to study the fracture behavior of crack patching. The failure mode was that crack grows along with adhesive debonding. The crack length and debonding area were measured at different numbers of cycles. The nonlinear three-dimensional(3D)finite element(FE)model considering adhesive debonding and crack growth simultaneously was developed. The experimental and analytical results were in good agreement with each other.

  16. Biomechanical comparison of orthogonal versus parallel double plating systems in intraarticular distal humerus fractures

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    Ata C. Atalar

    2017-01-01

    Conclusion: Our study showed that both plating systems had similar biomechanical stabilities when anatomic plates with distal locking screws were used in intraarticular distal humerus fractures in artificial humerus models.

  17. Posterior acetabular column and quadrilateral plate fractures: fixation with tension band principles.

    Science.gov (United States)

    Aly, Tarek A; Hamed, Hany

    2013-07-01

    Acetabular fractures can be classified into 5 simple and 5 associated fracture patterns. A significant amount of variation and complexity exists in these fractures patterns. Fractures of the posterior wall are the most common acetabular fractures. Comminution of the quadrilateral plate adds to fracture instability, and more rigid and stable internal fixation is mandatory. The goal of this study was to assess the results of reconstruction of comminuted posterior wall fractures of the acetabulum associated with quadrilateral plate fractures using the tension band technique. Twelve patients (9 men and 3 women) were included in the study. Mean patient age was 38.6 years (range, 24-47 years). Minimum follow-up was more than 2 years postoperatively. Reconstruction of the fracture included anatomic reduction of the fracture and fixation with a buttress plate for the posterior column and a prebent one-third tubular plate for the quadrilateral plate fracture. Clinical results were excellent in 58% of patients and good in 17% of patients. Radiologic results were excellent in 50% of patients and good in 17% of patients. Radiologically, based on the fracture gap postoperatively, 8 (66%) patients showed anatomic reduction, 2 (17%) showed good reduction, and 2 (17%) showed poor reduction. The study confirms that this method of reconstruction facilitates accurate and firm reduction of displaced posterior wall fractures of the acetabulum.

  18. 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.

  19. Comparison of minimally invasive plate osteosynthesis and conventional plate osteosynthesis for humeral shaft fracture

    Science.gov (United States)

    Yu, Bin-feng; Liu, Liang-le; Yang, Guo-jing; Zhang, Lei; Lin, Xi-peng

    2016-01-01

    Abstract Background: The objective of this meta-analysis was to compare the efficacy and safety of minimally invasive plate osteosynthesis (MIPO) and conventional plate osteosynthesis (CPO) for humeral shaft fracture. Methods: Potential academic articles were identified from the Cochrane Library, Medline (1966–2016.3), PubMed (1966–2016.3), Embase (1980–2016.3), and ScienceDirect (1966–2016.3). Gray studies were identified from the references of the included literature. Randomized controlled trials (RCTs) and non-RCT involving MIPO and CPO for humeral shaft fracture were included. Two independent reviewers performed independent data abstraction. I2 statistic was used to assess heterogeneity. Fixed or random effects model was used for meta-analysis. Results: Two RCTs and 3 non-RCTs met the inclusion criteria. There was a lower incidence of iatrogenic radial nerve palsy in patients with MIPO (P = 0.006). There was no statistically significant difference in in the risk of developing nonunion, delay union, malformation, screw loosening, infection, operation time, UCLA, and MEPS function score between the 2 groups. Conclusion: MIPO decreased incidence of iatrogenic radial nerve palsy and is an efficacy and safety technique for humeral shaft fracture. Due to the limited quality and data of the evidence currently available, more high-quality RCTs are required. PMID:27684839

  20. Three Dimensional Forming Simulation of the Shielded Slot Plate for the MCFC Using a Ductile Fracture Criterion

    Science.gov (United States)

    Lee, C. H.; Yang, D. Y.; Lee, S. R.; Chang, I. G.; Lee, T. W.

    2011-08-01

    The shielded slot plate, which has a sheared corrugated trapezoidal pattern, is a component of the metallic bipolar plate for the molten carbonate fuel cell (MCFC). In order to increase the efficiency of the fuel cell, the unit cell of the shielded slot plate should have a relatively large upper area. Additionally, defects from the forming process should be minimized. In order to simulate the slitting process, whereby sheared corrugated patterns are formed, ductile fracture criteria based on the histories of stress and strain are employed. The user material subroutine VUMAT is employed for implementation of the material and ductile fracture criteria in the commercial FEM software ABAQUS. The variables of the ductile fracture criteria were determined by comparing the simulation results and the experimental results of the tension test and the shearing test. Parametric studies were conducted to determine the critical value of the ductile fracture criterion. Employing these ductile fracture criteria, the three dimensional forming process of the shielded slot plate was numerically simulated. The effects of the slitting process in the forming process of the shielded slot plate were analyzed through a FEM simulation and experimental studies. Finally, experiments involving microscopic and macroscopic observations were conducted to verify the numerical simulations of the 3-step forming process.

  1. High Energy Gas Fracturing Test

    Energy Technology Data Exchange (ETDEWEB)

    Schulte, R.

    2001-02-27

    The Rocky Mountain Oilfield Testing Center (RMOTC) has recently completed two tests of a high-energy gas fracturing system being developed by Western Technologies of Crossville, Tennessee. The tests involved the use of two active wells located at the Naval Petroleum Reserve No. 3 (NPR-3), thirty-five miles north of Casper, Wyoming (See Figure 1). During the testing process the delivery and operational system was enhanced by RMOTC, Western Technologies, and commercial wireline subcontractors. RMOTC has assisted an industrial client in developing their technology for high energy gas fracturing to a commercial level. The modifications and improvements implemented during the technology testing process are instrumental in all field testing efforts at RMOTC. The importance of well selection can also be critical in demonstrating the success of the technology. To date, significant increases in well productivity have been clearly proven in well 63-TPX-10. Gross fluid production was initially raised by a factor of three. Final production rates increased by a factor of six with the use of a larger submersible pump. Well productivity (bbls of fluid per foot of drawdown) increased by a factor of 15 to 20. The above results assume that no mechanical damage has occurred to the casing or cast iron bridge plug which could allow well production from the Tensleep ''B'' sand. In the case of well 61-A-3, a six-fold increase in total fluid production was seen. Unfortunately, the increase is clouded by the water injection into the well that was necessary to have a positive fluid head on the propellant tool. No significant increase in oil production was seen. The tools which were retrieved from both 63-TPX-10 and 61-A-3 indicated a large amount of energy, similar to high gram perforating, had been expended downhole upon the formation face.

  2. A computer study of biodegradable plates for internal fixation of mandibular angle fractures

    NARCIS (Netherlands)

    Tams, J; Van Loon, JP; Otten, B; Bos, RRM

    2001-01-01

    Purpose: This computer-based study was performed to determine the suitability of small biodegradable plate systems for mandibular angle fractures. Materials and Methods: In a 3-dimensional computer model of the mandible, fracture mobility and plate strain were calculated for bite forces applied on 1

  3. Plate fixation of paediatric fractures of the distal tibia and fibula.

    Science.gov (United States)

    He, Bingshu; Wang, Jun

    2012-10-01

    The role of surgery in the management of paediatric long-bone shaft fractures remains a matter of debate. We present a series of paediatric patients with unstable fractures of the distal tibia and fibula, treated with titanium plate fixation. Excellent results were obtained after plate fixation.

  4. Increased rates of wound complications with locking plates in distal fibular fractures

    NARCIS (Netherlands)

    T. Schepers (Tim); E.M.M. van Lieshout (Esther); M.R.D. Vries; M. van der Elst (Maarten)

    2011-01-01

    textabstractIntroduction: There is a growing use of locking compression plates in fracture surgery. The current study was undertaken to investigate the wound complication rates of locking versus non-locking plates in distal fibular fractures. Patients and methods: During a 6-year study period all co

  5. 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.

  6. Preliminary experience with Piccolo Composite™, a radiolucent distal fibula plate, in ankle fractures.

    Science.gov (United States)

    Caforio, Marco; Perugia, Dario; Colombo, Massimiliano; Calori, Giorgio Maria; Maniscalco, Pietro

    2014-12-01

    The radiolucent plate has many advantageous properties in the treatment of complex ankle fractures, particularly trimalleolar fractures. Surgeons may sometimes have difficulty observing the posterior malleolus after synthesis of lateral malleolus with a traditional plate because common materials of conventional plates are not radiolucent. In this study, the authors highlight the importance of the radiolucent property in the treatment of ankle fractures and describe their preliminary experience with a carbon fibre-reinforced polyetheretherketone distal fibula plate, with good results at 4 months' follow-up and no signs of tissue inflammatory reaction.

  7. Biomechanical Evaluation of Plate Versus Lag Screw Only Fixation of Distal Fibula Fractures.

    Science.gov (United States)

    Misaghi, Amirhossein; Doan, Josh; Bastrom, Tracey; Pennock, Andrew T

    2015-01-01

    Traditional fixation of unstable Orthopaedic Trauma Association type B/C ankle fractures consists of a lag screw and a lateral or posterolateral neutralization plate. Several studies have demonstrated the clinical success of lag screw only fixation; however, to date no biomechanical comparison of the different constructs has been performed. The purpose of the present study was to evaluate the biomechanical strength of these different constructs. Osteotomies were created in 40 Sawbones(®) distal fibulas and reduced using 1 bicortical 3.5-mm stainless steel lag screw, 2 bicortical 3.5-mm lag screws, 3 bicortical 3.5-mm lag screws, or a single 3.5-mm lag screw coupled with a stainless steel neutralization plate with 3 proximal cortical and 3 distal cancellous screws. The constructs were tested to determine the stiffness in lateral bending and rotation and failure torque. No significant differences in lateral bending or rotational stiffness were detected between the osteotomies fixed with 3 lag screws and a plate. Constructs fixed with 1 lag screw were weaker for both lateral bending and rotational stiffness. Osteotomies fixed with 2 lag screws were weaker in lateral bending only. No significant differences were found in the failure torque. Compared with lag screw only fixation, plate fixation requires larger incisions and increased costs and is more likely to require follow-up surgery. Despite the published clinical success of treating simple Orthopaedic Trauma Association B/C fractures with lag screw only fixation, many surgeons still have concerns about stability. For noncomminuted, long oblique distal fibula fractures, lag screw only fixation techniques offer construct stiffness similar to that of traditional plate and lag screw fixation.

  8. 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.

  9. THERMAL FRACTURE OF FUNCTIONALLY GRADED PLATE WITH PARALLEL SURFACE CRACKS

    Institute of Scientific and Technical Information of China (English)

    Yuezhong Feng; Zhihe Jin

    2009-01-01

    This work examines the fracture behavior of a functionally graded material (FGM) plate containing parallel surface cracks with alternating lengths subjected to a thermal shock. The thermal stress intensity factors (TSIFs) at the tips of long and short cracks are calculated using a singular integral equation technique. The critical thermal shock △T_c that causes crack initiation is calculated using a stress intensity factor criterion. Numerical examples of TSIFs and △T_c for an Al_2O_3/Si_3N_4 FGM plate are presented to illustrate the effects of thermal property gradation, crack spacing and crack length ratio on the TSIFs and △T_c. It is found that for a given crack length ratio, the TSIFs at the tips of both long and short cracks can be reduced significantly and △T_c can be enhanced by introducing appropriate material gradation. The TSIFs also decrease dramatically with a decrease in crack spacing. The TSIF at the tips of short cracks may be higher than that for the long cracks under certain crack geometry conditions. Hence, the short cracks instead of long cracks may first start to grow under the thermal shock loading.

  10. The relationship between interfragmentary movement and cell differentiation in early fracture healing under locking plate fixation.

    Science.gov (United States)

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

    2016-03-01

    Interfragmentary movement (IFM) at the fracture site plays an important role in fracture healing, particularly during its early stage, via influencing the mechanical microenvironment of mesenchymal stem cells within the fracture callus. However, the effect of changes in IFM resulting from the changes in the configuration of locking plate fixation on cell differentiation has not yet been fully understood. In this study, mechanical experiments on surrogate tibia specimens, manufactured from specially formulated polyurethane, were conducted to investigate changes in IFM of fractures under various locking plate fixation configurations and loading magnitudes. The effect of the observed IFM on callus cell differentiation was then further studied using computational simulation. We found that during the early stage, cell differentiation in the fracture callus is highly influenced by fracture gap size and IFM, which in turn, is highly sensitive to locking plate fixation configuration. The computational model predicted that a small gap size (e.g. 1 mm) under a relatively flexible configuration of locking plate fixation (larger bone-plate distances and working lengths) could experience excessive strain and fluid flow within the fracture site, resulting in excessive fibrous tissue differentiation and delayed healing. By contrast, a relatively flexible configuration of locking plate fixation was predicted to improve cartilaginous callus formation and bone healing for a relatively larger gap size (e.g. 3 mm). If further confirmed by animal and human studies, the research outcome of this paper may have implications for orthopaedic surgeons in optimising the application of locking plate fixations for fractures in clinical practice.

  11. CLINICAL OUTCOMES OF LOCKING COMPRESSION PLATE FIXATION THROUGH MINIMALLY INVASIVE PERCUTANEOUS PLATE OSTEOSYNTHESIS IN THE TREATMENT OF DISTAL TIBIAL FRACTURE

    Directory of Open Access Journals (Sweden)

    Venkateswara Rao

    2015-07-01

    Full Text Available BACKGROUND: Distal diametaphyseal tibia 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 percutaneous plate osteosynthes is with locking compression plate (LCP has emerged as an alternative treatment option because it respects biology of distal tibia and fracture hematoma and also provides biomechanica l ly stable construct. OBJECTIVES: To find out suitability of minimally invasive percutaneous plate osteosynthesis with Locking compression plate for distal diametaphyseal tibia fracture including union time and complications. METHODS: Twenty patients with closed distal tibia fracture with or without intra articular extension (AO classification type - A1, type - A2, type - A3 treated with minimally invasive percutaneous plate osteosynthesis with Locking compression plate were prospectively followed for average duration of 12 months. RESULTS: Ave rage duration of injury - surgery interval was 4.5 days (Range 3 - 7 days all fractures got united with an average duration of 23.5 weeks (range17 - 30weeks. No non - union or mal - union were found. There was one superficial infection found which healed with exte nded period of intravenous antibiotics.

  12. Anterior decompression, structural bone grafting, and Caspar plate stabilization for unstable cervical spine fractures and/or dislocations.

    Science.gov (United States)

    Garvey, T A; Eismont, F J; Roberti, L J

    1992-10-01

    Fourteen patients who sustained acute cervical spine fractures and/or dislocations with associated posterior ligamentous disruption had anterior decompressions, structural bone grafting, and anterior Caspar plate stabilization. With an average 30-month follow-up, no patient has had loss of fixation. Despite criticism raised from biomechanical testing, the Caspar anterior plate system (Aesculape, Tuttlingen, Germany) may be added to structural bone grafting of unstable cervical fractures and/or dislocations, yielding an in vivo solid construct, which obviates the need for simultaneous posterior stabilization.

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

    Science.gov (United States)

    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.

  14. [Angle-fixed plate fixation or double-plate osteosynthesis in fractures of the proximal humerus: a biomechanical study].

    Science.gov (United States)

    Hessmann, Martin H; Korner, Jan; Hofmann, Alexander; Sternstein, Werner; Rommens, Pol M

    2008-06-01

    Internal fixation of fractures of the proximal humerus needs a high stability of fixation to avoid secondary loss of fixation. This is especially important in osteoporotic bone. In an experimental study, the biomechanical properties of the angle-fixed Philos plate (internal fixator) and a double-plate osteosynthesis using two one-third tubular plates were assessed. The fracture model was an unstable three-part fracture (AO type B2). Eight pairs of human cadaveric humeri were submitted to axial load and torque. In the first part of the study, it was assessed to which degree the original stiffness of the humeri could be restored after the osteotomy by the osteosynthesis procedure. Subsequently, subsidence during 200 cycles of axial loading and torque was analysed. During axial loading, the Philos plate was significantly stiffer and showed less irreversible deformation. Two double-plate fixations, but none of the Philos plate osteosynthesis, failed. During torsion, there were no significant differences between the two implants. From the biomechanical point of view, the angle-fixed Philos plate represents the implant of choice for the surgical fixation of highly unstable three-part fractures of the proximal humerus, as the internal fixator system is characterised by superior biomechanical properties.

  15. Research on Transverse Acetabular Fracture Fixation Using Different Plate Attachment Methods

    Directory of Open Access Journals (Sweden)

    Gediminas Gaidulis

    2015-03-01

    Full Text Available The article deals with the problem of transverse acetabular fracture fixation using different plate attachment methods. A 3D model of pelvis and hip joint structure was created and the design of three different fixation plates using SolidWorks was made. The plates were fixed at distances of 10, 20 and 30 mm from the acetabulum. The model was meshed into finite elements, a static external load of 2500 N was added and the analysis of stress distribution in plates and fracture displacement was performed. The obtained results showed that fracture displacement was quite similar in all fixation methods. However, the maximal stress in the nearest from the acetabulum plate was higher than yield strength. Thus, this placement is not eligible. The plate fixed at a distance of 30 mm from the acetabulum appeared the most suitable because of the smallest and symmetrical stress distribution in the plate.

  16. Plate selection for fixation of extra-articular distal humerus fractures: a biomechanical comparison of three different implants.

    Science.gov (United States)

    Scolaro, John A; Hsu, Jason E; Svach, David J; Mehta, Samir

    2014-12-01

    Operative fixation of extra-articular distal humerus using a single posterolateral column plate has been described but the biomechanical properties or limits of this technique is undefined. The purpose of this study was to evaluate the mechanical properties of distal humerus fracture fixation using three standard fixation constructs. Two equal groups were created from forty sawbones humeri. Osteotomies were created at 80mm or 50mm from the tip of the trochlea. In the proximal osteotomy group, sawbones were fixed with an 8-hole 3.5mm LCP or with a 6-hole posterolateral plate. In the distal group, sawbones were fixed with 9-hole medial and lateral 3.5mm distal humerus plates and ten sawbones were fixed with a 6-hole posterolateral plate. Biomechanical testing was performed using a servohydraulic testing machine. Testing in extension as well as internal and external rotation was performed. Destructive testing was also performed with failure being defined as hardware pullout, sawbone failure or cortical contact at the osteotomy. In the proximal osteotomy group, the average bending stiffness and torsional stiffness was significantly greater with the posterolateral plate than with the 3.5mm LCP. In the distal osteotomy group, the average bending stiffness and torsional stiffness was significantly greater with the posterolateral plate than the 3.5mm LCP. In extension testing, the yield strength was significantly greater with the posterolateral plate in the proximal osteotomy specimens, and the dual plating construct in the distal osteotomy specimens. The yield strength of specimens in axial torsion was significantly greater with the posterolateral plate in the proximal osteotomy specimens, and the dual plating construct in the distal osteotomy specimens. Limited biomechanical data to support the use of a pre-contoured posterolateral distal humerus LCP for fixation of extra-articular distal humerus exists. We have found that this implant provided significantly greater

  17. Augmentation plating in hypertrophic non-union after nail fixation of femoral shaft fracture compared with exchange plating

    Institute of Scientific and Technical Information of China (English)

    Jiang Liangjun; Pan Zhijun; Zheng Qiang

    2014-01-01

    Background Augmentation plating has been used successfully to treat hypertrophic non-union after nail fixation.This study compared the efficacy of augmentation plating and exchange plating for treating hypertrophic non-union of femoral shaft fracture after intramedullary nail fixation.Methods A total of 12 patients received augmentation plating and 15 patients received exchange plating as treatment for femoral shaft hypertrophic non-union.The procedures were conducted at our medical centre between January 2005and January 2012.Clinical follow-up was conducted at 2 weeks,1 month and then monthly until union was achieved to compare union time,operation time,bleeding and complications between the two groups.Results All patients underwent follow-up examinations until fracture union was achieved.The average length of followup time after the second treatment was (18.37±3.28) months.The time needed for union was (4.17±0.94) months in the augmentation plating group and (5.33±1.72) months in the exchange plating group.The operation time was (90.00±17.58) minutes in the augmentation plating group and (160.00±25.35) minutes in the exchange plating group.The amount of blood loss during the operation was (270.00±43.32) ml in the augmentation plating group and (530.00±103.65) ml in the exchange plating group.Both groups showed significant difference (P <0.05) in their results.No complications were reported after the second operation.Conclusions Augmentation plating after nail fixation could remove local rotation instability,facilitate simple operation,create minimal damage and enable exercise for early functional recovery.Therefore,augmentation plating is excellent for treating hypertrophic non-union after nail fixation in femoral shaft fracture.

  18. 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.

  19. EFFECTIVENESS OF LOCKING VERSUS DYNAMIC COMPRESSION PLATES FOR DIAPHYSEAL HUMERUS FRACTURES

    Directory of Open Access Journals (Sweden)

    Penugonda Ravi Shankar

    2015-02-01

    Full Text Available The aim of this study was to compare the effectiveness of locking compression plate (LCP over dynamic compression plate (DCP in the management of diaphyseal fractures of the humerus. 38 patients with diaphyseal fracture of the shaft of the humerus were randomized prospectively and treated by open reduction and internal fixation with LCP or DCP. 11 patients underwent internal fixation by LCP and 27 by DCP. Fixation was done through an anterolateral or posterior approach. The outcome was assessed in terms of the union time, union rate, functional outcome, ROM and the incidence of complications. Functional outcome was assessed using the Romen’s et al series grading system . On comparing the results by tests of significance like Chi - sqare test, there was no significant difference in Romen’s et al scores between the two groups ( P >0.05. Though the average union time and recovery of ROM was found to be better for LCP as compared to DCP, it is not statistically significant. Complications such as infection were found to be higher with DCP as compared to LCP. This study proves that LCP can be considered a better surgical option for the management of diaphyseal fractures of the humerus as it offers a short union time and lower incidence of serious complications like infection. However, there appears to be no difference between the two groups in terms of the rate of union and functional outcome

  20. Role of locking plates in treatment of difficult ununited fractures: a clinical study

    Institute of Scientific and Technical Information of China (English)

    Ashok Kumar; Himanshu Gupta; Chandra Shekhar Yadav; Shah Alam Khan; Shishir Rastogi

    2013-01-01

    Objective:To present our experience in treatment of difficult ununited long bone fractures with locking plate.Methods:Retrospective evaluation of locking plate fixation in 10 difficult nonunions of long bone fractures was done.Fixation was done with locking plate for femoral shaft fracture (3 patients),supracondylar fracture of femur (gap nonunion),fracture of clavicle,fracture of both forearm bones (radius and ulna) fracture of ulna,fracture of shaft of humerus,fracture of tibial diaphysis and supracondylar fracture of humerus (one patient each).Five fractures had more than one previous failed internal fixation.One patient had infected nonunion which was managed by debridement with cast immobilization followed by fixation with locking plate at six weeks.Seven fractures were atrophic,two were oligotrophic,and one was hypertrophic.Fibular autograft was used in 2 cases and iliac crest cancellous bone graft used in all the patients.Results:Minimum follow-up was 6 months (range,6 months to 2.5 years).Average rime for union was 3.4 months (range 2.5 to 6 months).None of the patients had platerelated complications or postoperative wound infections.Conclusion:Along with achieving stability with locking compression plate,meticulous soft tissue dissection,acceptable reduction,good fixation technique and bone grafting can help achieve union in difficult nonunion cases.Though locking plate does not by itself ensure bony union,we have found it to be another useful addition to our armamentarium for treating difficult fracture nonunions.

  1. Clinical and radiographic evaluation of biodegradable bone plates in the treatment of mandibular body fractures

    Directory of Open Access Journals (Sweden)

    Sherin Kamal Elhalawany

    2015-01-01

    Full Text Available Background: Many different systems are available for the treatment of fractures ranging from the heavy compression plates for mandibular reconstruction to low profile plates for mid-facial fixation, and are made either from stainless steel, titanium or vitallium. Recently, biodegradable, self-reinforced polylactide plates and screws have been used for the internal fixation of fractures of the mandible with good results. Aim of this study: This study evaluated clinically the biodegradable bone plates for treatment of mandibular body fracture and to evaluate bone healing during the follow-up period using digital radiography. Materials and Methods : Eight patients had been suffered from mandibular body fractures were treated using Inion CPS TM bioresorbable fixation system and the healing process were followed up using digitised panoramic radiography at first week and after 1, 3 and 6 months. Results: Clinical examination of fractured segments revealed stable fixation across the fracture sites while visual and quantitative assessment of radiograph showed healing process was comparable with results previously reported by titanium bone plates. Conclusion: Open reduction and internal fixation of mandibular fractures using bioresorbable fixation system with a brief period of inter-maxillary fixation have evolved to the point where the physical properties are sufficient to withstand the post-operative loads required for fracture repair of mandibular body fractures. The foreign body reaction is a major material-related problem which requires further studies.

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

    Science.gov (United States)

    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.

  3. Fixation of metatarsal fracture with bone plate in a dromedary heifer

    Directory of Open Access Journals (Sweden)

    S. Hashmi

    2013-03-01

    Full Text Available An oblique fracture of the distal third of the right metatarsus in a three-year-old dromedary heifer weighing about 300 kilograms was immobilized with a 4.5 mm broad-webbed 12-hole dynamic compression bone plate and two interfragmental compression screws. The animal showed slight lameness after 16 weeks of surgery that disappeared after removal of the plate. The result was quite encouraging and the fracture healed in 16 weeks without major complications. It is concluded that the fracture of this bone can be successfully handled with bone plating at least in young, light weight animals.

  4. Clinical Analysis of Internal Fixation Treatment of Intra-articular Calcaneal Fractures with Titanium Plate.

    Science.gov (United States)

    Chen, Xiao-Dong; Zhang, Chang-Chun; Li, Zhao-Cheng; Zhang, Heng; Zhou, Xin-She; Deng, Min

    2015-05-01

    To explore the clinical effect of internal fixation treatment of intra-articular calcaneal fractures with titanium plate, we used open reduction and internal fixation with titanium plate to 48 treated feet from 42 patients with intra-articular calcaneal fractures. The efficacy of surgical treatment was evaluated based on assessment of pain, function, and line of force aspects according to the American Orthopedic Foot and Ankle Society scoring system. Our data show that internal fixation with titanium plate is an effective treatment for calcaneal fractures. It provides satisfactory reduction, reliable fixation, and early rehabilitation.

  5. Closed treatment of condylar fractures by intermaxillary fixation with thermoforming plates.

    Science.gov (United States)

    Terai, Haruhiko; Shimahara, Masashi

    2004-02-01

    We report a new intermaxillary fixation (IMF) method for condylar fractures using a thermoforming plate. Fifteen cases of condylar fracture were selected and thermoforming plates were applied. The patient's recover was uneventful in all 15 cases, and the period of IMF ranged from 7 to 17 days, (mean 12) for the following 7 days IMF was used only at night together with functional jaw training during the day. The outcome was good. IMF using a thermoforming plate may be a useful technique for selected condylar fractures.

  6. Corrosion test cell for bipolar plates

    Science.gov (United States)

    Weisbrod, Kirk R.

    2002-01-01

    A corrosion test cell for evaluating corrosion resistance in fuel cell bipolar plates is described. The cell has a transparent or translucent cell body having a pair of identical cell body members that seal against opposite sides of a bipolar plate. The cell includes an anode chamber and an cathode chamber, each on opposite sides of the plate. Each chamber contains a pair of mesh platinum current collectors and a catalyst layer pressed between current collectors and the plate. Each chamber is filled with an electrolyte solution that is replenished with fluid from a much larger electrolyte reservoir. The cell includes gas inlets to each chamber for hydrogen gas and air. As the gases flow into a chamber, they pass along the platinum mesh, through the catalyst layer, and to the bipolar plate. The gas exits the chamber through passageways that provide fluid communication between the anode and cathode chambers and the reservoir, and exits the test cell through an exit port in the reservoir. The flow of gas into the cell produces a constant flow of fresh electrolyte into each chamber. Openings in each cell body is member allow electrodes to enter the cell body and contact the electrolyte in the reservoir therein. During operation, while hydrogen gas is passed into one chamber and air into the other chamber, the cell resistance is measured, which is used to evaluate the corrosion properties of the bipolar plate.

  7. Investigation of the mechanical properties and failure modes of hybrid natural fiber composites for potential bone fracture fixation plates.

    Science.gov (United States)

    Manteghi, Saeed; Mahboob, Zia; Fawaz, Zouheir; Bougherara, Habiba

    2017-01-01

    The purpose of this study is to investigate the mechanical feasibility of a hybrid Glass/Flax/Epoxy composite material for bone fracture fixation such as fracture plates. These hybrid composite plates have a sandwich structure in which the outer layers are made of Glass/Epoxy and the core from Flax/Epoxy. This configuration resulted in a unique structure compared to prior composites proposed for similar clinical applications. In order to evaluate the mechanical properties of this hybrid composite, uniaxial tension, compression, three-point bending and Rockwell Hardness tests were conducted. In addition, water absorption tests were performed to investigate the rate of water absorption for the specimens. This study confirms that the proposed hybrid composite plates are significantly more flexible axially compared to conventional metallic plates. Furthermore, they have considerably higher ultimate strength in tension, compression and flexion. Such high strength will ensure good stability of bone-implant construct at the fracture site, immobilize adjacent bone fragments and carry clinical-type forces experienced during daily normal activities. Moreover, this sandwich structure with stronger and stiffer face sheets and more flexible core can result in a higher stiffness and strength in bending compared to tension and compression. These qualities make the proposed hybrid composite an ideal candidate for the design of an optimized fracture fixation system with much closer mechanical properties to human cortical bone.

  8. A comparison between orthogonal and parallel plating methods for distal humerus fractures: a prospective randomized trial.

    Science.gov (United States)

    Lee, Sang Ki; Kim, Kap Jung; Park, Kyung Hoon; Choy, Won Sik

    2014-10-01

    With the continuing improvements in implants for distal humerus fractures, it is expected that newer types of plates, which are anatomically precontoured, thinner and less irritating to soft tissue, would have comparable outcomes when used in a clinical study. The purpose of this study was to compare the clinical and radiographic outcomes in patients with distal humerus fractures who were treated with orthogonal and parallel plating methods using precontoured distal humerus plates. Sixty-seven patients with a mean age of 55.4 years (range 22-90 years) were included in this prospective study. The subjects were randomly assigned to receive 1 of 2 treatments: orthogonal or parallel plating. The following results were assessed: operating time, time to fracture union, presence of a step or gap at the articular margin, varus-valgus angulation, functional recovery, and complications. No intergroup differences were observed based on radiological and clinical results between the groups. In our practice, no significant differences were found between the orthogonal and parallel plating methods in terms of clinical outcomes, mean operation time, union time, or complication rates. There were no cases of fracture nonunion in either group; heterotrophic ossification was found 3 patients in orthogonal plating group and 2 patients in parallel plating group. In our practice, no significant differences were found between the orthogonal and parallel plating methods in terms of clinical outcomes or complication rates. However, orthogonal plating method may be preferred in cases of coronal shear fractures, where posterior to anterior fixation may provide additional stability to the intraarticular fractures. Additionally, parallel plating method may be the preferred technique used for fractures that occur at the most distal end of the humerus.

  9. Trabecular Plate Loss and Deteriorating Elastic Modulus of Femoral Trabecular Bone in Intertrochanteric Hip Fractures

    Institute of Scientific and Technical Information of China (English)

    Ji Wang; Bin Zhou; Ian Parkinson; C. David L. Thomas; John G. Clement; Nick Fazzalari; X. Edward Guo

    2013-01-01

    Osteoporotic hip fracture is associated with significant trabecular bone loss, which is typically characterized as low bone density by dual-energy X-ray absorptiometry (DXA) and altered microstructure by micro-computed tomography (µCT). Emerging morphological analysis techniques, e.g. individual trabecula segmentation (ITS), can provide additional insights into changes in plate-like and rod-like trabeculae, two major micro-structural types serving different roles in determining bone strength. Using ITS, we evaluated trabecular microstructure of intertrochanteric bone cores obtained from 23 patients undergoing hip replacement surgery for intertrochanteric fracture and 22 cadaveric controls. Micro-finite element (µFE) analyses were performed to further understand how the abnormalities seen by ITS might translate into effects on bone strength. ITS analyses revealed that, near fracture site, plate-like trabeculae were seriously depleted in fracture patients, but trabecular rod volume was maintained. Besides, decreased plate area and rod length were observed in fracture patients. Fracture patients also showed decreased elastic moduli and shear moduli of trabecular bone. These results provided evidence that in intertrochanteric hip fracture, preferential loss of plate-like trabeculae led to more rod-like microstructure and deteriorated mechanical competence adjacent to the fracture site, which increased our understanding of the biomechanical pathogenesis of hip fracture in osteoporosis.

  10. Surgical Management of 3 and 4-Part Proximal Humerus Fractures with Locking Plates in Elderly

    Directory of Open Access Journals (Sweden)

    Emrah Kovalak

    2017-05-01

    Full Text Available Aim: Proximal humeral fractures are approximately 5% of all fractures and, %15-20 is displaced and unstable. By the introduction of locking plates there used to be a substantial rise in the osteosynthesis of the 3 and 4-part proximal humeral fractures. But there is still a lack of consensus for the optimal treatment of these complex fractures. In this retrospective study, we aimed to evaluate the functional outcomes and prognostic factors of 3 and 4-part proximal humerus fractures treated with locking plate osteosynthesis in elderly. Material and Method: 53 patients with displaced 3 and 4-part proximal humeral fractures treated with locking plate osteosynthesis between 2010 and 2015 were included. The fractures were classified according to Neer classification system. Outcomes were assessed by Constant-Murley scoring system (CMS, visual analog pain scale and plain radiographs. In reference to range of motion, forward elevation and abduction of the arm were measured.Results: No statistically significant differences found between the 3- part and 4- part fractures in CMS, forward elevation and, abduction (p>0.05. Pain was significantly higher in 4-part fractures (p=0.035. CMS, forward elevation, and abduction were inversely correlated with age and delay in surgery. There was statistical significance between the patients had complications and those not in terms of CMS, forward elevation and, abduction (p=0.029, p=0.017 and p=0.024. Discussion: Functional outcomes of locking plate fixation of proximal humerus fractures are associated with patient related factors, fracture pattern, surgeon and, the implant. When indications are carefully selected, locking plate osteosynthesis yield good outcomes in surgical treatment of 3 or 4-part proximal humerus fractures.

  11. Influence of hooks and a lag screw on internal fixation plates for lateral malleolar fracture: a biomechanical and ergonomic study.

    Science.gov (United States)

    Sakai, Rina; Uchino, Masataka; Yoneo, Terumasa; Ohtaki, Yasuaki; Minehara, Hiroaki; Matsuura, Terumasa; Gomi, Tsutomu; Ujihira, Masanobu

    2017-02-23

    For internal fixation of AO classification Type B lateral malleolar fracture, insertion of lag screws into the fracture plane and fixation with a one-third tubular plate as a neutralization plate are the standard treatment procedures. The one-third tubular plate is processed to a hook shape and hung on the distal end of the fibula. In this study, to compare the function of the hook and lag screws of a one-third tubular plate and LCP for osteosynthesis of lateral malleolar fracture, mechanical indices of internal fixation were compared among the one-third tubular plates with lag screws with and without the hook and a locking compression plate. As mechanical tests, a compression test was performed in which compression in the bone axis direction produced by supporting the body weight was simulated, and a torsion test was performed in which external rotation of the bone axis caused by plantar flexion of the ankle joint was simulated. Muscle strength during walking and the force and torque acting on the ankle and knee joints were determined using inverse dynamic analysis. Finite element analysis was performed to analyze the function of hooks and lag screws. The joint reaction force determined by inverse dynamic analysis was adopted as the loading condition of finite element analysis. A stiffness equivalent to that of healthy bone could be achieved by all three internal fixations. It was clarified that the presence of the hook does not make a difference in stiffness. Displacement of the one-third tubular plate was small regardless of the presence or absence of the hook compared with those of locking compression plates. The presence of the hook did not make any difference in stiffness, suggesting that active preparation of the hook is unnecessary. We also clarified that lag screws inhibit displacement.

  12. Salter-Harris II forearm fracture reduction and fixation using a buttress plate.

    Science.gov (United States)

    Barnes, Jonathan; Webb, Mark; v Fearon, Paul

    2014-01-31

    Distal radius fractures are common injuries in children. Those that affect the growth plate (physis) need to be managed carefully as inadequate management may lead to long-term deformity and a reduction in function. However, different management strategies all have drawbacks and controversy exists over how best to manage these cases. This is the case of a 13-year-old girl who presented with a Salter Harris II fracture, which was managed using a novel approach of utilising a T plate in a buttress mode to stabilise the fracture after anatomical reduction. This provided effective fracture fixation and should allow good bone healing without causing any iatrogenic growth plate damage and without fixing a plate across the physis, which may need removal in the future.

  13. 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....

  14. Plating and Grafting for Nonunion of a Subtrochanteric Femoral Fracture in a Dog

    OpenAIRE

    1984-01-01

    Healing problems following pin and wire reduction of an unstable subtrochanteric femoral fracture are described. A nonunion was treated in a two year old spayed Springer Spaniel by plating and autogenous bone grafting.

  15. Bicolumnar 90–90 plating of AO 13C type fractures

    National Research Council Canada - National Science Library

    Cemal Kural; Ersin Ercin; Mehmet Erkilinc; Evren Karaali; Mustafa Gokhan Bilgili; Suleyman Altun

    2017-01-01

    Objective: The aim of this study was to evaluate functional results and complication rate of patients who underwent medial-dorsolateral plating for intra-articular distal humeral fracture (Müller AO type 13C). Methods...

  16. Bicolumnar 90-90 plating of low-energy distal humeral fractures in the elderly patient.

    Science.gov (United States)

    Leigey, Daniel F; Farrell, Dana J; Siska, Peter A; Tarkin, Ivan S

    2014-09-01

    Fragility fractures of the distal humerus in elderly patients, especially the low transcondylar fracture pattern, can be difficult to optimally manage. Although the fractures are typically low energy resulting in either extra-articular or simple intra-articular patterns, gaining fixation into the distal fragments can be difficult with open reduction internal fixation (ORIF) using traditional 90-90 or parallel plating techniques. Anatomy preserving reconstruction with ORIF is preferred over total elbow arthroplasty (TEA) if possible. In this study, 15 patients were managed with a bicolumnar 90-90 plating construct as a novel method of enhancing distal fixation in these fractures. Fourteen patients went on to radiographic union at an average of 77 days after surgery with an average arc of motion of 105°. One patient was lost to follow-up. Bicolumnar 90-90 plating of distal humerus fractures in elderly patients may represent a viable alternative to traditional ORIF or TEA.

  17. Short-term follow-up of pertrochanteric fractures treated using the proximal femoral locking plate.

    Science.gov (United States)

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

    2014-05-01

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

  18. OPERATIVE MANAGEMENT OF INTRA-ARTICULAR DISTAL HUMERAL FRACTURES WITH LOCKING PLATES

    Directory of Open Access Journals (Sweden)

    Abhilekh

    2015-11-01

    Full Text Available BACKGROUND: Intra-articular distal humeral fractures are common, but complex elbow injuries. To obtain good results, anatomical reduction with rigid fixation and early range of mobilization is required. Treatment of these fractures with conventional plates is associated with many complications such as non-anatomic reduction of articular surfaces, malunion, non-union, loosening of implant, residual stiffness of the elbow and post-traumatic osteoarthrosis. In this situation the application of locking plates having a fixed angle plate screw construct can minimise most of the above complications. OBJECTIVE: To evaluate radiological and functional outcome of locking plate application for the management of intra-articular distal humeral fractures. MATERIAL AND METHODS: This prospective study was conducted from January 2013 to December 2014. We operated 20 patients of AO type-C intra-articular distal humeral fractures. Fracture was exposed using modified Campbell’s posterior approach in less comminuted fractures and a V-shaped Olecranon osteotomy was done to get better exposure of the articular surface in cases with severe articular comminution. The fracture was stabilized using an intercondylar screw, pre-contoured locking compression plates and/or locking reconstruction plates as per preoperative planning. Patients were reviewed at monthly interval for clinical-radiological evaluation. Final outcome measures included radiological assessment, range of motion and Mayo elbow performance score (MEPS. RESULTS: All the fractures were united at an average 12 weeks. Two patients developed numbness in the distribution of ulnar nerve and one patient developed superficial infection in immediate postoperative period. None of the patients had malunion and loosening of implant. The average arc of flexion-extension was 105`, although no patient had loss of supination/pronation. Mayo Elbow Performance Score was excellent in 15 (75%, good in 3 (15%, fair in 1 (5

  19. Central acetabular fracture with dislocation treated by minimally invasive plate osteosynthesis.

    Science.gov (United States)

    2015-06-01

    Central acetabular fractures with dislocation are usually the result of high-energy trauma, resulting in joint incongruity, and are frequently associated with other injuries. Open reduction and internal fixation has been the standard treatment for acetabular fractures, but it is associated with extensive surgical trauma, and complications such as haematoma formation, iatrogenic nerve injury, and heterotopic ossification. We present the case of a 63-year-old female who sustained a central acetabular fracture of the hip with dislocation as a result of an automobile collision. Closed reduction of the dislocation was performed, and the fracture was managed by minimally invasive plate osteosynthesis using a specially prepared plate. At 01 year postoperatively, radiographs showed the fracture to have been well-healed with good congruity of the joint. However, heterotopic ossification of the joint was noted. The technique allowed reduction of the fracture with minimal surgical trauma.

  20. Palmar and dorsal fixed-angle plates in AO C-type fractures of the distal radius: is there an advantage of palmar plates in the long term?

    National Research Council Canada - National Science Library

    Jakubietz, Michael G; Gruenert, Joerg G; Jakubietz, Rafael G

    2012-01-01

    .... This paper reports the result of a randomised clinical study comparing dorsal Pi plates and palmar, angle-stable plates for treatment of comminuted, intraarticular fractures of the distal radius over...

  1. Biomechanical evaluation of fracture fixation constructs using a variable-angle locked periprosthetic femur plate system.

    Science.gov (United States)

    Hoffmann, Martin F; Burgers, Travis A; Mason, James J; Williams, Bart O; Sietsema, Debra L; Jones, Clifford B

    2014-07-01

    In the United States there are more than 230,000 total hip replacements annually, and periprosthetic femoral fractures occur in 0.1-4.5% of those patients. The majority of these fractures occur at the tip of the stem (Vancouver type B1). The purpose of this study was to compare the biomechanically stability and strength of three fixation constructs and identify the most desirable construct. Fifteen medium adult synthetic femurs were implanted with a hip prosthesis and were osteotomized in an oblique plane at the level of the implant tip to simulate a Vancouver type B1 periprosthetic fracture. Fractures were fixed with a non-contact bridging periprosthetic proximal femur plate (Zimmer Inc., Warsaw, IN). Three proximal fixation methods were used: Group 1, bicortical screws; Group 2, unicortical screws and one cerclage cable; and Group 3, three cerclage cables. Distally, all groups had bicortical screws. Biomechanical testing was performed using an axial-torsional testing machine in three different loading modalities (axial compression, lateral bending, and torsional/sagittal bending), next in axial cyclic loading to 10,000 cycles, again in the three loading modalities, and finally to failure in torsional/sagittal bending. Group 1 had significantly greater load to failure and was significantly stiffer in torsional/sagittal bending than Groups 2 and 3. After cyclic loading, Group 2 had significantly greater axial stiffness than Groups 1 and 3. There was no difference between the three groups in lateral bending stiffness. The average energy absorbed during cyclic loading was significantly lower in Group 2 than in Groups 1 and 3. Bicortical screw placement achieved the highest load to failure and the highest torsional/sagittal bending stiffness. Additional unicortical screws improved axial stiffness when using cable fixation. Lateral bending was not influenced by differences in proximal fixation. To treat periprosthetic fractures, bicortical screw placement should be

  2. The Use of Mesh Plates for Difficult Fractures of the Patella.

    Science.gov (United States)

    Volgas, David; Dreger, Tina K

    2017-03-01

    Patella fractures present some of the more complicated fracture patterns in orthopaedic trauma care. This is partially due to the small size of the fragments but also the articular nature of each fragment. Fixation methods such as cerclage wiring, excision of smaller fragments, and screw fixation of larger fragments all have their own challenges. Our study examined our Level I trauma center's experience with variable angle locked 2.7 mm titanium plates for treatment of comminuted patella fractures or treatment of patellar nonunion. After Institutional Review Board approval, we used billing records to identify 105 patients who had undergone operative management of a displaced patella fracture between January 2011 and December 2015. We reviewed the radiographs of these patients to identify which patients underwent treatment with a mesh plate. We found 16 patients (6 males and 10 females) who had undergone fixation with a mesh plate; mean age was 47 years. Nine patients underwent primary open reduction internal fixation (ORIF) and seven underwent mesh plate fixation for failed ORIF of a patella fracture. The mean visual analog pain score was 2.75 (range, 0-9). The mean range of motion was 1 degree of extension (range, 0-10 degrees) to 110 degrees of flexion (range, 45-135 degrees). All fractures healed. Five patients required hardware removal for pain. This review illustrates the effectiveness of the locking mesh plate in two challenging clinical scenarios: that of patellar nonunion and comminuted fractures that preclude standard fixation methods. Although multiple options exist for patellar fracture fixation, the titanium mesh locking plate can be an effective option for retaining the patella in the setting of comminution. Further comparative studies should be undertaken to determine which method of treatment may be superior in the treatment of these fractures. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  3. Distal tibial fracture: An ideal indication for external fixation using locking plate

    Institute of Scientific and Technical Information of China (English)

    Jing-wei Zhang; Nabil A.Ebraheim; Ming Li; Xian-Feng He; Joshua Schwind; Li-Mei Zhu; Yi-Hui Yu

    2016-01-01

    Objective:To evaluate the feasibility and efficiency of one-stage external fixation by using locking plate in distal tibial fractures.Methods:In this non-control prospective study,28 patients with distal tibial fractures were included and underwent one-stage external fixation by using locking plate.There were 21 males and 7 females,with a mean age of 43 years (19-63).According to AO/OTA fracture classification,there were 9 cases of Type A1,9 of Type A2,10 of Type A3 fractures.There were 21 close and 7 open fractures.The locking plate was placed on the anteromedial aspect of the tibia with 4-5 bicortical screws inserted in both distal metaphysis and diaphysis.The radiographic and clinic results were evaluated.Results:All patients were followed up for the average of 16 months (ranging from 12 to 21 months).The average surgery duration was 38 (25-60) minutes.The mean time to fracture healing were 14.6 ± 2.67,17.5 ± 3.66,and 18.4 ± 3.37 (p < 0.05) weeks in type A1,A2,and A3 fractures respectively.By the end of the follow-ups,the mean AOFAS score were 96.11 ± 2.32,92.67 ± 1.80 and 92.00 ± 2.06 (p > 0.05) in type A1,A2,and A3 fractures respectively.None of nonunion,deep infection,or breakage of screw or plate were observed.Conclusions:Distal tibial fracture was the ideal indication for external fixation using locking plate.The external plating is characterized by ease of performance,less invasive,fewer soft tissue impingement,improved cosmesis,and convenient for removal.

  4. Evaluation of crack arrest fracture toughness of parent plate, weld metal and heat affected zone of BIS 812 EMA ship plate steel

    Science.gov (United States)

    Burch, I. A.

    1993-10-01

    The steel chosen for the pressure hull of the Collins class submarine has undergone evaluation to compare the crack arrest fracture toughness, K(Ia), of the parent plate with that of weld metal and heat affected zone. The tests were conducted over a range of subzero temperatures on specimens slightly outside the ASTM standard test method specimen configuration. Shallow face grooved specimens were used to vary the propagating crack velocity from that of non face grooved specimens and determine if K(Ia), is sensitive to changes in crack velocity. The weld metal, heat affected zone (HAZ), and parent plate were assessed to determine if the welding process had a deleterious effect on the crack arrest properties of this particular steel. Tests on each of these regions revealed that, for the combination of parent plate, welding procedure and consumables, no adverse effect on crack arrest properties was encountered. Crack arrest fracture toughness of the weld metal and HAZ was superior to that of the parent plate at comparable temperatures.

  5. A review of locking compression plate biomechanics and their advantages as internal fixators in fracture healing.

    Science.gov (United States)

    Miller, Danielle L; Goswami, Tarun

    2007-12-01

    Metallic implants are often involved in the open reduction and internal fixation of fractures. Open reduction and internal fixation is commonly used in cases of trauma when the bone cannot be healed using external methods such as casting. The locking compression plate combines the conventional screw hole, which uses non-locking screws, with a locking screw hole, which uses locking head screws. This allows for more versatility in the application of the plate. There are many factors which affect the functionality of the plate (e.g., screw placement, screw choice, length of plate, distance from bone, etc.). This paper presents a review of the literature related to the biomechanics of locking compression plates and their use as internal fixators in fracture healing. Furthermore, this paper also addresses the materials used for locking compression plates and their mechanical behavior, parameters that control the overall success, as well as inherent bone quality results.

  6. Treating patella fractures with a fixed-angle patella plate-A prospective observational study.

    Science.gov (United States)

    Wild, Michael; Fischer, Kai; Hilsenbeck, Florian; Hakimi, Mohssen; Betsch, Marcel

    2016-08-01

    Anterior tension wiring using Kirschner wires (K-wires) is still considered the standard treatment for patella fractures, despite its high complication rate. The objective of this prospective clinical study was to evaluate intra- and perioperative complications as well as the clinical outcome of patients with patella fracture treated with a new developed bilateral, polyaxial, fixed-angle 2.7mm patella plate. Between 2011 and 2014 all patients with a patella fracture were included in this prospective study and treated with a fixed-angle patella plate. Avulsion fractures of the inferior or superior pole of the patella were excluded. All fractures were classified according to the AO/OTA fracture classification. During a twelve-month follow up period all intra- and postoperative complications were recorded as well as the time until fracture healing. One year postoperatively the Lysholm Score, the pre- and postoperative Tegner Score, the Hospital for Special Surgery Knee Score (HSS), the Turba Score, the Oxford Knee Score, the Knee injury and Osteoarthritis Outcome Score (KOOS), the Bostman Score and the Iowa Knee Score were surveyed. Altogether, 20 patella fractures in 19 patients were included in this prospective study. The most frequent type of fracture, n=10, was a simple transverse patella fracture (C1), followed by 7 comminuted patella fractures (C3) and 3 T-shaped patella fractures (C2). During the 12-month follow up period two patients treated with the patella plate had a complication. In one patient a superficial wound infection occurred, which was treated successfully with hardware removal and in one patient a fracture dislocation due to an implant failure occurred. X-rays demonstrated complete bony healing in all fractures on average 3.2 months postoperatively. All knee scores showed good to excellent clinical results one year postoperatively. The results of this first clinical study indicate that the fixed-angle patella plate is an effective and safe

  7. Dual plating for fractures of the distal third of the humeral shaft.

    Science.gov (United States)

    Prasarn, Mark L; Ahn, Jaimo; Paul, Omesh; Morris, Elizabeth M; Kalandiak, Stephen P; Helfet, David L; Lorich, Dean G

    2011-01-01

    In this study, we present a novel method for performing dual plating of extra-articular fractures of the distal third of the humerus. Since 2006, we have treated 15 such fractures with dual plates from a single posterior midline incision. In the first part of the study, we provide the surgical protocol we have used in addressing these fractures. In the second part, the charts of these patients were reviewed retrospectively to examine their clinical and radiographic outcomes. Using this technique, we have achieved an excellent union rate without significant complications while allowing early and aggressive range of motion.

  8. Comparison of nail-plate fixation and Ender's nailing for intertrochanteric fractures.

    Science.gov (United States)

    Hall, G; Ainscow, D A

    1981-02-01

    Two comparable groups of patients with fractures of the trochanteric region of the femur were studied. One hundred and sixty-five fractures had been fixed with conventional nail-plates and 132 with Ender's nails. Ender's nails gave superior results in the treatment of trochanteric fractures. The operation was quicker and less traumatic than that using conventional nail-plates and both the mortality rate and the time in hospital were reduced. More patients in the group with Ender's nails who were initially independent returned to an independent existence.

  9. Arthroscopic evaluation for omalgia patients undergoing the clavicular hook plate fixation of distal clavicle fractures

    OpenAIRE

    2014-01-01

    Background The aim of this study is to investigate the anatomic changes in the shoulder joints responsible for omalgia after the clavicular hook plate fixation under arthroscope. Methods Arthroscopic examination was carried out for 12 omalgia patients who underwent clavicular hook plate fixation due to distal clavicle fractures. Functional outcome of shoulder was measured by the Japanese Orthopaedic Association (JOA) score before and after the withdrawal of the fixation plate. Results The rot...

  10. A new technique of fixation of radial head fractures using a modified tubular plate

    Directory of Open Access Journals (Sweden)

    Guha A

    2004-04-01

    Full Text Available Radial head fractures are fairly common, occurring in 17-44% of all elbow injuries. Mason Type 2 fractures may be fixed using mini fragment screws, this fixation often needing augmentation with a plate to make the construct rotationally stable. However, the drill holes needed to fix the plate to the radial head, carry the risk of inflicting more injury to the fractured fragments. In our case, the radial head fracture was fixed with a modified one-third tubular plate. The plate was cut through the distal hole and the two cut ends were bent into hooks. These two hooks were engaged into two breaches made on the margin of the radial head and this provided rotational stability to the head without causing further damage. The fracture healed well and the patient regained full movement in the elbow. We conclude that this method may be used to fix fractures of the radial head, which require additional support with a plate.

  11. 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

    internal fixation, and the introduction of locking-plate osteosynthesis may lead to improved outcome. We evaluated the outcome of Vancouver type B1 and C PFFs treated by locking-plate osteosynthesis, by assessing rates of fracture union and reoperations and by analyzing failure cases.......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...

  12. Complications and functional outcome after fixation of distal tibia fractures with locking plate - A multicentre study

    DEFF Research Database (Denmark)

    Viberg, Bjarke; Kleven, Silje; Hamborg-Petersen, Ellen

    2016-01-01

    and X-ray images for 6 hospitals (1 level 1, 5 level 2) in the Region of Southern Denmark. Between January 2007 and April 2011 70 consecutive patients with 71 distal tibia fractures were treated with low-profile locking plate were included. The proportion of post-operative complications, classified......INTRODUCTION: The aim of this study was to evaluate the proportion of complications and the functional outcome following ORIF with low-profile locking plates in patients with distal tibia fractures. METHOD: Retrospective data was retrieved using county databases, operation books, health record...... score was 73. Thirty-three percent of working patients had not returned to work as a result of the fracture. CONCLUSIONS: Our study suggest that treatment of distal tibia fractures with low-profile locking plates might have a higher proportion of complications and worse functional outcome than...

  13. Low Profile Mesh Plating for Patella Fractures: Video of a Novel Surgical Technique.

    Science.gov (United States)

    Verbeek, Diederik O; Hickerson, Lindsay E; Warner, Stephen J; Helfet, David L; Lorich, Dean G

    2016-08-01

    Patella fractures can be challenging to treat particularly in the presence of inferior pole comminution. In this video we present a novel surgical technique for the treatment of patella fractures using a small fragment low profile mesh plate. Key points are the surgical exposure with direct visualization of the articular reduction, the preparation of the mesh plate to accommodate patellar anatomy and the augmentation of the construct using Krackow sutures to address inferior pole comminution. Low profile mesh plating allows for multiplanar fixation of patella fractures while avoiding implant and fixation problems related to tension band fixation. Our early experience with this technique is encouraging and it appears that this technique is useful for the treatment of the majority of patella fractures.

  14. Use of copolymer polylactic and polyglycolic acid resorbable plates in repair of orbital floor fractures.

    Science.gov (United States)

    Lin, Jonathan; German, Michael; Wong, Brian

    2014-10-01

    The fractures of the orbital floor are common after craniofacial trauma. Repair with resorbable plates is a viable reconstructive option; however, there are few reports in the literature. This study describes our experience using copolymer polylactic and polyglycolic acid (PLLA/PGA) orbital reconstruction plates (LactoSorb, Lorenz Surgical, Jacksonville, FL) in 29 cases of the orbital floor fracture repair. We conducted a retrospective review of 29 orbital floor fractures at a single institution repaired through transconjunctival, preseptal dissection using PLLA/PGA plates fashioned to repair the orbital floor defect. Associated fractures included zygomaticomaxillary, LeFort, and nasoethmoid fractures. There were six patients with complications. Four patients had transient diplopia with complete resolution of symptoms within 1 year. One patient had diplopia postoperatively, but was later lost to follow-up. Two patients have had persistent enophthalmos since 1 year. In each of these cases, the floor fracture was coincident with significant panfacial or neurotrauma. We did not encounter any adverse inflammatory reactions to the implant material itself. The study concluded that orbital floor fracture repair with resorbable plates is safe, relatively easy to perform, and in the majority of cases was effective without complications. In the presence of severe orbital trauma, more rigid implant materials may be appropriate.

  15. Failure of volar locking plate fixation of an extraarticular distal radius fracture: A case report

    Directory of Open Access Journals (Sweden)

    Ozer Kagan

    2010-11-01

    Full Text Available Abstract Background Volar locking plates provide significant structural stability to the distal radius. Failure of a volar locked plating is a rarely reported complication in the literature. Case Presentation A 40 year-old, obese female patient who presented with a displaced extraarticular distal radius fracture, underwent open reduction and internal fixation of the fracture using a volar locking plate. Radiographs taken at 10 weeks postoperatively showed failure of fixation with breakage of the four distal locking screws. A hardware removal was performed at 6 months, and the patient was then lost to follow-up. She presented again at 18 months after the first surgery, with significant pain, and radiographic signs of a radial collapse and a fracture-nonunion. A total wrist fusion was performed as the method of choice at that point in time. Conclusion Volar locked plating represents the new "gold standard" of distal radius fracture fixation. However, despite the stability provided by locking plates, hardware failure may occur and lead to a cascade of complications which will ultimately require a wrist fusion, as outlined in this case report. Additional structural support by bone grafting may be needed in selected cases of volar locked plating, particularly in patients with a high risk of developing a fracture-nonunion.

  16. In vivo study of microarc oxidation coated biodegradable magnesium plate to heal bone fracture defect of 3mm width.

    Science.gov (United States)

    Wu, Y F; Wang, Y M; Jing, Y B; Zhuang, J P; Yan, J L; Shao, Z K; Jin, M S; Wu, C J; Zhou, Y

    2017-06-23

    Microarc oxidation (MAO) coated magnesium (Mg) with improved corrosion resistance appeal increasing interests as a revolutionary biodegradable metal for fractured bone fixing implants application. However, the in vivo corrosion degradation of the implants and bone healing response are not well understood, which is highly required in clinic. In the present work, 10μm and 20μm thick biocompatible MAO coatings mainly composed of MgO, Mg2SiO4, CaSiO3 and Mg3(PO4)2 phases were fabricated on AZ31 magnesium alloy. The electrochemical tests indicated an improved corrosion resistance of magnesium by the MAO coatings. The 10μm and 20μm coated and uncoated magnesium plates were separately implanted into the radius bone fracture site of adult New Zealand white rabbits using a 3mm width bone fracture defect model to investigate the magnesium implants degradation and uninhibited bone healing. Taking advantage of the good biocompatibility of the MAO coatings, no adverse effects were detected through the blood test and histological examination. The implantation groups of coated and uncoated magnesium plates were both observed the promoting effect of bone fracture healing compared with the simple fracture group without implant. The releasing Mg(2+) by the degradation of implants into the fracture site improved the bone fracture healing, which is attributed to the magnesium promoting CGRP-mediated osteogenic differentiation. Mg degradation and bone fracture healing promoting must be tailored by microarc oxidation coating with different thickness for potential clinic application. Copyright © 2017. Published by Elsevier B.V.

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

    Directory of Open Access Journals (Sweden)

    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

  18. The use of locking plates in proximal humeral fractures: Comparison of outcome by patient age and fracture pattern

    Directory of Open Access Journals (Sweden)

    Leonard Michael

    2009-01-01

    Full Text Available Purpose: This study was undertaken to evaluate the efficacy of a proximal humeral locking plate, and to specifically study the effect of patient age and fracture type on the outcome. Materials and Methods: Thirty-one cases of proximal humeral fractures fixed by using the proximal humeral interlocking (PHILOS plate were reviewed. Results: Average functional scores (minimum 18 months post operation per AO / ASIF fracture type were 25.3 for type A, 21.4 for type B, and 22.7 for type C. There was no statistically significant difference between the groups. The functional scores for patients over 65 years of age were significantly inferior (P = 0.03. At a final radiological review (mean 12 months post operation, 30 (96% of the patients demonstrated fracture union. Seven patients (22.5% required a second surgical procedure. Conclusion: We obtained both good functional results and bone healing with the PHILOS plate, irrespective of fracture type; the older patients had a poorer outcome. We caution the surgeons on the high potential for reoperations with its use.

  19. Deformation and fracture of a plate under thermal shock

    Energy Technology Data Exchange (ETDEWEB)

    Aptukov, V.N.; Pozdeev, A.A.

    1986-01-01

    The wave processes associated with thermal shock give rise to cumulative tensile stresses whose magnitude and location are determined by the plate geometry, the heating region, and the spatial distribution of the heat sources. Here, the wave processes, damage accumulation, and the development of macrofracture zones during thermal shock are analyzed using a two-dimensional axisymmetric formulation. The evolution of macrocracks during thermal shock in a plate, a cylinder, and a partially heated plate is shown graphically. 14 references.

  20. Comparisons of front plate, percutaneous sacroiliac screws, and sacroiliac anterior papilionaceous plate in fixation of unstable pelvic fractures.

    Science.gov (United States)

    Gu, Ronghe; Huang, Weiguo; Yang, Lijing; Liu, Huijiang; Xie, Kegong; Huang, Zonggui

    2017-09-01

    This observational study was aimed at comparing the clinical efficacy of sacroiliac anterior plate fixation (SAPF), sacroiliac anterior papilionaceous plate (SAPP), and percutaneous sacroiliac screw internal fixation (PSCIF) introduced for patients with unstable pelvic fracture. Seventy-eight patients with unstable pelvic fracture (Tile type B or C) were recruited. Twenty-six patients underwent SAPF, 26 underwent SAPP, and 26 underwent PSCIF. Matta scores were calculated to evaluate the reduction of pelvic fractures, and Majeed scores were applied for the assessment of functional recoveries after surgery. Other perioperative clinical indicators were also recorded, including operation time, bleeding status, length of incision, ambulation time, fracture healing time, and incision infection. Total operation time of PSCIF was remarkably shorter than that of SAPF and SAPP (P SAPP group was almost 26∼29 times as high as that of PSCIF group (P SAPP resulted in significant blood loss compared with SAPF (P SAPP and PSCIF (P SAPP groups than in the PSCIF group (P SAPP was associated with fewer complications than SAPF, and complications were barely observed in the PSCIF group. PSCIF may be more appropriate for patients with unstable pelvic fractures in comparison with SAPP and SAPF. Besides, SAPP is likely to be more efficacious than SAPF especially for Tile C patients.

  1. MANAGEMENT OF COMMINUTED FRACTURES OF LOWER EXTREMITY WITH MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS

    Directory of Open Access Journals (Sweden)

    Kapil A

    2015-07-01

    Full Text Available Comminuted multi fragmentary periarticular fractures are always a challenge to manage even today. Results of conservative management and ORIF by traditional methods are associated with number of complications. This study evaluate the role of minimally invasive plate osteosynthesis in management of such fractures. Seventeen (17 multi fragmentary fractures of long bones of lower extremity (in 15 patients were treated in t he present prospective study using the technique of minimally invasive plate osteosynthesis (MIPO. There were 11 cases of supracondylar fracture femur, two intra articular, 3 cases of proximal tibial fractures, 2 cases of tibial shaft fractures and 1 cases of subtrochanteric fracture. Mean age of the patients was 45.6 years with 13 male and 2 female patients. Most fractures were caused by high velocity road traffic accidents. Average injury surgery interval was 8.64 days. Average operative time was 67.35 mi nutes. Average period of union was 19.17 weeks and average period for full weight bearing was 15 weeks. Average hospital stay was 18.41 days. All fractures went on to union. Incidence of complications was low. Range of motion at the proximal and distal joi nts was excellent. Overall 93.33% (16 of 17 cases had excellent to good results.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

  3. Dorsal Plating of Distal Radius Fractures Historical Context and Appropriate Use.

    Science.gov (United States)

    Ayalon, Omri; Paksima, Nader

    2017-01-01

    The management of distal radius fractures has evolved over time from a largely nonoperative paradigm to a more commonly performed operative procedures today. Surgical trends have similarly developed, with dorsal plating falling out of favor due to complications involving extensor tendon pathology as well as due to the ubiquity of the volar plate along with the advent of locking plate technology. However, with the improvement in design of newer generation dorsal plates, this technique should be used in the appropriate clinical situation, including dorsal comminution and angulation with concomitant carpal pathology. Outcome data supports dorsal plating and has been shown to be comparable to that of volar plating, with some unique advantages. As such, the technique of dorsal plating should have a role in surgical management of these injuries.

  4. Mechanical Comparison of Headless Screw Fixation and Locking Plate Fixation for Talar Neck Fractures.

    Science.gov (United States)

    Karakasli, Ahmet; Hapa, Onur; Erduran, Mehmet; Dincer, Cemal; Cecen, Berivan; Havitcioglu, Hasan

    2015-01-01

    For talar neck fractures, open reduction and internal fixation have been thought to facilitate revascularization and prevent osteonecrosis. Newer screw systems allow for placement of cannulated headless screws, which provide compression by virtue of a variable pitch thread. The present study compared the biomechanical fixation strength of cannulated headless variable-pitch screw fixation and locking plate fixation. A reproducible talar neck fracture was created in 14 fresh cadaver talar necks. Talar head fixation was then performed using 2 cannulated headless variable-pitch 4-mm/5-mm diameter (4/5) screws (Acutrak; Acumed, Hillsboro, OR) and locking plate fixation. Headless variable-pitch screw fixation had lower failure displacement than did locking plate fixation. No statistically significant differences were found in failure stiffness, yield stiffness (p = .655), yield load (p = .142), or ultimate load between the 2 fixation techniques. Cannulated headless variable-pitch screw fixation resulted in better failure displacement than locking plate fixation in a cadaveric talus model and could be considered a viable option for talus fracture fixation. Headless, fully threaded, variable-pitch screw fixation has inherent advantages compared with locking plate fixation, because it might cause less damage to the articular surface and can compress the fracture for improved reduction. Additionally, plate fixation can increase the risk of avascular necrosis owing to the wider incision and dissection of soft tissues.

  5. Triple plating of tibia in a complex bicondylar tibial plateau fracture

    Institute of Scientific and Technical Information of China (English)

    Atin Jaiswal; Naiman Deepak Kachchhap; Yashwant S Tanwar; Birendra Kumar; Sachin K Yadav

    2014-01-01

    High-energy tibial plateau fracture poses a significant challenge and difficulty for orthopaedic surgeons.Fracture of tibial plateau involves major weight bearing joint and may alter knee kinematics.Anatomic reconstruction of the proximal tibial articular surfaces,restoration of the limb axis (limb alignment) and stable fixation permitting early joint motion are the goals of the treatment.In cases of complex bicondylar tibial plateau fractures,isolated lateral plating is frequently associated with varus malalignment and better results have been obtained with bilateral plating through dual incisions.However sometimes a complex type of bicondylar tibial plateau fractures is encountered in which medial plateau has a biplaner fracture in posterior coronal plane as well as sagittal plane.In such fractures it is imperative to fix the medial plateau with buttressing in both planes.One such fracture pattern of the proximal tibia managed by triple plating through dual posteromedial and anterolateral incisions is discussed in this case report with emphasis on mechanisms of this type of injury,surgical approach and management.

  6. Plate osteosynthesis of fractures of the shaft of the humerus: comparison of limited contact dynamic compression plates and locking compression plates.

    Science.gov (United States)

    Singh, Ashutosh Kumar; Narsaria, Nidhi; Seth, R R; Garg, S

    2014-06-01

    The aim of this retrospective study was to compare outcomes and complications of displaced fractures of the shaft of the humerus treated with limited-contact dynamic compression plates (LCDCPs) and locking compression plates (LCPs). Two hundred and twelve patients with displaced fractures of the shaft of the humerus, treated with plate osteosynthesis from January 2005 to December 2009 were reviewed. One hundred and two patients (group A) were treated with LCDCP osteosynthesis and 110 patients (group B) were treated with LCP osteosynthesis. Clinical and radiological assessments were made at monthly intervals for the first 6 months and then at 2-month intervals for the next 6 months. Primary outcome measures like operative time, duration of hospital stay, time to fracture union, union rate and secondary outcome measures (functional outcome and complications such as infection, malunion, delayed union, nonunion, implant failure and iatrogenic radial nerve palsy) were compared between both groups. The ULCA scoring system and Mayo elbow performance index (MEPI) were used to assess shoulder and elbow functions, respectively. Rodriguez-Merchan criteria were used to assess the functional outcomes of the fracture fixation. There was no significant difference found between the two groups in terms of primary outcome measures. According to Rodriguez-Merchan criteria, comparison of functional outcomes of both groups showed insignificant difference (p = 0.48). There was no significant difference found between the two groups regarding mean ULCA score (p = 0.34) and mean MEPI sore (p = 0.54). In terms of complications, no significant difference was found between the two groups. This study concludes that the principle of fracture fixation was more important than plate selection in fractures of the shaft of the humerus. Level 3.

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

    Science.gov (United States)

    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

  8. ROLE OF LOW PROFILE PRECONTOURED DISTAL TIBIAL LOCKING PLATE USING MIPPO TECHNIQUE IN PILON FRACTURE

    Directory of Open Access Journals (Sweden)

    Isaac Sunder

    2015-10-01

    Full Text Available : Tibial pilon fracture – Spectrum of injury ranging from fractures caused by low energy rotational foces to fractures caused by high energy axial compression forces due to RTA/ fall from height with significant metaphyseal communition articular communition with diaphyseal extension. Almost 80% patients will have fibula fracture. The aim of the study is study the efficacy of LP PD DTP in the management of closed pilon fractures (OTA type A Type B and Type C 1 and open pilon fractures (Grade 1 Grade II Grade III A (Gustilo Anterson grading. 1. I have studied 21 patients of pilon fracture classified using AO/OTA classification Type A-metaphyseal; Type B–Partially articular; Type C Metaphyseal fracture with articular involvement. 2. Used LP/ PC/ Distal tibial plate using MIPPO technique in OTA–A, B and C 1 closed & grade I II Grade III A compound fractures. OBSERVATIONS: 1. In contrary to stages protocol (Ist external fixation with fibular plating after 2-3 Weeks ORIF/MIPPO with/Without bone grafting, it is done percutaneously or minimally invasive and it can be done on day 1 without any major soft tissue problem & post-operative infection. 2. Duration of stay in the hospital can be reduced. 3. Since it is done through calcaneal traction or femoral distractor – fibula length restored & plating may not be necessary all the time and fibula plating can be avoid if the soft tissue condition is not favorable for plating laterally. 4. Since it is done through calcaneal traction/femoral distractor inspite of ground glass communition–good reduction is almost always possible. 5. Since MIPPO–need for bone grafting in less. 6. As in staged protocol more time is spent in soft tissue healing and after 2–3 weeks, fractures reduction if difficult and almost impossible with indirect reduction and may warrant open reduction. I conclude that LP PC distal tibial plate using MIPPO technique offers several advantages over two staged protocol and improved

  9. Cable plates and onlay allografts in periprosthetic femoral fractures after hip replacement: laboratory and clinical observations.

    Science.gov (United States)

    Howell, Jonathan R; Masri, Bassam A; Garbuz, Donald S; Greidanus, Nelson V; Duncan, Clive P

    2004-01-01

    Fractures of the femur after total hip replacement are an increasingly common and technically challenging problem. The results of nonsurgical treatment are poor. When the general condition of the patient allows, these injuries should be treated surgically. Several surgical treatments can be used to treat these fractures, and classification of the fracture assists the surgeon in the choice of procedure. Over the past decade, cable plate fixation systems and onlay strut allografts have become two of the most commonly used methods of fixation for fractures associated with hip prostheses. The ideal method of fixation is yet to be determined. However, laboratory studies have shown that dual fixation using either a lateral plate and anterior strut graft or two strut grafts produces the strongest construct. Cables rather than smooth wires should be used for fixation, and fixation strength increases with the number of cables used. The use of screws proximally produces a strong fixation but there are theoretical disadvantages to using screws around a femoral implant. Clinical data show high rates of fracture union using cable plate fixation, cortical onlay allograft fixation, and combined fixation methods for fractures that occur around well-fixed implants. Results have been less encouraging when these techniques have been used to fix fractures around prostheses that are either loose or malaligned; such fractures are better managed by revision of the femoral component to a long-stemmed device. Care should also be taken when there has been previous periosteal stripping of the femur because this may predispose to fracture nonunion. Periprosthetic fractures of the femur are a complex surgical problem and require specialized training in a range of surgical techniques.

  10. Management of extra-articular fractures of the distal tibia: intramedullary nailing versus plate fixation.

    Science.gov (United States)

    Casstevens, Chris; Le, Toan; Archdeacon, Michael T; Wyrick, John D

    2012-11-01

    Intramedullary nailing and plate fixation represent two viable approaches to internal fixation of extra-articular fractures of the distal tibia. Although both techniques have demonstrated success in maintaining reduction and promoting stable union, they possess distinct advantages and disadvantages that require careful consideration during surgical planning. Differences in soft-tissue health and construct stability must be considered when choosing between intramedullary nailing and plating of the distal tibia. Recent advances in intramedullary nail design and plate-and-screw fixation systems have further increased the options for management of these fractures. Current evidence supports careful consideration of the risk of soft-tissue complications, residual knee pain, and fracture malalignment in the context of patient and injury characteristics in the selection of the optimal method of fixation.

  11. Orion Boiler Plate Airdrop Test System

    Science.gov (United States)

    Machin, Ricardo A.; Evans, Carol T.

    2013-01-01

    On the 29th of February 2012 the Orion Capsule Parachute Assembly System (CPAS) project attempted to perform an airdrop test of a boilerplate test article for the second time. The first attempt (Cluster Development Test 2, July 2008) to deliver a similar boilerplate from a C-17 using the Low Velocity Air Drop (LVAD) technique resulted in the programmer parachute failing to properly inflate, the test article failing to achieve the desired test initiation conditions, and the test article a total loss. This paper will pick up where the CDT-2 failure investigation left off, describing the test technique that was adopted, and outline the modeling that was performed to gain confidence that the second attempt would be successful. The second boiler plate test (Cluster Development Test 3-3) was indeed a complete success and has subsequently been repeated several times, allowing the CPAS project to proceed with the full scale system level development testing required to integrate the hardware to the first Entry Flight Test vehicle as well as go into the Critical Design Review with minimum risk and a mature design.

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

    Directory of Open Access Journals (Sweden)

    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.

  13. A Sandwich Method Using Kapandji Intrafocal Pinning to Facilitate Palmar Plating of Displaced Distal Radius Fractures.

    Science.gov (United States)

    Huang, Hui-Kuang; Huang, Yi-Chao; Wang, Jung-Pan; Chang, Ming-Chau

    2017-09-01

    The use of palmar plating in the treatment of dorsally displaced distal radius fracture is very common, and can result in a good functional outcome. We present an easy "sandwich method" to reduce the fracture and to facilitate osteosynthesis. Firstly, the dorsal Kapandji intrafocal wire was applied to achieve the reduction of the dorsally displaced fracture and provide a volar-directed force. Then the intra-articular fractures were reduced or the metaphyseal defect is stuffed with bone graft if necessary. Finally, the anatomical plate is used to buttress and push back the distal fragment to complete the osteosynthesis. The postoperative radiographic parameters, comparing with the contralateral noninjured side, could achieve similar radial height, radial inclination, volar tilt, and ulnar variance without significant difference.

  14. Dynamic Hip Screw Compared to Condylar Blade Plate in the Treatment of Unstable Fragility Intertrochanteric Fractures

    Directory of Open Access Journals (Sweden)

    CK Yong

    2009-05-01

    Full Text Available Dynamic hip screw (DHS fixation is considered standard treatment for most intertrochanteric fractures. However, excessive sliding at the fracture site and medialisation of femoral shaft may lead in fixation failure. In contrast, fixed- angled 95° condylar blade plate (CBP has no effective dynamic capacity and causes little bone loss compared to DHS. We compared the outcome of 57consecutive unstable intertrochanteric fragility fractures treated with these two fixation methods. CBP instrumentation is more difficult requiring longer incision, operating time and higher surgeon- reported operative difficulty. The six month post-operative mortality rate is 16%. Post-operative Harris hip scores were comparable between the two methods. Limb length shortening more than 20 mm was 6-fold more common with DHS. In elderly patients with unstable intertrochanteric fragility fractures, fixed angled condylar blade plate appears to be a better choice than dynamic hip screws for preventing fixation failures.

  15. Outcome of Minimal Invasive Percutaneous Plate Osteosynthesis in closed fractures of distal tibia

    Directory of Open Access Journals (Sweden)

    Anil K Mishra

    2014-01-01

    Full Text Available Background: The limited soft tissue, subcutaneous location and poor vascularity render the dista tibial fractures very challenging. Treatment of distal tibial fractures using minimally invasive percutaneous plate osteosynthesis technique may minimise damage to soft tissues and vascular integrity of bony fragments, leaving comminuted fragments out of the mechanical construct, preserving soft tissues with limited operative exposure. Objective: To assess the outcome of patients treated with minimally invasive percutaneous plate osteosynthesis technique for closed distal tibial fractures. Methods: The study included total of 30 patients (24males and 6females with close distal tibia fracture, which were treated with distal tibia locking plate using minimally invasive percutaneous plate osteosynthesis technique. Results: The mean ages of the patient were 44.23 years (30 to58 years. Patients were followed up at 2 weeks, 6weeks, 12weeks, 24weeks and 1 year after the operation and evaluated clinically and radiologically. Among 30 pateints, all fractures went to union. The mean American orthopaedic foot and ankle score was 89.23% (SD-3.92. There was 2case of superficial infection and 3 case of plate impingement with no intraoperative complication and mortality rates. Conclusion: Minimally invasive percutaneous plate osteosynthesis is an effective technique for the management of distal tibial fractures. It is minimally invasive, though technically demanding, but preserves the biological environment by preserving the soft tissue with better outcome in terms of radiological union and functional outcome. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-2, 38-44 DOI: http://dx.doi.org/10.3126/jcmsn.v9i2.9686

  16. Treatment of intertrochanteric fractures of the femur withL.trapezoid compression plate and its mechanicalprinciples

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Objective: To improve the results of the treatment of unstable types of intertrochanteric fractures of the femur (ITFF) by internal fixation. Methods: A L-trapezoid compression plate system (L-TCP) was designed and compared to the AO/ASIF angle plates of 95° and 130° (L-AP) with mechanical tests. An Evans Type Ⅲ model was made, the simulation electrical test with loading on single and both legs were done. The results demonstrated that the stability of the L-TCP fixation was significantly greater, and the stress concentration at the upper screw hole was relevantly smaller than that of L-AP. From June 1986 to June 1998, 82 patients of ITFF were treated with L-TCP fixation. The average age was 67.4 years old (26-91). Seventy-four of those fractures were unstable. Fifty-eight patients were treated with open reduction, and 24 cases were treated by closed reduction and limited open (only lateral aspect of upper femur was exposed) fixation with L-TCP under X-ray monitoring. Results: Sixty-six patients were followed up for 6-69months. Complications, including 3 wound infection, 1 non-union, 3 coxa varus and 2 implant breakage (9complications of 7 cases ), all occurred in the open reduction group. No complication was found in the dosed reduction group. Conclusions: In the treatment of ITFF, the results of closed reduction and limited open fixation with L-TCP is significantly better than that of open reduction and fully exposed fixation.

  17. Custom 95 degree condylar blade plate for pediatric subtrochanteric femur fractures.

    Science.gov (United States)

    Segal, L S

    2000-02-01

    Subtrochanteric fractures in the older child and adolescent often are not amenable to conservative methods of treatment. The anatomic constraints of the proximal femur including the small diameter of the femoral neck and the presence of the capital femoral physis may limit the type of internal fixation used in these patients. This article presents our preliminary experience with a custom 95 degree condylar blade plate for subtrochanteric fractures in older children and adolescents.

  18. Minimally Invasive Stabilisation with Posterior Transiliac Plate of Pelvic Ring Fractures

    Directory of Open Access Journals (Sweden)

    Ferhat Say

    2013-11-01

    Full Text Available Aim: Transiliac posterior plate osteosynthesis is one of the surgical option for treating instable pelvic fractures. In this report, we aimed to evaluate clinical results of patients with pelvic fractures treated with transiliac plate osteosynthesis by minimally invasive methods. Material and Method: Patients with instable pelvic fractures treated with minimally invasive transiliac plate osteosynthesis were evaluated retrospectively. Radiographic assessments were made on pelvic x-rays using Tornetta and Matta methods. Functional results were evaluated using Hannover pelvic outcome score. Results: This study included 21 patients with a mean age of 37.8 years (range 17-62yrs. The mean follow-up period was 21.2 (6-38 months. According to AO classification, 14 patients had a C1 and 6 patients had a C2 and 1 patients had a C3 type pelvic fractures. Clinical results were excellent (4 point in 12 patients, good (3 point in 4 patients, fair (2 point in 5 patients according to Hannover pelvic outcome score. According to radiological assessments, the results were excellent (< 5 mm in 13 patients, good (5-10 mm dislocation in 6 patients and fair (10-20 mm dislocation in 2 patients. Superficial infection was detected in two patients. Loss of reduction occurred in two patients. Discussion: Minimally invasive transiliac plate osteosynthesis for treating pelvic fractures is a method with good clinical results and low neurovascular complication risks.

  19. Transforaminal Endoscopic Decompression for Displaced End Plate Fracture After Lateral Lumbar Interbody Fusion: Technical Note.

    Science.gov (United States)

    Wagner, Ralf; Telfeian, Albert E; Krzok, Guntram; Iprenburg, Menno

    2017-10-01

    Lateral lumbar interbody fusion is a minimally invasive approach to anterior spinal column fusion, deformity correction, and indirect decompression of the lumbar spine. A rarely reported possible complication of the procedure is end plate fracture, which has the potential for nerve root compression. Here we present a case of end plate fracture and nerve compression after stand-alone lateral lumbar interbody fusion, its diagnosis, and its subsequent successful treatment with transforaminal endoscopic spine surgery. The case highlights the possible role for minimally invasive endoscopic surgery as a rescue procedure after fusion complication. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Current Evidence: Plate Versus Intramedullary Nail for Fixation of Distal Tibia Fractures in 2016.

    Science.gov (United States)

    Vallier, Heather A

    2016-11-01

    Displaced distal tibia shaft fractures are effectively treated with standard plates and intramedullary nails. Plate fixation performed with meticulous soft tissue handling results in minimal risks of infection and poor wound healing. Standard plates have high rates of primary union, whereas locking plates may delay union because of increased stiffness. Tibial healing may also be delayed after plating of the fibula, although fibula reduction and fixation may aid accuracy of reduction of the tibia. Malalignment occurs more often with infrapatellar intramedullary nailing versus plates, and early results of suprapatellar nailing appear promising in minimizing intraoperative malalignment. Long-term function after fixation of the distal tibia is good for most, with poor outcomes often associated with baseline social and mental health issues.

  1. A STUDY OF SURGICAL MANAGEMENT OF DIAPHYSEAL FRACTURES OF HUMERUS BY DYNAMIC COMPRESSION PLATE OSTEOSYNTHESIS

    Directory of Open Access Journals (Sweden)

    Kuppa

    2015-01-01

    Full Text Available AIMS AND OBJECTIVES: To study the fractures, mechanism of injury, union rates and functional results of humeral shaft fractures treated with open reduction and internal fixation with dynamic compression plate. RESULTS: In present study, 25 patients of diaphyseal fractures of humerus, surgically managed by dynamic compression plate & screws, between O ctober 2012 to S eptember 2014 in government general hospital attached to kurnool medical college were included. The average age of the patient is 38.9 years, road traffic accidents being the most common mode of accident with 72%, middle third fractures were commonest with 80%, transverse fractures were the commonest with 52%, anterolateral approach was used in 88%, union achieved in 88% with mean time for union 15.56 weeks, iatrogenic radial nerve palsy in 4%, postoperative infection in 4%, full range of movements in 80%, with 8% nonunion . CONCLUSION : By the analysis of the data collected in the present study, dynamic compression plate & screws remains the implant of choice in the management of diaphyseal fractures of humerus.

  2. FUNCTIONAL AND RADIOLOGICAL OUTCOME OF DISTAL FEMORAL FRACTURES TREATED WITH LOCKING COMPRESSION PLATE

    Directory of Open Access Journals (Sweden)

    Muktevi

    2015-05-01

    Full Text Available AIM: To evaluate the clinical and radiological outcome in the management of distal femur fractures treated by distal femoral locking compression plate. BACKGROUND : Distal femur fractures are one of the common fractures occurring in road traffic accidents. Different treatment modalities with varying outcomes are seen in literature in the management of th e s e fractures. MATERIALS & METHODS: The study was con ducted in the department of orthopaedics at the Kamineni Institute of Medical sciences Narketpally. Patients treated for distal femur fractures with ORIF using distal femoral locking compression plates were evaluated to assess their clinical and functional results using Neer’s scoring system and compared with the available literature. RESULTS: The mean time for union was 20 wks. With mean time to full weight bearing being 10.5 wks . CONCLUSION: Surgery in the form of ORIF with distal femoral locking compression plate for Distal femur fracture is a comparatively good treatment option for better out come and early mobilization with minimum complications.

  3. Treatment of AO/OTA 31-A3 intertrochanteric femoral fractures with a percutaneous compression plate

    Directory of Open Access Journals (Sweden)

    Fei Luo

    2014-01-01

    Full Text Available OBJECTIVE: AO/OTA 31-A3 intertrochanteric femoral fractures have completely different fracture line directions and biomechanical characteristics compared with other types of intertrochanteric fractures. The choice of the fixation method has been a focus of dispute among orthopedic trauma surgeons. The purpose of this study was to review the outcomes of these fractures treated with a percutaneous compression plate at our institute. METHOD: Seventeen patients with AO/OTA 31-A3 intertrochanteric femoral fractures were treated with a percutaneous compression plate at our institute from January 2010 to December 2011. The clinical data and imaging results were retrospectively analyzed. RESULTS: The medical complication of popliteal vein thrombosis occurred in one patient. Sixteen patients were followed up for 12 to 21 months. Two patients had malunion and mild pain. Fracture collapse occurred in two patients, with one having head penetration. These two patients had moderate pain. There were no occurrences of nonunion or reoperation. The mean Harris hip score obtained during the last follow-up was 84.1 (61-97. Patients with a poor quality of reduction were more likely to have pain results (p = 0.001. A trend existed toward the presence of a poor quality of reduction (p = 0.05 in patients with a collapse of fracture. Patients with poor preoperative mobility were more likely to have a lower Harris hip score (p = 0.000. CONCLUSION: The percutaneous compression plate is an alternative device for the treatment of AO/OTA 31-A3 intertrochanteric femoral fractures. Good fracture reduction and an ideal placement position of the neck screw are important in the success of the device.

  4. Late extensor pollicis longus rupture following plate fixation in Galeazzi fracture dislocation

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    Dhananjaya Sabat

    2014-01-01

    Full Text Available Late rupture of extensor pollicis longus (EPL tendon after Galeazzi fracture dislocation fixation is an unknown entity though it is a well-established complication following distal radius fractures. We report the case of a 55-year old male who presented with late EPL tendon rupture 4 months following internal fixation of Galeazzi fracture dislocation with a Locking Compression Plate (LCP. He was managed with extensor indicis proprius (EIP transfer to restore thumb extension. At 4 years followup, functional result of the transfer was good. We identify possible pitfalls with this particular patient and discuss how to avoid them in future.

  5. Late extensor pollicis longus rupture following plate fixation in Galeazzi fracture dislocation.

    Science.gov (United States)

    Sabat, Dhananjaya; Dabas, Vineet; Dhal, Anil

    2014-07-01

    Late rupture of extensor pollicis longus (EPL) tendon after Galeazzi fracture dislocation fixation is an unknown entity though it is a well-established complication following distal radius fractures. We report the case of a 55-year old male who presented with late EPL tendon rupture 4 months following internal fixation of Galeazzi fracture dislocation with a Locking Compression Plate (LCP). He was managed with extensor indicis proprius (EIP) transfer to restore thumb extension. At 4 years followup, functional result of the transfer was good. We identify possible pitfalls with this particular patient and discuss how to avoid them in future.

  6. Multiplanar Fixation for Patella Fractures Using a Low-Profile Mesh Plate.

    Science.gov (United States)

    Lorich, Dean G; Warner, Stephen J; Schottel, Patrick C; Shaffer, Andre D; Lazaro, Lionel E; Helfet, David L

    2015-12-01

    Patella fractures are challenging orthopaedic injuries. Many commonly used fixation techniques can be ineffective and lead to poor clinical outcomes even with satisfactory reductions and fracture healing. In this investigation, we present the technique of cage plate fixation of patella fractures and the clinical outcomes of 9 initial patients surgically treated at our institution. This technique allows direct visualization of the articular reduction, provides multiplanar fixation, effectively stabilizes inferior pole comminution, and reduces the risk of patella vascular disruption. Using this technique, we have achieved excellent functional and radiographic outcomes.

  7. Treatment of distal clavicle fracture with distal radius volar locking compression plate

    Institute of Scientific and Technical Information of China (English)

    YU Chao; SUN Yue-hua; ZHAO Chang-qing; SHI Ding-wei; WANG You

    2009-01-01

    Objective: To observe the early clinical outcomes of the internal fixation with distal radius volar locking compression plate (LCP) in treatment of distal clavicle fracture.Methods: Six patients with unilateral distal clavicle fractures, identified as type Ⅱ according to Neer classification system, including 4 males and 2 females, were treated with open reduction and internal fixation using a distal radius volar LCP. Bone union was evaluated by routine X-ray radiography, and shoulder joint function were assessed by Constant score system.Results: All fractures achieved bone union at 6 to 8 weeks postoperatively, and Constant scores ranged from 95 to 100 at the postoperative 10 to 12 weeks.Conclusion: Fixation of distal clavicle fracture with distal radius volar LCP demonstrates excellent effects of bone union with rarely early complications, thus providing a new technique to treat distal clavicle fracture.

  8. Minimal invasive long PHILOS®-plate osteosynthesis in metadiaphyseal fractures of the proximal humerus.

    Science.gov (United States)

    Rancan, Mario; Dietrich, Michael; Lamdark, Tenzin; Can, Uenal; Platz, Andreas

    2010-12-01

    Minimal invasive plate osteosynthesis (MIPO) not only meets the criteria of a "biological" osteosynthesis by minimising invasivity as well as iatrogenic soft tissue damage, but can also provide adequate stability for fracture healing and early functional aftertreatment. Up to date, only few publications report on MIPO of humeral shaft fractures mainly using the anterolateral deltopectoral approach for proximal plate insertion. Objective of the present study was to assess the feasibility and clinical outcome of MIPO for metadiaphyseal fractures of the proximal humerus through a lateral approach using angular stable long PHILOS(®)-plates. We retrospectively evaluated 29 patients (mean age 77 years, range 48-95 years) with displaced metadiaphyseal fractures of the proximal humerus treated with MIPO technique. For the first time, an angular stable long PHILOS(®)-plate through a lateral deltoid-split approach proximally and a brachialis/brachioradialis intermuscular approach with exposure of the radial nerve distally, were used. There were no infections and no iatrogenic injuries to the axillary and radial nerve. One patient showed subacromial impingement and one patient had to be reoperated for redislocation of the distal fragment with screw breakage, which was most likely due to incorrect screw placement. This patient was successfully operated using the same method and implant. Besides one patient who refused further follow-up, 28 patients could be followed up to a mean of 8 months (range 3-12 months) each with an entirely healed fracture. Furthermore, patient's quality of life was documented using the SF-36 questionnaire. Comparison with published United States normative data showed no significant deficits in the physical as well as in the mental domains 8 months after MIPO. Minimal invasive long PHILOS(®)-plate osteosynthesis using a combined lateral deltoid-split and brachialis/brachioradialis intermuscular approach proved to be a safe procedure for the

  9. Contralateral reversed distal femoral locking plate for fixation of subtrochanteric femoral fractures

    Institute of Scientific and Technical Information of China (English)

    Paritosh Gogna; Reetadyuti Mukhopadhyay; Amanpreet Singh; Ashish Devgan; Sahil Arora; Amit Batra; Sushil Kumar Yadav

    2015-01-01

    Purpose:Subtrochanteric fractures of the femur are being managed successfully with various intramedullary and extramedulary implants with reasonable success.However,these implants require precise placement under image intensifier guidance,which exposes the surgeon to substantial amount of radiation.It also restricts the management of these fractures at peripheral centers where facility of image intensifiers is not available.Keeping this in mind we designed this study to identify if contralateral reversed distal femoral locking plate can be used successfully without the use of image intensifier.Methods:Twenty-four consecutive patients (18 men and 6 women) with a mean age of 28 years (range 19-47 years) suffering subtrochanteric fractures of the femur underwent open reduction and internal fixation with reversed contralateral distal femoral locking plate.The outcome was assessed at the mean follow-up period of 3.2 years (range 2-4.6 years) using the Harris hip score.Results:Twenty-one fractures united with the primary procedure,with a mean time of consolidation being 11 weeks (range,9-16 weeks).One patient developed superficial suture line infection,which resolved with oral antibiotics.Another patient had a fall 3 weeks after surgery and broke the plate.Repeat surgery with reversed distal femoral locking compression plate was performed along with bone grafting and the fracture united.Two cases had nonunion,which went in for union after bone grafting.The mean Harris hip score at the time of final follow-up was 90.63 (range 82-97).Conclusion:The reversed contralateral distal femoral plate is a biomechanically sound implant,which when used for fixation of the subtrochanteric fractures with minimal soft tissue stripping shows results comparable to those achieved by using other extramedullary implants as well as intramedullary devices.The added advantage of this implant is its usability in the absence of an image intensifier.

  10. A Comprehensive Study of Internal Distraction Plating, an Alternative Method for Distal Radius Fractures

    Science.gov (United States)

    Mavani, Kinjal J

    2016-01-01

    Introduction The management of highly comminuted distal radius fractures still remains a major treatment challenge. Articular comminution and compromised bone quality are the culprits. One novel approach is the technique of Internal Distraction Plating which involves “bridging” the fracture with the use of a standard 3.5mm plate applied dorsally in distraction from the radius, proximal to the fracture, to the long finger metacarpal distally, bypassing the comminuted segment. The plate is removed once fracture union has been achieved. Aim The present study was conducted with the aim to evaluate the role of internal dorsal distraction plating as an alternative method in the treatment of fracture distal radius in terms of special indications, technique and outcome. Materials and Methods This study was a prospective longitudinal study on 20 patients (mean age 62 years) treated with internal distraction plating for comminuted distal radius fractures with specific indications. Regular follow-ups with standard radiographs and analysis were done upto 24 months. Functional outcome were assessed by DASH Score and the Gartland and Werley demerit score. Results At final follow-up, all fractures had united and X-rays showed mean palmar tilt of 7°, positive ulnar variance of 0.5mm, radial inclination of 18° and average loss of 2mm of radial height. Mean range of motion values for wrist flexion 46°, extension 50°, pronation 79° and supination 77° At final follow-up, the mean DASH score was 32. 85% patient had excellent to good result as per Gartland and Werley demerit score. This construct has yield satisfactory clinical and radiographic results with these very challenging injuries. Conclusion The purpose of this study was to report the radiographic and the functional outcomes of treatment with this technique. External fixator and volar plating in communited distal end radius fractures are not always satisfactory in old age with osteoporotic bone because of

  11. Fracture behavior of stainless steel-toughened NiAl composite plate

    Science.gov (United States)

    Nardone, Vincent C.

    1992-02-01

    Analysis of the tensile and fracture behavior of a composite system consisting of boron carbide particulate-reinforced NiAl with continuous 304 stainless steel toughening regions was performed. The composite was fabricated by extrusion, with the toughening regions extending along the length of the plate in the extrusion direction. Mechanical properties were determined as a function of orientation. Tensile testing revealed that the composite modulus varied only slightly as a function of testing direction, the strength was approximately 25 pct greater in the longitudinal relative to the transverse orientation, and the transverse failure strain was only 0.3 pct compared to values in excess of 10 pct for longitudinal testing. Notched Charpy impact testing indicated that the energy absorption values varied significantly as a function of specimen location and crack growth direction, ranging from 2 to 40 Joules. In addition, K IC values measured on subsize compact tension samples were found to range from 17 to 27 MPa ṡ m1/2. It was also established that the K max values determined from the maximum load measured during compact tension testing were similar to the K Q values calculated from instrumented notched Charpy impact testing. Finally, the fatigue crack growth characteristics of the composite were determined as a function of orientation.

  12. STUDY OF FUNCTIONAL OUTCOME OF DISTAL FEMUR FRACTURES TREATED BY OPEN REDUCTION AND INTERNAL FIXATION WITH LOCKING COMPRESSION PLATE

    Directory of Open Access Journals (Sweden)

    Sahaya R

    2016-04-01

    Full Text Available BACKGROUND Distal femur fractures account for about 7% of all femur fractures. These fractures can lead to knee stiffness and have the tendency to collapse into varus. The management of distal femur fractures has seen a paradigm shift from nonoperative measures to biological fixation and evolution of modern implants like Locking Compression Plate has been used in current times. With the use of Locking Compression Plate double plating can be avoided. In our study, we have evaluated the short-term Functional Outcome of patients who underwent open reduction internal fixation with Locking Compression Plate using Sander’s criteria. Ours is both prospective and retrospective study of 20 patients with distal femur fractures treated operatively from April 2013 to October 2015. Our surgical modality of treatment is open reduction and internal fixation with locking compression plate using standard lateral approach. We have used AO classification to classify the distal femur fractures. With the results of our study, we have come to a conclusion that locking compression plate is a best option for both intra-articular and extra-articular distal femur fractures. It avoids the use of dual plating of distal femur which requires extensive soft tissue stripping in both sides, resulting in reduced blood supply, potential non-union and implant failure. Locking Compression Plate also helps in anatomical reduction of comminuted intra-articular fractures and it could also be used effectively in osteoporotic bone.

  13. Plasticity, Fracture and Friction in Steady-State Plate Cutting

    DEFF Research Database (Denmark)

    Simonsen, Bo Cerup; Wierzbicki, Tomasz

    1997-01-01

    A closed form solution to the problem of steady-state wedge cutting through a ductile metal plate is presented. The considered problem is an idealization of a ship bottom raking process, i.e. a continuous cutting damage of a ship bottom by a hard knife-like rock in a grounding event. A new...

  14. Early results for treatment of three- and four-part fractures of the proximal humerus using the PHILOS plate system.

    Science.gov (United States)

    Moonot, P; Ashwood, N; Hamlet, M

    2007-09-01

    Secure fixation of displaced proximal fractures of the humerus is a challenging problem. A total of 32 patients with acutely displaced three- or four-part proximal fractures of the humerus were treated by open reduction and internal fixation using the proximal humeral internal locking system (PHILOS) plate. There were 23 women and nine men with a mean age of 59.9 years (18 to 87). Data were collected prospectively and the outcomes were assessed using the Constant score. The mean follow-up was for 11 months (3 to 24). In 31 patients (97%) the fracture united clinically and radiologically at a mean of 10 weeks (8 to 24). The mean Constant score at final review was 66.5 (30 to 92). There was no significant difference in outcome when comparing patients aged more than 60 years (18 patients) with those aged less than 60 years (14 patients) (t-test, p = 0.8443). There was one case each of nonunion, malunion and a broken screw in the elderly population. This plate provides an alternative method of fixation for fractures of the proximal humerus. It provides a stable fixation in young patients with good-quality bone sufficient to permit early mobilisation. Failure of the screws to maintain fixation in the elderly remains a problem.

  15. 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...

  16. Clinical evaluation of locking compression plate fixation for comminuted olecranon fractures

    NARCIS (Netherlands)

    Buijze, G.; Kloen, P.

    2009-01-01

    BACKGROUND: In patients managed with plate fixation for the treatment of an olecranon fracture, the placement of an axial intramedullary screw may obstruct the placement of bicortical screws in the ulnar shaft. To overcome this problem, unicortical screws can be applied with use of a contoured locki

  17. The plate fixation in the treatment of complex forearm open fractures

    Directory of Open Access Journals (Sweden)

    Meric Ugurlar

    2017-04-01

    Conclusion: In high nergy traumas of the upper extremity associated with complex injuries and Type-IIIC forearm fractures, severity of soft tissue injuries determined the functional results in patients, demonstrating it is possible to achieve a safe and efficient fixation with immediate plate-screw osteosynthesis. [Hand Microsurg 2017; 6(1.000: 1-8

  18. Condylar orientation plating in comminuted intraarticular fractures of adult distal humerus

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    Sukhendu Sarkhel

    2015-01-01

    Conclusion: Excellent pain free range of motion with a high rate of union can be achieved in comminuted intraarticular distal humerus fractures in adults with the use of condylar orientation precontoured plating technique. Condylar orientation is very important with perfect articular congruity in elbow motion.

  19. A STUDY OF FUNCTIONAL OUTCOME OF FRACTURES OF UPPER END HUMERUS TREATED BY PHILOS PLATE

    Directory of Open Access Journals (Sweden)

    Ananthula Krishna

    2015-10-01

    Full Text Available Proximal humeral fractures account for about 5% of all injuries to the appendicular skeleton. The majority of proximal humeral fractures are either un - displaced or minimally displaced which can be managed conservatively. Only 20% of proximal humeral fractu res need surgical intervention. Many surgical techniques have been described. Over the last 3 decades, various modalities of fixations have been evolved for the treatment of these injuries (trans - osseous suturing, percutaneous pinning, tension band wiring, plating, nailing, arthroplasty. The proximal humerus internal locking system (PHILOS plate, a fixed - angle construct has been developed to maintain angular stability under load and to improve screw fixation in osteoporotic bones. In our study 29 patients with unstable proximal humerus fractures were treated with open reduction and internal fixation using PHILOS plate. In 85% of cases the results were excellent to good. In this study, w e observed that the locking compression plate is an advantageous implan t in the treatment of these cases due to its angular stability particularly in comminuted fractures and in osteoporotic bones.

  20. The basket plate in the osteosynthesis of comminuted fractures of distal pole of the patella.

    Science.gov (United States)

    Matejcić, A; Smiljanić, B; Bekavac-Beslin, M; Ledinsky, M; Puljiz, Z

    2006-06-01

    The purpose of this study was to evaluate the basket plate in the treatment of comminuted fractures of the distal pole of the patella (patellar apex fracture). The basket plate was designed by Smiljanić Branimir M.D., Clinical Professor of Surgery, at the Department of Surgery, The University Hospital Sestre milosrdnice, Zagreb, Croatia. In the period from 1988 to 2003, more than 100 patients with comminuted patellar apex fractures had been treated with basket plate osteosynthesis in the Department of Surgery. Only 51 patients were subsequently available for knee examination. For evaluation of the knee, we used a modified Cincinnati knee rating system, using a manual dynamometer in the evaluation of the knee extension. The results were excellent in 30 patients, good in 16 and satisfactory in 5 patients; no poor results were observed. The stability of the osteosynthesis by basket plate allows osseous consolidation if the fracture and permits loading the leg with full body weight early in the postoperative period.

  1. A simple technique for double plating of extraarticular distal humeral shaft fractures.

    Science.gov (United States)

    Sharaby, Mohamed; Elhawary, Ahmed

    2012-12-01

    Plate fixation of extraarticular distal humeral shaft fracture is often difficult. Traditional techniques do not allow for stable fixation. A single DCP plate may have inadequate purchase in the distal fragment. The use of large plates extending distally over the lateral supracondylar ridge is often associated with pain and sometimes interferes with elbow range of motion. In this study, 22 patients with extra articular distal humeral fractures were managed with dual plating using a paratricipital approach. The first plate--a narrow DCP--was fixed on the dorsal surface of the humerus. The second plate--a small 3.5 reconstruction plate--was fixed on the dorsolateral surface. Elbow motion was started immediately after surgery. The average follow-up duration was 25 months. The mean elbow flexion/extension are was 4 degrees to 138 degrees. Infection was reported in two cases and was managed successfully with conservative measures. Postoperative radial nerve contusion was reported in one case with complete resolution within 3 months.

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

    Directory of Open Access Journals (Sweden)

    Hassan BOUSSAKRI

    2016-03-01

    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.

  3. A RETROSPECTIVE STUDY OF PROXIMAL HUMERUS INTERNAL LOCKING SYSTEM PLATING FOR DISPLACED PROXIMAL HUMERUS FRACTURES

    Directory of Open Access Journals (Sweden)

    Kumarswami Ramulu

    2016-05-01

    Full Text Available AIM The aim of the present study was to evaluate the functional outcome, benefits and complications of open reduction and internal fixation of displaced proximal humerus fractures with proximal humerus locking plate. METHODS We studied the functional outcome of 40 patients aged between 15 to 65 years from September 2013 to February 2015, who had displaced proximal humerus fracture and underwent PHILOS plate fixation for the same. Fractures were classified according to NEER’s and AO classification. Patients were followed up for a minimum period of 1 year. Functional outcomes and shoulder range of movement were assessed based on the Constant and Murley scoring system. RESULTS Patients were followed up for 12 months. All fractures healed satisfactorily; 12 weeks (27.5% was the most common union time (radiological finding in the study population followed by 8 weeks (22.5% and 10 weeks (20%. Avascular necrosis was noted in 1 patient, mild infection in 2 patients and stiffness in 2 patients. The mean Constant score at 6 weeks was 40.39, at 12 weeks was 59.24, at 6 months was 73.88 and at one year was 75.62. Constant score continues to improve till 1 year. CONCLUSION Proximal humerus locking plate gives a reliable, stable fixation for fractures of proximal humerus with a good radiological union and good functional outcome.

  4. Finite Element-Derived Surrogate Models of Locked Plate Fracture Fixation Biomechanics.

    Science.gov (United States)

    Wee, Hwabok; Reid, J Spence; Chinchilli, Vernon M; Lewis, Gregory S

    2017-03-01

    Internal fixation of bone fractures using plates and screws involves many choices-implant type, material, sizes, and geometric configuration-made by the surgeon. These decisions can be important for providing adequate stability to promote healing and prevent implant mechanical failure. The purpose of this study was to develop mathematical models of the relationships between fracture fixation construct parameters and resulting 3D biomechanics, based on parametric computer simulations. Finite element models of hundreds of different locked plate fixation constructs for midshaft diaphyseal fractures were systematically assembled using custom algorithms, and axial, torsional, and bending loadings were simulated. Multivariate regression was used to fit response surface polynomial equations relating fixation design parameters to outputs including maximum implant stresses, axial and shear strain at the fracture site, and construct stiffness. Surrogate models with as little as three regressors showed good fitting (R (2) = 0.62-0.97). Inner working length was the strongest predictor of maximum plate and screw stresses, and a variety of quadratic and interaction terms influenced resulting biomechanics. The framework presented in this study can be applied to additional types of bone fractures to provide clinicians and implant designers with clinical insight, surgical optimization, and a comprehensive mathematical description of biomechanics.

  5. OSTEOSYNTHESIS OF PROXIMAL HUMERAL END FRACTURES WITH FIXED-ANGLE PLATE AND LOCKING SCREWS: TECHNIQUE AND RESULTS

    Science.gov (United States)

    Cohen, Marcio; Amaral, Marcus Vinicius; Monteiro, Martim; Brandão, Bruno Lobo; Motta Filho, Geraldo Rocha

    2015-01-01

    Describe the results of proximal humeral fractures surgically treated with the Philos locking plate system. Method: Between March 2003 and October 2004 we prospectively reviewed 24 of 26 patients with proximal humerus fractures treated with a Philos plate. The mean follow-up time was 12 months and the mean age of patients was 57 years. Six patients had four-part proximal humerus fractures, 11 patients had three-part proximal humerus fractures, and nine patients had two-part proximal humerus fractures. Clinical evaluation was performed using the University of California at Los Angeles (UCLA) criteria. Results: The mean UCLA score was 30 points (17-34). All fractures showed union. Three patients showed fracture union at varus position. The mean UCLA score for these patients was 27 points. Conclusion: Osteosynthesis with Philos plate provides a stable fixation method with good functional outcome. PMID:26998460

  6. Internal plate fixation versus plaster in displaced complete articular distal radius fractures, a randomised controlled trial.

    Science.gov (United States)

    Mulders, Marjolein A M; Walenkamp, Monique M J; Goslings, J Carel; Schep, Niels W L

    2016-02-09

    Of all distal radius fractures, 25 % are complete articular fractures (AO/OTA type C fractures). Two thirds of those fractures are displaced and require reduction. According to several International Guidelines, adequately reduced intra-articular distal radius fractures are best treated non-operatively with plaster immobilisation, while surgical fixation is suggested only when the articular step exceeds 2 mm after reduction. However, these recommendations are based on studies that did not differentiate between intra- and extra-articular distal radius fractures. Thus, no clear consensus about the best treatment for patients with displaced intra-articular distal radius fractures can be reached. Despite the lack of evidence, an increase in internal fixation of intra-articular distal radius fractures has been observed over the last decade. The aim of this study is to determine the difference in functional outcome following open reduction and plate fixation compared with non-operative treatment with closed reduction and plaster immobilisation in patients with a displaced intra articular distal radius fracture. This multicentre randomised controlled trial will randomise between open reduction and internal plate fixation (intervention group) and closed reduction and plaster immobilisation (control group). All consecutive adult patients from 18 to 65 years with a displaced intra-articular distal radius fracture (AO/OTA type C), which has been adequately reduced at the Emergency Department according to the Dutch National Guidelines, are eligible for inclusion in this study. The primary outcome is function and pain of the wrist assessed with the Patient-Rated Wrist Evaluation score (PRWE). Secondary outcomes are the Disability of the Arm, Shoulder and Hand score (DASH), pain, quality of life (SF-36), range of motion, grip strength, radiological parameters, complications, crossovers and cost-effectiveness of both treatments. A total of 90 patients will be included in this

  7. 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.

  8. Radionuclide Transport in Tuff and Carbonate Fractures from Yucca Flat, Nevada Test Site

    Energy Technology Data Exchange (ETDEWEB)

    Zavarin, M; Johnson, M R; Roberts, S K; Pletcher, R; Rose, T P; Kersting, A B; Eaton, G; Hu, Q; Ramon, E; Walensky, J; Zhao, P

    2006-02-01

    In the Yucca Flat basin of the Nevada Test Site (NTS), 747 shaft and tunnel nuclear detonations were conducted primarily within the tuff confining unit (TCU) or the overlying alluvium. The TCU in the Yucca Flat basin is hypothesized to reduce radionuclide migration to the regional carbonate aquifer (lower carbonate aquifer) due to its wide-spread aerial extent and chemical reactivity. However, shortcuts through the TCU by way of fractures may provide a migration path for radionuclides to the lower carbonate aquifer (LCA). It is, therefore, imperative to understand how radionuclides migrate or are retarded in TCU fractures. Furthermore, understanding the migration behavior of radionuclides once they reach the fractured LCA is important for predicting contaminant transport within the regional aquifer. The work presented in this report includes: (1) information on the radionuclide reactive transport through Yucca Flat TCU fractures (likely to be the primary conduit to the LCA), (2) information on the reactive transport of radionuclides through LCA fractures and (3) data needed to calibrate the fracture flow conceptualization of predictive models. The predictive models are used to define the extent of contamination for the Underground Test Area (UGTA) project. Because of the complex nature of reactive transport in fractures, a stepwise approach to identifying mechanisms controlling radionuclide transport was used. In the first set of TCU experiments, radionuclide transport through simple synthetic parallel-plate fractured tuff cores was examined. In the second, naturally fractured TCU cores were used. For the fractured LCA experiments, both parallel-plate and rough-walled fracture transport experiments were conducted to evaluate how fracture topography affects radionuclide transport. Tuff cores were prepared from archived UE-7az and UE-7ba core obtained from the USGS core library, Mercury, Nevada. Carbonate cores were prepared from archived ER-6-1 core, also obtained

  9. 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.

  10. The Outcome in Early Cases of Treatment of Subtrochanteric Fractures with Proximal Femur Locking Compression Plate

    Directory of Open Access Journals (Sweden)

    U Gunadham

    2014-07-01

    Full Text Available The objective of this study was to evaluate the outcome in early treatment of subtrochanteric fractures with proximal femur locking compression plate (PF-LCP.The patients included in this study were those with subtrochanteric fractures (AO type 32A-C treated with PF-LCP (Synthes between Jan 2009 and Jun 2011. The patient characteristics and details of clinical conditions were obtained from records. Clinical and radiographic follow-ups were done at one, two, four and 6 months intervals, and at one year. The primary outcome studied included fracture union and functional ambulatory status. Twenty-six patients were included in the study, 19 of whom were male with a mean age of 42.4 years. Fourteen patients (53.9% had sustained AO type 32B fractures, the majority in motor vehicle accidents. Twenty-two fractures (84.6% achieved union, while sixpatients (23.1% had complications such as broken plate, varus collapse, and broken screw. Four patients (15.4% underwent a second operation. At the end of the follow-ups, 25 patients (96.2% were community ambulators. We conclude that PF-LCP is an effective alternative treatment for subtrochanteric fractures when properly performed.

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

    Institute of Scientific and Technical Information of China (English)

    TONG Da-ke; JI Fang; CAI Xiao-bing

    2011-01-01

    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 operation 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.

  12. Comparison of crossed screw versus plate fixation for radial neck fractures.

    Science.gov (United States)

    Gutowski, Christina J; Darvish, Kurosh; Ilyas, Asif M; Jones, Christopher M

    2015-11-01

    Fixation of radial neck fractures can be achieved with a plate and screw construct or, in absence of comminution, with two obliquely-oriented screws. This study investigated the mechanical properties, specifically the stiffness and load to failure, of these two fixation strategies in a cadaver model. Ten matched-pair radii were removed from fresh cadaver arms. A transverse osteotomy was created at the neck of each radius. Right-sided radii were fixed with two oblique headless compression screws; left-sided radii were fixed with a radial neck plate. The distal aspect of each radius was potted in urethane casting resin. The radial head was loaded in shear in 4 different planes (medial to lateral, lateral to medial, posterior to anterior, and anterior to posterior) using an Instron machine. Stiffness and load to failure were recorded. The stiffness of both constructs was similar in all planes except for loading from medial to lateral where the screw construct was 1.8 times stiffer. Average ultimate failure occurred at 229N for the screws and 206N for the plate. Failure strength was not statistically different. However, mode of failure differed for both fixation constructs, the plate failed in bending while the screws failed by pullout and fracture. The two strategies provide similar strength and stiffness for the fixation of transverse, non-comminuted radial neck fractures. While plate and screw constructs are more appropriate for axially unstable or comminuted fractures, two oblique screws might be preferred for simple transverse neck fractures since this strategy requires less exposure and the implant is buried. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. HE NEW METHOD OF MINIMALLY INVASIVE OSTEOSYTHESIS OF HUMERAL SHAFT FRACTURES WITH HELICAL PLATES

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    A. Y. Kochish

    2016-01-01

    Full Text Available The purpose of investigation is to approve the new method of minimally invasive plate osteosynthesis in cases of diaphyseal humeral shaft fractures with helical plate.Materials and methods. During experimental cadaveric part of the study implantation of long helical plate on humerus using minimally invasive technique on 14 fresh cadaveric shoulders was done. plate was inserted from two incisions 3-5 cm long in the upper part of the shoulder on the lateral side and in the lower part on the anterior side. Clinical part of the study included 31 patients with isolated humeral shaft fractures and humeral shaft fractures associated with fractures of proximal humerus and treated by minimally invasive fixation with helical plate.Results. Cadaveric study included preparation and special measuring and showed that implantation of the helical plate in proposed way gives safe distances between plate and axial, radial, musculocutaneous, median nerves, main humeral vessels and tendon of the long head of the biceps.Results of the clinical part of the study: radiological evidence of bone healing were observed on the 12 weeks in 10 from 28 cases (36%, on the 18 weeks in 18 from 25 (72%, on the 24 weeks in all 25 cases (100%. On the 24 weeks after surgery results on the DASH scale in average were 13±3,6 (from 3 to 36. Where in good results were in 17 (68% cases, satisfactory in 8 (32% cases. On the Constant Shoulder Score at the same time averege results were 80±4,63 (from 60 to 91. Exellent result was in 7 (28% cases, good in 12 (48%, satisfactory in 5 (20% cases and bad in one (4% case with subacromial impidgement after wrong plate positioning. There were no any cases of vascular and neurological complications and nonunions.Conclusion. Minimally invasive fixation of humeral shaft fractures with helical plates is safe and effective method of surgical treatment with good dynamic of functional rehabilitation and can be recommended for clinical use.

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

    Science.gov (United States)

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

    2014-07-24

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

  15. Double plating in Vancouver type B1 periprosthetic proximal femur fractures: A biomechanical study.

    Science.gov (United States)

    Wähnert, Dirk; Grüneweller, Niklas; Gehweiler, Dominic; Brunn, Benjamin; Raschke, Michael J; Stange, Richard

    2017-02-01

    Periprosthetic hip fractures are an increasing problem in modern orthopedic and trauma surgery. Many options for the operative treatment are available to the surgeon ranging from modern variable angular systems to standard plates, screws, and cerclages. However, there is no gold standard and therefore, the aim of this study, was to investigate the biomechanical characteristics of double plating versus a lateral standard plate in a Vancouver B1 fracture model. Ten 4th generation composite femora were used to implant cementless total hip prosthesis and create Vancouver B1 periprosthetic fractures. Afterwards, the osteotomies were fixed using the locking compression plate in combination with the locking attachment plate (LCP, LAP, DePuy Synthes, Solothurn, Switzerland)-group I. Group II additionally achieved a 5-hole 4.5/5.0 mm LCP anteriorly. Each construct was cyclically loaded to failure in axial compression. Axial construct stiffness was 50.87 N/mm (SD 1.61) for group I compared to 738.68 N/mm (SD 94.8) for group II, this difference was statistically significant (p = 0.016). The number of cycles to failure was also significant higher for group II (2,375 vs. 13,000 cycles; p = 0.016). Double plating can significantly increase construct stiffness and stability, and thus, is an option in the treatment of complex periprosthetic fractures, in revision surgery and for patients with the inability to partial weight bear. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:234-239, 2017.

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

    Directory of Open Access Journals (Sweden)

    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.

  17. Comparative Study of Plating versus Nailing in Distal Tibia Metaphyseal Fractures

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    Jayesh V Vaza

    2014-12-01

    Full Text Available Distal tibial metaphyseal fracture are unique.we have studied 40 pt in sir j.j.hospital group of the hospitals from periods MAY 2009 and APRIL 2011 .The study prospective and comparative for the methods used for management of this fracture. The best option for surgical treatment of distal metaphyseal fractures of tibia is still unclear. The purpose of this study was, first, to confirm whether closed reduction and intramedullary nailing produces better results than open reduction and internal fixation with precontoured locked plate and screws and, second, to establish indications for each modality. The overall results were comparable and most patients were satisfied with the results. These results indicate that both modalities of treatment deserve a place in treating distal metaphyseal fractures of tibia. [Natl J Med Res 2014; 4(4.000: 340-344

  18. Functional outcome following proximal humeral interlocking system plating for displaced proximal humeral fractures

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    Thyagarajan David

    2009-01-01

    Full Text Available Aim: To assess the functional outcome following internal fixation with the PHILOS (proximal humeral interlocking system for displaced proximal humeral fractures. Patients and Methods: We reviewed 30 consecutive patients treated surgically with the proximal humeral locking plate for a displaced proximal humeral fracture. Functional outcome was determined using the American Shoulder and Elbow Society (ASES score and Constant Murley score. Results: Average age of the patients was 58 years (range, 19-92 years. The average overall ASES score was 66.5. The average overall Constant score was 57.5. Conclusion: Our results show that good fracture stability was achieved, and the functional outcome was very good in younger patients and it declined with increasing age. Early mobilization of the shoulder can be achieved without compromising fracture union.

  19. Reverse distal femoral locking compression plate a salvage option in nonunion of proximal femoral fractures

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    Sampat S Dumbre Patil

    2016-01-01

    Full Text Available Background: When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN or surface implants like Dynamic Condylar Screw (DCS are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other. We used the reverse distal femur locking compression plate (LCP of the contralateral side in such cases undergoing revision surgery. This implant has multiple options of fixation in proximal femur and its curvature along the length matches the anterior bow of the femur. We aimed to evaluate the efficacy of this implant in salvage situations. Materials and Methods: Twenty patients of failed primary proximal femoral fractures who underwent revision surgery with reverse distal femoral locking plate from February 2009 to November 2012 were included in this retrospective study. There were 18 subtrochanteric fractures and two ipsilateral femoral neck and shaft fractures, which exhibited delayed union or nonunion. The study included 14 males and six females. The mean patient age was 43.6 years (range 22-65 years and mean followup period was 52.1 months (range 27-72 months. Delayed union was considered when clinical and radiological signs of union failed to progress at the end of four months from initial surgery. Results: All fractures exhibited union without any complications. Union was assessed clinically and radiologically. One case of ipsilateral femoral neck and shaft fracture required bone grafting at the second stage for delayed union of the femoral shaft fracture. Conclusions: Reverse distal femoral LCP of the contralateral side can be used as a salvage option for failed fixation of proximal femoral fractures exhibiting nonunion.

  20. Reverse distal femoral locking compression plate a salvage option in nonunion of proximal femoral fractures

    Science.gov (United States)

    Dumbre Patil, Sampat S; Karkamkar, Sachin S; Patil, Vaishali S Dumbre; Patil, Shailesh S; Ranaware, Abhijeet S

    2016-01-01

    Background: When primary fixation of proximal femoral fractures with implants fails, revision osteosynthesis may be challenging. Tracts of previous implants and remaining insufficient bone stock in the proximal femur pose unique problems for the treatment. Intramedullary implants like proximal femoral nail (PFN) or surface implants like Dynamic Condylar Screw (DCS) are few of the described implants for revision surgery. There is no evidence in the literature to choose one implant over the other. We used the reverse distal femur locking compression plate (LCP) of the contralateral side in such cases undergoing revision surgery. This implant has multiple options of fixation in proximal femur and its curvature along the length matches the anterior bow of the femur. We aimed to evaluate the efficacy of this implant in salvage situations. Materials and Methods: Twenty patients of failed primary proximal femoral fractures who underwent revision surgery with reverse distal femoral locking plate from February 2009 to November 2012 were included in this retrospective study. There were 18 subtrochanteric fractures and two ipsilateral femoral neck and shaft fractures, which exhibited delayed union or nonunion. The study included 14 males and six females. The mean patient age was 43.6 years (range 22–65 years) and mean followup period was 52.1 months (range 27–72 months). Delayed union was considered when clinical and radiological signs of union failed to progress at the end of four months from initial surgery. Results: All fractures exhibited union without any complications. Union was assessed clinically and radiologically. One case of ipsilateral femoral neck and shaft fracture required bone grafting at the second stage for delayed union of the femoral shaft fracture. Conclusions: Reverse distal femoral LCP of the contralateral side can be used as a salvage option for failed fixation of proximal femoral fractures exhibiting nonunion. PMID:27512218

  1. Osteosynthesis of Proximal Humeral Fractures with the Fixed Angle PHILOS-plate.

    Science.gov (United States)

    Klitscher, Daniela; Blum, Jochen; Andreas, Dominik; Hessmann, Martin; Kuechle, Raphael; du Prel, Jean-Baptist; Rommens, Pol Maria

    2008-02-01

    In a retrospective study we analyzed the functional and radiological outcome of 30 proximal humeral fractures, treated by PHILOS-plate, a fixed-angle device. Two of them were characterized as type Neer III, 14 as type Neer IV, 5 as type Neer V and 9 as type Neer VI. There were 2 2-part, 16 3-part and 12 4-part fractures. According to the constant-score, the normalized constant-score and the UCLA-score, good to excellent results were obtained in 66.7, 76.7 and 76.7%. Twenty-six (86.7%) patients had no or mild pain. Active forward flexion and active abduction over 90° was possible in 26 (86.7%) cases. Four (13.3%) patients developed partial avascular necrosis. Screw perforation was seen in 3 (10%) cases, delayed union in 1 (3.3%) case, malunion in 1 case and a loosening of plate and screws in another one. A secondary varus displacement of 5°-35° with a mean of 7° was found in 19 (63.3%) cases. The average time to union was 75 days. Fixation with PHILOS-plate is an adequate treatment for displaced 2- to 4-part fractures. Even in dislocated or 4-part fractures or in patients over 65 years good to excellent results were seen in the majority of cases.

  2. Conservative treatment, plate fixation, or prosthesis for proximal humeral fracture. A prospective randomized study

    Directory of Open Access Journals (Sweden)

    Launonen Antti P

    2012-09-01

    Full Text Available Abstract Background Proximal humerus fracture is the third most common fracture type after hip and distal radius fracture in elderly patients. A comprehensive study by Palvanen et al. demonstrated an increase in the annual fracture rate of 13.7% per year over the past 33 years. Should this trend continue, the fracture rate would triple over the next three decades. The increasing incidence of low-energy fractures raises questions about the optimal treatment in terms of functional outcome, pain, and rehabilitation time, as well as the economical impact. Despite the high incidence and costs of proximal humerus fractures, there is currently no valid scientific evidence for the best treatment method. Several publications, including a Cochrane review outline the need for high-quality, well-designed randomized controlled trials. Methods/Design The study is a prospective, randomized, national multi-center trial. The hypothesis of the trial is that surgical treatment of displaced proximal humerus fractures achieves better functional outcome, pain relief, and patient satisfaction compared to conservative treatment. The trial is designed to compare conservative and surgical treatment of proximal humerus fractures in patients 60 years and older. The trial includes two strata. Stratum I compares surgical treatment with locking plates to conservative treatment for two-part fractures. Stratum II compares multi-fragmented fractures, including three- and four-part fractures. The aim of Stratum II is to compare conservative treatment, surgical treatment with the Philos locking plate, and hemiarthroplasty with an Epoca prosthesis. The primary outcome measure will be the Disabilities of the Arm, Shoulder and Hand (DASH score and the secondary outcome measures will be the EuroQol-5D (EQ-5D value, OSS, Constant-Murley Score, VAS, and 15D. Recruiting time will be 3 years. The results will be analyzed after the 2-year follow-up period. Discussion This publication

  3. Surgical outcome of proximal femoral fractures using proximal femoral - locking compression plate

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    Prakash A. Sasnur

    2015-07-01

    Full Text Available Introduction: Proximal femoral fractures are complex fractures following devastating injuries in young and elderly population. Despite marked improvement in implant design, surgical technique and patient care these fractures are associated with high incidence of implant failure, refracture and varus collapse. Intramedullary nails are technically demanding and associated with high re-operation rates. The study was done to evaluate the outcome of proximal femoral fractures treated with proximal femur locking compression plate (PF-LCP. Methods: This study is conducted at Al Ameen Medical College and Hospital, Bijapur during the period Jan 2012 to March 2014.Pertrochanteric fractures especially unstable intertrochanteric & subtrochanteric fractures were included. Technical difficulties with the implant and operating time were quantified. Union of fracture site and implant related complications were followed up clinically and radiological. The Harris Hip Score was used to evaluate the functional outcome. Results: Thirty-two patients were available for final evaluation with average age of 55.4 years. The average operation time was 1 hour and 35 minutes with mean blood loss of 180ml. Union was achieved in all the cases with an average time of 17 weeks. Complications included one case of delayed union and three cases of varus collapse. Conclusion: PF-LCP achieves anatomical reduction and stable fixation with higher union rate and fewer complications.

  4. Elastic-Plastic Fracture Toughness Testing Methods.

    Science.gov (United States)

    1983-12-01

    Notch Crack Test Figure 8. Tracing of HY80 -SB Fracture Surface 37 APPENDIX A TESTING METHODS A. INTRODUCTION The steps required to perform a J-integral...tinting the specimen, 10 minutes at 300C for &oat steel &, aid& in the visual identification of the amount of crack extension. After the specimen is removed...597085.603738 ULTIMATE TS - 689475.23 ELASTIC MODULUS - 1.9994783497E+8 FLOW STRESS - 643280.448369 BASED ON CURRENT INFORMATION FOR HY80 -5B: CURRENT CRACK

  5. Benefits and harms of locking plate osteosynthesis in intraarticular (OTA Type C) fractures of the proximal humerus

    DEFF Research Database (Denmark)

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

    2012-01-01

    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...... 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...... osteosynthesis with locking plate within two weeks of injury, and a follow-up period of six months or more. Patients should be evaluated with the Constant-Murley Score (CS). Two observers extracted data independently. RESULTS: Twelve studies and 282 Type C fractures were included. Results were categorised...

  6. Treatment of proximal humeral fractures using anatomical locking plate: correlation of functional and radiographic results

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    Antonio Carlos Tenor Junior

    2016-06-01

    Full Text Available ABSTRACT OBJECTIVE: To correlate the functional outcomes and radiographic indices of proximal humerus fractures treated using an anatomical locking plate for the proximal humerus. METHODS: Thirty-nine patients with fractures of the proximal humerus who had been treated using an anatomical locking plate were assessed after a mean follow-up of 27 months. These patients were assessed using the University of California Los Angeles (UCLA score and their range of motion was evaluated using the method of the American Academy of Orthopedic Surgeons on the operated shoulder and comparative radiographs on both shoulders. The correlation between radiographic measurements and functional outcomes was established. RESULTS: We found that 64% of the results were good or excellent, according to the UCLA score, with the following means: elevation of 124°; lateral rotation of 44°; and medial rotation of thumb to T9. The type of fracture according to Neer's classification and the patient's age had significant correlations with the range of motion, such that the greater the number of parts in the fracture and the greater the patient's age were, the worse the results also were. Elevation and UCLA score were found to present associations with the anatomical neck-shaft angle in anteroposterior view; fractures fixed with varus deviations greater than 15° showed the worst results (p < 0.001. CONCLUSION: The variation in the neck-shaft angle measurements in anteroposterior view showed a significant correlation with the range of motion; varus deviations greater than 15° were not well tolerated. This parameter may be one of the predictors of functional results from proximal humerus fractures treated using a locking plate.

  7. Open Reduction and Internal Fixation of Displaced Calcaneum, Intra-Articular Fractures by Locking Calcaneal Plate

    Science.gov (United States)

    Santosha; Singh, Arambam Mahendra; Waikhom, Sanjib; Pakhrin, Vishal; Mukherjee, Sagnik; Debbarma, Rajkumar; Prashant, Prabhu Shrinivas

    2016-01-01

    Introduction Calcaneal fractures constitute the most common fractures in hindfoot. Lots of controversies exist in the management of calcaneal fractures but now-a-days, it is preferable to perform open reduction and internal fixation and early mobilizatation. Aim To evaluate the functional outcome after open reduction and internal fixation of displaced intra-articular fractures of the calcaneum by locking calcaneal plate. Materials and Methods The study was conducted in the Department of Orthopaedic Surgery from September 2013 to April 2016. Thirty intra-articular fractures of the calcaneum were treated by locking calcaneal plate. Patients were followed up for a period of 24 months. Bohler’s angle was measured in preoperative, immediate Post-operative period and after 2 years, follow-up was compared. Results were evaluated according to American Orthopaedic Foot and Ankle Society (AOFAS) Score. Results After 24 months of follow-up, all 24 patients were available for evaluation. Radiological union was achieved in a mean time of 12.5 weeks. Mean duration of hospital stay was 21 days. Bohler’s angle was significantly higher after 2 years of follow-up when compared with preoperative x-ray. According to the AOFAS, Ankle–Hind foot Scale outcome score results were excellent in 43.3% of the patients, good in 33.3%, fair in 10%, and poor in 13.3% of patients. The mean AOFAS score was 79.9 (Range 49-96). Conclusion Open reduction and internal fixation of intra-articular fractures of the calcaneum with locking calcaneal plate gives good results. Maintenance of calcaneal height and Bohler’s angle helps to decrease the incidence of subtalar arthritis. PMID:28208957

  8. Distal Femoral Locking Compression Plate Fixation in Distal Femoral Fractures: Early Results

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    EJ Yeap

    2007-05-01

    Full Text Available We conducted a retrospective review on eleven patients who were treated for Type A and C distal femoral fractures (based on AO classification between January 2004 and December 2004. All fractures were fixed with titanium distal femoral locking compression plate. The patient’s ages ranged from 15 to 85 with a mean of 44. Clinical assessment was conducted at least 6 months post-operatively using the Schatzker scoring system. Results showed that four patients had excellent results, four good, two fair and one failure.

  9. The treatment of distal radius articular fractures of C1-C2 type with DVR plate: analysis of 40 cases.

    Science.gov (United States)

    Tarallo, L; Adani, R; Mugnai, R; Catani, F

    2011-12-01

    The aim of this investigation was to evaluate the efficiency of fixed angle plates DVR in the treatment of C1 and C2 type articular wrist fractures according to the AO classification. From July 2005 to March 2009, 40 wrist fractures were treated: 18 were of C1 type while 22 of C2 type according to AO classification. The age of patients varied from 25 to 79 years old. The average length of follow-up was 17 months (range, 4-37 months). The average articular motility was flexion 59.4° and extension 62.7°. Final radiographic parameters were of 18.7° of average ulnar inclination, 10.3° of average dorsal inclination, and 1.45 mm of negative ulnar variance. All patients were reassessed according to Mayo Modified Wrist Score getting a very good/good result in 82% of cases and a medium/poor one in 18%. The DASH score pulled off 46.3 points in the first group, 5.1 in the second group, and 6 in the third one. The statistical analysis based on Student's t test showed how C1 and C2 classification did not influence the results using the same treatment. DVR plate showed a very good reliability and a sufficient stability with both C1 and C2 fractures.

  10. Comparative clinical study of locking screws versus smooth locking pegs in volar plating of distal radius fractures.

    Science.gov (United States)

    Boretto, J G; Pacher, N; Giunta, D; Gallucci, G L; Alfie, V; De Carli, P

    2014-09-01

    The present study was performed to test the null hypothesis on no difference in stability of fixation after volar plating of intra-articular distal radius fractures (AO C2-C3) with either locking smooth pegs or locking screws in a clinical setting. A retrospective evaluation included adult patients with C2-C3 AO fractures treated with a volar plate with locking smooth pegs or locking screws. Radiographic assessment was performed to evaluate extra- and intra-articular parameters in the early postoperative period and after bone union. Twenty-seven consecutive patients were included. Thirteen cases had fixation with locking screws and 14 had fixation with locking smooth pegs. Both groups had bone fragment displacement after fixation. However, there were no significant differences between the groups either in extra- or intra-articular parameters defined by Kreder et al. (1996). Our study shows that, in a clinical setting, there is no difference in stability fixation between locking screws or smooth locking pegs in C2-C3 distal radius fractures.

  11. Routine removal of the plate after surgical treatment for mandibular angle fracture with a third molar in relation to the fracture line

    Science.gov (United States)

    Yamamoto, Kazuhiko; Matsusue, Yumiko; Horita, Satoshi; Murakami, Kazuhiro; Sugiura, Tsutomu; Kirita, Tadaaki

    2015-01-01

    Purpose: The purpose was to analyze the clinical course of surgically treated mandibular angle fractures from the viewpoint of routine removal of the plate because these fractures are associated with high rates of complications and plate removal. Subjects and Methods: The subjects were 40 patients with unilateral mandibular angle fracture, which was intraorally reduced and principally fixed with a single miniplate on the external oblique ridge. The third molar in relation to the fracture line was extracted in seven patients during the surgery. Clinical course was evaluated in terms of removal of the plate, preservation of the third molar and complications. Results: One patient showed a wound infection postoperatively, and two patients developed pericoronitis during the follow-up. These were managed with medication and local irrigation. One patient with a preserved third molar did not make a required visit and was lost from the follow-up. Removal of the plates was performed in 39 patients after confirmation of good fracture healing, mostly within a year. Twenty-four of 32 preserved third molars were simultaneously extracted. These procedures were generally performed under local anesthesia on an outpatient basis, and they did not cause any complications. Conclusions: Routine removal of the plate after surgical treatment for mandibular angle fractures, simultaneously with extraction of the third molar if indicated, may be beneficial to avoid complications related to the plate and the third molar later in life. PMID:26389039

  12. Finite element analysis of the stability of combined plate internal fixation in posterior wall fractures of acetabulum.

    Science.gov (United States)

    Liu, Xi-Ming; Pan, Chang-Wu; Wang, Guo-Dong; Cai, Xian-Hua; Chen, Lei; Meng, Cheng-Fei; Huang, Jin-Cheng

    2015-01-01

    This study aims to explore the mechanical stability of combined plate internal fixation in posterior wall fractures of the acetabulum. The fracture and internal fixation models were established in this study and they were divided into four kinds of internal fixation models, finite element analysis was performed. The four groups were 2 mini-plates and 1 reconstruction plate fixation (A), Reconstruction plate internal fixation group (B), 2 screws internal fixation group (C) and mini-plates internal fixation group (D). The displacement of each node was measured and evaluated. There was no distortion in the geometric shape of the finite element model. The results of stress showed that it was less in the anterior pelvic ring and distributed uniform in labrum acetabulare; the stress was bigger in the upper and middle of sacroiliac joint and sciatic notch in sitting position. Combined plate internal fixation for posterior wall fractures of acetabular were stable and reliable, it is better than the other three methods.

  13. Biomechanics of distal femoral fracture fixed with an angular stable LISS plate.

    Science.gov (United States)

    Pakuła, Grzegorz; Słowiński, Jakub; Scigała, Krzysztof

    2013-01-01

    Fractures of the distal end of the femur are infrequent and constitute less than 1% of all fractures. Only 3% to 6% of femoral fractures occur at the distal end. The two groups most at risk of the said fractures are young men and older women. The aim of treatment of fractures of the distal femur is to restore normal function of the knee joint. The authors asked themselves whether, following fixation of a 33-C2 fracture (according to the AO classification) with a LISS plate, a rehabilitation program can be undertaken immediately after surgery with the implementation of active movements in the knee joint of the operated limb. In order to answer this question, we created a digital model of a fractured femur fixed with the LISS method. The model was subjected to loads corresponding to the loads generated during active lifting of a limb extended in the knee joint and during flexing of a limb in the knee joint to the 90° angle. Interfragmentary movement (IFM) is one of the key parameters taken into account in the treatment of bone fractures. It allows classification of the treatment in terms of its quality both from the mechanical and histological points of view. We analyzed interfragmentary movement in all fracture gaps. The largest recorded displacement reached in our model was 243 μm, which, in the light of the literature data, should not interfere with bone consolidation, and thus implementation of active movement in the operated knee joint (keeping in mind the simplifications of the experimental method used) is possible in the early postoperative period.

  14. Evaluating formability of LCP plate for sacral fractures with one step inverse forming finite element analysis.

    Science.gov (United States)

    Li, Xiaoda; Zhang, Xiangkui; Hu, Ping; Liu, Weijie; Shen, Guozhe; Zhan, Xianghui

    2015-01-01

    The locking compression plate fixation treatment for the unstable sacral fractures is simple and effective, with less trauma and complications. Some locking compression plate parts have been made of high-strength Plate manufactured by hot stamping process since the demand for lightweight biomedical materials. Finite Element (FE) method of One-Step inverse forming based on deformation theory is the tool to evaluate the formability of locking compression plate panel quickly in initial design for reducing costs and development cycle of Plate. But current one-step inverse forming methods are all suitable for cold stamping, not hot-stamping. This paper proposed one-step inverse forming method and workflow for hot-stamping of locking compression Plate. And the B pillar of a sacral bone was simulated and its computing result was compared with experimental value. The result shows that the proposed method in this paper can quickly evaluate high temperature formability of high-strength Plate. And the method is proposed to be used in initial design.

  15. latrogenic brachial artery injury during anterolateral plating of humeral shaft fracture

    Institute of Scientific and Technical Information of China (English)

    Vishal Kumar; Prateek Behera; Sameer Aggarwal; Umesh Kumar Meena

    2013-01-01

    There are several well defined indications for surgical management of humeral shaft fractures.Operative procedures on the humerus are associated with their own complications.Iatrogenic brachial artery injury as a complication of humeral shaft plating has not been reported previously.We report a case of a 48 years old femalewho received operation at a district hospital and was referred to us when the surgeon could not palpate the pulse.CT angiogram showed that there was segmental non-opacification of the brachial artery.There was distal reformation and the thrombosis was decided to be managed conservatively.We believe that the arterial injury was a result ofimproper surgical technique and the segmental block might be due to improper use of plate holding forceps.This case report makes us aware of a rare complication of operative management of humeral shaft fractures and that basic principles of surgery must be always followed to prevent such injuries.

  16. Surgical treatment for unstable distal clavicle fracture with micromovable and anatomical acromioclavicular plate.

    Science.gov (United States)

    Liu, Qingjun; Miao, Jianyun; Lin, Bin; Lian, Kejian

    2012-01-01

    Between 2006 and 2009, 18 patients of distal clavicle fracture were treated with micro-movable and anatomical acromioclavicular plate (MAAP) in our department. According to the Neer's classification, all cases were unstable with type IIA (12 cases) and type IIB (6 cases). Functional outcome was evaluated using the Karlsson's criteria. The mean follow-up was 18 months (range, 12-36months). No postoperative plate screws complication was observed. Osseous union could be achieved at a mean time of 12 weeks after operation in 18 patients (range, 8 -16 weeks). According to Karlsson's criteria, radiographic appearances and postoperative shoulder functional recovery revealed a good and excellent rate in these cases. We conclude that surgical treatment using MAAP seems to be a good option for unstable type II fractures of the distal clavicle. This technique allows for reliable fixation with early functional exercises and functional recovery.

  17. Surgical Treatment for Unstable Distal Clavicle Fracture with Micromovable and Anatomical Acromioclavicular Plate

    Directory of Open Access Journals (Sweden)

    Qingjun Liu, Jianyun Miao, Bin Lin, Kejian Lian

    2012-01-01

    Full Text Available Between 2006 and 2009, 18 patients of distal clavicle fracture were treated with micro-movable and anatomical acromioclavicular plate (MAAP in our department. According to the Neer's classification, all cases were unstable with type IIA (12 cases and type IIB (6 cases. Functional outcome was evaluated using the Karlsson's criteria. The mean follow-up was 18 months (range, 12-36months. No postoperative plate screws complication was observed. Osseous union could be achieved at a mean time of 12 weeks after operation in 18 patients (range, 8 -16 weeks. According to Karlsson's criteria, radiographic appearances and postoperative shoulder functional recovery revealed a good and excellent rate in these cases. We conclude that surgical treatment using MAAP seems to be a good option for unstable type II fractures of the distal clavicle. This technique allows for reliable fixation with early functional exercises and functional recovery.

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

    Science.gov (United States)

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

    2010-12-01

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

  19. Early rehabilitation following less invasive surgical stabilisation plate fixation for distal femoral fractures.

    Science.gov (United States)

    Smith, T O; Hedges, C; MacNair, R; Schankat, K

    2009-06-01

    The less invasive surgical stabilisation (LISS) plate fixation method is an orthopaedic procedure for the fixation of distal femoral fractures. Early physiotherapy treatments of motion and mobilisation have been advocated following this procedure. This article critically appraises the evidence base assessing the early rehabilitation of patients following LISS fixation for distal femoral fractures. A review of EMBASE, Medline, CINAHL and AMED, and a hand search were undertaken. Two independent reviewers identified all eligible articles. Two reviewers extracted the data, which were verified by a third reviewer. All included articles were critically appraised by two independent reviewers using the Critical Appraisal Skills Programme tool. Seventeen case series assessing 508 patients with 535 fractures were reviewed. No clinical trials comparing physiotherapy programmes were identified. The review identified that following LISS fixation for distal femoral fractures, patients begin range-of-motion exercises immediately and are initially required to restrict weight-bearing following surgery. It remains unclear whether casts, braces or immobilisation aids are applied during the initial postoperative period. The efficacy of different physiotherapy protocols following LISS fixation for distal femoral fractures remains unclear. Further well-designed randomised controlled trials are required to compare different postoperative physiotherapy rehabilitation programmes for patients following LISS fixation of distal femoral fractures in order to determine the optimal postoperative management for this complex patient group.

  20. Plating of proximal fracture of the humerus: a study of 30 cases.

    Science.gov (United States)

    Iacobellis, C; Fountzoulas, K; Aldegheri, R

    2011-07-01

    In recent years, plate osteosynthesis with angular stable implants is frequently used for severely displaced three- and four-part proximal humeral fractures. The aim of this study is to evaluate early results of these fractures treated with insertion of LCP or Philos plates. We present results in 30 cases of proximal humeral fractures, 17 with 3 parts according to Neer and 13 with 4 parts, treated with Locking Compression Plates (LCP, 14 cases) and Philos plates (16) by the deltopectoral approach. Patients were checked with standard X-rays and clinical evaluation, according to the Constant-Murley shoulder score, Individual Constant score and Relative Constant score. Mean follow-up time was 21 months (range 6-42 months). The mean Constant-Murley shoulder scores were Pain 10.6 (3-15), Activities of Daily Living 15.3 (2-20), Range of Motion 26.8 (12-40) and Power 10.3 (3-25) and Total 63 (25-97). The Individual Constant score was 68.6% (27-98%) and the Relative Constant score 85.4% (36-130%). Fractures in 3 parts (of the surgical or anatomic humeral neck and major tubercle) had a mean Constant score of 69.1 (17 cases), but this fell to 55 (13 cases) in those in 4 parts (neck, major and lesser tubercles). Late necrosis of the humeral head occurred in two cases, both with 4-part breaks. We thus believe that 3-part fractures, in which both reduction and stable osteosynthesis are easier, show favourable prognosis and should be clearly distinguished from 4-part ones during assessments. The deltopectoral approach offers good exposure and is especially recommended in 4-part fractures, also because it provides a good view of the lesser tubercle. The osteosynthesis must be stable if early mobilisation of the shoulder and proper recovery of range of motion are to be achieved. As well as reduction and stabilisation of the tubercles, it is also important to restore the neck/shaft angle and stabilise it with oblique screws fitting the plate to avoid varus malposition.

  1. 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

  2. Tests of a Novel Design of Resistive Plate Chambers

    CERN Document Server

    Bilki, B; Freund, B; Neubüser, C; Onel, Y; Repond, J; Schlereth, J; Xia, L

    2015-01-01

    A novel design of Resistive Plate Chambers (RPCs), using only a single resistive plate, is being proposed. Based on this design, two large size prototype chambers were constructed and were tested with cosmic rays and in particle beams. The tests confirmed the viability of this new approach. In addition to showing an improved single-particle response compared to the traditional 2-plate design, the novel chambers also prove to be suitable for calorimetric applications.

  3. 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

  4. [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.

  5. [New minimally invasive approach for palmar plating in distal radius fractures].

    Science.gov (United States)

    Chmielnicki, M; Prokop, A

    2015-02-01

    Distal radius fractures are among the most common fractures. Types A3 and C2 make up almost half of these. Volar fixed-angle plate fixation is the gold standard of treatment today. We wanted to minimise the approach to the distal radius through a transverse 2-3 cm incision in the wrist flexor fold, tunnelling beneath the pronator muscle. The operative technique is demonstrated here. 11 patients, averaging 70 years of age, underwent surgery for 7 A3 and 4 C2 type fractures. Average operating time was 50 minutes. Length of admission averaged 2.9 days. Using a visual analogue scale, pain decreased from 6/10 preoperatively to 3/10 on post-op day one and 2/10 on post-op day three. After 6 weeks, flexion and extension averaged 45-0-45°, and radial and ulnar deviation 20-0-20°. Pronation and supination averaged 85-0-85°. Grip strength with manometer averaged 90 % compared to the contralateral side at 6 weeks and 96 % at 3 months. As comparison, from 1 January 2008 until 31 May 2013, we treated 908 patients with distal radius fractures with volar fixed-angle plates through a conventional longitudinal incision of 5-8 cm. The average skin to skin time was 46 minutes, with an average length of admission of 5.6 days. A minimally invasive approach to treat distal radius fractures with volar plate fixation and sparing of the pronator muscle is possible. The initial patients treated with this approach experienced minimal post-operative pain, shorter hospital admissions, and rapid grip strength recovery with almost undisturbed rotational motion.

  6. Outcomes evaluation of locking plate osteosynthesis in displaced fractures of the proximal humerus

    Directory of Open Access Journals (Sweden)

    Mauro Emilio Conforto Gracitell

    2013-12-01

    Full Text Available Objective: To evaluate functional outcomes, radiographic findings and complications of proximal humeral fractures treated with locking plates and to determine prognostic factors for successful clinical outcomes. Methods: Forty patients undergoing internal fixation of fractures of the proximal humerus with the Philos(r plate were included in the study. The surgeries were performed between 2004 and 2011 and the patients underwent radiographic and clinical evaluation, by Constant -Murley and Dash score. Outcomes were analyzed by use of multivariate regression with several different variables. Results: Patients were on average of 61.8 ± 16.28 years, and most were female (70%. The Constant -Murley score was 72.03 ± 14.01 and Dash score was 24.96 ± 19.99. The postoperative radiographs showed a head-shaft angle of 135.43º± 11.82. Regression analysis showed that the patient's age and the Hertel classification influenced the Constant -Murley scale (p = 0.0049 and 0.012, respectively. Other prognostic criteria such as Neer and AO classification, head-shaft angle, the presence of metaphyseal comminution and extension of the humeral metaphyseal fragment showed no effect on prognosis. Complications occurred in four patients (10%. Conclusion: The fixation with the Philos(r plate provided good clinical and radiographic results in fractures of the proximal humerus, with a low complication rate. Patient's age and Hertel classification were defined as prognostic factors that led to worse functional outcomes.

  7. EVALUATION OF RESULTS OF BRIDGE PLATING IN COMMINUT ED FRACTURES OF LONG BONES

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    Prasanta Kr.

    2013-03-01

    Full Text Available ABSTRACT: INTRODUCTION: Osteosynthesis with open reduction technique in comm inuted fracture has several disadvantages like increase ra te of non-union, soft tissue problem, infection and implant failure. These problems may be overcome b y percutaneous bridge plating technique which preserve the vascularity and soft ti ssue attachment of fracture fragments. MATERIALS AND METHODS: Twenty-five patients were involve in this study . Al l of twenty- five patients with closed comminuted diaphyseal fract ures of femur (n-10 and tibia (n-15 were operated on using the principle indirect reductio n and biological fixation with bridge plate under image intensifier. Partial and full weight be aring were allowed according to clinical and radiological union. RESULTS: Most regained excellent range of motion of knee and ankle. Mean time of radiological union was 20.12 weeks. Two pati ents had superficial skin problem which healed with local wound care. One patient had non un ion which was healed by bone grafting. In this study excellent result was seen in 18 cases, g ood in five and fair in two patients. CONCLUSION: Our study indicates that minimally invasive bridge plating is an effective alternative for treatment of comminuted diaphyseal f racture of long bones. These complex fractures give complete recovery of normal limb func tion at an ear ly stage with less complication.

  8. Clinical effect of distal radius fracture treated with open reduction and internal plate fixation

    Institute of Scientific and Technical Information of China (English)

    ZHANG Pei-xun; XUE Feng; DANG Yu; WANG Tian-bing; CHEN Jian-hai; XU Hai-lin; FU Zhong-guo; ZHANG Dian-ying; JIANG Bao-guo

    2012-01-01

    Background For some specific comminuted unstable intra-articular fracture,the plaster cast can not maintain the alignment of the articular surface effectively.The aim of this study was to evaluate the clinical effects of distal radius fracture treated with open reduction and internal plate fixation retrospectively.Methods From January 2002 to March 2010,539 cases of distal radius fracture were treated with open reduction and internal fixation,including 184 males and 355 females aging 21-72 years (mean 57 years).Fractures were caused by falling to the ground in 459 cases,by traffic accident in 62 cases and by athletic injuries in 18 cases.Of 539 cases,there were 523 cases of closed fracture and 16 cases of open fracture.According to Arbeitsgemeinschaft fur Osteosynthesefragen (AO) standards of classification,there were 14 cases of A2 type,22 of A3 type,18 of B1 type,24 of B2 type,62 of B3 type,91 of C1 type,162 of C2 type and 146 of C3 type.The time from injury to operation was 1-16 days (mean 5 days).All patitents received open reduction and internal plate screw fixation.Forty-seven patients with bone defect were given 6-15 g autologous ilium and 75 cases were given 5 ml calcium sulphate artificial aggregate after reduction.Results All incisions healed by first intention after operation.Patients were followed up for 15 to 32 months postoperatively (mean 22 months).The fractures healed within 10-18 weeks after operation (mean 12 weeks).During the last follow-up,the mean palmar tilt was (7.0±0.9)° and the mean ulnar variance was (21.0±4.2)°,showing significant difference when compared with preoperation ((-5.0±1.2)° and (8.0±3.8)°).The radial heights were not abbreviated.According to Gartland and Werley assessment system,the results were excellent in 314 cases,good in 163 cases,fair in 46 cases,and poor in 16 cases 12 weeks after operation,the excellent and good rate was 88.5%.Conclusions The clinical effect of distal radius fracture treated with open

  9. 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...

  10. Complications and functional outcome after fixation of distal tibia fractures with locking plate - A multicentre study

    DEFF Research Database (Denmark)

    Viberg, Bjarke; Kleven, Silje; Hamborg-Petersen, Ellen;

    2016-01-01

    INTRODUCTION: The aim of this study was to evaluate the proportion of complications and the functional outcome following ORIF with low-profile locking plates in patients with distal tibia fractures. METHOD: Retrospective data was retrieved using county databases, operation books, health record...... as minor and major complications, was retrieved from electronic health records and patient interviews. Long-term functional outcome assessed by EuroQol EQ-5D-5L questionnaire, AOFAS Ankle-Hindfoot scale, and return to pre-injury job function through patient interview and examination. RESULTS: There were 32...... 43A, 5 43B and 34 43C-fractures, 12 open and 10 high-energy fractures. Forty-nine cases (69%) experienced complications during the follow-up time, of which 34 were minor complications and 15 were major complications. Median EQ-5D-5L index value was 0.76, median EQ VAS-score was 80, and median AOFAS...

  11. The calcar screw in angular stable plate fixation of proximal humeral fractures - a case study

    Directory of Open Access Journals (Sweden)

    Simmen Hans-Peter

    2011-09-01

    Full Text Available Abstract Background With new minimally-invasive approaches for angular stable plate fixation of proximal humeral fractures, the need for the placement of oblique inferomedial screws ('calcar screw' has increasingly been discussed. The purpose of this study was to investigate the influence of calcar screws on secondary loss of reduction and on the occurrence of complications. Methods Patients with a proximal humeral fracture who underwent angular stable plate fixation between 01/2007 and 07/2009 were included. On AP views of the shoulder, the difference in height between humeral head and the proximal end of the plate were determined postoperatively and at follow-up. Additionally, the occurrence of complications was documented. Patients with calcar screws were assigned to group C+, patients without to group C-. Results Follow-up was possible in 60 patients (C+ 6.7 ± 5.6 M/C- 5.0 ± 2.8 M. Humeral head necrosis occurred in 6 (C+, 15.4% and 3 (C-, 14.3% cases. Cut-out of the proximal screws was observed in 3 (C+, 7.7% and 1 (C-, 4.8% cases. In each group, 1 patient showed delayed union. Implant failure or lesions of the axillary nerve were not observed. In 44 patients, true AP and Neer views were available to measure the head-plate distance. There was a significant loss of reduction in group C- (2.56 ± 2.65 mm compared to C+ (0.77 ± 1.44 mm; p = 0.01. Conclusions The placement of calcar screws in the angular stable plate fixation of proximal humeral fractures is associated with less secondary loss of reduction by providing inferomedial support. An increased risk for complications could not be shown.

  12. Management of infectious fractures with "Non-Contact Plate" (NCP) method.

    Science.gov (United States)

    Alemdar, Celil; Azboy, Ibrahim; Atiç, Ramazan; Özkul, Emin; Gem, Mehmet; Kapukaya, Ahmet

    2015-09-01

    The aim of this study was to evaluate the outcomes of internal fixation with Non-Contact Plating (NCP) after deep infection caused by previous surgeries of the tibia or femur fractures. The study included 15 patients (4 female and 11 male). The mean age patients was 36.6 years (range, 21-64 years). There were 6 femur and 9 tibia fractures. The mean follow-up period was 25.7 months (range, 15-45 months). The study comprised 11 open and 4 closed fractures. External fixator was used in 3, plate in 4, and intramedullary nail in 8 patients for index surgery. Deep infection was diagnosed via clinical findings, laboratory parameters, and microbiological evaulation. Deep infection was diagnosed within a mean period of 5.5 weeks (range, 2-10 weeks). The infecting organism was methicillin-resistant staphylococcus aureus (MRSA) in 5, methicillin-sensitive staphylococcus aureus (MSSA) in 6, pseudomonas auroginosa in 2, and enterobacteriacea in 2 patients. Union achieved in all patients. Mean time to union was 17 (range, 11-38) weeks. Delayed union was observed in 3 patients who required additional surgeries. Of these one patient developed osteomyelitis. The NCP is an effective alternative method in the treatment of deep infection encountered after internal or external fixation for the tibia, or femur fractures.

  13. Application of Minimally Invasive Treatment of Locking Compression Plate in SchatzkerⅠ~Ⅲ Tibial Plateau Fracture

    Institute of Scientific and Technical Information of China (English)

    Zhao Guohui

    2014-01-01

    Objective:To investigate the clinical effect of minimally invasive treatment of locking compression plate (LCP) in SchatzkerⅠ~Ⅲ tibial plateau fracture. Methods: Thirty-eight patients with SchatzkerⅠ~Ⅲtibial 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 efifcacy 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 artiifcial 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 SchatzkerⅠ~Ⅲ tibial plateau fracture can reduce the postoperative relocation loss, and has small trauma and stable ifxation.

  14. Osteogenesis and cytotoxicity of a new Carbon Fiber/Flax/Epoxy composite material for bone fracture plate applications.

    Science.gov (United States)

    Bagheri, Zahra S; Giles, Erica; El Sawi, Ihab; Amleh, Asma; Schemitsch, Emil H; Zdero, Radovan; Bougherara, Habiba

    2015-01-01

    This study is part of an ongoing program to develop a new CF/Flax/Epoxy bone fracture plate to be used in orthopedic trauma applications. The purpose was to determine this new plate's in-vitro effects on the level of bone formation genes, as well as cell viability in comparison with a medical grade metal (i.e. stainless steel) commonly employed for fabrication of bone plates (positive control). Cytotoxicity and osteogenesis induced by wear debris of the material were assessed using Methyl Tetrazolium (MTT) assay and reverse transcription polymerase chain reaction (RT-PCR) for 3 osteogenesis specific gene markers, including bone morphogenetic proteins (BMP2), runt-related transcription factor 2 (Runx2) and Osterix. Moreover, the Flax/Epoxy and CF/Epoxy composites were examined separately for their wettability properties by water absorption and contact angle (CA) tests using the sessile drop technique. The MTT results for indirect and direct assays indicated that the CF/Flax/Epoxy composite material showed comparable cell viability with no cytotoxicity at all incubation times to that of the metal group (p≥0.05). Osteogenesis test results showed that the expression level of Runx2 marker induced by CF/Flax/Epoxy were significantly higher than those induced by metal after 48 h (p=0.57). Also, the Flax/Epoxy composite revealed a hydrophilic character (CA=68.07°±2.05°) and absorbed more water up to 17.2% compared to CF/Epoxy, which reached 1.25% due to its hydrophobic character (CA=93.22°±1.95°) (p<0.001). Therefore, the new CF/Flax/Epoxy may be a potential candidate for medical applications as a bone fracture plate, as it showed similar cell viability with no negative effect on gene expression levels responsible for bone formation compared to medical grade stainless steel.

  15. Fracture mechanics life analytical methods verification testing

    Science.gov (United States)

    Favenesi, J. A.; Clemons, T. G.; Riddell, W. T.; Ingraffea, A. R.; Wawrzynek, P. A.

    1994-01-01

    The objective was to evaluate NASCRAC (trademark) version 2.0, a second generation fracture analysis code, for verification and validity. NASCRAC was evaluated using a combination of comparisons to the literature, closed-form solutions, numerical analyses, and tests. Several limitations and minor errors were detected. Additionally, a number of major flaws were discovered. These major flaws were generally due to application of a specific method or theory, not due to programming logic. Results are presented for the following program capabilities: K versus a, J versus a, crack opening area, life calculation due to fatigue crack growth, tolerable crack size, proof test logic, tearing instability, creep crack growth, crack transitioning, crack retardation due to overloads, and elastic-plastic stress redistribution. It is concluded that the code is an acceptable fracture tool for K solutions of simplified geometries, for a limited number of J and crack opening area solutions, and for fatigue crack propagation with the Paris equation and constant amplitude loads when the Paris equation is applicable.

  16. Combining of small fragment screws and large fragment plates for open reduction and internal fixation of periprosthetic humeral fractures.

    Science.gov (United States)

    Seybold, Dominik; Citak, Mustafa; Königshausen, Matthias; Gessmann, Jan; Schildhauer, Thomas A

    2011-10-01

    Operative treatment of periprosthetic humeral fractures in elderly patients with osteoporotic bone requires a stable fixations technique. The combination of 3.5 cortical screws with washers in a 4.5 Arbeitsgemeinschaft für Osteosynthesefragen, Limited-contact dynamic compression plate or Locking plate, allows a stable periprosthetic fixation with the small 3.5 screws and 4.5 screws above and below the prosthesis, respectively. This combination is a cost-effective technique to treat periprosthetic humeral fractures.

  17. Additive fiber-cerclages in proximal humeral fractures stabilized by locking plates: no effect on fracture stabilization and rotator cuff function in human shoulder specimens.

    Science.gov (United States)

    Voigt, Christine; Hurschler, Christof; Rechi, Louise; Vosshenrich, Rolf; Lill, Helmut

    2009-08-01

    The effect of additive fiber-cerclages in proximal humeral fractures stabilized by locking plates on fracture stabilization and rotator cuff function is unclear. Here it was assessed in a human cadaver study. 24 paired human shoulder specimens were harvested from median 77-year-old (range 66-85) female donors. An unstable 3-part fracture model with an intact rotator cuff was developed. 1 specimen of each pair received an additive fiber-cerclage of the rotator cuff after plate fixation, and the other one received a plate fixation without an additive fiber-cerclage. Force-controlled hydraulic cylinders were used to simulate physiological rotator cuff tension, while a robot-assisted shoulder simulator performed 4 relevant cases of load: (1) axial loading at 0 degrees, (2) glenohumeral abduction at 60 degrees, (3) internal rotation at 0 degrees abduction, and (4) external rotation at 0 degrees abduction, and imitated hanging arm weight during loading without affecting joint kinematics. A 3-dimensional real-time interfragmentary motion analysis was done in fracture gaps between the greater tuberosity and the head, as well as subcapital. The capacity of the rotator cuff to strain was analyzed with an optical system. Interfragmentary motion was similar between the groups with and without fiber-cerclages, in both fracture gaps and in any of the cases of load. Cerclages did not impair the capacity of the rotator cuff to strain. INTERPRETATION; Provided that unstable 3-part fractures are reduced and stabilized anatomically by a locking plate, additive fiber-cerclages do not reduce interfragmentary motion. Additive fiber-cerclages may be necessary in locking plate osteosyntheses of multiple-fractured greater tuberosities or lesser tuberosity fractures that cannot be fixed sufficiently by the plate.

  18. Effect of fixing distal radius fracture with volar locking palmar plates while preserving pronator quadratus

    Institute of Scientific and Technical Information of China (English)

    Fan Jian; Chen Kai; Zhu Hui; Jiang Bo; Yuan Feng; Zhu Xiaozhong; Mei Jiong

    2014-01-01

    Background L-shaped incision of pronator quadratus (PQ) muscle along its radial and distal borders was always taken for distal radius fractures reduction and internal fixation.Repair of the PQ muscle was always recommended at the end of operation for some instructive reasons.But repair of PQ is not satisfied because of poor quality of muscle and fascial tissues which may cause pain or impede forearm pronation and supination for post-operative scarring around PQ.Inserting the locking palmar plate to pass under the pronator quadratus muscle and the locking screws are inserted through miniincisions in pronator quadratus in some patients with distal radius fractures is a reasonable technique which can preserve the pronator quadratus.The purpose of this study was to evaluate and compare the clinical effects after volar plating of the distal radius fractures while preserving the pronator quadratus and pronator quadratus repair.Methods Between September 2010 and April 2012,65 patients (42 males and 23 females; aged 20-68 years and a mean age of 42.5 years) with distal radius fracture underwent open reduction and internal fixation using the volar locking palmar plates (Depuy or Smith companies).The patients were classified as 23A-2 through 23C-3 according to the Orthopaedic Trauma Association (OTA) classifications.All surgeries were completed by the same trained team.The volar locking palmar plates of distal radius performed with preserving pronator quadratus group involved 30 patients including 19 males and 11 females and performed with pronator quadratus repair group involved 35 patients including 23 males and 12 females.We compared the two groups for wrist pain,forearm range of motion,grip strength,pedoperative complications and wrist functional recovery score.Results The minimum follow-up for the whole cohort was one year.The differences between the two groups were significant with regard to wrist pain,forearm range of motion,grip strength and wrist function at 1,2,and

  19. [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

  20. Number and locations of screw fixation for volar fixed-angle plating of distal radius fractures: biomechanical study.

    Science.gov (United States)

    Mehling, Isabella; Müller, Lars P; Delinsky, Katharina; Mehler, Dorothea; Burkhart, Klaus J; Rommens, Pol M

    2010-06-01

    To compare the biomechanical properties of different numbers and locations of screws in a multidirectional volar fixed-angle plate in a distal radius osteotomy cadaver model. We created an extra-articular fracture in 16 pairs of fresh-frozen human cadaver radiuses. The 32 specimens were randomized into 4 groups. All fractures were fixated with a multidirectional volar fixed-angle plate. We tested 4 different screw-placement options in the distal fragment. The distal fragment was fixed with 4 locking screws in the distal row of the plate in group a, and with 4 locking screws alternately in the distal and proximal rows in group b. In group c, 3 locking screws were used in the proximal row; in group d, 7 locking screws were used, filling all screw holes in the distal and proximal rows of the plate. The proximal fragment was fixed with 3 screws. The specimens were loaded with 80 N under dorsal and volar bending and with 250 N axial loading. Finally, load to failure tests were performed. Group d had the highest mean stiffness, 429 N/mm under axial compression, and was statistically significantly stiffer than the other groups. Group b had a mean stiffness of 208 N/mm, followed by group a, with 177 N/mm. Group c showed only a mean stiffness of 83 N/mm under axial compression. There were no statistically significant differences under dorsal and volar bending. In this model of distal radial fractures, there was a difference regarding the stiffness and the placement of screws in the distal rows of a volar fixed-angle plate. Inserting screws in all available holes in the distal fragment offered the highest stability. Using only the proximal row with 3 screws created an unstable situation. Based on these findings, we recommend placing at least 4 screws in the distal fragment and assigning at least 2 screws to the distal row of the multidirectional screw-holes. Copyright 2010 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

  1. Quantitative tests for plate tectonics on Venus

    Science.gov (United States)

    Kaula, W. M.; Phillips, R. J.

    1981-01-01

    Quantitative comparisons are made between the characteristics of plate tectonics on the earth and those which are possible on Venus. Considerations of the factors influencing rise height and relating the decrease in rise height to plate velocity indicate that the rate of topographic dropoff from spreading centers should be about half that on earth due to greater rock-fluid density contrast and lower temperature differential between the surface and interior. Statistical analyses of Pioneer Venus radar altimetry data and global earth elevation data is used to identify 21,000 km of ridge on Venus and 33,000 km on earth, and reveal Venus ridges to have a less well-defined mode in crest heights and a greater concavity than earth ridges. Comparison of the Venus results with the spreading rates and associated heat flow on earth reveals plate creation rates on Venus to be 0.7 sq km/year or less and indicates that not more than 15% of Venus's energy is delivered to the surface by plate tectonics, in contrast to values of 2.9 sq km a year and 70% for earth.

  2. 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.

  3. 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

  4. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  6. Outcome of open reduction and internal fixation of intraarticular calcaneal fracture fixed with locking calcaneal plate

    Directory of Open Access Journals (Sweden)

    Jain Saurabh

    2013-12-01

    Full Text Available 【Abstract】Objective: Debate continues regarding the management of calcaneal fractures, between open re- duction and internal fixation and closed treatment. Hence we aim at evaluating the radiological and functional out- comes of open reduction and internal fixation in displaced joint depression type of calcaneal fractures fixed with lock- ing calcaneal plate. Methods: In this series, 28 patients (26 unilateral and 2 bilateral with joint depression type of calcaneal fractures as per Essex-Lopresti classification system were operated on with locking calcaneal plate within 3 weeks of injury. Patients were evaluated in terms of associated injuries and X-rays of anteroposterior, lateral and axial views of the calcaneum. CT scan was done to assess the amount of com- minution and articular depression. Patients were followed up clinically and radiologically at least for 1 year. Radiologi- cal assessment was done by Bohler’s angle and Gissane’s angle along with measurement of calcaneal height and width. Functional outcome was assessed using the American Or- thopaedics Foot and Ankle Society (AOFAS scale. Results: At average follow-up of 14.5 months, average AOFAS score was 86.3 (range 66 to 97, with 86% having excellent to good results and 2 (7.7% and 1 (3.7% having fair and poor results respectively. All patients had stable ankle joint with all having dorsiflexion and plantar flexion more than 30°. Average subtalar range of motion was 17°. The mean Bohler’s angle, mean Gissane’s angle, calcaneal height and width were 25.47°, 121.3°, 4.32 cm and 3.81cm respectively at final follow-up. Three patients had flap ne- crosis at incision site and one had superficial and deep infection. Subtalar arthritis was seen in 5 patients, whereas sural nerve hypoaesthesia in 1 patient. None of the patients had compartment syndrome, heel pad problems, peroneal tendinitis, reflex sympathetic dystropy or implant failure. Conclusion: Open reduction and

  7. Are Biodegradable Plates Applicable in Endoscope-Assisted Open Reduction and Internal Fixation of Mandibular Subcondyle Fractures?

    Science.gov (United States)

    Son, Jang-Ho; Ha, Jinhee; Cho, Yeong-Cheol; Sung, Iel-Yong

    2017-08-01

    To investigate whether biodegradable plates are applicable in endoscope-assisted open reduction and internal fixation (EAORIF) of mandibular subcondyle fractures. This retrospective case-series study included patients with mandibular subcondyle fractures treated with EAORIF using an unsintered hydroxyapatite particles/poly-l-lactide biodegradable plate system, with at least 6 months of clinical follow-up data available. The outcome variables were fracture healing with postoperative stability and postoperative complications. Other variables included age, gender, fracture site, cause of injury, accompanying mandibular fracture, total follow-up period, fracture classification, extent of displacement, preoperative status of occlusion, preoperative mandibular movements, fixation materials in accompanying mandibular fracture, location and number of fixation plates, periods of intermaxillary fixation/elastic bands, and postoperative mandibular movements. Fracture healing in these patients was assessed by comparing the immediate postoperative cone-beam computed tomography (CBCT) images with those obtained at least 3 months after surgery. A total of 11 patients, 9 male and 2 female, with a mean ± standard deviation age of 35.3 ± 15.9 years, were included. The mean follow-up period was 18.8 ± 7.8 months. Four patients had an accompanying mandibular fracture. Two 4-hole, 2.0-mm biodegradable plates were fixed with 6-mm screws along the posterior border of the mandibular ramus and near the sigmoid notch. Complete bone formation around the fracture lines or fading of the fracture lines, with no change in the position of the fractured segments, was observed on the postoperative CBCT images at 3 months. With the exception of 2 patients, no patient complained of plate palpability, deviation in occlusion, or discomfort during the postoperative follow-up period. EAORIF using biodegradable plates for mandible subcondylar fractures is a stable and reliable method, with

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

    Directory of Open Access Journals (Sweden)

    Rajendra Prasad

    2013-01-01

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

  9. Peri-prosthetic fracture vibration testing

    Energy Technology Data Exchange (ETDEWEB)

    Cruce, Jesse R [Los Alamos National Laboratory; Erwin, Jenny R [Los Alamos National Laboratory; Remick, Kevin R [Los Alamos National Laboratory; Cornwell, Phillip J [Los Alamos National Laboratory; Menegini, R. Michael [INDIANA UNIV.; Racanelli, Joe [STRYKER ORTHOPARDICS

    2010-11-08

    The purpose of this study was to establish a test setup and vibration analysis method to predict femoral stem seating and prevent bone fracture using accelerometer and force response data from an instrumented stem and impactor. This study builds upon earlier studies to identify a means to supplement a surgeon's tactile and auditory senses by using damage identification techniques normally used for civil and mechanical structures. Testing was conducted using foam cortical shell sawbones prepared for stems of different geometries. Each stem was instrumented with an accelerometer. Two impactor designs were compared: a monolithic impactor and a two-piece impactor, each with an integrated load cell and accelerometer. Acceleration and force measurements were taken in the direction of impaction. Comparisons between different methods of applying an impacting force were made, including a drop tower and a surgical hammer. The effect of varying compliance on the data was also investigated. The ultimate goal of this study was to assist in the design of an integrated portable data acquisition system capable of being used in future cadaveric testing. This paper will discuss the experimental setup and the subsequent results of the comparisons made between impactors, prosthetic geometries, compliances, and impact methods. The results of this study can be used for both future replicate testing as well as in a cadaveric environment.

  10. Assessment of the Treatment Outcome of Closed Extra-Articular Distal Tibia Fracture: IM Nailing vs Plating

    Directory of Open Access Journals (Sweden)

    Seyed Abas Behgoo

    2009-11-01

    Full Text Available Background:The tibial diaphyseal fractures are the most common type of long bone fractures encountered by most orthopedic surgeons.In accordance with descriptive indices of tibia fractures on the basis of their location in the bone,distal tibia fractures have the second incidence of all tibia fractures after the middle tibia fractures.The purpose of the study was to assess the complications and treatment outcome of closed extra-articular distal tibia fracture. Methods:The results of the management for 76 patients with closed extra-articular distal tibia fracture by intramedullary nailing and plating were reviewed retrospectively.The variables included AO (Arbeitsgemeinschaft fur Osteosynthesefragenclassification of tibia fracture, the mean duration of union, malunion,and nonunion.   Results: Twenty seven and forty nine patients were treated by intramedullary(IM nailing and plating respectively.The most common type of fractures was A1 which was observed in twenty five patients. Initial union and nonunion occurred in   sixty three and thirteen patients respectively. Eight patients had nonunion in plating   group and five of twenty seven patients in IM nailing group. Eleven of twenty seven patients in IM nailing group suffered from malunion while only four patients in the other group had this complication.   Conclusion: The plating Technique in comparison with IM nailing has a satisfactory functional outcome.The technique has a lower incidence of malunion and nonunion, and it should be recommended as a good treatment option for the management of extra-articular closed fracture of distal tibia.  

  11. 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

  12. Early outcomes of proximal humerus fracture fixation with locking plate and intramedullary fibular strut graft.

    Science.gov (United States)

    Tan, Edwin; Lie, Denny; Wong, M K

    2014-09-01

    Proximal humerus fractures are commonly encountered in elderly patients. Surgical treatment demonstrates high complication rates, including varus construct collapse and screw cutout. In this study, the authors evaluate the clinical outcome of locking plate fixation with intramedullary fibular strut graft augmentation as a primary surgical treatment in the prevention of early collapse and screw cutout. A total of 9 patients were evaluated. Surgery was performed for displaced proximal humerus fractures between April and December 2011. Patients were either class 2, 3, or 4, according to Neer classification. Mean patient age was 75.4 years. Preoperative and immediate, 6-week, and 3-month postoperative radiographs were evaluated. Head-shaft angles were measured to assess for varus collapse and displacement. Range of motion, complication rates, and functional recovery were also evaluated. Patients underwent open reduction and internal fixation with placement of an intramedullary fibular strut graft. Fixation was achieved with a Philos plate (Synthes, Oberdorf, Switzerland). Reduction and fixation were evaluated with radiographs. Passive exercises and range of motion were allowed immediately postoperatively, and all patients achieved active abduction and forward flexion 6 weeks postoperatively. Shoulder radiographs taken 12 weeks postoperatively revealed no loss of reduction or screw cutout. The introduction of the locking plate has improved outcomes. The addition of an intramedullary strut graft has shown improved preliminary results. Maintained reduction was observed in all 9 patients in the early postoperative period, and good functional motion was achieved. No incidence of screw cutout was recorded.

  13. Outcome of proximal humerus fractures treated by PHILOS plate internal fixation. Experience of a district general hospital.

    Science.gov (United States)

    Shahid, Rizwan; Mushtaq, Abid; Northover, Julian; Maqsood, Mohammad

    2008-10-01

    Proximal humerus fractures have been a challenge to achieve stable fixation. PHILOS (Proximal Humerus internal locking system) is part of the latest generation of locking compression plates for proximal humeral fracture fixation. We aim to assess the clinical and functional outcome of proximal humeral fractures (2-part, 3-part and 4-part) treated with the PHILOS plate. We prospectively reviewed 50 patients who had a proximal humeral fracture treated with the PHILOS plate from September 2002 to September 2006 in our institution. Clinical outcome was measured using the patient-based Oxford shoulder and DASH scoring systems. Five patients died and four were lost to follow-up. Eleven patients had 2-part, eleven 3-part and eighteen 4-part fractures. Mean follow-up time was 21.7 months (range: 6-44 months). Radiological union was achieved within 8 weeks in 40/41 fractures; complications were noted in four cases. Better results were achieved in younger than in older patients, and in male than in female patients. The number of fracture fragments did not appear to affect the results, but associated dislocation of the humeral head was a pejorative factor. Our study has shown that the PHILOS plate is a reliable implant. A direct correlation was observed between Oxford shoulder and DASH scores.

  14. MANAGEMENT OF PERIPROSTHETIC DISTAL FEMORAL FRACTURE AFTER TOTAL KNEE ARTHROPLASTY USING MINIMALLY INVASIVE PLATE OSTEOSYNTHESIS: A CASE REPORT

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    Reddy

    2015-07-01

    Full Text Available CONTEXT: The approximate incidence of periprosthetic supracondylar femur fractures after total knee arthroplasty ranges from 0.3 to 2.5 percent. Various methods of treatment of these fractures have been suggested in the past, such as conservative management, open reduction and plate fixation and intramedullary nailing. However, there were complications like pain, stiffness, infection and delayed union. Minimally invasive plate osteosynthesis (MIPO is a relatively newer technique in the treatment of distal femoral fractures, as it preserves the periosteal blood supply an d bone perfusion as well as minimizes soft tissue dissection. AIM: To evaluate the effectiveness of MIPO technique in the treatment of periprosthetic distal femoral fracture. SETTINGS AND DESIGN : In this study, we present a case report of a 54 year old female patient who sustained type 2 (Rorabeck et al. classification periprosthetic distal femoral fractures after TKA. Her fracture fixation was done with distal femoral locking plates using minimally invasive technique. METHODS AND MATERIAL : We evaluated the clinical (using Oxford knee scoring system and radiological outcomes of the patient till six months post - operatively. Radiologically, the fracture showed complete union and she regained her full range of knee motion by the end of three months. CONCLUSION: We conclude that MIPO can be considered as an effective surgical treatment option in the management of periprosthetic distal femoral fractures after TKA

  15. C6 plate puncture testing report.

    Energy Technology Data Exchange (ETDEWEB)

    Vangoethem, Douglas J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Cordova, Theresa Elena [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Reu, Phillip L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2013-04-01

    There are numerous scenarios where critical systems could be subject to penetration by projectiles or fixed objects (e.g., collision, natural disaster, act of terrorism, etc.). It is desired to use computational models to examine these scenarios and make risk-informed decisions; however, modeling of material failure is an active area of research, and new models must be validated with experimental data. The purpose of this report is to document the experimental work performed from FY07 through FY08 on the Campaign Six Plate Puncture project. The goal of this project was to acquire experimental data on the puncture and penetration of metal plates for use in model validation. Of particular interest is the PLH failure model also known as the multilinear line segment model. A significant amount of data that will be useful for the verification and validation of computational models of ductile failure were collected during this project were collected and documented herein; however, much more work remains to be performed, collecting additional experimental data that will further the task of model verification.

  16. 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.

  17. Osteosynthesis with long volar locking plates for metaphyseal-diaphyseal fractures of the distal radius

    Institute of Scientific and Technical Information of China (English)

    Paritosh Gogna; Harpal Singh Selhi; Rohit Singla; Mukul Mohindra; Amit Batra; Reetadyuti Mukhopadhyay; Rajesh Rohilla

    2013-01-01

    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 rotation 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 patients (22 males and 5 females) with metaphyseal-diaphyseal 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 assessment was done according to Gartland and Werley scoring system.Results:Postoperative radiological parameters were well maintained throughout the trial,and there was significant 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=l8) excellent and 33.33% (n=9) good results.There was one case of superficial infection which responded to antibiotics and another carpel tunnel syndrome which was managed conservatively.Conclusion:Volar locking plate fixation for metaphyseal-diaphyseal fractures of distal radius is associated with excellent to good functional outcome,early rehabilitation and minimal complications.

  18. Evidence based postoperative treatment of distal radius fractures following internal locking plate fixation.

    Science.gov (United States)

    Klein, S M; Prantl, L; Koller, M; Vykoukal, J; Dolderer, J H; Graf, S; Nerlich, M; Loibl, M; Geis, S

    2015-01-01

    Originally, the treatment method of choice for distal radial fractures (DRF) has been a non-operative approach with six to eight weeks of plaster casting. The introduction of volar locking plate systems at the beginning of the 21 st century has pushed trends towards open reduction and internal fixation (ORIF). While the introduction of fixed angle locking plates together with the increasing knowledge on wrist function and related variable outcomes has led to consensus that operative fixation in instable DRF is the treatment method of choice, there is no agreement on a postoperative care of these injuries. The authors will discuss the available evidence for current concepts of postoperative treatment of DRFs following fixed angle fixation under socioeconomical, biomechanical and burden of disease aspects. Further, relevant randomized controlled trials are evaluated with regard to applied postoperative treatment regimes and related risks for complications.

  19. Probabilistic fracture investigation of symmetric angle ply laminated composite plates using displacement correlation method

    Directory of Open Access Journals (Sweden)

    Lal Achchhe

    2016-01-01

    Full Text Available The second order statistics of mixed mode stress intensity factors (MSIF of single edge V-notched angle ply laminated composite plate subjected to uniaxial tensile load with uncertinity in the system properties using displacement correlation method (DCM is evaluated. The random system properties such as material properties, crack opening and crack length are modelled as combined uncorrelated and correlated random system variables. A C0 finite element method (FEM based on higher order shear deformation plate theory (HSDT is used for basic formulation. The Taylor series based first order perturbation technique (FOPT, second order perturbation technique (SOPT are used and direct Monte Carlo simulation (MCS is performed to evaluate the statistics (mean and coefficient of variance of the mixed mode SIFs. The present work signifies the accurate analysis of frature behaviour by influence of different random variables and fibre orientations on the fracture behaviour in angle ply laminates.

  20. 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

  1. Mechanical assessment of local bone quality to predict failure of locked plating in a proximal humerus fracture model.

    Science.gov (United States)

    Röderer, Götz; Brianza, Stefano; Schiuma, Damiano; Schwyn, Ronald; Scola, Alexander; Gueorguiev, Boyko; Gebhard, Florian; Tami, Andrea

    2013-09-01

    The importance of osteoporosis in proximal humerus fractures is well recognized. However, the local distribution of bone quality in the humeral head may also have a significant effect because it remains unclear in what quality of bone screws of standard implants purchase. The goal of this study was to investigate whether the failure of proximal humerus locked plating can be predicted by the DensiProbe (ARI, Davos, Switzerland). A 2-part fracture with metaphyseal impaction was simulated in 12 fresh-frozen human cadaveric humeri. Using the DensiProbe, local bone quality was determined in the humeral head in the course of 6 proximal screws of a standard locking plate (Philos; Synthes GmbH, Solothurn, Switzerland). Cyclic mechanical testing with increasing axial loading until failure was performed. Bone mineral density (BMD) significantly correlated with cycles until failure. Head migration significantly increased between 1000 and 2000 loading cycles and significantly correlated with BMD after 3000 cycles. DensiProbe peak torque in all screw positions and their respective mean torque correlated significantly with the BMD values. In 3 positions, the peak torque significantly correlated with cycles to failure; here BMD significantly influenced mechanical stability. The validity of the DensiProbe was proven by the correlation between its peak torque measurements and BMD. The correlation between the peak torque and cycles to failure revealed the potential of the DensiProbe to predict the failure of locked plating in vitro. This method provides information about local bone quality, potentially making it suitable for intraoperative use by allowing the surgeon to take measures to improve stability.

  2. Locking plate fixation combined with iliac crest bone autologous graft for proximal humerus comminuted fracture

    Institute of Scientific and Technical Information of China (English)

    Zhu Lian; Liu Yueju; Yang Zongyou; Li Han; Wang Juan; Zhao Changping; Chen Xiao

    2014-01-01

    Background Although the use of an intramedullary fibular allograft together with locking plate fixation can provide additional medial support and prevent varus malalignment in displaced proximal humeral fractures with promising results,the fibular autograft donor site often sustains significant trauma and cannot restore the articular surface of comminuted fractures.The aim of this study was to evaluate the clinical and radiographic outcomes of a locking plate and crest bone autologous graft for treating proximal humerus comminuted fractures.Methods We assessed the functional outcomes and complication rates in 40 patients with proximal humerus comminuted fractures.Eighteen patients were treated with a locking plate and an autologous crest bone graft (experimental group),and 22 were treated with only the locking plate and no bone graft (control group).Postoperative assessments included radiographic imaging,range of motion analysis,pain level based on the visual analogue scale (VAS),and the SF-36 (Short Form (36) Health Survey),as well as whether patients could retum to their previous occupation.Results All fractures healed both clinically and radiologically in the experimental group.There was no more than 2 mm collapse of the humeral head,and no osteonecrosis or screw penetration of the articular surface.In contrast,two patients had a nonunion in the control group,and they eventually accepted total shoulder replacements.The average time from surgery to radiographic union was significantly shorter in the experimental group ((4.66±1.63) months) compared with the control group ((5.98±1.57) months) (P <0.05).For the experimental versus controls groups,the mean shoulder active flexion (148.00±18.59 vs.121.73±17.20) degrees,extension (49.00±2.22 vs.42.06±2.06) degrees,internal rotation (45.00±5.61 vs.35.00±3.55)degrees,external rotation (64.00±9.17 vs.52.14±5.73)degrees,and abduction (138.00±28.78 vs.105.95±15.66) degrees were all significantly higher (all P

  3. Open reduction and Internal Fixation of Displaced Proximal Humerus Fractures with AO Stainless Steel T-Plate

    Directory of Open Access Journals (Sweden)

    Hussain S

    2014-03-01

    Full Text Available Background: Proximal humeral fractures are considered the last unsolved fractures in orthopaedics. The treatment is controversial and various operative modalities have been reported in the literature. The aim of the present study was to evaluate functional outcome and complication rate after open reduction and internal fixation of displaced proximal humerus fractures by proximal humerus AO stainless steel Tplate. Twenty-five (25 patients with displaced proximal humerus fractures treated with proximal humerus T-plate between May 2005 and June 2008 were included in the study. Fractures were classified according to the Neer classification into displaced 2-part, 3-part, and 4-part fractures. Patients were followed-up for a minimum period of two years. Functional evaluation was done according to the Neer scoring system. Scores were compared with other studies in the literature using similar implant. Twenty patients had 2-part fracture, four had 3-part fracture, and one had 4-part fracture. Eighty-eight [88% (n = 22] patients had good to excellent result, eight [8% (n = 2] had fair, and four [4% (n = 1] had poor result. Difference in Neer’s score between 2-part and 3-part fractures was not significant. Complications encountered in this series were screw backout in 8% (n = 2, superficial infection in 12% (n= 3, and avascular necrosis in 4% (n = 1 of cases. We conclude that proximal humerus AO T- plate is a cheap and easily available implant, aspects which are particularly relevant in third world countries like India. It gives reliable fixation for 2-part and 3-part fractures. Its use in more complicated fracture patterns of 4-part fractures is not recommended.

  4. STUDY OF OUTCOME OF DISTAL TIBIAL FRACTURES TREATED WITH LOCKING COMPRESSION PLATES: BY BOTH OPEN REDUCTION AND MIPO TECHNIQUE

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    Ravikiran Nandiraju

    2016-07-01

    Full Text Available BACKGROUND Tibia being the most common fractured long bone of the body; 1. Distal metaphyseal fractures comprise 5-7% of these injures; 2. With or without involving the articular surface. Encouraging results for open reduction and internal fixation (Plate osteosynthesis and closed manual reduction with osteosynthesis with minimal invasive percutaneous locking plates has been noted for lower third tibial fractures. Locking compression plate provides the advantage of anatomic reduction, stable fixation, preservation of blood supply, preventing joint stiffness, less soft tissue injury. METHODS AND MATERIAL This study included (40 patients with distal tibia fractures between 18-65 years presenting in the Department of Orthopaedics in Osmania Medical College and Osmania General Hospital .This is prospective study. These patients are treated with locking compression plates. RESULTS Patients were evaluated using AOFAS7 score for hindfoot scale (100 points. Excellent - 26 (65%, Good - 12 (30%, Fair - 2 (5% comparable to other studies. CONCLUSION Reduction and internal fixation of distal tibial fractures using locking compression plate medially by open and MIPO technique is one of the acceptable forms of treatment for lower third tibia including the articular surface with or without communication.

  5. A comparative study of fracture shaft of femur in adults treated with broad dynamic compression plate versus intramedullary interlocking nail

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    Sushil Thapa

    2016-08-01

    Full Text Available Background and Objectives: Diaphyseal femur fracture is one of the commonest fractures to present in an emergency room. The objective of the study was to compare femoral shaft fractures treated using nail with those using plate and screws. Patients and Methods: We studied a total of 62 patients of fracture shaft of femur admitted in the Bharatpur Hospital, Bharatpur, Chitwan and National Academy of Medical Sciences, BirHospital,Kathmandu. Two cases were lost to follow up. Thirty cases were treated with plating and 30 cases with nailing. The age group was from 16-30 years. Fifty-three were male and seven were females. Fifty-eight patients had closed fracture and two had Gustillo Anderson grade I openfracture. Result: Time from injury to surgery was 19 days on an average. Mean time for union was more in patients treated by plating, 19.46 weeks as compared to nailing 14.78 weeks. We found one case of infection with plating and breakage of plate in four patients. One patient with nailing did not show any signs of healing and two had failure in case of nailing. Our series revealed 23(38.3% excellent, five (8.3% good and two (3.3% poor results in patients who had nailing while 15 (25.5% excellent, nine (15% good, one (1.7% fair and five (8.3% poor in patients who had plating out of 30 patients in each group. Conclusion:In our study we found that there was no significant difference in outcomes between plating and intramedullary nailing of femoral diaphysis fracture in terms of union, infection and implant failure.JCMS Nepal. 2016;12(2:66-9.

  6. Study of proximal femoral locking compression plate in extra capsular fracture neck of femur

    Directory of Open Access Journals (Sweden)

    Ravi G.O.

    2015-12-01

    Results: In our study of 21 cases, cases 13 cases were intertrochanteric fracture and remaining 8 were subtrochanteric fracture with the mean age was 51.47 years. Minimum age was 19 years and maximum age was 85 years. 14 patients (67% were males and 7 patients (33% were females, 13 IX patients (62% had right-sided fracture and 8 patients (38% had left-sided fracture. with right side being more common side affected. The average duration of stay in the hospital was 25.31 days. The average follow up was 18 months [11 to 23 months]. Out of 21 patients in our study 16 patients (76% are able to sit cross-legged and can squat on ground without any problem. The functional results were graded according to Harris Hip Scoring, In our study, 10 patients (48%had excellent results, 8 patients (38%had good results, 2 patients (10%had poor result, and 1 failed case (5% as she is an elderly female of 85 years with limited activity both preoperatively due to physiological age and general weakness. Conclusions: In conclusion the potentiality of the Proximal Femoral Locking Compression Plate (PF-LCP in varied indications, shows its versatility. Although not free of complications our study has demonstrated excellent results. The procedure offers, faster mobilization, rapid return to activities of daily living, improves the quality of life and gave a long term solution in patients with extracapsular fracture neck of femur. Larger studies with longer follow up will further validate the procedure. [Int J Res Med Sci 2015; 3(12.000: 3726-3733

  7. Radiation-Associated Fracture Nonunion of the Clavicle Treated with Locking Plate Fixation and Autologous Bone Grafting

    Directory of Open Access Journals (Sweden)

    Takahiro Niikura

    2012-01-01

    Full Text Available We describe a case of radiation-associated fracture nonunion of the clavicle, which was treated by locking plate fixation and autologous bone grafting. The patient was a 67-year old man who received 70 Gy radiation therapy to treat nasopharyngeal carcinoma. Eight years later, he suffered a pathological fracture of the right clavicle. One year after the fracture, surgical treatment was performed due to persistent pain and weakness. Radiographs demonstrated atrophic nonunion. Bone scan demonstrated hot uptake at both ends of the fractured bone. MRI demonstrated a formation of pseudoarthrosis with fluid collection and suggested bone marrow edema at both ends of the fracture fragments. In surgery, fibrous pseudoarthrosis tissue was excised and both ends of the fracture fragments were refreshed to identify bleeding. Open reduction and internal fixation using a 7-hole locking plate and autologous bone grafting were performed. Successful bony union was obtained 1 year postoperatively, and no adverse events were observed up to 52 months after the operation. Our case suggests that a locking plate provides sufficient fixation and autologous bone grafting is effective in enhancing bone healing in a radiation-associated fracture nonunion of the clavicle in which it is difficult to achieve bony union.

  8. 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.

    Science.gov (United States)

    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.

  9. Biomechanical comparison of dynamic condylar screw and locking compression plate fixation in unstable distal femoral fractures: An in vitro study

    Directory of Open Access Journals (Sweden)

    Ashutosh Kumar Singh

    2013-01-01

    Full Text Available Background: Distal femur fractures are difficult to manage and the selection of implant for internal fixation remains controversial. The objective of this study is to establish the relative strength of fixation of a distal femoral locking plate (DFLP compared with the dynamic condylar screw (DCS in the distal femur fractures. Materials and Methods: Study was conducted on 16 freshly harvested cadaveric distal femoral specimens, eight implanted with DCS and other eight with DFLP. The construct was made unstable by removing a standard sized medial wedge of 1 cm base (gap-osteotomy beginning 6 cm proximal to the lateral joint line in distal metaphyseal region with the loss of medial buttress. Fatigue test was conducted under load control mode at the frequency of I Hz. Specimens were subjected to cyclic loading of 2 kN, under observation for 50,000 cycles or until failure/cutout, which ever occurred earlier. Results: In DFLP group, there was no implant failure and the average number of cycles sustained was 50,000. Six out of eight specimens completed 50,000 cycles and two failed in DCS group. The average number of cycles sustained by DCS was 46150. Though the bone quality as assessed by dual energy X-ray absorptiometry DEXA was comparable in both DFLP and DCS group ( P = 0.06, none failed in DFLP group and subsidence was 1.02 ± 0.34 mm (range: 0.60-1.32 mm, which was significantly 43% lower ( P = 0.006 than subsidence in DCS group (1.82 ± 0.58; range: 1.20-3.08 mm. The average stiffness of DCS group was 52.8 ± 4.2 N/mm, which was significantly lower than average stiffness of locked condylar plate group (71.2 ± 5.1 N/mm ( P = 0.02. Conclusions: DFLP fixation of the distal femur fractures resulted in stronger construct than the DCS fixation in both cyclic loading and ultimate strength in biomechanical testing of a simulated A3 distal femur fracture.

  10. Infection rate in mandibular angle fractures treated with a 2.0-mm 8-hole curved strut plate.

    Science.gov (United States)

    Bui, Peter; Demian, Nagi; Beetar, Patrick

    2009-04-01

    The aim of this study was to determine the rate of postoperative infection and the efficacy of removing teeth in the line of mandibular angle fractures treated with 2.0-mm 8-hole titanium curved strut plates. Our understanding is that this method of repair is currently being used only in a few centers in the United States. A retrospective review of mandibular angle fractures treated with a 2.0-mm 8-hole strut plate during a 4-year period. Postoperative antibiotics were given for 1 week. Follow-up appointments were 4 weeks or longer. A nonchewing diet was instructed for 6 weeks. Data for all selected patients include the information such as age, gender, etiology of injuries, medical history, concurrent injuries, nerve deficits, pre- and postoperative antibiotic administration, postop infection, a presence or absence of teeth in the line of fractures, and whether these teeth were removed. Four patients (4 of 49 or 8.2%) developed infections. Two of those patients had a tooth in the line of a fracture that was retained (2 of 14 or 14%). The third had a tooth in the line of a fracture that was extracted (1 of 18 or 5.6%). The fourth patient was 1 of the 17 patients who did not have teeth in the line of fracture and developed infection (1 of 17 or 5.9%). None of the patients developed failed hardware, malunion, nonunion, malocclusion, or iatrogenic nerve injury. The use of a 2.0-mm 8-hole strut plate is associated with a low infection rate (8.2%). The infection rate for those mandibular angle fractures with teeth in the line of fracture retained was 14% compared with 5.6% for those fractures with the teeth in the line of fracture extracted.

  11. The margin between Senja and Spitsbergen fracture zones: Implications from plate tectonics

    Science.gov (United States)

    Myhre, Annik M.; Eldholm, Olav; Sundvor, Eirik

    1982-10-01

    Analysis of multichannel seismic data from the continental margin off Svalbard between the Senja and Spitsbergen fracture zones suggests that the transition between continental and oceanic crust is located at or close to the Hornsund Fault Zone. In the Late Paleocene/Early Eoeene (57 m.y.) the region between Svalbard and Northeast-Greenland was subjected to regional shear movements associated with a transform system between the young Lofoten-Greenland Basin and the Arctic Ocean. Approximately 50 m.y. ago the spreading axis migrated to the northeast creating a deep basin north of the Greenland-Senja Fracture Zone forming the passive margin between Bear Island and 76.5°N. North of 76.5°N the regional transform was maintained. At the time of the main reorganization of relative plate motion (36 m.y.) the northern margin evolved. A continental fragment was possibly cut off from the Svalbard margin forming a small microcontinent. The microcontinent appears as the submarine ridge which has been associated with the Hovgaard Fracture Zone. It is suggested that the sediments west of the Hornsund Fault Zone are not older than Eocene in the south and mid-Oligocene in the north. The position of the spreading axis has greatly influenced the margin sedimentation.

  12. Humeral shaft fractures treated by dynamic compression plates, Ender nails and interlocking nails.

    Science.gov (United States)

    Chao, Ting-Cheng; Chou, Wen-Ying; Chung, Jui-Chang; Hsu, Chien-Jen

    2005-04-01

    Between January 1991 and December 2002, we treated 92 acute, displaced, closed humeral shaft fractures (AO classification type A). We used three fixation methods: dynamic compression plates (DCP) in 36 patients, Ender nails (EN) in 32 patients and interlocking nails (ILN) in 24 patients. The patients were followed for a minimum of 24 months. At one year, all fractures except two (one DCP/one ILN) had united. Patients treated with EN had shorter mean operation time, 51 (35-110) min; less mean blood loss, 70 (30-170) ml and shorter mean hospital stay, 5.8 (3-12) days. There were three iatrogenic radial nerve palsies: two in the DCP group and one in the ILN group. There was one wound infection. There were three cases with impingement of the shoulder but range of motion was restored after nail removal. For patients with multiple trauma or high operative risk, EN fixation served as a safer and faster procedure. ILN fixation offered a stable fixation via a smaller incision but more fracture comminution might happen.

  13. 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

    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...... 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....... Interpretation of sonobuoy data and revised modeling of existing OBS data across Segment B indicate a continental composition of the segment. This interpretation is supported by magnetic anomaly data. The Segments A and B are bounded by portions of the Greenland Fracture Zone with a distinct similar to 10...

  14. Analysis of the results of different types of diaphyseal tibial fractures with intraosseous and of plate osteosynthesis

    Directory of Open Access Journals (Sweden)

    V. V. Pisarev

    2013-01-01

    Full Text Available Aim of this study - comparative assesment of treatment outcomes of different types of diaphyseal shin fractures in patients with bone and intraosteal lackable osteosynthesis. Material and methods. We examined 222 patients with fused diaphyseal shin fractures. In 122 patients close reduction and intraosteal lackable osteosynthesis of shin bones was performed, in 100 - open reduction and osteosynthesis of shin bones with plates LCDCP All patients were divided into subgroups according to АО/ASIF classification (fractures type А, В, С. The evaluation of the results was done in two years period after surgery with questionnaire SF36, outpatients clinic cards analysis, CITO cards study outcomes of fractures, rheovasography and X-ray examination. Results. We found that in patients with fractures types A and В these two types of osteosynthesis lead to similar results according to questionnaire SF36, comparable with control group. Bone osteosynthesis in treatment of fractures type С results in higher quality of life, comparable with control group, than intraosteal. Indicators of treatment outcomes in accordance with CITO card in bone osteosynthesis were higher than in intraosteal. In bone osteosynthesis of fractures type A the terms of temporary disability and fusion significantly lower than in intraosteal osteosynthesis of the similar fractures. Reduce of the tolerance to heavy physical stress in patients with fractures type С in intraosteal osteosynthesis determined by low blood flow in shin. Treatment of shin fractures with bone and intraosteal osteosynthesis follows by equal risks of complications.

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    Colin Murphy

    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.

  17. Fixation of 3- and 4-part proximal humerus fractures using the PHILOS plate: mid-term results.

    Science.gov (United States)

    Gaheer, Rajinder Singh; Hawkins, Amanda

    2010-09-07

    Treatment of unstable, displaced, and comminuted fractures of the proximal humerus remains challenging, and optimal treatment continues to be controversial. Fifty-six patients with displaced 3- and 4-part fractures of the proximal humerus had open reduction and internal fixation using the proximal humeral internal locking system (PHILOS) plate (Synthes, Stratec Medical Ltd, Mezzovico, Switzerland). Data were collected retrospectively, and clinical and radiological outcomes were assessed. Mean follow-up was 40 months (range, 18-62 months). The study shows that the PHILOS plate gives good results in the treatment of displaced 3- and 4-part fractures of the proximal humerus. Good fracture stability can be achieved early, allowing early mobilization without compromising fracture union. Most importantly, it requires minimal soft tissue dissection, does not need contouring, and gives good stability. No differences were observed in the functional outcomes of patients younger and older than 65 years. Few complications were associated with the plate, and the number of ≥2 surgeries was minimal. The complications noted were 1 case each of superficial wound infection, failure of the plate, and persistent stiffness. One patient had screw perforation of the humeral head articular surface, and 1 had subacromial impingement. Of the 32 patients who had been in active employment before the injury, 28 returned to their previous occupation.

  18. Combining of small fragment screws and large fragment plates for open reduction and internal fixation of periprosthetic humeral fractures

    Directory of Open Access Journals (Sweden)

    Dominik Seybold

    2011-01-01

    Full Text Available Operative treatment of periprosthetic humeral fractures in elderly patients with osteoporotic bone requires a stable fixations technique. The combination of 3.5 cortical screws with washers in a 4.5 Arbeitsgemeinschaft fόr Osteosynthesefragen, Limited-contact dynamic compression plate or Locking plate, allows a stable periprosthetic fixation with the small 3.5 screws and 4.5 screws above and below the prosthesis, respectively. This combination is a cost-effective technique to treat periprosthetic humeral fractures.

  19. Minimally invasive percutaneous compression plating versus dynamic hip screw for intertrochanteric fractures: a randomized control trial

    Institute of Scientific and Technical Information of China (English)

    Cheng Qiang; Huang Wei; Gong Xuan; Wang Changdong; Liang Xi; Hu Ning

    2014-01-01

    Objective:Intertrochanteric femur fracture is a common injury in elderly patients.The dynamic hip screw (DHS) has served as the standard choice for fixation; however it has several drawbacks.Studies of the percutaneous compression plate (PCCP) are still inconclusive in regards to its efficacy and safety.By comparing the two methods,we assessed their clinical therapeutic outcome.Methods:Atotal of 121 elderly patients with intertrochanteric femur fractures (type AO/OTA 31.A 1-A2,Evans type 1) were divided randomly into two groups undergoing either a minimally invasive PCCP procedure or a conventional DHS fixation.Results:The mean operation duration was significantly shorter in the PCCP group (55.2 min versus 88.5 min,P<0.01).The blood loss was 156.5 ml±18.3 ml in the PCCP group and 513.2 ml±66.2 ml in the DHS group (P<0.01).Among the patients treated with PCCP,3.1% needed blood transfusions,compared with 44.6% of those that had DHS surgery (P<0.01).The PCCP group displayed less postoperative complications (P<0.05).The mean American Society of Anesthesiologists score and Harris hip score in the PCCP group were better than those in the DHS group.There were no significant differences in the mean hospital stay,mortality rates,or fracture healing.Conclusion:Due to several advantages,PCCP has the potential to become the ideal choice for treating intertrochanteric fractures (type AO/OTA 31.A1-A2,Evans type 1),particularly in the elderly.

  20. Clinical results of using the proximal humeral internal locking system plate for internal fixation of displaced proximal humeral fractures.

    Science.gov (United States)

    Norouzi, Masoud; Naderi, Mohammad Nasir; Komasi, Mehdi Hemmati; Sharifzadeh, Seyyed Reza; Shahrezaei, Mostafa; Eajazi, Alireza

    2012-05-01

    Proximal humerus fractures are accounting for 4-5% of all fractures with increasing incidence. Proximal Humeral Internal Locking System (PHILOS) plate is a new plate which permits early mobility and lowers the risk of complications. The aim of this study was to evaluate the functional outcome and the complication rate after using this plate. Between 2006-2008, 37 patients with displaced 2-, 3-, and 4-part fractures of the proximal humerus underwent surgery using PHILOS plate. The mean range of follow-up was 12 months. Twenty patients were aged 60 years and younger, and 17 were aged older than 60 years. The average American Shoulder and Elbow Surgeons (ASES) score at the final follow-up was 77.62. According to Michener and colleagues classification, 5.4% of patients had an excellent outcome, 72.9% were minimally functionally limited, 16.2% were moderately functionally limited, and 5.4% were maximally functionally limited. The average ASES score between patients 60 years and older and those 60 years and younger was not different significantly. One patient developed avascular necrosis of the humeral head, 2 patients developed an infection, and no patients developed a nonunion. Fixation with PHILOS plate can be considered a good method with high union rates for this kind of fracture, especially in the older population with osteoporotic bone.

  1. Temporary Sternoclavicular Plating for an Unusual Double Clavicle Fracture (Medial Nonunion, Lateral Acute Complicated by an Intraoperative Pneumothorax

    Directory of Open Access Journals (Sweden)

    John G. Skedros

    2014-01-01

    Full Text Available Double (segmental clavicle fractures, involving both the medial and lateral aspects of the clavicle, are very uncommon. Even less common is an asynchronous double fracture with one of the fractures being a nonunion. We report the case of a 30-year-old healthy male patient who had an unusual double clavicle fracture (medial nonunion, lateral acute that occurred in separate traumatic events during motocross (motorcycle racing. His fractures were treated surgically in two stages. In the first stage a long reconstruction plate was used that spanned onto the sternum and two transcortical screws were placed into the manubrium to enhance purchase for the deficient bone of the medial clavicle. In accordance with the preoperative plan, the medial one-third of the plate and the medial four screws (of the total 13 used were removed. Although our patient had an excellent final result, he did have an intraoperative pneumothorax that was treated uneventfully with a chest tube. Medial clavicle fractures are difficult to treat, especially if they are nonunions and surgical complication rates can be high. Our case is one of the few that has been described where temporary sternoclavicular plating was successful in achieving an excellent long-term outcome.

  2. Temporary sternoclavicular plating for an unusual double clavicle fracture (medial nonunion, lateral acute) complicated by an intraoperative pneumothorax.

    Science.gov (United States)

    Skedros, John G; Knight, Alex N; Mears, Chad S; Langston, Tanner D

    2014-01-01

    Double (segmental) clavicle fractures, involving both the medial and lateral aspects of the clavicle, are very uncommon. Even less common is an asynchronous double fracture with one of the fractures being a nonunion. We report the case of a 30-year-old healthy male patient who had an unusual double clavicle fracture (medial nonunion, lateral acute) that occurred in separate traumatic events during motocross (motorcycle) racing. His fractures were treated surgically in two stages. In the first stage a long reconstruction plate was used that spanned onto the sternum and two transcortical screws were placed into the manubrium to enhance purchase for the deficient bone of the medial clavicle. In accordance with the preoperative plan, the medial one-third of the plate and the medial four screws (of the total 13 used) were removed. Although our patient had an excellent final result, he did have an intraoperative pneumothorax that was treated uneventfully with a chest tube. Medial clavicle fractures are difficult to treat, especially if they are nonunions and surgical complication rates can be high. Our case is one of the few that has been described where temporary sternoclavicular plating was successful in achieving an excellent long-term outcome.

  3. Outcome of open reduction and internal fixation of intraarticular calcaneal fracture fixed with locking calcaneal plate

    Institute of Scientific and Technical Information of China (English)

    Saurabh Jain; Anil Kumar Jain; Ish Kumar

    2013-01-01

    Objective:Debate continues regarding the management of calcaneal fractures,between open reduction and internal fixation and closed treatment.Hence we aim at evaluating the radiological and functional outcomes of open reduction and internal fixation in displaced joint depression type of calcaneal fractures fixed with locking calcaneal plate.Methods:In this series,28 patients (26 unilateral and 2 bilateral) with joint depression type of calcaneal fractures as per Essex-Lopresti classification system were operated on with locking calcaneal plate within 3 weeks of injury.Patients were evaluated in terms of associated injuries and X-rays of anteroposterior,lateral and axial views of the calcaneum.CT scan was done to assess the amount ofcomminution and articular depression.Patients were followed up clinically and radiologically at least for 1 year.Radiological assessment was done by Bohler's angle and Gissane's angle along with measurement ofcalcaneal height and width.Functional outcome was assessed using the American Orthopaedics Foot and Ankle Society (AOFAS) scale.Results:At average follow-up of 14.5 months,average AOFAS score was 86.3 (range 66 to 97),with 86% having excellent to good results and 2 (7.7%) and 1 (3.7%) having fair and poor results respectively.All patients had stable ankle joint with all having dorsiflexion and plantar flexion more than 30°.Average subtalar range of motion was 17°.The mean Bohler's angle,mean Gissane's angle,calcaneal height and width were 25.47°,121.3°,4.32 cm and 3.81cm respectively at final follow-up.Three patients had flap necrosis at incision site and one had superficial and deep infection.Subtalar arthritis was seen in 5 patients,whereas sural nerve hypoaesthesia in 1 patient.None of the patients had compartment syndrome,heel pad problems,peroneal tendinitis,reflex sympathetic dystropy or implant failure.Conclusion:Open reduction and internal fixation with locking calcaneal plate gives sound functional outcome

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

    Directory of Open Access Journals (Sweden)

    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.

  5. 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......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...... 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....

  6. Prospective blind comparative clinical study of two point fixation of zygomatic complex fracture using wire and mini plates

    Directory of Open Access Journals (Sweden)

    Gandi Lakshmi N

    2012-03-01

    Full Text Available Abstract Background The zygomatic maxillary complex (ZMC fractures are one of the most frequent injuries of the facial skeleton due to its position and facial contour. Assaults, road traffic accidents and falls are the principal etiologic factors that may cause fractures of zygomatic bone. The different fixation methods are applied to treat the zygomatic bone fractures, with many more classifications which have been described in the literature for the ease of management. The type of the fracture, its severity and associated facial fractures usually interferes the treatment modality. Purpose of study The aim of this paper is to show the results of 18yrs prospective blind comparative study using wire and plate osteosynthesis which needed open reduction and internal fixation involving Type II to Type IV Spissel and Schroll ZMC fractures. Materials and methods Total 80 cases included in the study out of 1780 ZMC cases which were treated using wire and plate osteosynthesis over a period of 18 yrs, involving only Type II to Type IV Spissel and Schroll ZMC fractures. Other types excluded from study to prevent observer bias. All the fixations carried out through Standard Dingman's incision using stainless steel 26 gauze wire and titanium 1.5 mm mini plate system under general anesthesia by single maxillofacial surgeon and evaluated by another maxillofacial surgeon who is blinded for surgical procedure after 2 and 4 wks of follow-up for facial symmetry, wound healing, functional assessment (mouth opening, diplopia, and sensory disturbance. All the data tabulated in Excel software (Microsoft for statistical analysis. P-value calculated to know the Significance of treatment modality in all aspects. Results Result shows no significant p-values indicating both the operating techniques are equally efficient in the surgical management of ZMC fracture. Conclusion Osteosynthesis by mini plates is simple, logical and effective treatment compared to wire

  7. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  9. Summary of Radionuclide Reactive Transport Experiments in Fractured Tuff and Carbonate Rocks from Yucca Flat, Nevada Test Site

    Energy Technology Data Exchange (ETDEWEB)

    Zavarin, M; Roberts, S; Reimus, P; Johnson, M

    2006-10-11

    In the Yucca Flat basin of the Nevada Test Site (NTS), 747 shaft and tunnel nuclear detonations were conducted primarily within the tuff confining unit (TCU) or the overlying alluvium. The TCU in the Yucca Flat basin is hypothesized to inhibit radionuclide migration to the highly transmissive and regionally extensive lower carbonate aquifer (LCA) due to its wide-spread aerial extent, low permeability, and chemical reactivity. However, fast transport pathways through the TCU by way of fractures may provide a migration path for radionuclides to the LCA. Radionuclide transport in both TCU and the LCA fractures is likely to determine the location of the contaminant boundary for the Yucca Flat/Climax Mine Corrective Action Unit (CAU). Radionuclide transport through the TCU may involve both matrix and fracture flow. However, radionuclide migration over significant distances is likely to be dominated by fracture transport. Transport through the LCA will almost certainly be dominated by fracture flow, as the LCA has a very dense, low porosity matrix with very low permeability. Because of the complex nature of reactive transport in fractures, a stepwise approach to identifying mechanisms controlling radionuclide transport was used. The simplest LLNL experiments included radionuclide transport through synthetic parallel-plate fractured tuff and carbonate cores. These simplified fracture transport experiments isolated matrix diffusion and sorption effects from all other fracture transport processes (fracture lining mineral sorption, heterogeneous flow, etc.). Additional fracture transport complexity was added by performing induced fractured LCA flowthrough experiments (effect of aperture heterogeneity) or iron oxide coated parallel plate TCU flowthrough experiments (effect of fracture lining minerals). Finally naturally fractured tuff and carbonate cores were examined at LLNL and LANL. All tuff and carbonate core used in the experiments was obtained from the USGS Core Library

  10. Effects of cooling rate on the fracture properties of TA15 ELI alloy plates

    Institute of Scientific and Technical Information of China (English)

    LI Shikai; XIONG Baiqing; HUI Songxiao

    2007-01-01

    The effects of cooling rate on the mechanical properties and the fatigue crack growth behavior of TA15 ELI alloy plates with different microstructures were investigated at room temperature. The results indicate that the cooling rate (water quench, air cooling, and furnace cooling) has a pronounced influence on the mechanical properties and on the fatigue crack growth,especially for air cooling and furnace cooling.Optical microstructure observation and scanning electron microscopy of tensile fracture surfaces were performed to gain an insight into the mechanism of properties.The dependence of mechanical properties and fatigue crack growth behavior on the cooling rate can be attributed to the α lamellae width and the α colony size,which induce the change in slip length. The microstructure produced by air cooling shows the best damage tolerance behavior when compared with water quench and furnace cooling.

  11. Bone splint technique and plating application in adolescent high-energy comminuted fracture of distal femur with bone defects

    Institute of Scientific and Technical Information of China (English)

    LIU Hui; DING Zhen-qi; ZHAI Wen-liang; KANG Liang-qi; YAO Xiao-tao

    2008-01-01

    @@ Comminuted fracture of distal femur is a common lower limb injury from traffic accidents, especially from motor accidents. Routine dynamic condylar screw ( DCS ) or 95-degree condylar plate ( CP ) sometimes cannot solve the bone defect in the center of alignment and contralateral diaphysis for the reason of absent screw anchor point, especially for AO C2. 2-2. 3 types.

  12. The WST method, a fracture mechanics test method for FRC

    DEFF Research Database (Denmark)

    Lofgren, I.; Stang, Henrik; Olesen, John Forbes

    2008-01-01

    FRC compositions. Furthermore, for the WST method, two different specimen sizes have been investigated. Results from this investigation demonstrate the applicability of the WST method and show that the scatter of the test results is lower than for the 3PBT. Through inverse analysis, stress......The applicability of the wedge-splitting test method (WST), for determining fracture properties of fibre-reinforced concrete, is discussed. Experimental results, using the WST method, are compared with results from uniaxial tension tests (UTT) and three-point bending tests (3PBT) for five different......-crack opening (sigma-w) relationships have been determined for each mix and test method. For the two WST specimen sizes, there is no apparent difference either in the number of fibres (per cm(2)) crossing the fracture plane or in the fracture properties. The major factor contributing to the scatter in the test...

  13. Repositioning and stabilization of the radial styloid process in comminuted fractures of the distal radius using a single approach: the radio-volar double plating technique

    OpenAIRE

    Jacobi Matthias; Wahl Peter; Kohut Georges

    2010-01-01

    Abstract Background A possible difficulty in intra-articular fracture of the distal radius is the displacement tendency of the radial styloid process due to the tension of the brachioradialis tendon. Methods Ten patients treated within one year for complex distal radius fractures by double-plating technique with a radial buttress plate and volar locking plate, through a single volar approach, were followed prospectively during 24 months. Outcome measures included radiographic follow-up, range...

  14. A modified preauricular-temporal approach for fixing comminuted and redisplaced zygomatic arch fractures with the resorbable bone plate

    Institute of Scientific and Technical Information of China (English)

    CHEN Peng; LIU Bing; ZHANG Hai-zhong; BU Jing-qiu

    2012-01-01

    Objective: To evaluate the effectiveness of the rigid internal fixation for comminuted and redisplaced zygomatic arch fractures by modified preauricular-temporal approach with the resorbable bone fixation.Methods: Totally twenty patients aged from 14 to 68 years and admitted to our hospital between September 2006 and June 2011 were reviewed,of whom seventeen had a unilateral comminuted zygomatic arch fracture and three redisplaced arch fracture after failed closed reduction.The fracture segments were aligned to restore the preinjury form of the arch by rigid fixation with resorbable plates and screws through a modified preauricular-temporal incision.Results: The fractures were well reduced,preauricular-temporal scar and lateral facial contour were aesthetically satisfying,and no case had limited mouth opening as well as facial palsy.The resorbable plates were not palpated one year after the operation.Conclusion: The rigid internal fixation through the preauricular-temporal approach with the resorbable bone is an effective method for the comminuted and redisplaced zygomatic arch fractures.

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

    Directory of Open Access Journals (Sweden)

    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

  16. 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

    2017-01-01

    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. PMID:28772395

  17. 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.

  18. Nonlinear Fracture Mechanics and Plasticity of the Split Cylinder Test

    DEFF Research Database (Denmark)

    Olesen, John Forbes; Østergaard, Lennart; Stang, Henrik

    2006-01-01

    demonstrates the influence of varying geometry or constitutive properties. For a split cylinder test in load control it is shown how the ultimate load is either plasticity dominated or fracture mechanics dominated. The transition between the two modes is related to changes in geometry or constitutive......The split cylinder testis subjected to an analysis combining nonlinear fracture mechanics and plasticity. The fictitious crack model is applied for the analysis of splitting tensile fracture, and the Mohr-Coulomb yield criterion is adopted for modelling the compressive crushing/sliding failure. Two...

  19. Fibular allograft and anterior plating for dislocations/fractures of the cervical spine

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    Ramnarain A

    2008-01-01

    Full Text Available Background: Subaxial cervical spine dislocations are common and often present with neurological deficit. Posterior spinal fusion has been the gold standard in the past. Pain and neck stiffness are often the presenting features and may be due to failure of fixation and extension of fusion mass. Anterior spinal fusion which is relatively atraumatic is thus favored using autogenous grafts and cages with anterior plate fixation. We evaluated fresh frozen fibular allografts and anterior plate fixation for anterior fusion in cervical trauma. Materials and Methods: Sixty consecutive patients with single-level dislocations or fracture dislocations of the subaxial cervical spine were recruited in this prospective study following a motor vehicle accident. There were 38 males and 22 females. The mean age at presentation was 34 years (range 19-67 years. The levels involved were C5/6 ( n = 36, C4/5 ( n = 15, C6/7 ( n = 7 and C3/4 ( n = 2. There were 38 unifacet dislocations with nine posterior element fractures and 22 were bifacet dislocations. Twenty-two patients had neurological deficit. Co-morbidities included hypertension ( n = 6, non-insulin-dependent diabetes mellitus ( n = 2 and asthma ( n = 1. All patients were initially managed on skull traction. Following reduction further imaging included Computerized Tomography and Magnetic Resonance Imaging. Patients underwent anterior surgery (discectomy, fibular allograft and plating. All patients were immobilized in a Philadelphia collar for eight weeks (range 7-12 weeks. Eight patients were lost to follow-up within a year. Follow-up clinical and radiological examinations were performed six-weekly for three months and subsequently at three-monthly intervals for 12 months. Pain was analyzed using the visual analogue scale (VAS. The mean follow-up was 19 months (range 14-39 months. Results: Eight lost to followup, hence 52 patients were considered for final evaluation. The neurological recovery was 1.1 Frankel

  20. 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

  1. Fractures and fracture-dislocations of the proximal humerus: A retrospective analysis of 82 cases treated with the Philos(®) locking plate.

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    Erasmo, Rocco; Guerra, Giovanni; Guerra, Luigi

    2014-12-01

    To present the experience in a single institution of the management of 82 consecutive fractures and fracture-dislocations of the proximal humerus treated with the Proximal Humeral Internal Locking System (Philos(®)) plate. A total of 81 patients with 82 proximal humerus fractures (one patient had bilateral fracture) were treated at our institution with open reduction and internal fixation with Philos(®) plate from January 2008 to December 2012 and the clinico-radiological outcome was analysed. Twelve of these patients also had a dislocation of the proximal humerus. According to the Neer classification, there were seven two-part fractures, 40 three-part fractures and 35 four-part fractures. All patients received a similar physical therapy programme following internal fixation. Mean final follow-up was 32 months. Functional outcome was evaluated for each patient using the Constant-Murley score; radiographic evaluation was also conducted and complications were recorded. At the end of the follow-up period, the mean Constant-Murley score for the injured side was 75 points (range 42-92); results were graded as excellent for eight patients, good for 52, moderate for 17 and poor for five. Twenty-three patients (28%) had complications during the follow-up period. Reoperation was required in 12 patients. Complications included avascular necrosis of the humeral head in 10 patients (12%), varus positioning of the head in four patients (4.8%), impingement syndrome in three patients (3.6%), secondary screw perforation in three patients (3.6%), non-union of the fracture in two patients (2.4%) and infection in one patient (1.2%). Open reduction and internal fixation of proximal humeral fractures with the Philos(®) plate was associated with good clinical outcomes provided the correct surgical technique was used. To better evaluate the real incidence of complications, it is important to follow patients for more than one year after surgery as some complications may arise after

  2. EARLY RESULTS OF UNSTABLE DISTAL RADIUS FRACTURES- ORIF WITH LOCKING COMPRESSION PLATE VERSUS LIGAMENTOTAXIS WITH EXTERNAL FIXATORS

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    Mondeep Gayan

    2017-04-01

    Full Text Available BACKGROUND External Fixation (EF and Open Reduction and Internal Fixation (ORIF have been the traditional surgical modalities for unstable distal radius fractures. The Locking Compression Plates (LCP acting as “internal external fixators” are particularly valuable in difficult situations of fractures. We undertook a study to evaluate the outcome of unstable distal radius fractures treated with ORIF with LCP versus those treated by ligamentotaxis with external fixators. MATERIALS AND METHODS A comparative study was carried out in a tertiary care centre with 30 cases of unstable distal radius fractures (15 cases in each group. In one group, open reduction and internal fixation with distal radius volar locking compression plate was carried out and in the other group ligamentotaxis with external fixator was done. The patients were treated and followed up over a period of one and a half year between June 2011 to November 2012. The fractures were classified according to AO classification (Arbeitsgemeinschaft für Osteosynthesefragen: German for “Association for the Study of Internal Fixation” or AO. The functional results were evaluated at the end of 6 months according to Demerit point system of Gartland and Werley modified by Sarmiento (1975 and the anatomical results as per Lindstrom criteria (1959 modified by Sarmiento (1980. RESULTS Overall 86.66% (13 cases had good-to-excellent anatomical results in external fixator group as compared to 93.33% (14 cases in LCP group. The functional outcome was excellent in 80% (12 and good in 13.33% (2 cases in external fixator group as compared to 66.66% (10 excellent and 26.66% (4 good in LCP group. CONCLUSION Both open reduction and internal fixation with locking compression plate and ligamentotaxis with external fixators are good treatment modalities for unstable distal radius fractures. However, the choice should be guided by the fracture configuration, surgeons’ experience and patient’s profile.

  3. The use of parallel pre-contoured plates in the treatment of A and C fractures of the distal humerus.

    Science.gov (United States)

    Rebuzzi, Enrico; Vascellari, Alberto; Schiavetti, Stefano

    2010-05-01

    The purpose of this study was to retrospectively evaluate the clinical and radiological results of fixation with parallel pre-contoured plates in intra-articular and extra-articular distal humerus fractures. We retrospectively evaluate seven cases of type A and six cases of type C fracture treated with the Mayo Clinic Congruent Elbow Plate system (Acumed, Hillsboro, Oregon) after a mean follow-up of 14.8 and 21.3 months, respectively. Mayo Elbow Performance Score (MEPS) was utilized for functional evaluation. Mean MEPS was (92.86 +/- 16.8) in the first group showing 6 excellent and one poor result, while (94.17 +/- 12) showing five excellent and one fair in the second group, showing no significant difference between the two groups (P = 0.87). The mean active motion recovered postoperatively was 120 degrees (+/-34.5 degrees) in type A fractures and 113 degrees (+/-14.7 degrees) in type C fractures, and there was no significant difference (P = 0.67). Complications occurred in 6 of the 13 patients analysed at follow-up (3 radial neuropathy, one ulnar neuropathy, one screw mobilization and one heterotopic ossification). The fractures healed in every patient, and no synthesis failed. The parallel plate system has proved to be extremely useful in the treatment of intra-articular and extra-articular distal humerus fractures. The pre-contoured geometry allows easier reduction and stabilization of complex fractures. The higher stability achieved permits early mobilization, thus obtaining a higher percentage of excellent results.

  4. Characterization of Rubbers from Spherical Punch - Plate Indentation Tests

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    Florina Carmen Ciornei

    2016-12-01

    Full Text Available Rubber plates with different compositions and hardness were tested by continuous indentation, using a spherical punch and hysteretic phenomenon was evidenced. The experimental data interpolation with polynomial functions is accurate and permits estimation of the lost work during loading cycles. The interpolation by power law functions is more convenient by using less parameters and having a form accepted in literature. From the rubbers tested, two were considered to present good damping properties.

  5. Functional Results of Intercondylar Fractures of the Humerus Fixed with Dual Y-Plate; A Technical Note

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    Swagat Mahapatra

    2017-01-01

    Full Text Available Objective: To evaluate and report the functional results of surgical management of intercondylar fractures of the humerus in adults using a novel dual plating technique. Methods: A total number of 60 patients with Riseborough and Radin type II, III, and IV intercondylar humerus fractures were operated with open reduction through a Trans-olecranon approach and internal fixation using two plates in inverted-Y configuration. Patients were followed for 3 weeks, 3 and 6 months were evaluated using the Mayo Elbow performance score and Quick-DASH score. Results: There were 50(83.33%men and 10 (16.67%women with mean age of 34.9 ± 12.63 years. 63.3% of the cases were following Motor vehicle accident and rest following fall. The right upper limb was more commonly affected than the left side. Riseborough and Radin type II fractures accounted for 3.33% of cases; type III fractures accounted for 50% of cases and type IV accounted for 46.67%. Excellent to Good results were seen in almost 80% of cases as per the Mayo Elbow performance score at 6-month follow-up. Quick-DASH scores for the series at 6-month follow-up was on average of 15.96 ± 9.92. Conclusion: Dual plating in inverted Y configuration offers a reliable fixation, which permits early mobilization and good functional outcome.

  6. Functional Results of Intercondylar Fractures of the Humerus Fixed with Dual Y-Plate; A Technical Note  

    Science.gov (United States)

    Mahapatra, Swagat; Abraham, Vineet Thomas

    2017-01-01

    Objective: To evaluate and report the functional results of surgical management of intercondylar fractures of the humerus in adults using a novel dual plating technique. Methods: A total number of 60 patients with Riseborough and Radin type II, III, and IV intercondylar humerus fractures were operated with open reduction through a Trans-olecranon approach and internal fixation using two plates in inverted-Y configuration. Patients were followed for 3 weeks, 3 and 6 months were evaluated using the Mayo Elbow performance score and Quick-DASH score. Results: There were 50(83.33%)men and 10 (16.67%)women with mean age of 34.9 ± 12.63 years. 63.3% of the cases were following Motor vehicle accident and rest following fall. The right upper limb was more commonly affected than the left side. Riseborough and Radin type II fractures accounted for 3.33% of cases; type III fractures accounted for 50% of cases and type IV accounted for 46.67%. Excellent to Good results were seen in almost 80% of cases as per the Mayo Elbow performance score at 6-month follow-up. Quick-DASH scores for the series at 6-month follow-up was on average of 15.96 ± 9.92. Conclusion: Dual plating in inverted Y configuration offers a reliable fixation, which permits early mobilization and good functional outcome.

  7. Efficacy of radial styloid targeting screws in volar plate fixation of intra-articular distal radial fractures: a biomechanical study in a cadaver fracture model

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    Yamashita Toshihiko

    2010-12-01

    Full Text Available Abstract Background The locking screws target the radial styloid, theoretically provide greater stability against radial styloid fragment. However, it is unknown whether the radial styloid locking screws increased the stability of the volar plating system fixation along the entire distal radius or not. In this study, we evaluated the stability of the volar plating system fixation with or without the radial styloid screws using a biomechanical study in a cadaver fracture model. Methods Six matched pairs of fresh-frozen human cadaver wrists complete from the proximal forearm to the metacarpal bones were prepared to simulate standardized 3-part intra-articular and severe comminuted fractures. Specimens were fixed using the volar plating system with or without 2 radial styloid screws. Each specimen was loaded at a constant rate of 20 mm/min to failure. Load data was recorded and, ultimate strength and change in gap between distal and proximal fragments were measured. Data for ultimate strength and screw failure after failure loading were compared between the 2 groups. Results The average ultimate strength at failure of the volar plate fixation with radial styloid screws (913.5 ± 157.1 N was significantly higher than that without them (682.2 ± 118.6 N. After failure loading, the average change in gap between the ulnar and proximal fragment was greater than that between the radial and proximal fragment. The number of bent or broken screws in ulnar fragment was higher than that in radial fragment. The number of specimens with bent or broken screws in cases with radial styloid screws was fewer than that in the fixation without radial styloid screws group. Conclusion The ulnar fragment is more intensively stressed than the radial fragment under axial loading of distal radius at full wrist extension. The radial styloid screws were effective in stable volar plate fixation of distal radial fractures.

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

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    Sven Mardian

    2015-01-01

    Full Text Available 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 (ROM; KSS; VAS, radiographic (osteoarthritis score, loss of reduction and quality of life (WOMAC; Lysholm scores. There were 46 males and 55 females. The average of patients was 51 years (range 22-77 years. Study groups were assigned according to the AO fracture classification. Results: Mean followup was 57 ± 30 months. Fracture type distribution revealed a significantly (P < 0.001 increased number of type B- (62.4% compared to C-fractures. Functional assessment showed a significantly better total KSS (84.1 ± 15.6 vs. 74.7 ± 18.0; P = 0.01 as well as ROM (active: 124°±17° vs. 116°±15°, P = 0.014; passive: 126°±18° vs. 118 ± 14°, P = 0.017 in the B-fracture group. VAS was found to be markedly higher (P = 0.0039 following type C-fractures. Rating osteoarthritis secondary to a tibial plateau fracture as a function of injury severity (r = 0.485; P < 0.001 and relating the loss of reduction to the grade of evolving osteoarthritis (r = 0.643;P < 0.001 a positive correlation was found. Quality of life showed significantly improved results for Lysholm score (P = 0.004 following B-fractures with low overall values for the WOMAC score. Conclusion: Presented data provide sufficient evidence that anatomic restoration of tibial plateau fractures with angular stable plate fixation result in decreased loss of reduction and declined incidence of posttraumatic osteoarthritis, thereby providing acceptable mid to long term outcome.

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

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    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.

  10. Femoral Head Growth Plate Dysplasia and Fracture in Juvenile Rabbits Induced by Off-target Antiangiogenic Treatment.

    Science.gov (United States)

    Hall, A Peter; Mitchard, T; Rolf, M G; Stewart, J; Duffy, P

    2016-08-01

    Epiphyseal growth plate dysplasia (chondrodysplasia) might be considered as the pathognomonic feature of antiangiogenic treatment in preclinical species as it is reliably and dose-responsively induced in rodents and monkeys with vascular endothelial growth factor receptor (VEGFR) inhibitors, fibroblast growth factor (FGF) receptor inhibitors, matrix metalloproteinase inhibitors, and vascular targeting agents. Here we report epiphyseal growth plate dysplasia in juvenile rabbits treated with an oral spleen tyrosine kinase inhibitor induced by off-target antiangiogenic inhibition of VEGF and FGF family kinase receptors. Epiphyseal growth plate dysplasia resulted in weakening and fracturing of the femoral head physis in 6 of 10 male and 1 of 10 female animals as well as microfracturing and dysplasia of the distal femoral articular cartilage in 1 male animal. Fracture lines ran through the zone of hypertrophic cartilage (as well as adjacent zones), were orientated parallel to the physeal plane, and often involved displacement of the femoral head. We would suggest that the high prevalence of growth plate fracture in the rabbit may represent a potential additional adverse risk to those already established for children treated with antiangiogenic therapy.

  11. A prospective study of biological fixation with either plate or interlocking nail on the mean duration of union in diaphyseal fractures of tibia

    Directory of Open Access Journals (Sweden)

    Rajendra B Uppin

    2013-01-01

    Full Text Available Objective: To study the results of Biological plating or Interlocking nail for the closed diaphyseal fracture of the tibia in Department of Orthopedics, KLE University′s, Dr. Prabhakar Kore Hospital and Medical Research Center, Belgaum. The aim of this study was the evaluation of the results of biological plating or interlocking nail for closed diaphyseal fractures of the tibia. Materials and Methods: The study included 30 patients. All the patients underwent a comprehensive orthopedic examination and work-up was done to diagnose and classify tibial fractures. The treatment modalities were suggested accordingly. Results: Intramedullary nailing should be the method of choice for treating the closed type of tibial shaft fractures. Biological plating should be considered as an alternative in intramedullary interlocking nail in specific indications. Conclusion: Comprehensive orthopedic examination with detailed study of fracture pattern and type of fracture help to evaluate the different modalities of treatment.

  12. Novel management of distal tibial and fibular fractures with Acumed fibular nail and minimally invasive plating osteosynthesis technique

    Science.gov (United States)

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

    2017-01-01

    Abstract Rationale: 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. Patient concerns: 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. Diagnosis: Closed fracture of the distal third of the left tibia and fibula (AO: 43-A3). Interventions: 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. Outcomes: 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. Lessons: 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. PMID:28328865

  13. Lost in Iceland? Fracture Zone Complications Along the Mid-Atlantic Plate Boundary

    Science.gov (United States)

    Brandsdóttir, B.; Einarsson, P.; Detrick, R. S.; Mayer, L.; Calder, B.; Driscoll, N.; Richter, B.

    2003-12-01

    The mid-Atlantic plate boundary breaks up into a series of segments across Iceland. Two transform zones, the South Iceland Seismic Zone (SISZ) and the Tjörnes Fracture Zone (TFZ) separate the on land rift zones from the Reykjanes Ridge (RR), and the Kolbeinsey Ridge (KR), offshore N-Iceland. Both are markedly different from fracture zones elsewhere along the plate boundary. The 80 km E-W and 10--15 km N-S SISZ is made up of more than 20 N-S aligned, right-lateral, strike-slip faults whereas the TFZ consists of a broad zone of deformation, roughly 150 km E-W and 75 km N-S. The over-all left-lateral transform motion within the SISZ is accommodated by bookshelf faulting whereas the right-lateral transform motion within the TFZ is incorporated within two WNW-trending seismic zones, spaced ˜40 km apart, the Grímsey Seismic Zone (GSZ) and the Húsavík-Flatey fault (HFF). Recently collected EM300 and RESON8101 multibeam bathymetric data along with CHIRP subbottom data has unveiled some tectonic details within the TFZ. The GSZ runs along the offshore extension of the Northern Volcanic Rift Zone (NVRZ) and is made up of four left-stepping, en-echelon, NS-striking rift segments akin to those on land. Large GSZ earthquakes seem to be associated with lateral strike-slip faulting along ESE-striking fault planes. Fissure swarms transecting the offshore volcanic systems have also been subjected to right-lateral transformation along the spreading direction. As the Reykjanes Peninsula, the on land extension of the RR, the GSZ bears the characteristics of an oblique rift zone. The plate boundary segments connecting to the RR and KR are thus symmetrical with respect to the plate separation vector (105° ) and orientation of individual volcanic systems. The HFF has an overall strike of N65° W and can be traced continuously along its 75--80 km length, between the Theistareykir volcanic system within the NVRZ, across the central TFZ-graben, the Skjálfandi bay, and into the largest

  14. Bilateral traumatic proximal humerus fractures managed by open reduction and internal fixation with locked plates

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    Jaiswal Atin

    2013-12-01

    Full Text Available 【Abstract】Fractures of the proximal humerus are uncommon in young patients. Although bilateral fracture of proximal humerus itself is rare, association with epilepsy and electrocution is frequent. Only one case of traumatic bilateral proximal humerus fracture has been reported in the literature. We report a rare case of bilateral traumatic dis- placed proximal humerus fractures in a 40 years old male patient, which was treated by means of open reduction and internal fixation with proximal humerus locked pates on both sides and obtained a good functional outcome. Key words: Humeral fractures; Shoulder fractures; Fracture fixation, internal

  15. Complex fractures of the proximal humerus in the elderly--outcome and complications after locking plate fixation.

    Science.gov (United States)

    Schliemann, B; Siemoneit, J; Theisen, Ch; Kösters, C; Weimann, A; Raschke, M J

    2012-05-01

    Open reduction and internal fixation (ORIF) with locking plates or primary arthroplasty remains a controversial issue in the management of complex proximal humerus fractures. Aim of this study was to evaluate the surgeon- and patient-based outcome of patients older than 65 years who underwent ORIF using locking plate fixation of a 3- or 4-part fracture of the proximal humerus. Twenty-seven patients older than 65 years were treated with locking plate fixation (PHILOS, Fa. Synthes, Umkirch, Germany). At an average follow-up of 44 months, the clinical and the subjective outcome were evaluated, and complications were analyzed. The mean age- and gender-related Constant score was 70% (30–100%) compared with 92% (47–108%) of the contralateral non-injured shoulder. The mean DASH score was 29 points (0–71). Five patients (18.5%) showed clinical signs of an impingement, which was related to malpositioning of the plate in 3 cases. Screw cutout was seen in 22.2% (6 patients). Avascular necrosis of the head or the tubercula was found in 8 patients (29.6%). The revision rate was 29.6%. However, the patients considered the functional status of their shoulder as “good” or “satisfactory.” The functional and patient-orientated results of the locking plate fixation of complex displaced proximal humerus fractures in the elderly are comparable to those of primary arthroplasty and minimally invasive treatment. Proper surgical technique (screw length, plate position) is mandatory for reducing the revision rate.

  16. Rate of Improvement following Volar Plate Open Reduction and Internal Fixation of Distal Radius Fractures

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    Chris Dillingham

    2011-01-01

    Full Text Available Purpose. To determine recovery timeline of unstable distal radius fractures treated by open reduction and internal fixation with a locking volar plate. Methods. Data was collected prospectively on a consecutive series of twenty-seven patients during routine post-operative visits at 2 and 6 weeks, and 3, 6, 12 and 24 months. Range of motion measures and grip strength for both wrists were recorded. Results. Greatest gains were made within the first 3 months after surgery. Supination and pronation returned more quickly than flexion or extension, with supination and pronation both at 92% of the uninjured wrist at 3 months. Only flexion improved significantly between 3 and 6 months. All wrist motions showed some improvement until 1 year. Grip strength returned to 94% of the uninjured wrist by 12 months. Conclusions. Range of motion improvement will be greatest between 2 weeks and 3 months, with improvement continuing until 12 months. Grip strength should return to near normal by one year. Function and pain will improve, but not return to normal by the end of 12 months. Clinical Relevance. These results provide the surgeon with information that can be shared with patients on the anticipated timeline for normal recovery of function and strength.

  17. Color-discrimination threshold determination using pseudoisochromatic test plates

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    Kaiva eJurasevska

    2014-11-01

    Full Text Available We produced a set of pseudoisochromatic plates for determining individual color-difference thresholds to assess test performance and test properties, and analyzed the results. We report a high test validity and classification ability for the deficiency type and severity level (comparable to that of the fourth edition of the Hardy–Rand–Rittler (HRR test. We discuss changes of the acceptable chromatic shifts from the protan and deutan confusion lines along the CIE xy diagram, and the high correlation of individual color-difference thresholds and the red–green discrimination index. Color vision was tested using an Oculus HMC anomaloscope, a Farnsworth D15, and an HRR test on 273 schoolchildren, and 57 other subjects with previously diagnosed red–green color-vision deficiency.

  18. Fracture mechanics life analytical methods verification testing

    Science.gov (United States)

    Favenesi, J. A.; Clemmons, T. G.; Lambert, T. J.

    1994-01-01

    Verification and validation of the basic information capabilities in NASCRAC has been completed. The basic information includes computation of K versus a, J versus a, and crack opening area versus a. These quantities represent building blocks which NASCRAC uses in its other computations such as fatigue crack life and tearing instability. Several methods were used to verify and validate the basic information capabilities. The simple configurations such as the compact tension specimen and a crack in a finite plate were verified and validated versus handbook solutions for simple loads. For general loads using weight functions, offline integration using standard FORTRAN routines was performed. For more complicated configurations such as corner cracks and semielliptical cracks, NASCRAC solutions were verified and validated versus published results and finite element analyses. A few minor problems were identified in the basic information capabilities of the simple configurations. In the more complicated configurations, significant differences between NASCRAC and reference solutions were observed because NASCRAC calculates its solutions as averaged values across the entire crack front whereas the reference solutions were computed for a single point.

  19. Wedge Splitting Test and Fracture Energy on Particulate Reinforced Composites

    Energy Technology Data Exchange (ETDEWEB)

    Na, Seong Hyeon; Kim, Jae Hoon; Choi, Hoon Seok [Chungnam National Univ., Daejeon (Korea, Republic of); Park, Jae Beom; Kim, Shin Hoe; Jung, Gyoo Dong [Agency for Defense Developmen, Daejeon (Korea, Republic of)

    2016-03-15

    The effect of temperature on the fracture energy, crack propagation, and crack tip opening displacement(CTOD) was determined for particulate reinforced composites using the wedge splitting test. The materials that were used consisted of a polymer binder, an oxidizing agent, and aluminum particles. The test rate of the wedge splitting specimen was 50 mm/min, the temperature conditions were 50℃, room temperature, -40℃, and -60℃. The fracture energy, calculated from splitting load-crack mouth opening displacement(CMOD) curves, increased with decreasing temperature from 50℃ to -40℃. In addition, the strength of the particulate reinforced composites increased sharply at -60℃, and the composites evidenced brittle fracture due to the glass transition temperature. The strain fields near the crack tip were analyzed using digital image correlation.

  20. Bicortical screw fixation of distal fibula fractures with a lateral plate: an anatomic and biomechanical study of a new technique.

    Science.gov (United States)

    Milner, Brenton F; Mercer, Deana; Firoozbakhsh, Keikhosrow; Larsen, Kenna; Decoster, Thomas A; Miller, Richard A

    2007-01-01

    One of the potential drawbacks of lateral plating of distal fibula fractures is less than satisfactory fixation of unicortical screws commonly placed in the distal fragment to avoid implant penetration of the ankle joint. This study examines the anatomy of the distal fibula, proposes new techniques for bicortical screw fixation and radiographic evaluation of screw placement, and compares pullout strength of unicortical versus bicortical screws in this area. Sixteen pairs of human cadaver feet were used in this study. It was found that a large percentage of the surface area of the distal fibula is nonarticular and that the distal fibula could be divided into 3 zones with distinct anatomic features. Zone I is defined as the distal most 1.5 cm of the fibula, zone II is the next 1 cm of fibula proximal to zone I, and zone III is defined as the fibula above the ankle joint, starting at just over 2.5 cm proximal to the tip of the fibula. We determined a safe corridor for bicortical screw placement by means of a lateral plate in each zone. An improved radiographic view is described for confirmation of extraarticular screw placement. Screw pullout testing was performed on 8 pairs of fresh-frozen human cadaver fibulas. In both zone I and zone II, the bicortical screw fixation was significantly stronger than the unicortical screw fixation. In zone I, the average pullout strength for the bicortical screw fixation was 2.3 times higher than the unicortical screw fixation. In zone II, the average pullout strength for the bicortical screw fixation was 3.3 times higher than the unicortical screw fixation. This study shows that not only is bicortical screw placement in the distal fibula technically feasible, but it is also biomechanically stronger than unicortical placement in this area.

  1. Fracture Testing of Integral Stiffened Structure

    Science.gov (United States)

    Newman, John A.; Smith, Stephen W.; Piascik, Robert S.; Dawicke, David S.; Johnston, William M.; Willard, Scott A.

    2008-01-01

    Laboratory testing was conducted to evaluate safety concerns for integrally-stiffened tanks that were found to have developed cracks during pressurization testing. Cracks occurred at fastener holes where additional stiffeners were attached to the integrally-stiffened tank structure. Tests were conducted to obtain material properties and to reproduce the crack morphologies that were observed in service to help determine if the tanks are safe for operation. Reproducing the cracking modes observed during pressurization testing required a complex loading state involving both a tensile load in the integrally-stiffened structure and a pin-load at a fastener hole.

  2. The treatment of complex proximal humeral fractures: analysis of the results of 55 cases treated with PHILOS plate.

    Science.gov (United States)

    Fattoretto, D; Borgo, A; Iacobellis, C

    2016-08-01

    Complex proximal humerus fractures are often difficult to treat. Their frequency is high, especially in the elderly, and their treatment is still controversial. The aim of this study was to analyze the clinical and radiological results achieved by patients with complex proximal humerus fractures, treated with PHILOS plate only. A cohort of 55 patients was selected. The mean age was 63.4 (range 33-89), while the mean follow-up time was 21.5 months (range 6-75). Clinical outcome was evaluated with the "Constant-Murley shoulder score." All the informations about the presence of complications were gathered, and radiological images were used to calculate the head-shaft angle. The overall mean Constant score was 61.93 ± 18.59, the Individual CS was 70 ± 20 % and the Relative CS was 83 ± 23 %. No significant differences were found between fractures Neer 3 and Neer 4 and between the surgical approaches (delta-split vs. delto-pectoral). Six patients had a fracture with dislocation, seven patients (12.7 %) had complications while in four patients a head-shaft angle beyond the normal range was found. Osteosynthesis with PHILOS plate is stable in the greater part of the cases, and it allows an earlier rehabilitation and so a good functional result, which could be compromised by a prolonged immobilization. Therefore, PHILOS plate is a good option for the treatment of complex proximal humerus fractures.

  3. Type II olecranon fractures in patients over 65. Tension band or pre-formed plate? Analysis and results.

    Science.gov (United States)

    Liñán-Padilla, A; Cáceres-Sánchez, L

    2017-07-19

    The objective of this study was to compare the clinical outcomes of surgical treatment using tension band with needles and preformed plates in type ii olecranon fractures according to the Mayo classification in patients older than 65 years. A descriptive, retrospective study of 49 patients with a mean age of 75.1 years who underwent surgery olecranon fracture using 2 different fixing systems. The Mayo classification was used to define them, excluding type i and iii, and the VAS to assess postoperative pain. Patients were assessed functionally by the questionnaire Quick DASH. All measurement was performed with goniometer and joint balance serial radiographs at one month, 3, 6 and 12 months. Minimum follow-up was one year. In 26 patients the tension band was used and the preformed plates in 23. There were no statistically significant differences in functional outcomes, joint balance or postoperative VAS between the 2 groups. There were a greater proportion of patients who had to be operated because of problems related to osteosynthesis material in those in which preformed plates were used. Treatment of olecranon fractures with tension band with needles and cerclage remains the surgery of choice in patients older than 65 years. Copyright © 2017 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

  4. FUNCTIONAL OUTCOME OF LOCKING COMPRESSION PLATE OSTEOSYNTHESIS IN SCHATZKER’S TYPE V AND VI TIBIAL PLATEAU FRACTURES

    Directory of Open Access Journals (Sweden)

    Deependra

    2015-11-01

    Full Text Available : Tibial plateau fractures are the common injuries that may be associated with poor outcomes and a high rate of complications. The problem rise significantly in high energy trauma and severe soft tissue injuries. Early technique of osteosysnthesis were based on extensive surgical approach. Introduction of minimally invasive plate osteosynthesis using locking compression plate conserves the vascularity of the bone but also leads to the overall improvement in the values of bone healing. MATERIALS AND METHODS: Inclusion criteria for this study were patients of either sex, tibial plateau fractures Schatzker’s Type V and VI, age group 15 to 60 years and compounding upto Gustilo and Anderson’s Grade II and excluded the patients where the compounding was grade III and displacement <2mm. The fractures were treated applying LCP percutaneously either medially or laterally depending on the side of comminution. RESULTS: In our study conducted on 45 patients 4 lost to follow up in first 6 months with displaced tibial plateau overall the functional result using Rasmussen’s criteria was acceptable in all of the cases with an average score of 26.38. All the patients in our series showed union with average time for union being 13.3 weeks. DISCUSSION: Our study confirms that minimally invasive locking compression plate osteosynthesis is a viable alternative as a treatment for open tibial plateau fractures Gustilo and Anderson’s type I and II. The incidence of infection in our study wad 10% which is comparable with most of the series in literature that select the high energy tibial plateau fractures. None of the patients had nonunion only one had delayed union and does not required bone grafting as the metaphyseal area has a good blood supply. There were superficial infection in 4 cases which resolved to the dressing and antibiotic treatment within 3 weeks. The mean range motion at knee joint was 5 degree to 130 degree.(1 CONCLUSION: This paper reports the

  5. 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.

  6. Pterygoid plate fracture in Le Fort I osteotomy with and without pterygoid chisel: a computed tomography scan evaluation of 58 patients.

    Science.gov (United States)

    Precious, D S; Goodday, R H; Bourget, L; Skulsky, F G

    1993-02-01

    The incidence of pterygoid plate fracture as determined by computed tomography (CT) scan is much higher than that determined at surgery. This observation is irrespective of whether a chisel is used to effect pterygo-maxillary separation.

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Intramedullary nail versus dynamic compression plate fixation in treating humeral shaft fractures: grading the evidence through a meta-analysis.

    Directory of Open Access Journals (Sweden)

    JianXiong Ma

    Full Text Available There is a debate regarding the choice of operative intervention in humeral shaft fractures that require surgical intervention. The choices for operative interventions include intramedullary nailing (IMN and dynamic compression plate (DCP. This meta-analysis was performed to compare fracture union, functional outcomes, and complication rates in patients treated with IMN or DCP for humeral shaft fractures and to develop GRADE (Grading of Recommendations, Assessment, Development, and Evaluation-based recommendations for using the procedures to treat humeral shaft fractures. A systematic search of all the studies published through December 2012 was conducted using the Medline, Embase, Sciencedirect, OVID and Cochrane Central databases. The randomized controlled trials (RCTs and quasi-RCTs that compared IMN with DCP in treating adult patients with humeral shaft fractures and provided data regarding the safety and clinical effects were identified. The demographic characteristics, adverse events and clinical outcomes were manually extracted from all of the selected studies. Ten studies that included a total of 448 patients met the inclusion criteria. The results of a meta-analysis indicated that both IMN and DCP can achieve similar fracture union with a similar incidence of radial nerve injury and infection. IMN was associated with an increased risk of shoulder impingement, more restriction of shoulder movement, an increased risk of intraoperative fracture comminution, a higher incidence of implant failure, and an increased risk of re-operation. The overall GRADE system evidence quality was very low, which reduces our confidence in the recommendations of this system. DCP may be superior to IMN in the treatment of humeral shaft fractures. Because of the low quality evidence currently available, high-quality RCTs are required.

  9. [Unstable fracture of the distal radius and its treatment: comparison of three techniques: external fixation, intramedullary pinning and AO plates].

    Science.gov (United States)

    Sennwald, G R; Della Santa, D

    2001-06-01

    This retrospective study compares 94 distal radius fractures. Sixty one women (median age 66) and 33 men (median age 42) were reviewed clinically and radiologically by a surgeon not involved in treatment. Fractures were classified into three AO groups. Standard X-rays were used for radiological evaluation. Fractures of the distal ulna were evaluated separately. Chi-square tests, Wilcoxon, Mann-Whitney and Fisher's tests were used for statistical evaluation. Women presented mainly "A" type fractures. They were treated by intramedullary pinning. Forty two fractures were grafted, using autogenous bone for young patients and bone substitute for the elderly. Twelve scapholunate dissociations were recorded, all but one were detected in women, 50 years of age or more. Four were painfree, two presented climatic pain and six claimed pain during effort; none had snapping. Radio-ulnar laxity was similar with or without styloid fractures. External fixator and autogenous grafts appeared the most efficient technique for maintaining radial length. Ulnar head fractures were related to a significant higher incidence of sympathetic dystrophy with reduced prono-supination, a correlation not previously noted to your knowledge. This suggests that radius and ulnar head fracture should be classified independently. The amount of pain was not related to classification, internal fixation or gender.

  10. Resorbable poly(D,L)lactide plates and screws for osteosynthesis of condylar neck fractures in sheep.

    Science.gov (United States)

    Rasse, Michael; Moser, Doris; Zahl, Christian; Gerlach, Klaus Louis; Eckelt, Uwe; Loukota, Richard

    2007-01-01

    We made osteotomies in the condylar neck in 12 adult sheep to simulate fractures, and joined the two ends with 2 poly(D,L)lactide (PDLLA) plates and 8 PDLLA screws 2mm in diameter. The animals were killed after 2, 6, and 12 months and bony healing was assessed macroscopically and histologically. The plates and screws remained intact and there was no displacement of the bony ends. The degrading plates, which were still visible in the specimens after 6 months, had been replaced by bone. At 12 months the PDLLA had been resorbed with no foreign body reaction and no resorption of underlying bone. The articular discs showed no signs of degeneration.

  11. Testing the Fracture Behaviour of Chocolate

    Science.gov (United States)

    Parsons, L. B.; Goodall, R.

    2011-01-01

    In teaching the materials science aspects of physics, mechanical behaviour is important due to its relevance to many practical applications. This article presents a method for experimentally examining the toughness of chocolate, including a design for a simple test rig, and a number of experiments that can be performed in the classroom. Typical…

  12. Testing the Fracture Behaviour of Chocolate

    Science.gov (United States)

    Parsons, L. B.; Goodall, R.

    2011-01-01

    In teaching the materials science aspects of physics, mechanical behaviour is important due to its relevance to many practical applications. This article presents a method for experimentally examining the toughness of chocolate, including a design for a simple test rig, and a number of experiments that can be performed in the classroom. Typical…

  13. Tensile and fracture toughness test results of neutron irradiated beryllium

    Energy Technology Data Exchange (ETDEWEB)

    Chaouadi, R.; Moons, F.; Puzzolante, J.L. [Centre d`Etude de l`Energie Nucleaire, Mol (Belgium)

    1998-01-01

    Tensile and fracture toughness test results of four Beryllium grades are reported here. The flow and fracture properties are investigated by using small size tensile and round compact tension specimens. Irradiation was performed at the BR2 material testing reactor which allows various temperature and irradiation conditions. The fast neutron fluence (>1 MeV) ranges between 0.65 and 2.45 10{sup 21} n/cm{sup 2}. In the meantime, un-irradiated specimens were aged at the irradiation temperatures to separate if any the effect of temperature from irradiation damage. Test results are analyzed and discussed, in particular in terms of the effects of material grade, test temperature, thermal ageing and neutron irradiation. (author)

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

    Science.gov (United States)

    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

  15. 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.

  16. PHILOS钢板治疗肱骨近端骨折%PHILOS plate in the treatment of proximal humeral fractures

    Institute of Scientific and Technical Information of China (English)

    李敏; 张鹏翼; 姚龚; 于沈敏; 慕小瑜

    2012-01-01

    Objective To investigate the clinical effect of the PHILOS plate in the treatment of proximal humeral fractures. Methods 47 cases of proximal humerus fractures were treated with operation through deltopectoral approach. A small incision was opened for fixation with PHILOS plate and allogeneic bone implantation. Results The patients were followed up for 5-24 months, the fractures were all healed in the last follow-up. Neer score of the shoulder function was excellent in 15 cases, good in 21 cases, fair in 7 cases and poor in 4 cases, and the excellent and good rate was 76. 6% . Conclusions The treatment of proximal humeral fractures with PHILOS plate can obtain good effect.%目的 探讨采用PHILOS钢板治疗肱骨近端骨折的临床效果.方法 对47例肱骨近端骨折患者采用三角肌胸大肌入路,小切口插入PHILOS钢板,植入同种异体骨后固定骨折断端.结果 患者均获随访,时间5~24个月,骨折均愈合.肩关节功能按Neer百分评分:优15例,良21例,中7例,差4例,优良率为76.6%.结论 小切口PHILOS钢板治疗肱骨近端骨折可获得较好的疗效.

  17. Assessment of the Resistance of a Polymethylmethacrylate (Pmma Dynamic Compression Plate (DCP Prototype Tested on Osteotomized Canine Femurs

    Directory of Open Access Journals (Sweden)

    Leonel Cardona R.

    2011-06-01

    Full Text Available Femur fractures are the most frequent long bone fractures in small animals. Due to the femur’s anatomical position, it is difficult to immobilize, and therefore internal fixations are very useful. Dynamic compression plates (DCP provide high stability, are durable, minimize fragment movement and promote primary healing of the bone. Advantages of this treatment include anatomical reconstruction, early mobility and carrying capacity of the affected limb. Polymethylmethacrylate (PMMA is an acrylic resin that has proved very useful in bone tumor treatment, cranial deformation prosthesis, percutaneous vertebroplasty and testicular prosthesis in animals. The purpose of this study was to manufacture DCP-PMMA and test its resistance to the different forces present in a fracture. Forty-eight (48 3.5MM x 4-hole DCP were made from an alginate mold. Six (6 femurs were obtained from canine cadavers zeighing from 10 to 20 kg, which underwent osteotomy simulating an oblique fracture. The plates were subsequently positioned in the osteotomized bones to submit them to the various forces involved in a fracture. The DCP-PMMA resisted a torque force of 2.83 newton/metres and a compression and flexion force of 0.21 kilonewton. The obtained resistance of the DCP-PMMA was an average of 20 kg per force. The results of this study show that it is possible to make a DCP-PMMA 3.5 mm x 4-hole, the resistance of which is of 20 kg against the three applied forces, and that it can be used to stabilize long bone fractures subjected to a pressure of less than 20 kg.

  18. Endurance test for mini-plate fuel rig

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Heung June; Yang, Sun Kyu; Park, Jong Man; Kim, Chang Kyu; Ryu, Jeong Soo

    1999-07-01

    This report presents the pressure drop, vibration and endurance test results for mini-plate fuel rig which were designed by KAERI and fabricated by Daewoo Precision Co. From the pressure drop test results, it is noted that the flow velocity across the fuel rig corresponding to the pressure drop of 200 kPa is measured to be about 6.78 kg/sec. Vibration frequency for the fuel rig ranges from 14 to 19 Hz. RMZ (Root Mean Square) displacement for the fuel rig is less than 7 {mu}m, and the maximum displacement is less than 20 {mu}m. Based on the endurance rest results, the appreciable fretting wear for the fuel rig is not observed but the small amount of wear was observed at the interface region between the mini-plates and upper housing cap as well as at the slot regions of a bottom endplate interfacing with the bottom guide arms. (author). 4 refs., 10 tabs., 33 figs.

  19. Applications of Automation Methods for Nonlinear Fracture Test Analysis

    Science.gov (United States)

    Allen, Phillip A.; Wells, Douglas N.

    2013-01-01

    Using automated and standardized computer tools to calculate the pertinent test result values has several advantages such as: 1. allowing high-fidelity solutions to complex nonlinear phenomena that would be impractical to express in written equation form, 2. eliminating errors associated with the interpretation and programing of analysis procedures from the text of test standards, 3. lessening the need for expertise in the areas of solid mechanics, fracture mechanics, numerical methods, and/or finite element modeling, to achieve sound results, 4. and providing one computer tool and/or one set of solutions for all users for a more "standardized" answer. In summary, this approach allows a non-expert with rudimentary training to get the best practical solution based on the latest understanding with minimum difficulty.Other existing ASTM standards that cover complicated phenomena use standard computer programs: 1. ASTM C1340/C1340M-10- Standard Practice for Estimation of Heat Gain or Loss Through Ceilings Under Attics Containing Radiant Barriers by Use of a Computer Program 2. ASTM F 2815 - Standard Practice for Chemical Permeation through Protective Clothing Materials: Testing Data Analysis by Use of a Computer Program 3. ASTM E2807 - Standard Specification for 3D Imaging Data Exchange, Version 1.0 The verification, validation, and round-robin processes required of a computer tool closely parallel the methods that are used to ensure the solution validity for equations included in test standard. The use of automated analysis tools allows the creation and practical implementation of advanced fracture mechanics test standards that capture the physics of a nonlinear fracture mechanics problem without adding undue burden or expense to the user. The presented approach forms a bridge between the equation-based fracture testing standards of today and the next generation of standards solving complex problems through analysis automation.

  20. Outcome Analysis of Intra-Articular Scapula Fracture Fixation with Distal Radius Plate: A Multicenter Prospective Study

    Directory of Open Access Journals (Sweden)

    Panigrahi

    2016-08-01

    Full Text Available Background Scapula fractures occur in approximately 1% of all fractures and constitute about 3% - 5% of all injuries of the shoulder joint. Objectives This study aimed to evaluate the clinical outcomes of 20 surgically treated patients with displaced glenoid fractures after stabilization with distal radius plate. Methods Between 2012 and 2015, at 2 centers (HMCH & SHCE of Bhubaneswar Odisha, we stabilized 20 scapular intra-articular fractures surgically with distal radius locking plate and studied the outcome of the surgeries. The outcome of the 20 fractures was determined using the Constant and Murley score. Both shoulders were assessed and the score on the injured side was given as a percentage of that on the uninjured side. Results The median score was 88% (mean 65%, range 30 to 100. The median score for strength was 21/25 (mean 19, range 0 to 25 and that for pain 11/15 (mean 11, range 5 to 15. The median functional score was 16/20 (mean 15, range 0 to 20. The mean range of active abduction of the shoulder was 135° (20 to 180, the mean range of flexion 138° (20 to 180 and the mean range of external rotation 38° (0 to 100. Five patients showed excellent result; 11 patients showed good result; three patients showed fair result and one patient had poor outcome according to the Constant-Murley score. A superficial infection settled with antibiotics after operation in one patient whose score at final follow-up was 96%. In one patient, delayed healing was reported because of infection. One patient with stiffness of the shoulder at six weeks underwent manipulation under anesthesia with a follow-up score of 81%. Conclusions Various fixation modalities have been described in the literature, however fixation of intra-articular fracture of glenoid with distal radius locking plate for articular reconstruction in the presented series provides good functional outcome with early restoration of the range of motion of the shoulder.

  1. Bilateral traumatic proximal humerus fractures managed by open reduction and internal fixation with locked plates

    Institute of Scientific and Technical Information of China (English)

    Atin Jaiswal; Naiman Deepak Kachchhap; Rupak Chaterjee; Yashwant Singh Tanwar; Masood Habib; Satya Prakash Singh

    2013-01-01

    Fractures of the proximal humerus are uncommon in young patients.Although bilateral fracture of proximal humerus itself is rare,association with epilepsy and electrocution is frequent.Only one case of traumatic bilateral proximal humerus fracture has been reported in the literature.We report a rare case of bilateral traumatic displaced proximal humerus fractures in a 40 years old male patient,which was treated by means of open reduction and internal fixation with proximal humerus locked pates on both sides and obtained a good functional outcome.

  2. Bilateral traumatic proximal humerus fractures managed by open reduction and internal fixation with locked plates.

    Science.gov (United States)

    Jaiswal, Atin; Kachchhap, Naiman Deepak; Chaterjee, Rupak; Tanwar, Yashwant Singh; Habib, Masood; Singh, Satya Prakash

    2013-01-01

    Fractures of the proximal humerus are uncommon in young patients. Although bilateral fracture of proximal humerus itself is rare, association with epilepsy and electrocution is frequent. Only one case of traumatic bilateral proximal humerus fracture has been reported in the literature. We report a rare case of bilateral traumatic displaced proximal humerus fractures in a 40 years old male patient, which was treated by means of open reduction and internal fixation with proximal humerus locked pates on both sides and obtained a good functional outcome.

  3. 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.

  4. Some effects of experimental error in fracture testing.

    Science.gov (United States)

    Orange, T. W.

    1973-01-01

    The purpose of this paper is to show the effects of experimental imprecision on the stress intensity factors calculated for various practical specimen types. A general form equation for the stress intensity factor is presented, and a general error equation is derived. The expected error in the stress intensity factor is given in terms of the precision levels of the basic experimental measurements and derivatives of the stress intensity calibration factor. Nine common fracture specimen types are considered, and the sensitivity of the various types to experimental error is illustrated. Some implications for fracture toughness testing and crack growth rate testing are discussed, and methods of analysis are proposed to compensate for the effects of experimental error.

  5. LATERAL APPROACH UNDER FLUROSCOPIC GUIDANCE WITH NONLOCKING CALCANEAL PLATE IS AN EFFECTIVE TECHNIQUE FOR CLOSED CALCANEAL FRACTURE

    Directory of Open Access Journals (Sweden)

    Alok Sobhan

    2014-06-01

    Full Text Available Intra-articular calcaneal fractures which accounts for about 75% of calcaneal fractures is usually associated with poor functional outcome. The present was under taken to evaluate the efficacy of open reduction and internal fixation of displaced articular fractures of calcaneum in adults through lateral approach under fluroscopic guidance with non-locking calcaneal plate and ipsilateral iliac crest bone graft. 30 adult patients (25 males and 5 females with closed displaced intra articular fractures of calcaneum of less than 15 days constituted the study group. All cases were operated by lateral approach as described by Seligson, a modification of Gould’s technique under spinal anaesthesia. All machers Arthrosis Rating Scale were used for the evaluation of posttraumatic posterior facet degenerative changes. Primarily27 of all 35 wounds (77% healed without any form of wound complications. Excellent to good results noted in 3 (100% patients with preoperative Bohler´s angle larger or equal to 20° (n = 3 whereas patients with preoperative Bohler´s angle smaller than 20° (n=32 achieved excellent to good results in 16 cases (50% Clinically significant subtalararthrosis (Allmacher grade 2-4 noted in 7 cases (20% cases with Bohler´s angle smaller than 20° (n=32. In 5 cases, clinically significant complaints (Allmachers Arthrosis Rating Scale grades II to V noted. Therapeutic success of such fracture depends on timely open reduction and internal fixation with proper fracture reduction and early rehabilitation. Thus management of these injuries as well as complications should be performed in a specialized orthopaedics or traumatology center.

  6. Fracture Testing of Honeycomb Core Sandwich Composites Using the DCB-UBM Test

    DEFF Research Database (Denmark)

    Saseendran, Vishnu; Berggreen, Christian; Carlsson, Leif A.

    2015-01-01

    of the face/core interface. In this paper, a novel test-rig exploiting the double cantilever beam-uneven bending moments (DCB-UBM) concept is used to determine the fracture toughness of aircraft type honeycomb core sandwich composites as a function of the phase angle (mode-mixity), within the framework......Face/core debonds in sandwich structures cause loss of integrity of sandwich structures. The debond problem in honeycomb core sandwich composites has not been widely studied. A suitable fracture approach coupled with experimental validation is paramount to determine the fracture resistance...... of Linear Elastic Fracture Mechanics (LEFM). The Double Cantilever Beam subjected to Uneven Bending Moments (DCB-UBM) test set-up, which was introduced by Sørensen.et.al [1], circumvents any dependency of the pre-crack length in calculation of Gc. The new test setup is based on rotary actuators which...

  7. Small female rib cage fracture in frontal sled tests.

    Science.gov (United States)

    Shaw, Greg; Lessley, David; Ash, Joseph; Poplin, Jerry; McMurry, Tim; Sochor, Mark; Crandall, Jeff

    2017-01-02

    The 2 objectives of this study are to (1) examine the rib and sternal fractures sustained by small stature elderly females in simulated frontal crashes and (2) determine how the findings are characterized by prior knowledge and field data. A test series was conducted to evaluate the response of 5 elderly (average age 76 years) female postmortem human subjects (PMHS), similar in mass and size to a 5th percentile female, in 30 km/h frontal sled tests. The subjects were restrained on a rigid planar seat by bilateral rigid knee bolsters, pelvic blocks, and a custom force-limited 3-point shoulder and lap belt. Posttest subject injury assessment included identifying rib cage fractures by means of a radiologist read of a posttest computed tomography (CT) and an autopsy. The data from a motion capture camera system were processed to provide chest deflection, defined as the movement of the sternum relative to the spine at the level of T8.  A complementary field data investigation involved querying the NASS-CDS database over the years 1997-2012. The targeted cases involved belted front seat small female passenger vehicle occupants over 40 years old who were injured in 25 to 35 km/h delta-V frontal crashes (11 to 1 o'clock). Peak upper shoulder belt tension averaged 1,970 N (SD = 140 N) in the sled tests. For all subjects, the peak x-axis deflection was recorded at the sternum with an average of -44.5 mm or 25% of chest depth. The thoracic injury severity based on the number and distribution of rib fractures yielded 4 subjects coded as Abbreviated Injury Scale (AIS) 3 (serious) and one as AIS 5 (critical). The NASS-CDS field data investigation of small females identified 205 occupants who met the search criteria. Rib fractures were reported for 2.7% of the female occupants. The small elderly test subjects sustained a higher number of rib cage fractures than expected in what was intended to be a minimally injurious frontal crash test condition. Neither field studies nor

  8. FRACTURE TOUGHNESS OF 6.4 MM (0.25 INCH) ARC-CAST MOLOBDENUM AND MOLYBDENUM-TZM PLATE AT ROOM TEMPERATURE AND 300 DEGREES C

    Energy Technology Data Exchange (ETDEWEB)

    J. A. SHIELDS, JR.; P. LIPETZKY; A. J. MUELLER

    2001-04-11

    THE FRACTURE TOUGHNESS OF 6.4 mm (0.25 INCH) LOW CARBON ARC-CAST (LCAC) MOLYBDENUM AND ARC-CAST MOLYBDENUM-TZM ALLOY PLATE WERE MEASURED AT ROOM TEMPERATURE AND 300 DEGREES C USING COMPACT TNESION SPECIMENTS. THE EFFECT OF CRACK PLANE ORIENTATION (LONGITUDINAL VS. TRANSVERSE) AND ANNEALING PRACTICE (STRESS-RELIEVED VS. RECRYSTALLIZED) WERE EVALUATED. DEPENDING UPON THE TEST TEMPERATURE EITHER A STANDARD K[SUB]IC OR A J-INTEGRAL ANALYSIS WAS USED TO OBTAIN THE TOUGHNESS VALUE. AT ROOM TEMPERATURE, REGARDLESS OF ALLOY, ORIENTATION, OR MICROSTURECTURE, FRACTURE TOUGHNESS VALUES BETWEEN 15 AND 22 MPa m{sup 1/2} (14 AND 20 KSI IN{sup 1/2}) WERE MEASURED. THESE K[SUB]IC VALUES WERE CONSISTENT WITH MEASUREMENTS BY THE AUTHORS. INCREASING TEMPERATURE IMPROVES THE TOUGHNESS, DUE TO THE FACT THAT ONE TAKES ADVANTAGE OF THE DUCTIVE-BRITTLE TRANSITION BEHAVIOR OF MOLYBDENUM. AT 300 DEGREES C, THE FRACTURE TOUGHNESS OF RECRYSTALLIZED LCAC AND ARC-CAST TZM MOLYBDENUM WERE ALSO SIMILAR AT APPROXI MATELY 64 MPa m{sup 1/2} (58 KSI IN{sup 1/2}). IN THE STRESS-RELIEVED CONDITION, HOWEVER, THE TOUGHNESS OF ARC-CAST TZM (91 MPa m{sup 1/2}/83 KSI IN{sup 1/2}) WAS HIGHER THAN THAT OF THE LCAC MOLYBDENUM (74 MPa m{sup 1/2}/67 KSI IN{sup 1/2}).

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

    Directory of Open Access Journals (Sweden)

    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.

  10. Incidence of Peroneal Tendinopathy After Application of a Posterior Antiglide Plate for Repair of Supination External Rotation Lateral Malleolar Fractures.

    Science.gov (United States)

    Ahn, Jungtae; Kim, Sehun; Lee, Jung-Soo; Woo, Kyungjei; Sung, Ki-Sun

    2016-01-01

    Posterior antiglide plating is widely used to treat lateral malleolar fractures caused by supination-external rotation injuries. Despite its widespread use, this technique can be associated with postoperative peroneal tendinopathy. The purpose of the present observational review was to report the incidence of peroneal tendinopathy after the use of posterior antiglide plating to treat lateral malleolar fractures caused by a supination-external rotation injury. A total of 70 patients were followed up for a minimum of 12 (mean 55, range 12 to 109) months. Bony union was obtained in all cases after a mean of 57 (range 37 to 81) days. The median number of screw holes in the plate was 4.9 (range 4 to 7), and the median number of screws used to fixate the fibula was 6.58 (range 5 to 10). The mean American Orthopaedic Foot and Ankle Society hindfoot-ankle score at the final follow-up examination was 90.8 (range 55 to 100). Clinically, 3 (4.29%) of the 70 patients had lateral or posterolateral ankle pain indicative of peroneal tendinopathy after the index surgery, without any objective evidence. Of the 70 patients, 41 (58.57%) underwent surgical removal of the fibular hardware, 2 (4.87%) because of lateral ankle discomfort. At removal, inspection of the peroneal tendon sheath and/or tendons showed no gross evidence of tendinopathy in any of the patients. We concluded that the incidence of clinically evident peroneal tendon symptoms associated with posterior antiglide plating is low (4.3%), and direct operative inspection revealed no gross evidence of tendinopathy. Copyright © 2016 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Open reduction and internal fixation of OTA type C2-C4 fractures of the calcaneus with a triple-plate technique.

    Science.gov (United States)

    Brunner, Alexander; Müller, Jochen; Regazzoni, Pietro; Babst, Reto

    2012-01-01

    The purpose of this study was to present a surgical technique of open reduction and internal fixation of displaced intra-articular calcaneal fractures with 3 AO mini-fragment plates and to evaluate the clinical and radiological outcome of a consecutive group of patients after a mean follow-up of 41.7 months. A series of 54 patients (16 women and 38 men) with 62 calcaneal fractures were treated over a period of 6.5 years. Forty-five patients with 50 calcaneal fractures were completely clinically and radiologically followed up. Clinical follow-up included assessment of range of motion, pain according to a visual analogue scale, the American Orthopaedic Foot and Ankle Society hindfoot score, and the short-form 36 health survey. Radiological follow-up included plain axial and lateral radiographs and measurement of the Böhler's angle and Gissane's angle. Independent Student's t test and paired Student's t test were used alongside the chi-square test to compare clinical and radiological data and score values between different groups of patients. Eleven patients showed breakage of the osteosynthesis material during the healing process and 2 patients sustained deep wound infection requiring revision surgery. At the final follow-up all fractures had healed. The average range of motion was supination 26.4° (range 0° to 50°; SD 11.6°), pronation 15.4° (range 0° to 30°; SD 6.4°), dorsal extension 14.3° (range -10° to 30°; SD 8.0°), and plantarflexion 39.6° (range 20° to 65°; SD 11.7°). Patients with OTA type C4 fractures achieved significantly lower supination (p fracture types. The mean visual analog scale pain score was 3.6 (range 0 to 8; SD 2.3) points, average American Orthopaedic Foot and Ankle Society hindfoot score was 70.8 (range 33 to 100; SD 17.1) points, and the mean short-form 36 score was 60.98 (range 22.9 to 93.0; SD 18.4) points. The mean postoperative Böhler's angle was 28.9° (range 8° to 38°; SD 7.1°), which decreased to 23.6° (range 4

  12. Application of Electrical Potential Testing Technique in Fracture Detection%Application of Electrical Potential Testing Technique in Fracture Detection

    Institute of Scientific and Technical Information of China (English)

    Zhong Di; Ge Zhiguang

    2011-01-01

    Fracturing is an important method to transform lowpermeability oil reservoirs, and it has been widely used in low-permeability oil reservoirs exploitation. Through the fracturing, artificial fractures are formed underground, so as to improve the condition

  13. [Application of three-dimensional printing personalized acetabular wing-plate in treatment of complex acetabular fractures via lateral-rectus approach].

    Science.gov (United States)

    Mai, J G; Gu, C; Lin, X Z; Li, T; Huang, W Q; Wang, H; Tan, X Y; Lin, H; Wang, Y M; Yang, Y Q; Jin, D D; Fan, S C

    2017-03-01

    Objective: To investigate reduction and fixation of complex acetabular fractures using three-dimensional (3D) printing technique and personalized acetabular wing-plate via lateral-rectus approach. Methods: From March to July 2016, 8 patients with complex acetabular fractures were surgically managed through 3D printing personalized acetabular wing-plate via lateral-rectus approach at Department of Orthopedics, the Third Affiliated Hospital of Southern Medical University. There were 4 male patients and 4 female patients, with an average age of 57 years (ranging from 31 to 76 years). According to Letournel-Judet classification, there were 2 anterior+ posterior hemitransverse fractures and 6 both-column fractures, without posterior wall fracture or contralateral pelvic fracture. The CT data files of acetabular fracture were imported into the computer and 3D printing technique was used to print the fractures models after reduction by digital orthopedic technique. The acetabular wing-plate was designed and printed with titanium. All fractures were treated via the lateral-rectus approach in a horizontal position after general anesthesia. The anterior column and the quadrilateral surface fractures were fixed by 3D printing personalized acetabular wing-plate, and the posterior column fractures were reduction and fixed by antegrade lag screws under direct vision. Results: All the 8 cases underwent the operation successfully. Postoperative X-ray and CT examination showed excellent or good reduction of anterior and posterior column, without any operation complications. Only 1 case with 75 years old was found screw loosening in the pubic bone with osteoporosis after 1 month's follow-up, who didn't accept any treatment because the patient didn't feel discomfort. According to the Matta radiological evaluation, the reduction of the acetabular fracture was rated as excellent in 3 cases, good in 4 cases and fair in 1 case. All patients were followed up for 3 to 6 months and all

  14. An adjustable parallel-plate capacitor instrument—Test of the theoretical capacitance formula

    Science.gov (United States)

    Wells, Beau; Baker, Emily; Farwell, Austin; Foster, Harrison; Gao, Xiaohan; Gruber, Benjamin; Jones, Erica; Vu, Dennis; Xu, Sonya; Ye, Jingbo

    2016-09-01

    We describe an adjustable parallel-plate capacitor apparatus designed for use in an undergraduate laboratory that permits precise variation of plate separation distances and overlap area. Two experiments are performed with the device to test the ideal capacitor formula derived from Gauss's Law. After correcting for edge effects and minor plate tilt, the device yields capacitance values within 3% of theoretical values.

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

    Science.gov (United States)

    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.

  16. The Use of Calcaneal Anatomic Plate in Arthroscopically-assisted Open Reduction and Internal Fixation of Intra-articular Calcaneal Fractures

    Institute of Scientific and Technical Information of China (English)

    WANG Hong; ZHANG Qingsong; DUAN Deyu; YAN Lijun

    2006-01-01

    To discuss and evaluate the method and effect of using calcaneal anatomic plate in treatment of intra-articular fractures of the calcaneus with assistant of arthroscope, 86 intra-articular fractures of the calcaneus in 78 patients were reduced by open reduction, and rigid fixation was made with calcaneal anatomic plate under assistant of arthroscope. The average follow-up duration was 18 months (range 12-30 months). The effect of treatment was evaluated according to AOFAS and X-ray before and after operation. The results showed that 86 patients have obtained satisfactory reduction according to X-ray, and there was significant difference before and after operation (P<0.01), the total excellent and fine rate was 91.86 %. Treating intra-articular fractures of the calcaneus with calcaneal anatomic plate under arthroscope may provide more chance to achieve anatomical reconstruction, which can lead to satisfied recovery of function and few complication.

  17. Variation of strain energy release rate with plate thickness. [fracture mode transition

    Science.gov (United States)

    Sih, G. C.; Hartranft, R. J.

    1973-01-01

    An analytical model of a through-thickness crack in a statically stretched plate is presented in which the crack front stress state is permitted to vary in the direction of the plate thickness. The amplitude or intensity of this stress field can be made nearly constant over a major portion of the interior crack front which is in a state of plane strain. The average amount of work available for extending a small segment of the crack across the thickness is associated with an energy release rate quantity in a manner similar to the two-dimensional Griffith crack model. The theoretically calculated energy release rate is shown to increase with increasing plate thickness, indicating that available work for crack extension is higher in a thicker plate.

  18. PLATE

    DEFF Research Database (Denmark)

    Kling, Joyce; Hjulmand, Lise-Lotte

    2008-01-01

    ’s level of English is sufficient for the increasing number of courses offered in English each semester. This paper addresses these concerns and describes a pilot project initiated in 2003 at CBS to gauge the overall English language proficiency of those teaching content courses in English. Through......Copenhagen Business School (CBS) finds itself needing to address the issue of English-medium instruction for its increasing number of foreign exchange and full degree students. With internationalisation as a main pillar of the institution’s agenda, there are concerns whether the teaching faculty...... the Project in Language Assessment for Teaching in English (PLATE) language professionals from CBS’s Language Center observe teachers and provide feedback using evaluation criteria from the Common European Framework for Reference (CEFR) supplemented by some additional criteria which take the LSP nature...

  19. PLATE

    DEFF Research Database (Denmark)

    Kling, Joyce; Hjulmand, Lise-Lotte

    2008-01-01

    Copenhagen Business School (CBS) finds itself needing to address the issue of English-medium instruction for its increasing number of foreign exchange and full degree students. With internationalisation as a main pillar of the institution’s agenda, there are concerns whether the teaching faculty......’s level of English is sufficient for the increasing number of courses offered in English each semester. This paper addresses these concerns and describes a pilot project initiated in 2003 at CBS to gauge the overall English language proficiency of those teaching content courses in English. Through...... the Project in Language Assessment for Teaching in English (PLATE) language professionals from CBS’s Language Center observe teachers and provide feedback using evaluation criteria from the Common European Framework for Reference (CEFR) supplemented by some additional criteria which take the LSP nature...

  20. Metaphyseal locking plate as a definitive external fixator for treating open tibial fractures--clinical outcome and a finite element study.

    Science.gov (United States)

    Ma, Ching-Hou; Wu, Chin-Hsien; Tu, Yuan-Kun; Lin, Ting-Sheng

    2013-08-01

    We evaluated both the outcome of using a locking plate as a definitive external fixator for treating open tibial fractures and, using finite element analysis, the biomechanical performance of external and internal metaphyseal locked plates in treating proximal tibial fractures. Eight open tibial patients were treated using a metaphyseal locked plate as a low-profile definitive external fixator. Then, finite element models of internal (IPF) as well as two different external plate fixations (EPFs) for proximal tibial fractures were reconstructed. The offset distances from the bone surface to the EPFs were 6 cm and 10 cm. Both axial stiffness and angular stiffness were calculated to evaluate the biomechanical performance of these three models. The mean follow-up period was 31 months (range, 18-43 months). All the fractures united and the mean bone healing time was 37.5 weeks (range, 20-52 weeks). All patients had excellent or good functional results and were walking freely at the final follow-up. The finite element finding revealed that axial stiffness and angular stiffness decreased as the offset distance from the bone surface increased. Compared to the IPF models, in the two EPF models, axial stiffness decreased by 84-94%, whereas the angular stiffness decreased by 12-21%. The locking plate used as a definitive external fixator provided a high rate of union. While the locking plate is not totally rigid, it is clinically stable and may be advisable for stiffness reduction of plating constructs, thus promoting fracture healing by callus formation. Our patients experienced a comfortable clinical course, excellent knee and ankle joint motion, satisfactory functional results and an acceptable complication rate.

  1. Use of a long distally fixed intramedullary stem to treat a periprosthetic femoral fracture following total hip arthroplasty using a thrust plate hip prosthesis: A case report.

    Science.gov (United States)

    Hatanaka, Hiroyuki; Motomura, Goro; Ikemura, Satoshi; Sonoda, Kazuhiko; Kubo, Yusuke; Utsunomiya, Takeshi; Yamamoto, Takuaki; Nakashima, Yasuharu

    2017-01-01

    The thrust plate hip prosthesis (TPP; Zimmer, Winterthur, Switzerland) is a hip prosthesis that is no longer in production. Few reports have focused on periprosthetic fractures following total hip arthroplasty (THA) with the use of a TPP. We report a 57-year-old woman with a periprosthetic femoral fracture 13 years after THA with the use of a TPP. A plain radiograph showed a displaced subtrochanteric fracture of the right femur just below the distal tip of the lateral plate without implant loosening. She underwent revision surgery with a long distally fixed intramedullary stem in conjunction with a plate and cable system. Three months after surgery, bone union was confirmed using radiography and the patient was clinically asymptomatic. We encountered three major problems while planning surgical treatment, these being, discontinuation of the TPP system, loss of proximal femoral cancellous bone, and difficulties with the type of subtrochanteric fracture. After considering these problems, we planned revision surgery using a long distally fixed intramedullary stem in conjunction with a plate and cable system. This case shows that sufficient implant preparation based on precise preoperative planning is necessary to obtain good clinical results for the surgical treatment of periprosthetic femoral fractures following THA with the use of a TPP. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  2. 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.

  3. SURGICAL MANAGEMENT OF FRACTURES OF DISTAL END RADIUS WITH LOCKING COMPRESSION PLATE

    Directory of Open Access Journals (Sweden)

    Chinta Shyam

    2015-10-01

    Full Text Available Fractures of distal end of radius continue to pose a therapeutic challenge. Intra articu l ar and extra articular malalignment can lead to various complications like post - traumatic osteoarthrosis, decreased grip strength and endurance, as well as limited motion and carpal instability. Open reduction and internal fixation is indicated to address th e unstable distal radius fractures and those with articular incongruity that cannot be anatomically reduced and maintained through external manipulation and ligamentotaxis, provided sufficient bone stock is present to permit early range of motion. METHODS : Sixty adult patients with distal radial fractures treated at Dept. of Orthopaedics, Government General Hospital and Royal Hospital, Vijayawada between May 2010 and April 2015 were included in this study. RESULTS : In this series 9 (15% patients were betwee n 21 - 30 years, 15(25% between 31 - 40 years, 24(40% between 41 - 50 years, 9(15% between 51 - 60 years and 3 (5% patients between 61 - 70 years. The age of the patients ranged from 26 - 62 years with an average of 43.3 years. Out of 60 patients, 48(80% were male s and 12 (20% were females, showing a male preponderance with the ratio being M : F 4 : 1. Right side ( D ominant wrist was involved in 42(70% patients and the left side was involved in 18(30% patients. In our study there were 36 (60% patients with road t raffic accidents and 24(40% patients fell on their outstretched hand. Of the 60 cases, 12(20% of the fractures were of Type I Frykman’s classification, 6(10% of Type II, 21(35% of Type III, 9(15% of Type IV, 3(5% of Type V and 9(15% of Type VIII. Th ere were no cases of Type VI and VII fractures. SUMMARY : Males were predominant with right wrist affection more than left. All fractures were either due to road traffic accidents or fall on the outstretched hand, with road traffic accidents being more comm on of the two. Most of the fractures were of Frykman Type I, III and IV. All (100

  4. Fixation of complex proximal humeral fractures in elderly patients with a locking plate: A retrospective analysis of radiographic and clinical outcome and complications

    Institute of Scientific and Technical Information of China (English)

    Fabio Rodia; Emmanouil Theodorakis; Georgios Touloupakis; Angelo Ventura

    2016-01-01

    Purpose:The optimal surgical treatment of displaced type B and C fractures of the proximal humerus in the elderly remains controversial.Good clinical results have been reported by plating these fractures as well as a high rate of complications.Our retrospective study aims to evaluate clinical recovery and complications using the S3 locking plate in elderly patients.Methods:Fifty-one patients older than 65 years of age,with a complex proximal humeral fracture type B or C (AO classification system),were included.Patients have been followed up for a minimum of 12 months.We assessed callus formation,radiological results,clinical outcome (according to the Constant Shoulder Score System) and complications.Any difference in the clinical recovery among the 2 types of fracture pattern (B and C) was investigated.Results:The mean time of fracture healing was 12.4 weeks.The mean Constant score at 3,6 and 12 months was 68,73 and 75 respectively.No statistically significant difference in the clinical outcome was observed between the B and C fracture patterns (p > 0.05).We noticed an overall of 5 complications (9.8%).There was no need to revision any of the implants.Conclusion:Anatomic reduction and proper plate positioning are essential for minimizing implantrelated complications.In our experience the S3 angular stability system offers a proper osteosyntesis and a good clinical recovery with a low rate of complications.

  5. Is plate tectonis withstanding the test of time?

    Directory of Open Access Journals (Sweden)

    O. Shields

    1997-06-01

    Full Text Available Since the theory of plate tectonics was first proposed thirty years ago, some problems have arisen in its practical application. These call into question its fundamental assumptions of horizontal plate motion, hotspot fixity, true polar wander, Panthalassa, and the Earth’s constant size while leaving seafloor spreading and subduction intact. A rapidity expanding earth solves these problems and privides an alternative viewpoint worth reconsidering.

  6. Analysis of Fracture in Cores from the Tuff Confining Unit beneath Yucca Flat, Nevada Test Site

    Energy Technology Data Exchange (ETDEWEB)

    Lance Prothro

    2008-03-01

    The role fractures play in the movement of groundwater through zeolitic tuffs that form the tuff confining unit (TCU) beneath Yucca Flat, Nevada Test Site, is poorly known. This is an important uncertainty, because beneath most of Yucca Flat the TCU lies between the sources of radionuclide contaminants produced by historic underground nuclear testing and the regional carbonate aquifer. To gain a better understanding of the role fractures play in the movement of groundwater and radionuclides through the TCU beneath Yucca Flat, a fracture analysis focusing on hydraulic properties was performed on conventional cores from four vertical exploratory holes in Area 7 of Yucca Flat that fully penetrate the TCU. The results of this study indicate that the TCU is poorly fractured. Fracture density for all fractures is 0.27 fractures per vertical meter of core. For open fractures, or those observed to have some aperture, the density is only 0.06 fractures per vertical meter of core. Open fractures are characterized by apertures ranging from 0.1 to 10 millimeter, and averaging 1.1 millimeter. Aperture typically occurs as small isolated openings along the fracture, accounting for only 10 percent of the fracture volume, the rest being completely healed by secondary minerals. Zeolite is the most common secondary mineral occurring in 48 percent of the fractures observed.

  7. A novel hot-plate test sensitive to hyperalgesic stimuli and non-opioid analgesics

    OpenAIRE

    T.R. Lavich; Cordeiro, R S B; Silva,P.M.R.; M.A. Martins

    2005-01-01

    It is widely accepted that the classical constant-temperature hot-plate test is insensitive to cyclooxygenase inhibitors. In the current study, we developed a variant of the hot-plate test procedure (modified hot-plate (MHP) test) to measure inflammatory nociception in freely moving rats and mice. Following left and right hind paw stimulation with a phlogogen and vehicle, respectively, the animals were placed individually on a hot-plate surface at 51ºC and the withdrawal latency for each paw ...

  8. The Plate-Joystick technique to reduce proximal humeral fractures and nonunions with a varus deformity through the extended deltoid-splitting approach.

    Science.gov (United States)

    Robinson, C Michael; Inman, Dominic; Phillips, Sally-Anne

    2011-10-01

    Fractures and nonunions in which there is a varus deformity of the humeral head producing posterinferior subluxation of the articular surface are increasingly recognized as an important subgroup of proximal humeral fractures. Operative open reduction and internal fixation of these injuries is often recommended when the varus deformity is severe. We describe a simple technique to assist in the open reduction and locking plate stabilization of this challenging and complex fracture subtype using tools and implants that are readily available in most modern orthopaedic trauma operating rooms.

  9. 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

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

    Science.gov (United States)

    Døssing, Arne; Japsen, Peter; Watts, Anthony; Nielsen, Tove; Jokat, Wilfried; Thybo, Hans

    2016-04-01

    Tectonic models predict that, following breakup, rift margins undergo only decaying thermal subsidence during their post-rift evolution. However, post-breakup stratigraphy beneath the NE Atlantic shelves shows evidence of regional-scale unconformities, commonly cited as outer margin responses to inner margin episodic uplift, including the formation of coastal mountains. The origin of these events remains enigmatic. We present a seismic reflection study from the Greenland Fracture Zone - East Greenland Ridge (GFZ-EGR) and the NE Greenland shelf. We document a regional intra-Miocene seismic unconformity (IMU), which marks the termination of syn-rift deposition in the deep-sea basins and onset of: (i) thermo-mechanical coupling across the GFZ, (ii) basin compression, and (iii) contourite deposition, north of the EGR. The onset of coupling across the GFZ is constrained by results of 2-D flexural backstripping. We explain the thermo-mechanical coupling and the deposition of contourites by the formation of a continuous plate boundary along the Mohns and Knipovich ridges, leading to an accelerated widening of the Fram Strait. We demonstrate that the IMU event is linked to onset of uplift and massive shelf-progradation on the NE Greenland margin. Given an estimated middle-to-late Miocene (~15-10 Ma) age of the IMU, we speculate that the event is synchronous with uplift of the East and West Greenland margins. The correlation between margin uplift and plate-motion changes further indicates that the uplift was triggered by plate tectonic forces, induced perhaps by a change in the Iceland plume (a hot pulse) and/or by changes in intra-plate stresses related to global tectonics.

  11. Ridge-spotting: A new test for Pacific absolute plate motion models

    Science.gov (United States)

    Wessel, Paul; Müller, R. Dietmar

    2016-06-01

    Relative plate motions provide high-resolution descriptions of motions of plates relative to other plates. Yet geodynamically, motions of plates relative to the mantle are required since such motions can be attributed to forces (e.g., slab pull and ridge push) acting upon the plates. Various reference frames have been proposed, such as the hot spot reference frame, to link plate motions to a mantle framework. Unfortunately, both accuracy and precision of absolute plate motion models lag behind those of relative plate motion models. Consequently, it is paramount to use relative plate motions in improving our understanding of absolute plate motions. A new technique called "ridge-spotting" combines absolute and relative plate motions and examines the viability of proposed absolute plate motion models. We test the method on six published Pacific absolute plate motions models, including fixed and moving hot spot models as well as a geodynamically derived model. Ridge-spotting reconstructs the Pacific-Farallon and Pacific-Antarctica ridge systems over the last 80 Myr. All six absolute plate motion models predict large amounts of northward migration and monotonic clockwise rotation for the Pacific-Farallon ridge. A geodynamic implication of our ridge migration predictions is that the suggestion that the Pacific-Farallon ridge may have been pinned by a large mantle upwelling is not supported. Unexpected or erratic ridge behaviors may be tied to limitations in the models themselves or (for Indo-Atlantic models) discrepancies in the plate circuits used to project models into the Pacific realm. Ridge-spotting is promising and will be extended to include more plates and other ocean basins.

  12. Plate osteosynthesis of the humerus shaft fracture an its association with radial nerve injury--a retrospective study in Melaka General Hospital.

    Science.gov (United States)

    Lim, K E; Yap, C K; Ong, S C; Aminuddin

    2001-06-01

    Over a seven-year period, 170 cases of humerus fractures were plated in Hospital Melaka. Of these, 131 cases were successfully traced for this study. Besides looking at fracture epidemiology, its relationship with radial nerve injury was examined. The incidence of post-traumatic wrist drop in closed and compound fractures were 14.9% and 35.3% respectively. In relation to the site of fracture, lower third fracture had the highest incidence of wrist drop (29%). The recovery from post-traumatic wrist drop was 83%. The average duration taken for recovery was 11.8 weeks. The incidence of post-operative wrist drop was high at 17.6% but all recovered during follow-up.

  13. THE FUNCTIONAL OUTCOME OF LOCKING VS NON-LOCKING DUAL PLATE FIXATION IN INTRAARTICULAR FRACTURE DISTAL END HUMERUS: A RETROSPECTIVE COMPARATIVE STUDY

    Directory of Open Access Journals (Sweden)

    Manish Bairagi

    2016-07-01

    Full Text Available BACKGROUND Despite all advances in treatment, it is a challenge to most of the orthopaedic surgeons to give better result in the management of distal end humerus intra-articular fractures, because it has complex anatomy. This study has been done to evaluate the functional outcome of double plate fixation with right angle to each other for intra-articular fracture of distal end humerus and compared with locking vs non-locking plate fixation. AIM This study has been done to evaluate the functional outcome of double plate fixation with right angle to each other for intraarticular fracture of distal end humerus with comparison of locking and non-locking plate fixation. METHODS This is retrospective comparative study done between 2006 and 2014 in the Department of Orthopaedics, G.R. Medical College and J.A. Group of Hospital, Gwalior (M.P., India. All patients who were presented to Department of Orthopaedics with intra-articular fracture, distal end humerus fracture, medically fit patient who were of age group between 18-80 years of age with close or type 1 GA (Gustilo Anderson compound fracture and fracture type AO type C were included. Other patients who sustained GA type 2 and 3, severely comminuted and severe osteoporotic bone were excluded. RESULT A total no. of 60 patients. The age of patients ranged from 22 to 65 years. To classifying according to AO classification, 15 cases were of type C1, 39 were of type C2 and 06 were of type C3. The results were rated using Jupiter’s criteria as excellent in 26 (43.3% cases, good in 16 (26.7%, fair in 11 (18.3% cases and poor in 07 (11.7%. CONCLUSION Double plate fixation is standard and effective method of treating intra-articular fracture of distal humerus, the method gives a stable fixation and allow early mobilization of elbow joint without risk of implant failure. In the study, there is no much advantage from the locking plate fixation in comparison with the non-locking plates.

  14. EFFECT OF TESTING ENVIRONMENT ON FRACTURING BEHAVIOR OF Fe3Si BASED ALLOY

    Institute of Scientific and Technical Information of China (English)

    J.H. Peng; G.L. Chen

    2003-01-01

    The mechanical behavior of Fe3Si based alloy with B2 structure was studied by tensionand fracture toughness test in various testing media. The fracture strength σb ofFe3Si alloy decreased in the following order: oxygen, air and hydrogen respectively.The fracture toughness in different testing environment showed that KiC in oxygenis 11.5±0.3MPa. m1/2, and is 8.6±0.4MPa. m1/2 in distilled water. The reductionof fracture toughness is contributed to the environmental reaction of Si with water.Addition of Al element in Fe3Si is not beneficial to improve the intrinsic ductility ofFe-14Si-3Al alloy. The scattering phenomenon of fracture strength was found, andexplained by fracture mechanics. It was found by means of SEM that the fracture modechanged from transgranular in oxygen to intergranular in hydrogen gas and distilledwater.

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

    DEFF Research Database (Denmark)

    Simonsen, Bo Cerup; Wierzbicki, Tomasz

    1996-01-01

    A closed form solution to the problem of steady state wedge cutting through a ductile metal plate is presented. The considered problem is an idealization of a ship bottom raking process, i.e. a continuous cutting damage of a ship bottom by a hard knife-like rock in a grounding event. A new...

  16. Baseline Fracture Toughness and CGR testing of alloys X-750 and XM-19 (EPRI Phase I)

    Energy Technology Data Exchange (ETDEWEB)

    J. H. Jackson; S. P. Teysseyre

    2012-02-01

    The Advanced Test Reactor National Scientific User Facility (ATR NSUF) and Electric Power Research Institute (EPRI) formed an agreement to test representative alloys used as reactor structural materials as a pilot program toward establishing guidelines for future ATR NSUF research programs. This report contains results from the portion of this program established as Phase I (of three phases) that entails baseline fracture toughness, stress corrosion cracking (SCC), and tensile testing of selected materials for comparison to similar tests conducted at GE Global Research. The intent of this Phase I research program is to determine baseline properties for the materials of interest prior to irradiation, and to ensure comparability between laboratories using similar testing techniques, prior to applying these techniques to the same materials after having been irradiated at the Advanced Test Reactor (ATR). The materials chosen for this research are the nickel based super alloy X-750, and nitrogen strengthened austenitic stainless steel XM-19. A spare core shroud upper support bracket of alloy X-750 was purchased by EPRI from Southern Co. and a section of XM-19 plate was purchased by EPRI from GE-Hitachi. These materials were sectioned at GE Global Research and provided to INL.

  17. Baseline Fracture Toughness and CGR testing of alloys X-750 and XM-19 (EPRI Phase I)

    Energy Technology Data Exchange (ETDEWEB)

    J. H. Jackson; S. P. Teysseyre

    2012-10-01

    The Advanced Test Reactor National Scientific User Facility (ATR NSUF) and Electric Power Research Institute (EPRI) formed an agreement to test representative alloys used as reactor structural materials as a pilot program toward establishing guidelines for future ATR NSUF research programs. This report contains results from the portion of this program established as Phase I (of three phases) that entails baseline fracture toughness, stress corrosion cracking (SCC), and tensile testing of selected materials for comparison to similar tests conducted at GE Global Research. The intent of this Phase I research program is to determine baseline properties for the materials of interest prior to irradiation, and to ensure comparability between laboratories using similar testing techniques, prior to applying these techniques to the same materials after having been irradiated at the Advanced Test Reactor (ATR). The materials chosen for this research are the nickel based super alloy X-750, and nitrogen strengthened austenitic stainless steel XM-19. A spare core shroud upper support bracket of alloy X-750 was purchased by EPRI from Southern Co. and a section of XM-19 plate was purchased by EPRI from GE-Hitachi. These materials were sectioned at GE Global Research and provided to INL.

  18. Distal radius anatomy applied to the treatment of wrist fractures by plate: a review of recent literature

    Directory of Open Access Journals (Sweden)

    Obert Laurent

    2015-01-01

    Full Text Available Few studies on the anatomy of the radial epiphysis have been published in the past 10 years. However, with the availability of new intra- and extra-medullary implants and the recent rash of avoidable iatrogenic injuries, now is the time for a more detailed description of the metaphyseal-epiphyseal regions in the distal radius. Published studies on distal radius anatomy in recent years have focused on three aspects: distal limit and watershed line, dorsal tubercle, and wrist columns. Furthermore, a fresh look at distal radius biomechanics shows that the loads experienced by the distal radius vary greatly. This information should be taken into account during volar plating of distal radius fractures.

  19. Evaluation of the Biodegradable Plates (PG910/PDO) for Reconstruction of Various Sizes of Orbital Floor Defects in the Blow-Out Fractures.

    Science.gov (United States)

    Tabrizi, Reza; Langner, Nicole J; Pouzesh, Ayatollah; Arabion, Hamidreza

    2013-09-01

    The aim of our study was to evaluate the biodegradable plates (PG910/PDO) for reconstruction of various sizes of the orbital floor defects in the blow-out fractures. We included patients who had an impure blow-out fracture. All patients had a recent trauma and also the surgical intervention was done between 1 and 10 days after trauma. The amount of the orbital floor defect was measured in each case through computed tomography scan. In the surgical intervention, a biodegradable plate was used for the reconstruction of the orbital floor defect along with titanium miniplates used for bone fixation in orbital rim. Due to aesthetic reasons, all patients underwent secondary surgery including removal of titanium miniplates after 18 months. The orbital floor was reevaluated during the removal of the miniplates. The clinical evaluation of remnant defects and biodegradable plates (presence of complete or partial resorption) were documented for each patient. In our study a total of 15 patients (10 males and 5 females) underwent the orbital floor reconstruction using biodegradable miniplates. The size of the orbital floor defects was meanly 3.51 ± 1.29 cm(2). Results demonstrated that 4 out of 15 patients had a remnant defect after resorption of the biodegradable plate. In 10 out of 15 patients, the biodegradable plates completely replaced with fibrous tissues after 18 months. Remaining five patients had partial resorption of plates. There was not any relationship between the defect size and the remnant defects (p > 0.05). A significant relationship was seen between the defect size and the plates' resorption rate (p biodegradable plates is an appropriate option for reconstruction of the orbital floor defects. The defect size does not have any effect on the stability of the plate. However, incomplete plate resorption increases the risk of remnant defects in the orbital floor. The larger defects lead to slow degradation of biodegradable plates.

  20. Fracturing tests on reservoir rocks: Analysis of AE events and radial strain evolution

    CERN Document Server

    Pradhan, S; Fjær, E; Stenebråten, J; Lund, H K; Sønstebø, E F; Roy, S

    2015-01-01

    Fracturing in reservoir rocks is an important issue for the petroleum industry - as productivity can be enhanced by a controlled fracturing operation. Fracturing also has a big impact on CO2 storage, geothermal installation and gas production at and from the reservoir rocks. Therefore, understanding the fracturing behavior of different types of reservoir rocks is a basic need for planning field operations towards these activities. In our study, the fracturing of rock sample is monitored by Acoustic Emission (AE) and post-experiment Computer Tomography (CT) scans. The fracturing experiments have been performed on hollow cylinder cores of different rocks - sandstones and chalks. Our analysis show that the amplitudes and energies of acoustic events clearly indicate initiation and propagation of the main fractures. The amplitudes of AE events follow an exponential distribution while the energies follow a power law distribution. Time-evolution of the radial strain measured in the fracturing-test will later be comp...

  1. 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.

  2. SEGMENTAL FRACTURE OF PROXIMAL SHAFT FEMUR OF POLIO AFFECTED PARALYTIC LIMB TREATED WITH 95 DEGREE ANGLED PLATE FIXATION BY MIPO TECHNIQUE

    Directory of Open Access Journals (Sweden)

    Rajan

    2014-11-01

    Full Text Available Subtrochanteric fractures extending below lesser trochanter are always difficult to treat and their higher incidence of unsatisfactory results are noted after operative treatment. There are various implants available for fixation but in this study we did 95 DEG ANGLED PLATE FIXATION BY MIPO TECHNIQUE

  3. Functional Recovery Following Pertrochanteric Hip Fractures Fixated with the Dynamic Hip Screw vs. the Percutaneous Compression Plate

    Directory of Open Access Journals (Sweden)

    Yocheved Laufer

    2005-01-01

    Full Text Available The Dynamic Hip Screw (DHS is currently the most frequently used implant for the treatment of pertrochanteric hip fractures. The Percutaneous Compression Plate (PCCP is a recently developed, alternative device that involves minimal invasive surgery. The objective of the present study was to compare functional recovery following these two surgical procedures. A total of 76 consecutive elderly subjects (mean age and standard deviation, 80.6 ± 5.5 following pertrochanteric hip fracture fixation were evaluated prospectively. Functional recovery was assessed 3 and 12 weeks and 2 years following surgery. Differences between groups 3 weeks postsurgery were found only in pain level during ambulation and in the weight-bearing capability of the operated extremity, which were both in favor of the PCCP. By 3 months, both groups had improved in all measures, but did not reach their preinjury level of independence. However, the PCCP group ambulated with fewer assistive devices and demonstrated better recovery of basic activities of daily living (BADL. While the majority of the subjects from both groups ambulated independently 2 years postsurgery, the PCCP group exhibited less pain during ambulation, was more independent in ADL, and required fewer assistive devices for ambulation. To summarize, the PCCP presents enhanced short- and long-term recovery of functional abilities in comparison to DHS. However, given the limited number of patients, further studies are necessary to substantiate these results.

  4. 髌骨骨折内固定板的生物力学性能%Biomechanical properties of internal fixation plate for patellar fracture

    Institute of Scientific and Technical Information of China (English)

    管志海; 王勤业; 王以进; 罗亚平; 常小波; 冯夏莺

    2014-01-01

    背景:目前治疗髌骨骨折的各种手术方法均有优缺点,不能更好地满足患者的需求。  目的:评价髌骨内固定板固定髌骨骨折的生物力学性能,为临床应用提供基础理论依据。  方法:根据国人髌骨数据,采用钛合金制成蜘蛛形内固定板。采集6具新鲜尸体膝关节标本,随机分为两组,制成粉碎性骨折模型,分别采用髌骨内固定板和NiTi聚髌器固定,行生物力学实验,比较两种内固定物的生物力学性能。  结果与结论:两种不同内固定方法均能满足1 kN股四头肌收缩力,髌骨内固定板固定后髌骨的分离位移、肌力和关节力以及髌骨关节接触面力学特征均优于常用聚髌器内固定,统计两者力学指标差异有显著性意义(P OBJECTIVE:To evaluate biomechanical properties of internal fixation plate to treat patel ar fracture and to provide theoretical evidence for clinical application. METHODS:According to the statistics of patel a in the Chinese population, a titanium al oy spider internal fixation plate was designed and manufactured for the treatment of patel ar fractures. Knee joint specimens in six fresh cadavers were randomly divided into two groups and the comminuted fracture model of patel a were established. The models were fixed with internal fixation plate of patel a and NiTi patel ar concentrator. Biomechanical tests were carried out to compare the biomechanical properties. RESULTS AND CONCLUSION:Both the two fixation methods could meet the 1-kN quadriceps femoris contraction. The internal fixation plate of patel a was superior to NiTi patel ar concentrator in the patel ar isolation shift, muscle strength and joint strength, as wel as mechanical properties of patel a-point surface. There were significant differences between the two groups (P<0.05). The internal fixation plate of patel a is designed in accordance with the anatomical and biomechanical properties of the

  5. The Schwickerath adhesion test: A fracture mechanics analysis.

    Science.gov (United States)

    Schneider, G A; Swain, M V

    2015-08-01

    The Schwickerath three point bending adhesion test is the basis of the International Standard ISO 9693:1999 procedure for assessing porcelain bonding to metals [1]. It has also been used to evaluate the adhesion of porcelain to zirconia. The purpose of this paper is a fracture mechanics analysis of this test, which allows determination of the crack-length load-displacement and toughness dependence of cracks extending along or near the interface. Linear elastic mechanics is used to develop expressions for the strain energy and compliance of Schwickerath geometry specimens as a function of crack extension along or near the interface. From the derivative of the compliance as a function of crack growth the strain energy release rate (G, N/m) is determined. The energy release rate for interface crack extension of Schwickerath geometry specimens is determined. It is found that a simple relationship between the minima of the force-displacement response and the strain energy release rate G exists. Further development enables the predicted force-displacement response as a function of crack length to be derived for different values of G. Experimental results of porcelain bonded to zirconia with and without notches of various lengths machined along the interface verify the expressions and analysis developed. With the fracture mechanics analysis developed in this paper it is possible to determine the quality of adhesion in Schwickerath specimens by the interface toughness in addition to the nominal interface shear bond strength. As the toughness of brittle materials has much less scatter than its strength, the interface toughness characterization of the adhesion should allow for a better distinction between the adhesion quality of bonding. Copyright © 2015 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

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

    DEFF Research Database (Denmark)

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

    2016-01-01

    Tectonic models predict that, following breakup, rift margins undergo only decaying thermal subsidence during their post-rift evolution. However, post-breakup stratigraphy beneath the NE Atlantic shelves shows evidence of regional-scale unconformities, commonly cited as outer margin responses to ...... by plate tectonic forces, induced perhaps by a change in the Iceland plume (a hot pulse) and/or by changes in intra-plate stresses related to global tectonics.......Tectonic models predict that, following breakup, rift margins undergo only decaying thermal subsidence during their post-rift evolution. However, post-breakup stratigraphy beneath the NE Atlantic shelves shows evidence of regional-scale unconformities, commonly cited as outer margin responses...... to inner margin episodic uplift, including the formation of coastal mountains. The origin of these events remains enigmatic. We present a seismic reflection study from the Greenland Fracture Zone – East Greenland Ridge (GFZ-EGR) and the NE Greenland shelf. We document a regional intra-Miocene seismic...

  7. On gravity from SST, geoid from Seasat, and plate age and fracture zones in the Pacific

    Science.gov (United States)

    Marsh, B. D.; Marsh, J. G.; Williamson, R. G. (Principal Investigator)

    1984-01-01

    A composite map produced by combining 90 passes of SST data show good agreement with conventional GEM models. The SEASAT altimeter data were deduced and found to agree with both the SST and GEM fields. The maps are dominated (especially in the east) by a pattern of roughly east-west anomalies with a transverse wavelength of about 2000 km. Comparison with regional bathymetric data shows a remarkedly close correlation with plate age. Most anomalies in the east half of the Pacific could be partly caused by regional differences in plate age. The amplitude of these geoid or gravity anomalies caused by age differences should decrease with absolute plate age, and large anomalies (approximately 3 m) over old, smooth sea floor may indicate a further deeper source within or perhaps below the lithosphere. The possible plume size and ascent velocity necessary to supply deep mantle material to the upper mantle without complete thermal equilibration was considered. A plume emanating from a buoyant layer 100 km thick and 10,000 times less viscous than the surrounding mantle should have a diameter of about 400 km and must ascend at about 10 cm/yr to arrive still anomalously hot in the uppermost mantle.

  8. Screw augmentation reduces motion at the bone-implant interface: a biomechanical study of locking plate fixation of proximal humeral fractures.

    Science.gov (United States)

    Schliemann, Benedikt; Seifert, Robert; Rosslenbroich, Steffen B; Theisen, Christina; Wähnert, Dirk; Raschke, Michael J; Weimann, Andre

    2015-12-01

    Shear forces at the bone-implant interface lead to a loss of reduction after locking plate fixation of proximal humeral fractures. The aim of the study was to analyze the roles of medial support screws and screw augmentation in failure loads and motion at the bone-implant interface after locking plate fixation of proximal humeral fractures. Unstable 3-part fractures were simulated in 6 pairs of cadaveric humeri and were fixed with a DiPhos-H locking plate (Lima Corporate, Udine, Italy). An additional medial support screw was implanted in 1 humerus of every donor. The opposite humerus was stabilized with a medial support screw and additional bone cement augmentation of the 2 anteriorly directed head screws. Specimens were loaded in the varus bending position. Stiffness, failure loads, plate bending, and the motion at the bone-implant interface were evaluated using an optical motion capture system. The mean load to failure was 669 N (standard deviation [SD], 117 N) after fixation with medial support screws alone and 706 N (SD, 153 N) after additional head screw augmentation (P = .646). The initial stiffness was 453 N/mm (SD, 4.16 N/mm) and 461 N/mm (SD, 64.3 N/mm), respectively (P = .594). Plate bending did not differ between the 2 groups. However, motion at the bone-implant interface was significantly reduced after head screw augmentation (P Board of Trustees. Published by Elsevier Inc. All rights reserved.

  9. Analysis on the deformation and fracture behavior of carbon steel by in situ tensile test

    Institute of Scientific and Technical Information of China (English)

    Fan Li; Haibo Huang

    2006-01-01

    The deformation and fracture behaviors of low-carbon steel, medium-carbon steel, and high-carbon steel were studied on internal microstructure using the scanning electron microscopy in situ tensile test. The microstructure mechanism of their deformation and fracture behavior was analyzed. The results show that the deformation and fracture behavior of low-carbon steel depends on the grain size of ferrite, the deformation and fracture behavior of medium-carbon steel depends on the size of ferrite grain and pearlite lump,and the deformation and fracture behavior of high-carbon steel depends on the size of pearlite lump and the pearlitic interlamellar spacing.

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

    Science.gov (United States)

    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.

  11. Test Method for High β Particle Emission Rate of 63Ni Source Plate

    Directory of Open Access Journals (Sweden)

    ZHANG Li-feng

    2015-01-01

    Full Text Available For the problem of measurement difficulties of β particle emission rate of Ni-63 source plate used for Ni-63 betavoltaic battery, a relative test method of scintillation current method was erected according to the measurement principle of scintillation detector.β particle emission rate of homemade Ni-63 source plate was tested by the method, and the test results were analysed and evaluated, it was initially thought that scintillation current method was a feasible way of testing β particle emission rate of Ni-63 source plate with high β particle emission rate.

  12. Autologous grafts of double-strut fibular cortical bone plate to treat the fractures and defects of distal femur: a case report and review of literature

    Directory of Open Access Journals (Sweden)

    CHEN Xu

    2012-02-01

    Full Text Available 【Abstract】We reported a 23-year-old man who was involved in a high-speed motorcycle accident. He sustained a closed fracture at the right distal femur. The primary fracture happened on February 2008. He underwent open reduction and internal fixation with cloverleaf plate. And one hundred days after the surgery, the proximal screws were pulled-out, but the bone union was not achieved. Treatment consisted of exchanging the cloverleaf plate with a locking compression plate and using an auto-iliac bone graft to fill the nonunion gap. In July 2009, the patient had a sharp pain in the right lower limb. The X-ray revealed that the plate implanted last year was broken, causing a nonunion at the fracture site. Immediately the plate and screws were removed and an intramedullary nail was inserted reversely from the distal femur as well as a 7 cm long bone from the right fibula was extracted and longitudinally split into two pieces to construct cortical bone plates. Then we placed them laterally and medially to fracture site, drilled two holes respectively, and fastened them with suture. We carried on auto-iliac bone grafting with the nonunion bone grafts. The follow-up at 15 months after operation showed that the treatment was successful, X-ray confirmed that there was no rotation and no angular or short deformity. We briefly reviewed the literature regarding such an unusual presentation and discussed in details the possible etiology and the advantages of autologous double-strut fibular grafts to cope with such an intractable situation. Key words: Femur; Transplantation, autologous; Bone screws

  13. Autologous grafts of double-strut fibular cortical bone plate to treat the fractures and defects of distal femur: a case report and review of literature

    Institute of Scientific and Technical Information of China (English)

    CHEN Xu; LI Jian-jun; KONG Zhan; YANG Dong-xiang; YUAN Xiang-nan

    2011-01-01

    We reported a 23-year-old man who was involved in a high-speed motorcycle accident. He sustained a closed fracture at the right distal femur. The primary fracture happened on February 2008. He underwent open reduction and internal fixation with cloverleaf plate. And one hundred days after the surgery, the proximal screws were pulled-out, but the bone union was not achieved. Treat ment consisted of exchanging the cloverleaf plate with a locking compression plate and using an auto-iliac bone graft to fill the nonunion gap. In July 2009, the patient had a sharp pain in the right lower limb. The X-ray revealed that the plate implanted last year was broken, causing a nonunion at the fracture site. Immediately the plate and screws were removed and an intramedullary nail was inserted reversely from the distal femur as well as a 7 cm long bone from the right fibula was extracted and longitudinally split into two pieces to construct cortical bone plates. Then we placed them laterally and medially to fracture site, drilled two holes respectively, and fastened them with suture. We carried on auto-iliac bone grafting with the nonunion bone grafts. The follow-up at 15 months after operation showed that the treatment was successful, X-ray confirmed that there was no rotation and no angular or short deformity. We briefly reviewed the literature regarding such an unusual presentation and discussed in details the possible etiology and the advantages of autologous double-strut fibular grafts to cope with such an intractable situation.

  14. Evaluation of fracture models through pressurized-thermal-shock testing

    Energy Technology Data Exchange (ETDEWEB)

    Pugh, C.E.; Bryan, R.H.; Bass, B.R.; Nanstad, R.K.

    1988-01-01

    Two multiple-transient pressurized-thermal-shock experiments (PTSEs) have been conducted under the NRC-sponsored Heavy-Section Steel Technology (HSST) program. The first test (PTSE-1) employed an SA-508 class 2 steel with high Charpy upper-shelf energy level and a relatively high brittle-to-ductile transition temperature. The second test (PTSE-2) used a 2 1/4 Cr-1 Mo steel (SA-387 grade 22) that had been given a special heat treatment to yield a low Charpy upper-shelf energy level and attendant low tearing resistance. Each experiment included two combined thermal and pressure transients that give rise to propagation and arrest of an initial long flaw that extended about 10% through the thick wall of the test cylinder. Both materials exhibited the ability to inhibit crack propagation by warm prestressing, high initiation toughness values and high crack-arrest toughness values. Cleavage initiation and arrest are modeled well by available fracture theories. However, calculations of ductile tearing based on resistance curves did not consistently predict the observed tearing.

  15. Simulating infiltration tests in fractured basalt at the Box Canyon Site, Idaho

    Energy Technology Data Exchange (ETDEWEB)

    Unger, Andre J.A.; Faybishenko, Boris; Bodvarsson, Gudmundur S.; Simmons, Ardyth M.

    2003-04-01

    The results of a series of ponded infiltration tests in variably saturated fractured basalt at Box Canyon, Idaho, were used to build confidence in conceptual and numerical modeling approaches used to simulate infiltration in fractured rock. Specifically, we constructed a dual-permeability model using TOUGH2 to represent both the matrix and fracture continua of the upper basalt flow at the Box Canyon site. A consistent set of hydrogeological parameters was obtained by calibrating the model to infiltration front arrival times in the fracture continuum as inferred from bromide samples collected from fracture/borehole intersections observed during the infiltrating tests. These parameters included the permeability of the fracture and matrix continua, the interfacial area between the fracture and matrix continua, and the porosity of the fracture continuum. To calibrate the model, we multiplied the fracture-matrix interfacial area by a factor between 0.1 and 0.01 to reduce imbibition of water from the fracture continuum into the matrix continuum during the infiltration tests. Furthermore, the porosity of the fracture continuum, as calculated using the fracture aperture inferred from pneumatic-test permeabilities, was increased by a factor of 50 yielding porosity values for the upper basalt flow in the range of 0.01 to 0.02. The fracture-continuum porosity was a highly sensitive parameter controlling the arrival times of the simulated infiltration fronts. Porosity values are consistent with those determined during the Large-Scale Aquifer Pumping and Infiltration Test at the Idaho National Engineering and Environmental Laboratory.

  16. Numerical development of a new correlation between biaxial fracture strain and material fracture toughness for small punch test

    Science.gov (United States)

    Kumar, Pradeep; Dutta, B. K.; Chattopadhyay, J.

    2017-04-01

    The miniaturized specimens are used to determine mechanical properties of the materials, such as yield stress, ultimate stress, fracture toughness etc. Use of such specimens is essential whenever limited quantity of material is available for testing, such as aged/irradiated materials. The miniaturized small punch test (SPT) is a technique which is widely used to determine change in mechanical properties of the materials. Various empirical correlations are proposed in the literature to determine the value of fracture toughness (JIC) using this technique. bi-axial fracture strain is determined using SPT tests. This parameter is then used to determine JIC using available empirical correlations. The correlations between JIC and biaxial fracture strain quoted in the literature are based on experimental data acquired for large number of materials. There are number of such correlations available in the literature, which are generally not in agreement with each other. In the present work, an attempt has been made to determine the correlation between biaxial fracture strain (εqf) and crack initiation toughness (Ji) numerically. About one hundred materials are digitally generated by varying yield stress, ultimate stress, hardening coefficient and Gurson parameters. Such set of each material is then used to analyze a SPT specimen and a standard TPB specimen. Analysis of SPT specimen generated biaxial fracture strain (εqf) and analysis of TPB specimen generated value of Ji. A graph is then plotted between these two parameters for all the digitally generated materials. The best fit straight line determines the correlation. It has been also observed that it is possible to have variation in Ji for the same value of biaxial fracture strain (εqf) within a limit. Such variation in the value of Ji has been also ascertained using the graph. Experimental SPT data acquired earlier for three materials were then used to get Ji by using newly developed correlation. A reasonable

  17. Heat as a tracer for understanding transport processes in fractured media: Theory and field assessment from multiscale thermal push-pull tracer tests

    Science.gov (United States)

    Klepikova, Maria V.; Le Borgne, Tanguy; Bour, Olivier; Dentz, Marco; Hochreutener, Rebecca; Lavenant, Nicolas

    2016-07-01

    The characterization and modeling of heat transfer in fractured media is particularly challenging as the existence of fractures at multiple scales induces highly localized flow patterns. From a theoretical and numerical analysis of heat transfer in simple conceptual models of fractured media, we show that flow channeling has a significant effect on the scaling of heat recovery in both space and time. The late time tailing of heat recovery under channeled flow is shown to diverge from the T>(t>)∝t-1.5 behavior expected for the classical parallel plate model and follow the scaling T>(t>)∝1/t>(log⁡t>)2 for a simple channel modeled as a tube. This scaling, which differs significantly from known scalings in mobile-immobile systems, is of purely geometrical origin: late time heat transfer from the matrix to a channel corresponds dimensionally to a radial diffusion process, while heat transfer from the matrix to a plate may be considered as a one-dimensional process. This phenomenon 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. These findings are supported by the results of a field experimental campaign performed on the fractured rock site of Ploemeur. The scaling of heat recovery in time and space, measured from thermal breakthrough curves measured through a series of push-pull tests at different scales, shows a clear signature of flow channeling. The whole data set can thus be successfully represented by a multichannel model parametrized by the mean channel density and aperture. These findings, which bring new insights on the effect of flow channeling on heat transfer in fractured rocks, show how heat recovery in geothermal tests may be controlled by fracture geometry. In addition, this highlights the interest of thermal push-pull tests as a complement to solute tracers tests to infer fracture aperture and geometry.

  18. Methods for testing Zernike phase plates and a report on silicon-based phase plates with reduced charging and improved ageing characteristics.

    Science.gov (United States)

    Marko, Michael; Meng, Xing; Hsieh, Chyongere; Roussie, James; Striemer, Christopher

    2013-11-01

    Imaging with Zernike phase plates is increasingly being used in cryo-TEM tomography and cryo-EM single-particle applications. However, rapid ageing of the phase plates, together with the cost and effort in producing them, present serious obstacles to widespread adoption. We are experimenting with phase plates based on silicon chips that have thin windows; such phase plates could be mass-produced and made available at moderate cost. The windows are coated with conductive layers to reduce charging, and this considerably extends the useful life of the phase plates compared to traditional pure-carbon phase plates. However, a compromise must be reached between robustness and transmission through the phase-plate film. Details are given on testing phase-plate performance by means of imaging an amorphous thin film and evaluating the power spectra of the images.

  19. Tests on impact effect of partial fracture at steel frame connections

    Institute of Scientific and Technical Information of China (English)

    Yiyi CHEN; Ruoning BIAN; Fangfang LIAO

    2008-01-01

    Impact effect of sudden fracture at steel frame connections under severe earthquake or other extreme loads is presented in this paper. The relation of impulse caused by structural fracture to the release of inner force at the cracked location, the magnitude of the response to impact on the basis of one degree of freedom model, and the ratio of the peak value of response to natural period of the system are investigated. Two types of fracture tests were designed and carried out both on uniaxial steel bar tensioned and moment resistant steel frame model. It is proven that the response during the fracture process can be measured quite well using high-frequency data proces-sing system. It is also revealed that the instant fracture of structural connection is characterized by progressive and partial fracture. Numerical evaluation of the impact effect of connection fracture is carried out.

  20. Propagation of fractures from an interface in a Brazilian test specimen

    CSIR Research Space (South Africa)

    Malan, DF

    1994-12-01

    Full Text Available The influence of an interface on the initiation and propagation of fractures was investigated using the Brazilian tensile test (diametral compression of a disc). Failure in the Brazilian test takes the form of an extension fracture in the loaded...

  1. Early results of reverse less invasive stabilization system plating in treating elderly intertrochanteric fractures: a prospective study compared to proximal femoral nail

    Institute of Scientific and Technical Information of China (English)

    YAO Chen; ZHANG Chang-qing; JIN Dong-xu; CHEN Yun-feng

    2011-01-01

    Background Intertrochanteric femur fracture is common in elderly population. Though multiple treatment options are available, the choice of implant remains controversial. The reverse less invasive stabilization system (LISS) plating was introduced for treatment of a patient with ipsilateral intertrochanteric and midshaft femoral fractures. The aim of this research was to compare such technique to intramedullary nailing (proximal femoral nail, PFN) for intertrochanteric fractures.Methods Fifty-six patients with an age of at least sixty-five years and an AO/OTA type-A1 or A2 fractures were included and divided into LISS and PFN treatment group. Background parameters, fracture and surgery details were documented. Follow-up time was at least 12 months. Radiology, complication, Harris Hip Score and Rapid Disability Rating Score (RDRS) were recorded to evaluate fixation status and hip function for each patient during follow-up.Results There was no significant difference between the two groups in surgical time ((48.0±8.6) minutes, vs.(51.8±10.8) minutes, P=0.3836) and intraoperative blood loss ((149.1±45.1) ml vs. (176.4±25.4) ml, P=0.0712). The LISS group had less postoperative haemoglobin (Hb) reduction ((10.2±4.5) g/L Hb, vs. (15.1~5.9) g/L Hb, P=0.0475). There was no complication observed in PFN group. All 31A1 type fracture in LISS group showed 100% maintenance of reduction. One nonunion with locking screw breakage and 2 varus union were found in the LISS group. Postoperative hip function was similar between the two groups.Conclusions Though reverse LISS plating may not be recommended as a routine fixation method for elderly unstable intertrochanteric fractures compared to PFN, it may possibly be reserved for rapid fixation and damage control in polytrauma patients and ORIF of subtrochanteric and reverse oblique intertrochanteric fractures.

  2. Cosmic ray tests of large area Multigap Resistive Plate Chambers

    CERN Document Server

    An, S; Kim, J; Williams, M C S; Zichichi, A; Zuyeuski, R

    2007-01-01

    We have built Multigap Resistive Plate Chambers (MRPC) with six gas gaps and an active area of . The signals are generated on 2.5 cm wide copper pickup strips; these are read out at each end thus allowing the position of the hit along the strip to be obtained from the time difference. Using three of these chambers we have set up a cosmic tracking system in a similar manner as planned for the Extreme Energy Events (EEE) project. The details of the set-up are presented in this paper. In addition we discuss the time and position resolution of these MRPCs measured using cosmic rays.

  3. Brownian motion of a charged test particle in vacuum between two conducting plates

    Science.gov (United States)

    Yu, Hongwei; Chen, Jun

    2004-12-01

    The Brownian motion of a charged test particle caused by quantum electromagnetic vacuum fluctuations between two perfectly conducting plates is examined and the mean squared fluctuations in the velocity and position of the test particle are calculated. Our results show that the Brownian motion in the direction normal to the plates is reinforced in comparison to that in the single plate case. The effective temperature associated with this normal Brownian motion could be three times as large as that in the single plate case. However, the negative dispersions for the velocity and position in the longitudinal directions, which could be interpreted as reducing the quantum uncertainties of the particle, acquire positive corrections due to the presence of the second plate, and are thus weakened.

  4. Brownian motion of a charged test particle in vacuum between two conducting plates

    CERN Document Server

    Yu, H; Yu, Hongwei; Chen, Jun

    2004-01-01

    The Brownian motion of a charged test particle caused by quantum electromagnetic vacuum fluctuations between two perfectly conducting plates is examined and the mean squared fluctuations in the velocity and position of the test particle are calculated. Our results show that the Brownian motion in the direction normal to the plates is reinforced in comparison to that in the single-plate case. The effective temperature associated with this normal Brownian motion could be three times as large as that in the single-plate case. However, the negative dispersions for the velocity and position in the longitudinal directions, which could be interpreted as reducing the quantum uncertainties of the particle, acquire positive corrections due to the presence of the second plate, and are thus weakened.

  5. Radiographic evaluation of fracture healing after rigid plate fixation. Experiments in the rabbit

    Energy Technology Data Exchange (ETDEWEB)

    Paavolainen, P.; Karaharju, E.; Slaetis, P.; Waris, P. (Helsinki Univ. Central Hospital (Finland). Meilahti Clinic)

    1981-01-01

    Experimental osteotomies were made in 35 rabbit tibio-fibular bones and fixed with rigid stainless steel osteosynthesis plates (DCP/ASIF). The radiographic and histopathologic appearances in the healing osteotomies and adjacent bone were analysed at intervals from 3 up to 24 weeks postoperatively. Radiologically the osteotomy had closed at 9 weeks and microscopically this could be confirmed as longitudinal orientation of the cutter heads across the osteotomy gap with longitudinal orientation of the bone structure. The healing of the osteotomy was accompanied by gross structural changes in the adjacent cortical bone with loss of intracortical and subendosteal osteons, cementing lines and intermediate tissue between the osteons. This was characterized by decreasing attenuation of the cortical bone after healing of the osteotomy and should clinically be regarded as an indication for removal of the implant.

  6. Numerical modelling of sandstone uniaxial compression test using a mix-mode cohesive fracture model

    CERN Document Server

    Gui, Yilin; Kodikara, Jayantha

    2015-01-01

    A mix-mode cohesive fracture model considering tension, compression and shear material behaviour is presented, which has wide applications to geotechnical problems. The model considers both elastic and inelastic displacements. Inelastic displacement comprises fracture and plastic displacements. The norm of inelastic displacement is used to control the fracture behaviour. Meantime, a failure function describing the fracture strength is proposed. Using the internal programming FISH, the cohesive fracture model is programmed into a hybrid distinct element algorithm as encoded in Universal Distinct Element Code (UDEC). The model is verified through uniaxial tension and direct shear tests. The developed model is then applied to model the behaviour of a uniaxial compression test on Gosford sandstone. The modelling results indicate that the proposed cohesive fracture model is capable of simulating combined failure behaviour applicable to rock.

  7. Characterizing hydraulic fractures in shale gas reservoirs using transient pressure tests

    Directory of Open Access Journals (Sweden)

    Cong Wang

    2015-06-01

    This work presents an unconventional gas reservoir simulator and its application to quantify hydraulic fractures in shale gas reservoirs using transient pressure data. The numerical model incorporates most known physical processes for gas production from unconventional reservoirs, including two-phase flow of liquid and gas, Klinkenberg effect, non-Darcy flow, and nonlinear adsorption. In addition, the model is able to handle various types and scales of fractures or heterogeneity using continuum, discrete or hybrid modeling approaches under different well production conditions of varying rate or pressure. Our modeling studies indicate that the most sensitive parameter of hydraulic fractures to early transient gas flow through extremely low permeability rock is actually the fracture-matrix contacting area, generated by fracturing stimulation. Based on this observation, it is possible to use transient pressure testing data to estimate the area of fractures generated from fracturing operations. We will conduct a series of modeling studies and present a methodology using typical transient pressure responses, simulated by the numerical model, to estimate fracture areas created or to quantity hydraulic fractures with traditional well testing technology. The type curves of pressure transients from this study can be used to quantify hydraulic fractures in field application.

  8. CLINICAL AND FUNCTIONAL OUTCOME OF DISTAL RADIUS FRACTURES MANAGED BY LIGAMENTOTAXIS AND/OR PERCUTANEOUS PINNING VERSUS OPEN REDUCTION & INTERNAL FIXATION BY BUTTRESS PLATES

    Directory of Open Access Journals (Sweden)

    Biju

    2015-05-01

    Full Text Available INTRODUCTI ON: We studied the clinical and functional outcome of distal radius fractures managed by ligamentotaxis and/or percutaneous pinning versus open reduction & internal fixation by buttress plates. METHODS : This prospective study was conducted during Aug 2012 to October 2014. All skeletally matured patients were having both Intra articular and extra articular Closed Distal Radius fractures were studied. Treatment was done either external fixator supplemented with k wires or internal fixation with plate and screws. The radiographic evaluation included radial length, palmar tilt, any evidence of jointincongruity and radio ulnar joint instability and arthritis. The assessments that were made includes Subjective assessment – pain, numbness, weakness of hand, stiffness, OBJECTIVE : R ange of motion measured by hand held goniometer, Measurement of grip strength done by commercially available hand dynamometer. Unaffected hand served as control. RESULTS : Male patients (85.46% outnumbered female patients (14.54% in incidence. The incidence of distal ra dius fractures was common between the ages of 20 to 40 years. Left sided fractures were more common (52.73%. Type III was most common type of fracture (Frykman’s Classification, accounting for 29% of all fractures.25 cases were treated by external fixati on and 30 cases were treated by open reduction and buttress plating. The results were evaluated by using STEWART ET AL anatomical and functional scoring system. The average range of movement at the knee joint was Dorsiflexion 70*, Palmar Flexion 65*, Ulnar Deviation 25*, Radial Deviation 15*, Supination 70*, Pronation 65*. Most common early complication was pin tract infection. Based on the stewar et al scoring, 4(7.27% had excellent, 43(78.18% had good, 7(12.72% had fair, 1(1.81% had poor results. CONC LUSION : We observed that both fixations were equally same, there is no superiority with over the other. The incidence of complications in

  9. Anatomical plate lateral proximal and distal tibia fractures%外侧解剖型钢板治疗胫骨远近端骨折

    Institute of Scientific and Technical Information of China (English)

    闫开文; 翟江华; 许业伦

    2011-01-01

    目的 探讨外侧解剖型钢板内固定治疗小腿胫骨远近端骨折疗效.方法 回顾性总结分析采用外侧解剖型钢板内固定治疗小腿胫骨远近端骨折33例.结果 所有患者均得到随访,时间18~24个月,骨折均获骨折愈合,关节功能恢复基本正常.结论 外侧解剖型钢板内固定治疗小腿胫骨远近端骨折对位对线良,固定可靠,可早期功能锻炼,是治疗小腿胫骨远近端骨折较好的方法.%Objective To investigate the anatomical lateral plate internal fixation of tibial proximal and distal lower leg fractures.Methods Retrospectively analysis from January 2006 to April 2009 with lateral plate internal fixation with anatomic leg proximal and distal tibial fractures of 33 cases. Results All patients were followed up for 18 to 24 months, fractures were fracture healing, joint function was normal. Conclusion The anatomical lateral plate fixation proximal and distal tibial fractures leg position on the line of good, reliable fixation, and early functional exercise is the treatment of proximal and distal tibial fractures leg better way.

  10. 78 FR 33132 - Quality Verification for Plate-Type Uranium-Aluminum Fuel Elements for Use in Research and Test...

    Science.gov (United States)

    2013-06-03

    ... COMMISSION Quality Verification for Plate-Type Uranium-Aluminum Fuel Elements for Use in Research and Test... Verification for Plate-Type Uranium-Aluminum Fuel Elements for Use in Research and Test Reactors.'' This guide... plate-type uranium-aluminum fuel elements used in research and test reactors (RTRs). ADDRESSES: Please...

  11. Distribution and migration of aftershocks of the 2010 Mw 7.4 Ogasawara Islands intraplate normal-faulting earthquake related to a fracture zone in the Pacific plate

    Science.gov (United States)

    Obana, Koichiro; Takahashi, Tsutomu; No, Tetsuo; Kaiho, Yuka; Kodaira, Shuichi; Yamashita, Mikiya; Sato, Takeshi; Nakamura, Takeshi

    2014-04-01

    describe the aftershocks of a Mw 7.4 intraplate normal-faulting earthquake that occurred 150 km east Ogasawara (Bonin) Islands, Japan, on 21 December 2010. It occurred beneath the outer trench slope of the Izu-Ogasawara trench, where the Pacific plate subducts beneath the Philippine Sea plate. Aftershock observations using ocean bottom seismographs (OBSs) began soon after the earthquake and multichannel seismic reflection surveys were conducted across the aftershock area. Aftershocks were distributed in a NW-SE belt 140 km long, oblique to the N-S trench axis. They formed three subparallel lineations along a fracture zone in the Pacific plate. The OBS observations combined with data from stations on Chichi-jima and Haha-jima Islands revealed a migration of the aftershock activity. The first hour, which likely outlines the main shock rupture, was limited to an 80 km long area in the central part of the subsequent aftershock area. The first hour activity occurred mainly around, and appears to have been influenced by, nearby large seamounts and oceanic plateau, such as the Ogasawara Plateau and the Uyeda Ridge. Over the following days, the aftershocks expanded beyond or into these seamounts and plateau. The aftershock distribution and migration suggest that crustal heterogeneities related to a fracture zone and large seamounts and oceanic plateau in the incoming Pacific plate affected the rupture of the main shock. Such preexisting structures may influence intraplate normal-faulting earthquakes in other regions of plate flexure prior to subduction.

  12. Evaluation of result of minimally invasive plating osteosynthesis (MIPO technique in the treatment of fracture distal tibia: a prospective follow-up study from Chhattisgarh, India.

    Directory of Open Access Journals (Sweden)

    Pravin Kumar Jangde

    2015-09-01

    Full Text Available Background High speed motor vehicle accidents are on the rise over the past few years, a major cause of complex fractures of tibia. The main treatment aim of this type of fractures is reinstatement of the normal alignment and articular congruity. Although different surgical techniques are available, but minimally invasive plating osteosynthesis (MIPO is most popular in minimal articular comminution and damage of soft tissue envelope. MIPO advantages are no periosteal dissections, no disruption of hematoma, stable fixation, early mobilization, less complications and relatively higher rates of union. The main objective of this study was to evaluate the functional and clinical outcomes of distal tibia fracture patients, treated by internal fixation by MIPO technique with locking compression plate (LCP. Methods Twenty patients with closed distal tibia fracture with or without intra articular extension treated with MIPO with LCP were prospectively followed for average duration of 18.45 months (range 5-30 months. Fractures were classified according AO classification into broad types. Results Average duration of injury-surgery interval was 12days. The age incidence was an average of 38.95 yrs. High occurrence of fracture was seen in labourer (65%, maximum cases (50% mode of injury was due to road traffic accidents. 75% of the patients showed radiologic union in 13-16 weeks, full weight bearing was achieved in 13-16 weeks. Overall achievement was 75% excellent, 10% good, 10% fair and 5% with poor result. Conclusion The present study confirmed that MIPO with LCP is an effective and safe treatment method in terms of union time and complications rate for distal tibia fracture.

  13. 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

  14. NON-LCL AND TRACER TEST FOR GROUNDWATER FLOW IN A SINGLE FRACTURE

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    The validity of Local Cubic Law (LCL) is an important issue to study groundwater flow and transport in fractured media. According to laboratory simulaion tests, the average velocity with a lower gradient in a single fracture is calculated by the LCL, which is compared with the measured average velocity. Then dye tracer test is designed and completed. The evidence for non-LCL is drawn from the results of the simulation tests and the dye tracer tests. Then the Reynolds number of groundwater is calculated, the critical value of Re for laminar flow is discussed in a single fracture under different conditions. The motion types for groundwater flow have been discussed.

  15. Mapping fracture flow paths with a nanoscale zero-valent iron tracer test and a flowmeter test

    Science.gov (United States)

    Chuang, Po-Yu; Chia, Yeeping; Chiu, Yung-Chia; Teng, Mao-Hua; Liou, Sofia Ya Hsuan

    2017-08-01

    The detection of preferential flow paths and the characterization of their hydraulic properties are important for the development of hydrogeological conceptual models in fractured-rock aquifers. In this study, nanoscale zero-valent iron (nZVI) particles were used as tracers to characterize fracture connectivity between two boreholes in fractured rock. A magnet array was installed vertically in the observation well to attract arriving nZVI particles and identify the location of the incoming tracer. Heat-pulse flowmeter tests were conducted to delineate the permeable fractures in the two wells for the design of the tracer test. The nZVI slurry was released in the screened injection well. The arrival of the slurry in the observation well was detected by an increase in electrical conductivity, while the depth of the connected fracture was identified by the distribution of nZVI particles attracted to the magnet array. The position where the maximum weight of attracted nZVI particles was observed coincides with the depth of a permeable fracture zone delineated by the heat-pulse flowmeter. In addition, a saline tracer test produced comparable results with the nZVI tracer test. Numerical simulation was performed using MODFLOW with MT3DMS to estimate the hydraulic properties of the connected fracture zones between the two wells. The study results indicate that the nZVI particle could be a promising tracer for the characterization of flow paths in fractured rock.

  16. Arthroscopic button plate fixation therapy for instable distal clavicular fracture%关节镜下纽扣钢板固定术治疗不稳定锁骨远端骨折

    Institute of Scientific and Technical Information of China (English)

    陈建海; 党育; 付中国; 姜保国

    2015-01-01

    guide pin is corret;through guide pin,use a 4.5 mm hollow drill for drilling,introduce the shuttle wire,and take out guider.Take two 4-hole button plates,remove loop spinalium,and use two No.5 Ethicon suture to perform plate connection as shown in Figure 9.By means of shuttle wire,introduce the button plates to pass through clavicle and coracoid,place one plate under coracoid,place another plate on the surface of clavicle.Perform reduction of fracture.If there are soft tissues entrapped at the fracture end,use probe for release. Maintain fracture reduction,tighten the suture for knotting and fixation,perform fluoroscopy again to validate fracture reduction;perform arthroscopy to validate that the plate under coracoid is completely attached on the lower surface of coracoid.Conventionally close incision.Ⅲ.Postoperative treatment:Use shoulder joint protector to suspend the injured shoulder for 4 weeks.In 4 weeks post operation, allow the shoulder joint to perform passive uplifting and external rotation activities;In the 2nd month after operation,perform intensive joint traction exercise,active assisted shoulder joint uplifting as well as internal and external rotation activities;2 months post operation,when preliminary fracture healing is realized and there is no local pressing pain,start active motion of shoulder joint,gradually recover daily activities as well as muscle strength and endurance training on rotator cuff and shoulder girdle.Ⅳ.Post-operative follow-up:After operation,perform re-examination once per month,take X-ray film,examine the fracture union situation until bony union of fracture.In the final follow-up,make evaluation on patient through shoulder joint constant scoring,simple shoulder joint test (SST),VAS pain scoring and examination on the range of shoulder joint motion.Results All 1 7 cases obtained follow-up,with average follow-up time of 50 months (42-66 months).1 6 cases achieved fracture union,with average union time of 3.2 months;there is 1

  17. In-situ stress from hydraulic fracture measurements in G Tunnel, Nevada Test Site

    Energy Technology Data Exchange (ETDEWEB)

    Smith, C.; Vollendorf, W. C.; Warren, W. E.

    1981-04-01

    Hydraulic fracture work in G Tunnel, Nevada Test Site, performed to obtain the in-situ stress state is discussed. Field equipment and procedures are described; analysis is developed to relate the hydraulic fracture pressures to the in-situ stress state. Pressure data are analyzed to provide estimates of the stress state at a number of locations in the tunnel complex. A unique feature of the work is the mineback - a mining process in which the rock is cut away to reveal the actual plane of the fracture. Advantages, limitations, and problem areas associated with extracting in-situ stress fields from hydraulic fracture pressure records are discussed in detail.

  18. Guarded Flat Plate Cryogenic Test Apparatus and Calorimeter

    Science.gov (United States)

    Fesmire, James E. (Inventor); Johnson, Wesley L. (Inventor)

    2017-01-01

    A test apparatus for thermal energy measurement of disk-shaped test specimens has a cold mass assembly locatable within a sealable chamber with a guard vessel having a guard chamber to receive a liquid fluid and a bottom surface to contact a cold side of a test specimen, and a test vessel having a test chamber to receive a liquid fluid and encompassed on one side by a center portion of the bottom surface shared with the guard vessel. A lateral wall assembly of the test vessel is closed by a vessel top, the lateral wall assembly comprising an outer wall and an inner wall having opposing surfaces that define a thermal break including a condensable vapor pocket to inhibit heat transfer through the lateral wall from the guard vessel to the test vessel. A warm boundary temperature surface is in thermal communication with a lower surface of the test specimen.

  19. Bridging the gap between clinical failure and laboratory fracture strength tests using a fractographic approach

    NARCIS (Netherlands)

    Aboushelib, M.N.; Feilzer, A.J.; Kleverlaan, C.J.

    2009-01-01

    Objective: The aim of this study was to analyze and to compare the fracture type and the stress at failure of clinically fractured zirconia-based all ceramic restorations with that of morphologically similar replicas tested in a laboratory setup. Methods: Replicas of the same shape and dimensions we

  20. Bridging the gap between clinical failure and laboratory fracture strength tests using a fractographic approach

    NARCIS (Netherlands)

    Aboushelib, M.N.; Feilzer, A.J.; Kleverlaan, C.J.

    2009-01-01

    Objective: The aim of this study was to analyze and to compare the fracture type and the stress at failure of clinically fractured zirconia-based all ceramic restorations with that of morphologically similar replicas tested in a laboratory setup. Methods: Replicas of the same shape and dimensions

  1. New model for well test analysis in a purely fractured medium

    Energy Technology Data Exchange (ETDEWEB)

    Karasaki, K.; Long, J.C.S.; Witherspoon, P.A.

    1985-01-01

    In a porous medium the flow conduits are small and a large number of conduits are connected to the well. For this reason the medium appears to behave like a continuum on the scale of the well test, and volumetric averaging and continuum approximations are justified. On the contrary, in a fractured medium, only a small number of fractures may intersect the pumping well. These particular fractures will be stressed by a large gradient under well test conditions. Consequently, the early time behavior will be dominated by these fractures. The volumetrically averaged permeability does not control flow in the vicinity of an active well. The individual fractures close to the well must be characterized in order to understand the well test behavior especially if the hydraulic parameters of these fractures are significantly different from the average values for the entire system. In the present study, a new analytical model is proposed for well test problems in fracture networks where the matrix is impermeable. The model accounts for the difference in the flow regime around the active well from that of the system as a whole. The analytical solutions are presented in a series of type curves for ranges of dimensionless parameters. The flow properties of the fracture system can be determined by curve matching.

  2. Use of a condylar screw plate for repair of a Salter-Harris type-III fracture of the femur in a 2-year-old horse.

    Science.gov (United States)

    Byron, Christopher R; Stick, John A; Brown, Jennifer A; Lugo, Joel

    2002-11-01

    A 2-year-old sexually intact male Paint horse weighing 427 kg (940 lb) was admitted for examination and treatment of intermittent non-weight-bearing lameness of the right hind limb of 1 week's duration. Radiography revealed a displaced Salter-Harris type-III fracture of the right femoral condyle with the sagittal component of the fracture line located in the intercondylar space and the transverse component exiting on the medial aspect of the femur. The fracture was repaired with a condylar screw plate designed for repair of femoral condylar fractures in humans. The owner reported by telephone 9 months after surgery that the horse was sound. To our knowledge, use of this particular implant system for fixation of a Salter-Harris type-III fracture on the medial side of the femur in a horse has not been described. Results in this horse suggest that this implant can be successfully used for repair of femoral condylar fractures in selected adult horses.

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

    Directory of Open Access Journals (Sweden)

    CK Chan

    2013-07-01

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

  4. The Anterior Intrapelvic Approach for Acetabular Fractures Using Approach-Specific Instruments and an Anatomical-Preshaped 3-Dimensional Suprapectineal Plate.

    Science.gov (United States)

    Gras, Florian; Marintschev, Ivan; Grossterlinden, Lars; Rossmann, Markus; Graul, Isabel; Hofmann, Gunther O; Rueger, Johannes M; Lehmann, Wolfgang

    2017-07-01

    Anatomical acetabular plates the anterior intrapelvic approach (AIP) were recently introduced to fix acetabular fractures through the intrapelvic approach. Therefore, we asked the following: (1) Does the preshaped 3-dimensional suprapectineal plate interfere with or even impair the fracture reduction quality? (2) How often does the AIP approach need to be extended by the first (lateral) window of the ilioinguinal approach? Observational case series. Two Level 1 trauma centers. Patients with unstable acetabular fractures in 2014. Fracture fixation with anatomical-preshaped, 3-dimensional suprapectineal plates through the AIP approach ± the first window of the ilioinguinal approach. Fracture reduction results were measured in computed tomography scans and graded according to the Matta quality of reduction. Intraoperative parameters and perioperative complications were recorded. Radiological results (according to Matta) and functional outcome (modified Merle d'Aubigné score) were evaluated at 1-year follow-up. Thirty patients (9 women + 21 men; mean age ± SE: 64 ± 8 years) were included. The intrapelvic approach was solely used in 19 cases, and in 11 cases, an additional extension with the first window of the ilioinguinal approach (preferential for 2-column fractures) was performed. The mean operating time was 202 ± 59 minutes; the fluoroscopic time was 66 ± 48 seconds. Fracture gaps and steps in preoperative versus postoperative computed tomography scans were 12.4 ± 9.8 versus 2.0 ± 1.5 and 6.0 ± 5.5 versus 1.3 ± 1.7 mm, respectively. At 13.4 ± 2.9 months follow-up, the Matta grading was excellent in 50%, good in 25%, fair in 11%, and poor in 14% of cases. The modified Merle d'Aubigné score was excellent in 17%, good in 37%, fair in 33%, and poor in 13% of cases. The AIP approach using approach-specific instruments and an anatomical-preshaped, 3-dimensional suprapectineal plate became the standard procedure in our departments. Radiological and functional

  5. Acute unstable complex radial head and neck fractures fixed with a mini T-shaped plate in a 20-year-old man: a case report

    Directory of Open Access Journals (Sweden)

    Yu W

    2016-05-01

    Full Text Available Weiguang Yu,1,* Jun Hu,1,* Xinchao Zhang,2 Xingfei Zhu,2 Yinfeng Xu,1 Jianhua Yi,1 Yunjiang Liu1 1Department of Orthopedics, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, 2Department of Orthopedics, Jinshan Hospital, Fudan University, Shanghai, People’s Republic of China *These authors contributed equally to this work Abstract: Acute unstable complex radial head and neck fractures in adults are seldom reported in the literature. Early recognition and appropriate management are essential to prevent long-term consequences of the loss of elbow function, forearm rotation, and chronic pain. Here, we describe an unusual case of a 20-year-old man who exhibited acute unstable complex fractures of the head and neck of the right radius without other injuries or comorbidity. An open reduction and mini T-shaped plate fixation were performed within 3 hours after injury, and the results were satisfactory. A long plaster fixation was continued for 3 weeks. A gradual mobilization was started after the removal of the plaster under the supervision of a physiotherapist. At the 12-month follow-up, no complications associated with the use of the mini T-shaped plate were noted, and the Mayo Elbow Performance Score was 97 (excellent. To our knowledge, acute unstable complex radial head and neck fractures in adults can be successfully treated with a mini T-shaped plate reconstruction technique. Keywords: unstable complex fractures, mini T-shaped plate, radial head, internal fixation, radial head replacement

  6. Comparative evaluation of Rose Bengal plate agglutination test, mallein test, and some conventional serological tests for diagnosis of equine glanders.

    Science.gov (United States)

    Naureen, Abeera; Saqib, Muhammad; Muhammad, Ghulan; Hussain, Muhammad H; Asi, Muhammad N

    2007-07-01

    The Rose Bengal plate agglutination test (RBT) was evaluated for the diagnosis of equine glanders, and its diagnostic efficiency was compared with that of mallein and other serological tests, including indirect hemagglutination test (IHAT), complement fixation test (CFT), and modified counter immunoelectrophoresis test (mCIET). Sera from 70 naturally infected culture-positive, 96 potentially exposed cohorts, and 110 healthy equines were tested. All tests but mCIET showed 100% specificity when testing the sera from glanders-negative equines. The calculated sensitivities of RBT, IHAT, CFT, mCIET, and mallein test when testing culture-positive equines were 90.0, 97.1, 91.4, 81.4, and 75.7%, respectively. The RBT was significantly (P glandered and nonglandered animals, the highest agreement (0.987) was found between RBT and CFT followed by RBT and IHAT (0.940), RBT and mallein test (0.871), and RBT and mCIET (0.852). Because the RBT is simpler and rapid to perform, the inclusion of the test as a supplementary test for the diagnosis of glanders in field conditions is recommended.

  7. Computational modelling of long bone fractures fixed with locking plates - How can the risk of implant failure be reduced?

    LENUS (Irish Health Repository)

    Nassiri, M

    2013-03-01

    The Locking Compression Plate (LCP) is part of a new plate generation requiring an adapted surgical technique and new thinking about commonly used concepts of internal fixation using plates. Knowledge of the fixation stability provided by these new plates is very limited and clarification is still necessary to determine how the mechanical stability and the risk of implant failure can best be controlled.

  8. Development of nondestructive testing techniques for plated-through holes in multilayer printed circuit boards

    Science.gov (United States)

    Anthony, P. L.; Mcmurtrey, J. E.

    1971-01-01

    The development of a nondestructive test with the capability to interrogate plated-through holes as small as 0.51 millimeters inside diameter is discussed. The system can detect defects such as holes, voids, cracks, and thin spots that reduce the current carrying capability of plates-through interconnects by 20 percent or more. Efforts were directed toward the design and fabrication of magnetic circuitry mutual coupling probes and to evaluate the effectiveness of these devices for detecting in multilayer board plated-through holes.

  9. Analysis of Orbital Volume Measurements Following Reduction and Internal Fixation Using Absorbable Mesh Plates and Screws for Patients With Orbital Floor Blowout Fractures.

    Science.gov (United States)

    Hwang, Won Joo; Lee, Do Heon; Choi, Won; Hwang, Jae Ha; Kim, Kwang Seog; Lee, Sam Yong

    2017-08-22

    Hinge-shaped fractures are common type of orbital floor blowout fractures, for which reduction and internal fixation is ideal. Nonetheless, orbital floor reconstruction using alloplastic materials without reducing the number of bone fragments is the most frequently used procedure. Therefore, this study analyzed and compared the outcomes between open reduction and internal fixation using absorbable mesh plates and screws, and orbital floor reconstruction, by measuring the orbital volume before and after surgery. Among patients with orbital floor blowout fractures, this study was conducted on 28 patients who underwent open reduction and internal fixation, and 27 patients who underwent orbital floor reconstruction from December 2008 to September 2015. The mechanism of injury, ophthalmic symptoms before and after surgery, and the degree of enophthalmos were examined; subsequently, the volumes of the affected and unaffected sides were measured before and after surgery based on computed tomography images. This study compared the degree of recovery in the correction rate of the orbital volume, ophthalmic symptoms, and enophthalmos between the 2 groups. The patients who underwent open reduction and internal fixation, and the patients who underwent orbital floor reconstruction showed average correction rates of 100.36% and 105.24%, respectively. Open reduction and internal fixation showed statistically, significantly superior treatment outcomes compared with orbital floor reconstruction. The ophthalmic symptoms and incidence of enophthalmos completely resolved in both groups. For orbital floor blowout fractures, open reduction and internal fixation using absorbable mesh plates and screws was a feasible alternative to orbital floor reconstruction.

  10. A CLINICAL STUDY OF PROXIMAL FEMUR LOCKING COMPRESSION PLATE (LCP - PF IN THE MANAGEMENT OF COMMUNITED INTERTROCHANTERIC AND SUBTROCHANTERIC FRACTURES OF THE FEMUR

    Directory of Open Access Journals (Sweden)

    Hari Babu

    2015-10-01

    Full Text Available Fractures of proximal femur and hip are relatively common injuries in elderly individuals . The incidence of peritrochanteric and intertrochanteric fracture is also increasing among young population, who sustain high energy trauma Rigid Internal fixation and early mobilization has been the standard method of treatment. A combination of orthopaedic surgery and early postoperative physiotherapy and ambulation is the best approach. The overall goal in the treatment of hip fractures is to return the patient to pre - morbid level of function. AIMS & OBJECTIVE : To analyse the anatomical and f unctional outcome of the treatment with LCP - Proximal femur. METHODOLOGY : The present study consists of 12 adult patients of peritrochanteric factures of femur satisfying the inclusion criteria , treated with Proximal Femoral Locking Compression Plate at S. V. R. R . Govt . General Hospital, Tirupati during the period of nov 2013 to Oct 2015. INCLUSION CRITERIA : Age >18years , comminuted trochanteric and sub trochanteric fractures , Signed written informed consent . EXCLUSION CRITERIA: Inter trochanteric fractures involving piriformis fossa , Compound fractures . Pathological fractures . Any displacement of a femoral neck fracture . A ssociated malignancy. RESULTS : Average age incidence in the present study was 62.7 years. , Predominantly males (75% were affected. , Most cases occurred after a fall 10 (50% cases which was statistically significant , Right side involvement was more common. , Average post - operative stay was 13.5 days. , Out of the 12 cases, evaluated using Salvati - Wilson scoring : 3 cases (25% had good, 8 cases (66.67% fair, 1 case (8.33% had poor score , Average weight bearing time was14.5 weeks , Average union rate was 19.45 weeks.

  11. Evaluation of susceptibility of high strength steels to delayed fracture by using cyclic corrosion test and slow strain rate test

    Energy Technology Data Exchange (ETDEWEB)

    Li Songjie [School of Materials Science and Engineering, University of Science and Technology Beijing, No. 30 Xueyuan Road, Hidian Zone, Beijing 100083 (China); Structural Metals Center, National Institute for Materials Science, 1-2-1 Sengen, Tsukuba, Ibaraki 305-0047 (Japan); Zhang Zuogui [Structural Metals Center, National Institute for Materials Science, 1-2-1 Sengen, Tsukuba, Ibaraki 305-0047 (Japan); Akiyama, Eiji [Structural Metals Center, National Institute for Materials Science, 1-2-1 Sengen, Tsukuba, Ibaraki 305-0047 (Japan)], E-mail: AKIYAMA.Eiji@nims.go.jp; Tsuzaki, Kaneaki [Structural Metals Center, National Institute for Materials Science, 1-2-1 Sengen, Tsukuba, Ibaraki 305-0047 (Japan); Zhang Boping [School of Materials Science and Engineering, University of Science and Technology Beijing, No. 30 Xueyuan Road, Hidian Zone, Beijing 100083 (China)

    2010-05-15

    To evaluate susceptibilities of high strength steels to delayed fracture, slow strain rate tests (SSRT) of notched bar specimens of AISI 4135 with tensile strengths of 1300 and 1500 MPa and boron-bearing steel with 1300 MPa have been performed after cyclic corrosion test (CCT). During SSRT the humidity around the specimen was kept high to keep absorbed diffusible hydrogen. The fracture stresses of AISI 4135 steels decreased with increment of diffusible hydrogen content which increased with CCT cycles. Their delayed fracture susceptibilities could be successfully evaluated in consideration of both influence of hydrogen content on mechanical property and hydrogen entry.

  12. Assembly and tests of Resistive Plate Chambers (RPC) for the CMS barrel detector

    CERN Multimedia

    Gabriella Pugliese, Bari

    2006-01-01

    The pictures 1-3 show some assembly steps of Resistive Plate Chambers in Bari and their tests with cosmic rays (4-6: moving RPC to the test towers; 7-8 cosmic tests). Pictures 9-10 show assembly and tests in Sofia, 11 shows RPC coupling with drift tubes at ISR and 12-13 tests at the CMS site at CERN.

  13. Progress on treatment and research of quadrilateral plate fractures of acetabular%髋臼方形区骨折的治疗及研究进展

    Institute of Scientific and Technical Information of China (English)

    彭烨; 张立海; 唐佩福

    2015-01-01

    Acetabular is an important human joint for weight bearing. Quadrilateral plate is a crucial structure of medial acetabulum with special morphology and important function. Quadrilateral plate fractures are common fracture in acetabulum. Quadrilateral plate fracture is hard to expose and reduction because it is in the medial of acetabulum. At the same time ,the bone in the quadrilateral plate is not easy to fixed for thinning bones and adjacent to the articular cavity. The operator should know well about the anatomy and choose the suitable internal fixation. After quadrilateral plate fractures ,the femur head may⁃be displace medially even break into pelvis. That make reduction and treatment always be a challenge. With different kinds of fractures,the efficacy of treatment is not the same. This paper intend to review the relation of anatomic features,approaches, internal fixations,key point of treatment and efficacy.%髋臼是人体的重要承重关节,髋臼方形区是髋臼内侧壁的重要结构,具有特殊的形态结构和重要功能。方形区骨折是髋臼骨折中常遇到的骨折,由于髋臼方形区处于骨盆内侧,所以手术中的显露及复位十分困难。同时,髋臼方形区骨质较薄较难固定,外侧有髋关节,选择合适的内固定和对相关解剖的了解十分重要。方形区骨折后,股骨头容易向内侧移位,甚至突入盆腔造成嵌顿,其复位和治疗一直是骨科中的难点。对于方形区骨折不同的治疗方法,其疗效也不一。本文就方形区的解剖学特点、手术入路选择、内固定治疗方式、治疗要点和疗效等做一综述。

  14. Finite element analysis and fracture resistance testing of a new intraradicular post

    Directory of Open Access Journals (Sweden)

    Eron Toshio Colauto Yamamoto

    2012-08-01

    Full Text Available OBJECTIVES: The objective of the present study was to evaluate a prefabricated intraradicular threaded pure titanium post, designed and developed at the São José dos Campos School of Dentistry - UNESP, Brazil. This new post was designed to minimize stresses observed with prefabricated post systems and to improve cost-benefits. MATERIAL AND METHODS: Fracture resistance testing of the post/core/root complex, fracture analysis by microscopy and stress analysis by the finite element method were used for post evaluation. The following four prefabricated metal post systems were analyzed: group 1, experimental post; group 2, modification of the experimental post; group 3, Flexi Post, and group 4, Para Post. For the analysis of fracture resistance, 40 bovine teeth were randomly assigned to the four groups (n=10 and used for the fabrication of test specimens simulating the situation in the mouth. The test specimens were subjected to compressive strength testing until fracture in an EMIC universal testing machine. After fracture of the test specimens, their roots were sectioned and analyzed by microscopy. For the finite element method, specimens of the fracture resistance test were simulated by computer modeling to determine the stress distribution pattern in the post systems studied. RESULTS: The fracture test presented the following averages and standard deviation: G1 (45.63±8.77, G2 (49.98±7.08, G3 (43.84±5.52, G4 (47.61±7.23. Stress was homogenously distributed along the body of the intraradicular post in group 1, whereas high stress concentrations in certain regions were observed in the other groups. These stress concentrations in the body of the post induced the same stress concentration in root dentin. CONCLUSIONS: The experimental post (original and modified versions presented similar fracture resistance and better results in the stress analysis when compared with the commercial post systems tested (08/2008-PA/CEP.

  15. Hydrogen Embrittlement - Loading Rate Effects in Fracture Mechanics Testing

    NARCIS (Netherlands)

    Koers, R.W.J.; Krom, A.H.M.; Bakker, A.

    2001-01-01

    The fitness for purpose methodology is more and more used in the oil and gas industry to evaluate the significance of pre-existing flaws and material deficiencies with regard to the suitability of continued operation of equipment. In this methodology, traditional fracture mechanics is integrated wit

  16. Minimum fatigue pre-crack extension for fracture testing

    NARCIS (Netherlands)

    Walters, C.L.; Voormeeren, L.O.

    2013-01-01

    The minimum pre-crack necessary to achieve an accurate measurement of the J-integral is examined with the use of elastic-plastic finite element analysis. This minimum pre-crack is shorter than what is specified in fracture codes ASTM E1820 and BS 7448. A variety of steel properties are considered, b

  17. Thyroid function tests in the reference range and fracture

    DEFF Research Database (Denmark)

    Aubert, Carole E.; Floriani, Carmen; Bauer, Douglas C.

    2017-01-01

    as study-specific standard deviation increase, because assays varied between cohorts. Results: During 659,059 person-years, 2,565/56,835 participants had hip fracture (4.5%; 12 studies with data on hip fracture). The pooled adjusted HR (95% CI) for hip fracture was 1.25 (1.05-1.49) for TSH 0.45-0.99m......IU/L, 1.19 (1.01-1.41) for TSH 1.00-1.49mIU/L, 1.09 (0.93-1.28) for TSH 1.50-2.49mIU/L, and 1.12 (0.94-1.33) for TSH 2.50-3.49mIU/L (P for trend = 0.004). Hip fracture was also associated with FT4 (HR [95%CI] 1.22 [1.11-1.35] per one standard deviation increase in FT4). FT4 only was associated with any...

  18. Measuring the initial earth pressure of granite using hydraulic fracturing test; Goseong and Yuseong areas

    Energy Technology Data Exchange (ETDEWEB)

    Park, Byoung Yoon; Bae, Dae Seok; Kim, Chun Soo; Kim, Kyung Su; Koh, Young Kwon; Won, Kyung Sik [Korea Atomic Energy Research Institute, Taejeon (Korea)

    2002-02-01

    This report provides the initial earth pressure of granitic rocks obtained from Deep Core Drilling Program which is carried out as part of the assessment of deep geological environmental condition. These data are obtained by hydraulic fracturing test in three boreholes drilled up to 350{approx}500 m depth at the Yuseong and Goseong sites. These sites were selected based on the result of preliminary site evaluation study. The boreholes are NX-size (76 mm) and vertical. The procedure of hydraulic fracturing test is as follows: - Selecting the testing positions by preliminary investigation using BHTV logging. - Performing the hydraulic fracturing test at each selected position with depth.- Estimating the shut-in pressure by the bilinear pressure-decay-rate method. - Estimating the fracture reopening pressure from the pressure-time curves.- Estimating the horizontal principal stresses and the direction of principal stresses. 65 refs., 39 figs., 12 tabs. (Author)

  19. Factors with independent influence on the 'timed up and go' test in patients with hip fracture

    DEFF Research Database (Denmark)

    Kristensen, Morten Tange; Foss, Nicolai Bang; Kehlet, Henrik

    2009-01-01

    be used as references, to which individuals can expect to perform. Multivariate testing suggests that clinicians should use age, pre-fracture function, fracture type and walking-aid specific data when interpreting the TUG test results. Physiotherapists should be aware of this if TUG scores are to be used......BACKGROUND AND PURPOSE: Data on performance times for the 'timed up and go' (TUG) test with analyses of factors, that eventually could affect the result in patients with hip fracture, have not been published to date. The aims of the present study, therefore, were to assess normative reference...... values of TUG performances and determine the influence of individual and clinical factors on TUG-test scores in patients with hip fracture. METHOD: In this prospective, descriptive study, a total of 196 consecutive patients over the age of 60, and able to perform the TUG when discharged directly...

  20. Planning and Analysis of Fractured Rock Injection Tests in the Cerro Brillador Underground Laboratory, Northern Chile

    Science.gov (United States)

    Fairley, J. P., Jr.; Oyarzún L, R.; Villegas, G.

    2015-12-01

    Early theories of fluid migration in unsaturated fractured rock hypothesized that matrix suction would dominate flow up to the point of matrix saturation. However, experiments in underground laboratories such as the ESF (Yucca Mountain, NV) have demonstrated that liquid water can migrate significant distances through fractures in an unsaturated porous medium, suggesting limited interaction between fractures and unsaturated matrix blocks and potentially rapid transmission of recharge to the sat- urated zone. Determining the conditions under which this rapid recharge may take place is an important factor in understanding deep percolation processes in arid areas with thick unsaturated zones. As part of an on-going, Fondecyt-funded project (award 11150587) to study mountain block hydrological processes in arid regions, we are plan- ning a series of in-situ fracture flow injection tests in the Cerro Brillador/Mina Escuela, an underground laboratory and teaching facility belonging to the Universidad la Serena, Chile. Planning for the tests is based on an analytical model and curve-matching method, originally developed to evaluate data from injection tests at Yucca Mountain (Fairley, J.P., 2010, WRR 46:W08542), that uses a known rate of liquid injection to a fracture (for example, from a packed-off section of borehole) and the observed rate of seepage discharging from the fracture to estimate effective fracture aperture, matrix sorptivity, fracture/matrix flow partitioning, and the wetted fracture/matrix interac- tion area between the injection and recovery points. We briefly review the analytical approach and its application to test planning and analysis, and describe the proposed tests and their goals.

  1. Value of routine blood tests for prediction of mortality risk in hip fracture patients

    DEFF Research Database (Denmark)

    Mosfeldt, Mathias; Pedersen, Ole B; Riis, Troels

    2012-01-01

    There is a 5- to 8-fold increased risk of mortality during the first 3 months after a hip fracture. Several risk factors are known. We studied the predictive value (for mortality) of routine blood tests taken on admission.......There is a 5- to 8-fold increased risk of mortality during the first 3 months after a hip fracture. Several risk factors are known. We studied the predictive value (for mortality) of routine blood tests taken on admission....

  2. A reciprocating pin-on-plate test-rig for studying friction materials for holding brakes

    DEFF Research Database (Denmark)

    Poulios, Konstantinos; Drago, Nicola; Klit, Peder

    2014-01-01

    -on-plate test-rig for studying the evolution of wear by monitoring the pin height reduction using Eddy-current proximity sensors is presented. Moreover, a new mechanism for recording the friction force is suggested. Apart from the design of the test-rig, friction force and wear rate measurements for two...

  3. 肱骨远端C型骨折三种双钢板固定方法疗效比较%Comparative study on curative effect of internal fixations with three dual plates for type C fractures of distal humerus

    Institute of Scientific and Technical Information of China (English)

    陶然; 徐华; 王友华; 曹毅; 周振宇; 陆跃; 刘璠

    2013-01-01

    目的 比较肱骨远端C型骨折的三种双钢板固定方法. 方法 选择2004年1月-2008年12月收治的59例肱骨远端C型骨折患者,均采用双钢板固定.其中垂直双钢板固定34例(A组),背侧双钢板固定14例(B组),平行双钢板固定11例(C组).采用Mayo的肘关节评分系统(MEPS)对患侧肘关节进行功能评分.三组围术期的变量用方差分析、x2检验及Fish-er确切概率法进行比较. 结果 平均随访时间28个月(12 ~55个月).所有骨折均顺利愈合,各组疗效均较满意.三组功能结果差异无统计学意义,C组中固定有难度的患者比例明显高于其他两组.A组和B组中常需要1枚额外的髁间螺钉,但在C组中很少需要. 结论 三种双钢板固定均为治疗肱骨远端C型骨折的有效方法,钢板位置的放置常取决于临床骨科医师的经验及骨折的具体形态.%Objective To compare three different internal fixations using dual plates in treatment of type C distal humerus fractures.Methods A total of 59 patients with type C distal humerus fractures fixed with dual plates between January 2004 and December 2008 were enrolled in the study,including 34 patients managed by perpendicular dual plate internal fixation (Group A),14 patients by dorsal dual plate internal fixation (Group B),and 11 patients by parallel dual plate internal fixation (Group C).Functional outcomes of injured elbow joints were assessed using Mayo elbow performance score (MEPS).Fisher' s exact probability,chi-square test and variance analysis were used to compare the perioperative variables among groups.Results The patients were followed up for average 28 months (range,12-55 months),which showed that all fractures were smoothly healed with satisfactory curative effects in each group.There were no significant differences with respect to functional outcomes among three groups.The patients with surgery difficulty in Group C were more than those in other two groups.Besides,an additional

  4. On some principal features of data processing of spall fracture tests

    Science.gov (United States)

    Volkov, G. A.; Petrov, Yu. V.; Utkin, A. A.

    2017-02-01

    A method for processing the results of dynamic spall fracture tests, based on the exact solution of the wave equation, and its commonly used simplified version based on the assumed unique relation between the free surface velocity drop and the ultimate medium fracture stress, are analyzed. Using the considered exact solutions of the wave technique, tensile stress pulses during spalling are determined. The obtained stress levels at the fracture point are compared with the spall strength calculated by the velocity drop technique. The cases of agreement and disagreement of the results obtained using both techniques are shown. By the example of differently shaped loading pulses, possible scenarios of sample fracture are presented, in particular, the probability of the fracture delay effect is shown, which can be lost in the simplified processing method.

  5. Extremely Low-Stress Triaxiality Tests in Calibration of Fracture Models in Metal-Cutting Simulation

    Science.gov (United States)

    Šebek, František; Kubík, Petr; Petruška, Jindřich; Hůlka, Jiří

    2016-11-01

    The cutting process is now combined with machining, milling, or drilling as one of the widespread manufacturing operations. It is used across various fields of engineering. From an economical point of view, it is desirable to maintain the process in the most effective way in terms of the fracture surface quality or minimizing the burr. It is not possible to manage this experimentally in mass production. Therefore, it is convenient to use numerical computation. To include the crack initiation and propagation in the computations, it is necessary to implement a suitable ductile fracture criterion. Uncoupled ductile fracture models need to be calibrated first from fracture tests when the test selection is crucial. In the present article, there were selected widespread uncoupled ductile fracture models calibrated with, among others, an extremely low-stress triaxiality test realized through the compression of a cylinder with a specific recess. The whole experimental program together with the cutting process experiment were carried out on AISI 1045 carbon steel. After the fracture models were calibrated and the cutting process was simulated with their use, fracture surfaces and force responses from computations were compared with those experimentally obtained and concluding remarks were made.

  6. Numerical Modelling of Extended Leak-Off Test with a Pre-Existing Fracture

    Science.gov (United States)

    Lavrov, A.; Larsen, I.; Bauer, A.

    2016-04-01

    Extended leak-off test (XLOT) is one of the few techniques available for stress measurements in oil and gas wells. Interpretation of the test is often difficult since the results depend on a multitude of factors, including the presence of natural or drilling-induced fractures in the near-well area. Coupled numerical modelling of XLOT has been performed to investigate the pressure behaviour during the flowback phase as well as the effect of a pre-existing fracture on the test results in a low-permeability formation. Essential features of XLOT known from field measurements are captured by the model, including the saw-tooth shape of the pressure vs injected volume curve, and the change of slope in the pressure vs time curve during flowback used by operators as an indicator of the bottomhole pressure reaching the minimum in situ stress. Simulations with a pre-existing fracture running from the borehole wall in the radial direction have revealed that the results of XLOT are quite sensitive to the orientation of the pre-existing fracture. In particular, the fracture initiation pressure and the formation breakdown pressure increase steadily with decreasing angle between the fracture and the minimum in situ stress. Our findings seem to invalidate the use of the fracture initiation pressure and the formation breakdown pressure for stress measurements or rock strength evaluation purposes.

  7. Functions for patch test in finite element analysis of the Mindlin plate and the thin cylindrical shell

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    Current patch test for Mindlin plate element only satisfies the zero shear deformation condition.The patch test of non-zero constant shear for Mindlin plate problem cannot be performed.For shell element, the patch test does not even exist.Based on the theory of enhanced patch test proposed by Chen W J (2006),the authors proposed the enhanced patch test function for Mindlin plate and thin cylindrical shell elements.This enhanced patch test function can be used to assess the convergence of the Mindlin plate and cylindrical thin shell elements.

  8. Double plate in treatment of comminuted fracture of tibial plateau%双钢板治疗胫骨平台粉碎性骨折

    Institute of Scientific and Technical Information of China (English)

    梁强; 叶文胜; 杨华

    2012-01-01

    目的 探讨双钢板内固定治疗胫骨平台粉碎性骨折的临床效果.方法 分析32例采用双钢板内固定加植骨治疗胫骨平台粉碎性骨折,内侧用小的直钢板,外侧用"高尔夫"钢板,辅以植骨,术后早期膝关节功能锻炼.结果 所有病例均骨性愈合,有3例出现外侧平台再次塌陷,有2例出现切口渗液,经对症治疗后,Ⅱ期愈合.参照Lysholmy评分标准,优良率达90.6%.结论 双钢板治疗胫骨平台粉碎性骨折是一种较为确切的临床治疗方法.%Objective To explore the double plate by fixation of tibial plateau comminuted fracture. Methods All 32 cases of double steel plate fixation and bone graft in the treatment of the tibial plateau comminuted fracture were analysed, with small straight plate applied in medial, " Golf" steel in lateral, supplemented with bone grafting, and early postoperative knee function exercise. Results All cases were healed, of which 3 cases appeared outside platform to collapse, 2 cases were with incisional drainage after symptomatic therapy, which healed in two phases. According to Lysholmy standard, the excellent and good rate was 90. 6% . Conclusion Double plate in treatment of comminuted fracture of tibia plateau is a more precise clinical treatment method.

  9. Comparative study of fracture appearance in crack tip opening angle testing of gas pipeline steels

    Energy Technology Data Exchange (ETDEWEB)

    Hashemi, S.H., E-mail: shhashemi@birjand.ac.ir [Department of Mechanical Engineering, The University of Birjand, PO Box 97175-376, Birjand (Iran, Islamic Republic of)

    2012-12-15

    The crack tip opening angle (CTOA) experiments were conducted on API X65, X70, X80 and X100 steels using a modified double cantilever beam (MDCB) geometry. The fracture surfaces of the test specimens were examined after fracture tests by optical and scanning electron microscopy. The fracture surfaces of the lower grade X65 and X70 steels had fully ductile features including classic flat and slant fracture characteristics. However, repetitive propagation and arrest of quasi-cleavage in the form of chevron arrow-head fractures was observed on the fracture surfaces of higher grade X80 and X100 steels. Interestingly, the analysis of load-displacement records from the latter steels demonstrated local ragged patterns after the test peak load, associated with the repetitive low energy quasi-cleavage mechanism. Detailed discussion on the micro-fractographs of the tested steels and comparison of the test observations with the only newly published work in this filed conclude the paper.

  10. Testing Novel CR-39 Detector Deployment System For Identification of Subsurface Fractures, Soda Springs, ID

    Energy Technology Data Exchange (ETDEWEB)

    McLing, Travis [Idaho National Lab. (INL), Idaho Falls, ID (United States); Carpenter, Michael [Idaho National Lab. (INL), Idaho Falls, ID (United States); Brandon, William [Idaho National Lab. (INL), Idaho Falls, ID (United States); Zavala, Bernie [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-06-01

    The Environmental Protection Agency (EPA) has teamed with Battelle Energy Alliance, LLC (BEA) at Idaho National Laboratory (INL) to facilitate further testing of geologic-fracture-identification methodology at a field site near the Monsanto Superfund Site located in Soda Springs, Idaho. INL has the necessary testing and technological expertise to perform this work. Battelle Memorial Institute (BMI) has engaged INL to perform this work through a Work for Others (WFO) Agreement. This study continues a multi-year collaborative effort between INL and EPA to test the efficacy of using field deployed Cr-39 radon in soil portals. This research enables identification of active fractures capable of transporting contaminants at sites where fractures are suspected pathways into the subsurface. Current state of the art methods for mapping fracture networks are exceedingly expensive and notoriously inaccurate. The proposed WFO will evaluate the applicability of using cheap, readily available, passive radon detectors to identify conductive geologic structures (i.e. fractures, and fracture networks) in the subsurface that control the transport of contaminants at fracture-dominated sites. The proposed WFO utilizes proven off-the-shelf technology in the form of CR-39 radon detectors, which have been widely deployed to detect radon levels in homes and businesses. In an existing collaborative EPA/INL study outside of this workscope,. CR-39 detectors are being utilized to determine the location of active transport fractures in a fractured granitic upland adjacent to a landfill site at the Fort Devens, MA that EPA-designated as National Priorities List (NPL) site. The innovative concept of using an easily deployed port that allows the CR-39 to measure the Rn-222 in the soil or alluvium above the fractured rock, while restricting atmospheric Rn-222 and soil sourced Ra from contaminating the detector is unique to INL and EPA approach previously developed. By deploying a series of these

  11. Innovative design of composite structures: Design, manufacturing, and testing of plates utilizing curvilinear fiber trajectories

    Science.gov (United States)

    Hyer, M. W.; Rust, R. J.; Waters, W. A., Jr.

    1994-01-01

    As a means of improving structural design, the concept of fabricating flat plates containing holes by incorporating curvilinear fiber trajectories to transmit loads around the hole is studied. In the present discussion this concept is viewed from a structural level, where access holes, windows, doors, and other openings are of significant size. This is opposed to holes sized for mechanical fasteners. Instead of cutting the important load-bearing fibers at the hole edge, as a conventional straightline design does, the curvilinear design preserves the load-bearing fibers by orienting them in smooth trajectories around the holes, their loading not ending abruptly at the hole edge. Though the concept of curvilinear fiber trajectories has been studied before, attempts to manufacture and test such plates have been limited. This report describes a cooperative effort between Cincinnati Milacron Inc., NASA Langley Research Center, and Virginia Polytechnic Institute and State University to design, manufacture, and test plates using the curvilinear fiber trajectory concept. The paper discusses details of the plate design, details of the manufacturing, and a summary of results from testing the plates with inplane compressive buckling loads and tensile loads. Comparisons between the curvilinear and conventional straightline fiber designs based on measurements and observation are made. Failure modes, failure loads, strains, deflections, and other key responses are compared.

  12. Modeling Single Well Injection-Withdrawal (SWIW) Tests for Characterization of Complex Fracture-Matrix Systems

    Energy Technology Data Exchange (ETDEWEB)

    Cotte, F.P.; Doughty, C.; Birkholzer, J.

    2010-11-01

    The ability to reliably predict flow and transport in fractured porous rock is an essential condition for performance evaluation of geologic (underground) nuclear waste repositories. In this report, a suite of programs (TRIPOLY code) for calculating and analyzing flow and transport in two-dimensional fracture-matrix systems is used to model single-well injection-withdrawal (SWIW) tracer tests. The SWIW test, a tracer test using one well, is proposed as a useful means of collecting data for site characterization, as well as estimating parameters relevant to tracer diffusion and sorption. After some specific code adaptations, we numerically generated a complex fracture-matrix system for computation of steady-state flow and tracer advection and dispersion in the fracture network, along with solute exchange processes between the fractures and the porous matrix. We then conducted simulations for a hypothetical but workable SWIW test design and completed parameter sensitivity studies on three physical parameters of the rock matrix - namely porosity, diffusion coefficient, and retardation coefficient - in order to investigate their impact on the fracture-matrix solute exchange process. Hydraulic fracturing, or hydrofracking, is also modeled in this study, in two different ways: (1) by increasing the hydraulic aperture for flow in existing fractures and (2) by adding a new set of fractures to the field. The results of all these different tests are analyzed by studying the population of matrix blocks, the tracer spatial distribution, and the breakthrough curves (BTCs) obtained, while performing mass-balance checks and being careful to avoid some numerical mistakes that could occur. This study clearly demonstrates the importance of matrix effects in the solute transport process, with the sensitivity studies illustrating the increased importance of the matrix in providing a retardation mechanism for radionuclides as matrix porosity, diffusion coefficient, or retardation

  13. Apparent fracture toughness of acrylic bone cement: effect of test specimen configuration and sterilization method.

    Science.gov (United States)

    Lewis, G

    1999-01-01

    The plane strain fracture toughness of Palacos R bone cement was determined using linear elastic fracture mechanics (LEFM) principles and three different test specimen configurations: single edge notched three-point (SENB), rectangular compact tension (RCT), and chevron notched short rod (CNSR). Another aspect of the study was an investigation of the effect of three methods used to sterilize the powder constituents of the cement-none, gamma irradiation and ethylene oxide--on the fracture toughness of the fully polymerized material. A detailed justification is provided for using LEFM. The fracture toughness results obtained using the CNSR specimens were, on average, 14 and 16% higher than those obtained using the SENB and RCT types, respectively. These differences are accounted for in terms of differences in four aspects of these specimen configuration (namely, residual stress effects, loading rate, material inhomogeneity, and the nature of the test). For a given specimen configuration, gamma irradiation produced a statistically significant decrease in fracture toughness which, it is suggested, is due to the concomitant depreciation in molecular weight. For a given cement type, there is no statistically significant difference in fracture toughness results obtained using SENB and RCT specimens. It is thus suggested that either of these configurations can be used to determine the fracture toughness of acrylic bone cement.

  14. Experimental biomechanical analysis of standing position in both-column acetabular fractures fixed by anterior reconstruction plate combinated with trans-plate quadrilateral screws%前路钛板加方形区螺钉治疗髋臼双柱骨折的站立位力学分析

    Institute of Scientific and Technical Information of China (English)

    蔡贤华; 吴咏德; 刘曦明; 张红喜

    2013-01-01

    [目的]探讨前路特殊塑形钛板加方形区螺钉治疗髋臼双柱骨折早期站立的可能性.[方法]选取成年防腐保湿处理的全骨盆标本6具,保留韧带及髋关节囊,制作单侧髋臼高位双柱骨折模型,随机先后采用前路特殊塑形钛板加方形区螺钉(B组)及常规塑形钛板加1/3管型钛板(C组)内固定,固定标本于ZWICKZ100电子万能材料试验机上,模拟站立位以400~700 N垂直加载,分别测定完整骨盆(A组)、B组及C组后柱内壁横向位移、髋臼顶纵向位移,并计算刚度.[结果]随着载荷增加,各位移值呈逐渐增加的线性关系,且A组<B组<C组;在生理负荷600N载荷下,横向与纵向位移值均为C组>B组>A组、刚度为C组>B组>A组,C组与B组、A组与C组间差异明显(P<0.05),B组与A组差异无显著意义(P>0.05).[结论]站立位下,前路特殊塑形钛板加方形区螺钉较常规塑形钛板加1/3管型钛板内固定即刻力学性能更为可靠,稳定性与完整骨盆接近,这表明早期站立并不影响前路特殊塑形钛板加方形区螺钉内固定的稳定性.%[ Objective] To explore the standing possibility in the early after both - column acetabular fracture fixed by anterior specially - shaped reconstruction plate combinated with trans - plate quadrilateral screws on cadaver. [ Method] Six Chinese adult wetly pelvic specimens with their ligament and joint capsule of hip joint preserved with antisepsis were made into the model with high both-column acetabular fracture on one side. The fractures were fixed randomly by anterior specially-shaped titanium plate with quadrilateral screws( group B) or conventionally-shaped reconstruction titanium plate with 1/3 tubular titanium plate (group C). To imitate the static standing position o