Pathologic fracture of the distal radius in a 25-year-old patient with a large unicameral bone cyst.

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Massen, Felix; Baumbach, Sebastian; Volkmer, Elias; Mutschler, Wolf; Grote, Stefan

2014-06-13

Distal radius fractures (DRF) are often referred to as osteoporosis indicator fractures as their incidence increases from age 45. In the group of young adults, distal radius fractures normally result from high-energy trauma. Wrist fractures in young patients without adequate trauma thus raise suspicion of a pathologic fracture. In this report we present the case of a fractured unicameral bone cyst (UBC) at the distal radius in a young adult.To the author's best knowledge, this is the first detailed report in an UBC at the distal radius causing a pathologic DRF in an adult patient. A 25-year-old otherwise healthy male presented to our Emergency Department after a simple fall on his right outstretched hand. Extended diagnostics revealed a pathologic, dorsally displaced, intra-articular distal radius fracture secondary to a unicameral bone cyst occupying almost the whole metaphysis of the distal radius. To stabilize the fracture, a combined dorsal and volar approach was used for open reduction and internal fixation. A tissue specimen for histopathological examination was gathered and the lesion was filled with an autologous bone graft harvested from the ipsilateral femur using a reamer-irrigator-aspirator (RIA) system. Following one revision surgery due to an intra-articular step-off, the patient recovered without further complications. Pathologic fractures in young patients caused by unicameral bone cysts require extended diagnostics and adequate treatment. A single step surgical treatment is reasonable if fracture and bone cyst are treated appropriately. Arthroscopically assisted fracture repair may be considered in intra-articular fractures or whenever co-pathologies of the carpus are suspected.

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

Science.gov (United States)

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

2014-06-01

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

The correlation of initial radiographic characteristics of distal radius fractures and injuries of the triangular fibrocartilage complex.

Science.gov (United States)

Kasapinova, K; Kamiloski, V

2016-06-01

Our purpose was to determine the correlation of initial radiographic parameters of a distal radius fracture with an injury of the triangular fibrocartilage complex. In a prospective study, 85 patients with surgically treated distal radius fractures were included. Wrist arthroscopy was used to identify and classify triangular fibrocartilage complex lesions. The initial radial length and angulation, dorsal angulation, ulnar variance and distal radioulnar distance were measured. Wrist arthroscopy identified a triangular fibrocartilage complex lesion in 45 patients. Statistical analysis did not identify a correlation with any single radiographic parameter of the distal radius fractures with the associated triangular fibrocartilage complex injuries. The initial radiograph of a distal radius fracture does not predict a triangular fibrocartilage complex injury. III. © The Author(s) 2016.

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

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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

The reliability of AO classification for distal radius fracture, using CT findings

International Nuclear Information System (INIS)

Nakanishi, Yasuaki; Ono, Hiroshi; Furuta, Kazuhiko; Fujitani, Ryoutarou; Ota, Hiroyoshi

2006-01-01

The purpose of this study was to assess the reliability of the AO (Association for the Study of Internal Fixation) classification of distal radius fracture, using plain radiographs and 2 cross-sectional computed tomographic (CT) surface images. Five observers independently classified 32 distal radius fractures into 9 groups under AO classification. We established 4 methods for observation. First, using only two-directional radiographs; second, four-directional radiographs; third, CT (axial view) with four-directional radiographs; and fourth, CT (axial and sagittal views) with four-directional radiographs. Kappa statistics were used to establish the relative level of agreement between the observers. Interobserver reliability was poor in both first and second methods in which only plain radiographs were used (κ=0.30 and 0.23, respectively). Furthermore, reliability did not increase in the third method with the addition of 1 CT surface image (κ=0.29). In the fourth method, with the addition of 2 cross-sectional CT surface images, the reliability increased to a moderate level (κ=0.44). Interobserver reliability of the AO system of the classification of distal radius fractures was observed on using 2 cross-sectional CT surface images with four-directional radiographs. (author)

A COMPARATIVE STUDY OF CONSERVATIVE MANAGEMENT VS. EXTERNAL FIXATION OF COMMINUTED DISTAL RADIUS FRACTURES

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Sanjeev Kumar Kare

2016-12-01

Full Text Available BACKGROUND Fracture of the distal radius (‘broken wrist’ is a common clinical problem. It can be treated conservatively usually involving wrist immobilisation in a plaster cast or surgically. A key method of surgical fixation is external fixation. MATERIALS AND METHODS A prospective study was carried out on 66 patients admitted between June 2014 to May 2016 for evaluation of conservative and surgical management of distal radius fractures. RESULTS Excellent, fair or good result was noticed in around 85% of cases managed conservatively and in above 90% of cases managed by external fixator. CONCLUSION There is some evidence to support the use of external fixation for dorsally displaced fractures of the distal radius in adults. Though, there is insufficient evidence to confirm a better functional outcome, external fixation reduces redisplacement gives improved anatomical results and most of the excess surgically-related complications are minor.

A PROSPECTIVE STUDY OF CLINICAL OUTCOME AFTER USING LIGAMENTOTAXIS IN MANAGEMENT OF DISTAL RADIUS FRACTURES

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Chandrashekhar V. Mudgal

2017-04-01

Full Text Available BACKGROUND A study was done to evaluate the effect of the ligamentotaxis in the management of intraarticular fractures of the distal radius. MATERIALS AND METHODS 34 patients were studied prospectively between March 2014 and February 2016. All patients had intraarticular fracture of distal end of radius and all were treated with ligamentotaxis after closed reduction with fluoroscopic guidance. The follow-up period was 12 months. At the time of surgery, the mean age was 45.29 years. RESULTS In all fracture cases, the mean of fracture union was 5.8 weeks. During the final follow-up, the mean range of motion was 55.30 in flexion, 56.60 in extension, 21.0 in ulnar deviation, 9.00 in radial deviation, 70.30 in pronation and 67.10 in supination. According to the scoring system of Gartland and Werley, the clinical and functional outcomes showed that 15 patients (44.1% had excellent results, 14 (41.1% had good results, 3 (8.8% had fair results and 2 (5.8% had poor results. CONCLUSION Closed reduction under fluoroscopic image guidance and the ligamentotaxis is useful and effective in the treatment of intraarticular fractures of the distal radius.

Analysis of the Arthroscopically Diagnosed Soft-Tissue Injuries Associated With the Distal Radius Fractures

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Katerina Katerina Kasapinova

2014-06-01

CONCLUSIONS: The frequency of the associated soft-tissue lesions in distal radius fractures is high. Ulnar styloid fracture was identified as risk factor for associated LT lesion, as well as combined lesion of both scapholunate and luntriquetral ligament.

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

Science.gov (United States)

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

2017-04-01

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

Classification and treatment of distal radius fractures: a survey among orthopaedic trauma surgeons and residents

NARCIS (Netherlands)

M.A.M. Mulders (Marjolein A. M.); D. Rikli; J.C. Goslings (Carel); N.W.L. Schep (Niels)

2017-01-01

textabstractPurpose: Classification, the definition of an acceptable reduction and indications for surgery in distal radius fracturemanagement are still subject of debate. The purpose of this study was to characterise current distal radius fracture management in Europe. Methods: During the European

Fractures of the shafts of the radius and ulna

International Nuclear Information System (INIS)

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

1985-01-01

Although the clinical presentation of fracture of the forearm bones is usually quite obvious, thorough radiologic examination of the radius and ulna and adjacent wrist and elbow joints is mandatory. Standard views of the forearm of the patient include the AP and lateral projections. The degree of shortening, angulation, rotation, and comminution should be noted. The selected films must be long enough to include the adjacent elbow and wrist joints

Treatment of unstable intraarticular fracture of distal radius: POP casting with external fixation.

Science.gov (United States)

ur Rahman, Obaid; Khan, Mohammad Qadeem; Rasheed, Haroon; Ahmad, Saleem

2012-04-01

To compare radiological and functional outcome of external fixation and distraction with conservative Plaster of Paris (POP) cast for unstable intra-articular fractures of the distal radius. The study was conducted on 60 patients with unstable intra-articular fracture of distal radius who reported to emergency or outpatient Orthopaedic Surgery department of Benazir Bhutto Hospital, Rawalpindi, between March and August 2007. They were divided into two equal groups: Group A and Group B, treated by Plaster of Paris cast, and external fixation with distraction respectively. The functional outcome in terms of freedom from pain, range of movement, grip power and deformity, and the radiological outcome of radial length, incongruity and radio-ulnar joint position were analysed at three months follow-up using a 3-point scoring scale. In Group A, 1 (3%) patient showed excellent result, 8 (27%) patients good results, 19 (63%) patients fair results and 2 (7%) patients poor result. In Group B, 14 (47%) patients showed excellent results, 11 (37%) patients good results, 4 (13%) patients fair results and 1 (3%) patient poor result. The outcome score of the Group B patients was significantly better compared to the Group A patients (p value advantages over conventional Plaster of Paris cast in the treatment of unstable intra-articular fractures of distal radius.

Stress fractures of the humerus, radius, and tibia in horses: clinical features and radiographic and/or scintigraphic appearance

International Nuclear Information System (INIS)

Mackey, V.S.; Trout, D.R.; Meagher, D.M.; Hornof, W.J.

1987-01-01

The medical records, radiographic and nuclear scintigraphic findings of 26 racing horses with 27 stress fracture episodes of the humerus, radius, or tibia were reviewed. The purposes of this study were to describe the radiographic and/or scintigraphic features of stress fractures of the humerus, radius, or tibia, and to evaluate the signalment and history of horses in which stress fracture occurred. Stress fractures of the three long bones examined were primarily seen in 2- and 3-year-old male Thoroughbred horses; commonly, the onset of lameness was immediately following training gallops or racing. There were 13 humeral stress fracture episodes in 12 horses. Ten were in the proximal caudolateral cortex, and three were in the distal craniomedial cortex. Radical stress fractures were seen in three horses, all in the midshaft radius. Tibial stress fractures were diagnosed in 11 horses. They were located in the proximal lateral tibia in six horses, the distal caudolateral tibia in three horses, and the midshaft tibia in three horses. Fifteen stress fractures were diagnosed with radiography alone, one was diagnosed with scintigraphy alone, nine were diagnosed with radiographs and scintigraphy, and, in two horses, radiographs were negative, but the scintigraphic findings were consistent with stress fracture

Clinical and functional outcome of open primary repair of triangular fibrocartilage complex tears associated with distal radius fractures.

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Johandi, Faisal; Sechachalam, Sreedharan

2017-01-01

We evaluate the clinical and functional outcome of open primary repair of acute TFCC tears in distal radius fracture, when there is gross intraoperative distal radioulnar joint (DRUJ) instability after fixation of the distal radius, in the absence of an ulnar styloid fracture or when the ulnar fracture fragment is too small to be fixed. A retrospective review of our institution's distal radius fracture database over a 4-year period (January 2010 to December 2013). A total of 12 (1.38%) out of 3379 patients had an open TFCC repair in the same setting as fixation of distal radius. Assessment of outcome involved the analysis of objective and subjective clinical and functional outcomes. All patient regained Activities of Daily Living (ADL) independence; eleven out of 12 patients (91.7%) returned to pre-injury function and 8 out of 11 patients (72.7%) returned to their jobs. DRUJ stability was preserved in 10 patients (83.3%) with 10 patients (83.3%) having grip strength of at least 50%, compared to the uninjured hand, and 7 (58.3%) with grip strength of more than or equal to 75%. Complications of surgery identified can be classified into 4 broad categories: infection, neurological complications, persistent DRUJ instability and prolonged pain. The authors believe a primary open repair of the TFCC should be considered when patients present with instability during intra-operative DRUJ ballottement test after distal radius fixation, in the absence of an ulnar styloid fracture or when the ulnar fracture fragment is too small to be fixed.

A new building block: costo-osteochondral graft for intra-articular incongruity after distal radius fracture.

Science.gov (United States)

Tang, Chris Yuk Kwan; Fung, Boris; Poon, T L; Fok, Margaret

2014-01-01

Even with the invention of locking plates, intra-articular fractures of distal radius with extreme comminution remain a challenge for orthopaedic surgeons. Osteochondral graft is a potential choice to reconstruct the articular defect. We report a patient who had a fracture of distal radius with costo-osteochondral graft for articular reconstruction which has not yet been described in the English literature. At nine-year follow-up, he was pain free and had full range of movement of the wrist. The authors suggest that costo-osteochondral graft could be an option with satisfactory result.

The effect of search term on the quality and accuracy of online information regarding distal radius fractures.

Science.gov (United States)

Dy, Christopher J; Taylor, Samuel A; Patel, Ronak M; Kitay, Alison; Roberts, Timothy R; Daluiski, Aaron

2012-09-01

Recent emphasis on shared decision making and patient-centered research has increased the importance of patient education and health literacy. The internet is rapidly growing as a source of self-education for patients. However, concern exists over the quality, accuracy, and readability of the information. Our objective was to determine whether the quality, accuracy, and readability of information online about distal radius fractures vary with the search term. This was a prospective evaluation of 3 search engines using 3 different search terms of varying sophistication ("distal radius fracture," "wrist fracture," and "broken wrist"). We evaluated 70 unique Web sites for quality, accuracy, and readability. We used comparative statistics to determine whether the search term affected the quality, accuracy, and readability of the Web sites found. Three orthopedic surgeons independently gauged quality and accuracy of information using a set of predetermined scoring criteria. We evaluated the readability of the Web site using the Fleisch-Kincaid score for reading grade level. There were significant differences in the quality, accuracy, and readability of information found, depending on the search term. We found higher quality and accuracy resulted from the search term "distal radius fracture," particularly compared with Web sites resulting from the term "broken wrist." The reading level was higher than recommended in 65 of the 70 Web sites and was significantly higher when searching with "distal radius fracture" than "wrist fracture" or "broken wrist." There was no correlation between Web site reading level and quality or accuracy. The readability of information about distal radius fractures in most Web sites was higher than the recommended reading level for the general public. The quality and accuracy of the information found significantly varied with the sophistication of the search term used. Physicians, professional societies, and search engines should consider

Patterns of triangular fibrocartilage complex (TFCC) injury associated with severely dorsally displaced extra-articular distal radius fractures.

Science.gov (United States)

Scheer, Johan H; Adolfsson, Lars E

2012-06-01

The aim of the study was to examine triangular fibrocartilage (TFCC) injury patterns associated with unstable, extra-articular dorsally displaced distal radius fractures. Twenty adult patients with an Arbeitsgemeinschaft für Osteosynthesefragen (AO), type A2 or A3, distal radius fracture with an initial dorsal angulation greater than 20° were included. Nine had a tip fracture (distal to the base) of the ulnar styloid and 11 had no such fracture. They were all openly explored from an ulnopalmar approach and TFCC injuries were documented. Eleven patients also underwent arthroscopy and intra-articular pathology was recorded. All patients had TFCC lesions of varying severity, having an extensor carpi ulnaris subsheath avulsion in common. Eighteen out of 20 also displayed deep foveal radioulnar ligament lesions, with decreasingly dorsal fibres remaining. The extent of this foveal injury could not be appreciated by radiocarpal arthroscopy. Severe displacement of an extra-articular radius fracture suggests an ulnar-sided ligament injury to the TFCC. The observed lesions concur with findings in a previous cadaver study. The lesions follow a distinct pattern affecting both radioulnar as well as ulnocarpal stabilisers. Copyright © 2012 Elsevier Ltd. All rights reserved.

Treatment of unstable distal radius fractures with Ilizarov circular, nonbridging external fixator.

Science.gov (United States)

Tyllianakis, Minos; Mylonas, Spyros; Saridis, Alkis; Kallivokas, Alkiviadis; Kouzelis, Antonis; Megas, Panagiotis

2010-03-01

Unstable distal radius fractures remain a challenge for the treating orthopaedic surgeon. We present a retrospective follow-up study (mean follow-up 12.5 months) of 20 patients with 21 unstable distal radius fractures that were reduced in a closed manner and stabilized with a nonbridging Ilizarov external fixator. Subsequent insertion of olive wires for interfragmentary compression was performed in cases with intra-articular fractures. According to the overall evaluation proposed by Gartland and Werley scoring system 12 wrists were classified as excellent, 6 as good, 2 as fair and 1 as poor. Grade II pin-tract infection in distal fracture fragment was detected in 3 wires from a total of 78 (3.8%) and in 4 half pins out of a total of 9 (44.4%). Pronation was the most frequently impaired movement. This was restricted in 4 patients (19%) in whom a radioulnar transfixing wire was applied. Symptoms of irritation of superficial sensory branch of the radial nerve occurred in 3 patients with an olive wire applied in a closed manner in the distal fragment. Ilizarov method yields functional results comparable to that of other methods whilst it avoids wrist immobilization, open reduction and reoperation for implant removal. The method is associated with a low rate of major complication and satisfactory functional outcome. Copyright 2009 Elsevier Ltd. All rights reserved.

Fracture configurations of the equine radius and tibia after a simulated kick

OpenAIRE

Fürst, Anton; Oswald, Susanne E; Jäggin, S; Piskoty, G; Michel, S; Auer, Jörg A

2008-01-01

The objective of this postmortem study was to determine the fracture configurations of the equine radius and tibia after a simulated kick. Fracture configurations of 35 radii and 36 tibiae from 19 adult horses were evaluated after a simulated kick in an experimental exvivo study. The bones were dissected, the proximal and distal ends were embedded in resin, fixed horizontally and preloaded in compression, and a steel impactor, designed to simulate a shod equine hoof, was dropped from a height...

AO Distal Radius Fracture Classification: Global Perspective on Observer Agreement

Science.gov (United States)

Jayakumar, Prakash; Teunis, Teun; Giménez, Beatriz Bravo; Verstreken, Frederik; Di Mascio, Livio; Jupiter, Jesse B.

2016-01-01

Background The primary objective of this study was to test interobserver reliability when classifying fractures by consensus by AO types and groups among a large international group of surgeons. Secondarily, we assessed the difference in inter- and intraobserver agreement of the AO classification in relation to geographical location, level of training, and subspecialty. Methods A randomized set of radiographic and computed tomographic images from a consecutive series of 96 distal radius fractures (DRFs), treated between October 2010 and April 2013, was classified using an electronic web-based portal by an invited group of participants on two occasions. Results Interobserver reliability was substantial when classifying AO type A fractures but fair and moderate for type B and C fractures, respectively. No difference was observed by location, except for an apparent difference between participants from India and Australia classifying type B fractures. No statistically significant associations were observed comparing interobserver agreement by level of training and no differences were shown comparing subspecialties. Intra-rater reproducibility was “substantial” for fracture types and “fair” for fracture groups with no difference accounting for location, training level, or specialty. Conclusion Improved definition of reliability and reproducibility of this classification may be achieved using large international groups of raters, empowering decision making on which system to utilize. Level of Evidence Level III PMID:28119795

Association of Insulin-like Growth Factor-1, Bone Mass and Inflammation to Low-energy Distal Radius Fractures and Fracture Healing in Elderly Women Attending Emergency Care.

Science.gov (United States)

Chisalita, Simona I; Chong, Lee Ti; Wajda, Maciej; Adolfsson, Lars; Woisetschläger, Mischa; Spångeus, Anna

2017-11-01

Elderly patients suffer fractures through low-energy mechanisms. The distal radius is the most frequent fracture localization. Insulin-like growth factor-1 (IGF1) plays an important role in the maintenance of bone mass and its levels decline with advancing age and in states of malnutrition. Our aim was to investigate the association of IGF1 levels, bone mass, nutritional status, and inflammation to low-energy distal radius fractures and also study if fracture healing is influenced by IGF1, nutritional status, and inflammation. Postmenopausal women, 55 years or older, with low-energy distal radius fractures occurring due to falling on slippery ground, indoors or outdoors, were recruited in the emergency department (ED) and followed 1 and 5 weeks after the initial trauma with biomarkers for nutritional status and inflammation. Fractures were diagnosed according to standard procedure by physical examination and X-ray. All patients were conservatively treated with plaster casts in the ED. Patients who needed interventions were excluded from our study. Fracture healing was evaluated from radiographs. Fracture healing assessment was made with a five-point scale where the radiological assessment included callus formation, fracture line, and stage of union. Blood samples were taken within 24 h after fracture and analyzed in the routine laboratory. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA). Thirty-eight Caucasian women, aged 70.5 ± 8.9 years (mean ± SD) old, were recruited. Nutritional status, as evaluated by albumin (40.3 ± 3.1 g/L), IGF1 (125.3 ± 39.9 μg/L), body mass index (26.9 ± 3.6 kg/m 2 ), arm diameter (28.9 ± 8.9 cm), and arm skinfold (2.5 ± 0.7 cm), was normal. A positive correlation was found between IGF1 at visit 1 and the lowest BMD for hip, spine, or radius (r = 0.39, P = 0.04). High sensitive C-reactive protein (hsCRP) and leukocytes were higher at the fracture event compared to 5 weeks later (P = 0.07 and P

Complaints in the follow-up of conservatively treated distal radius fractures - predictors in the initial radiograph

International Nuclear Information System (INIS)

Freund, W.; Aschoff, A.J.; Einsiedel, T.; Kramer, M.; Trnavac, S.; Bezirkskrankenhaus Guenzburg

2007-01-01

Purpose: Radius fractures are frequent in adults, and the long-term results of conservative treatment remain disappointing. This study examines predictors for the clinical outcome in the initial radiograph. This will help to identify patients who will benefit from surgical treatment. Materials and Methods: A cohort study including a standardized telephone interview (Cooney score) was used to identify all conservatively treated patients with a distal radius fracture over a five-year period. The additional selection criteria were: over 15 years old, initial X-ray available, patient reachable by phone for the follow-up interview. The following measurements were taken from the initial radiograph: Radius-base angle, radial shortening, radiopalmar angle and intraarticular displacement. Correlations and a simple test to predict negative outcome were computed. Results: Of the initially identified 2211 patients with distal radius fracture, 179 also fulfilled the other criteria. The patients were 56.2 years old on average (standard deviation SD = ± 22.45 years) and 72 % were female. 60 % of the fractures were on the right side. The average follow-up was 4.3 years (SD ± 1.66). The Cooney score results averaged 85 points (with 100 being the optimal and maximum score), indicating good or very good functional results in the long term follow-up for 61 % of patients. However, 31 % received a rating of fair or poor and therefore had an unfavorable outcome. With respect to the correlations, age and shortening of the radius (but not gender) had a significant influence on the functional result. Using an age of 75 years or above and a radial shortening of at least 4 mm to predict an unfavorable outcome, the sensitivity is only 16 %, but the positive predictive value is 73 % and the specificity is 96 %. (orig.)

Peak incidence of distal radius fractures due to ice skating on natural ice in The Netherlands

NARCIS (Netherlands)

van Lieshout, Arno P. W.; van Manen, Christiaan J.; du Pré, Karel J.; Kleinlugtenbelt, Ydo V.; Poolman, Rudolf W.; Goslings, J. Carel; Kloen, Peter

2010-01-01

An increase of distal radius fractures was seen in 2009 when an extended cold spell allowed natural ice skating in Amsterdam. This resulted in overload of our Emergency Departments and operating rooms. This study reports patient and fracture characteristics of these injuries. We also determined

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

Science.gov (United States)

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

2017-11-01

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

A STUDY ON FRACTURE FIXATION OF DISTAL END OF RADIUS BY PERCUTANEOUS PINNING

Directory of Open Access Journals (Sweden)

Kiran Kumar L

2016-07-01

Full Text Available BACKGROUND Various treatment modalities have been described for the treatment of distal radius fractures each with its own merits and demerits. Most of the work done with percutaneous pinning has shown a significant residual stiffness of the hand and wrist. Our technique involves percutaneous pinning of the fracture and immobilisation in neutral position of the wrist for. This study's aim was to examine the functional outcome of percutaneous K-wiring of these distal radius fractures with immobilisation in neutral position of the wrist. METHODS A prospective study conducted on thirty adult patients with distal radial fractures treated at Department of Orthopaedics, Rangaraya Medical college, Kakinada between October 2013 to September 2015. RADIOGRAPHIC EXAMINATION Standard radiographs in PA and lateral views were taken for confirmation of the diagnosis and also to know the type of fracture. Oblique views were also taken in a few patients who had complex comminuted fractures. The fracture fragments were analysed and involvement of radiocarpal and distal radioulnar joints were assessed and classified according to the Frykman classification. Of the cases, 6(20% of the fractures were type I, 2(6.6% of type II, 3(10% of type III, 6(20% of type IV, 8(26.6% of type V, 5(16.6% of type VI, no cases of type VII and VIII.SURGICAL PROCEDURE The procedures were performed under regional anaesthesia in all cases. After sterile preparation and draping, fracture is reduced by traction and the reduction was evaluated fluoroscopically. A 1.5 cm incision given longitudinally (if needed beginning at the radial styloid and proceeds proximally across to the medial metaphysis and diaphysis. At least two pins (1.6 mm Kirschner wire were inserted and adequate reduction was confirmed on AP/LAT views under image intensifier. Another 1.6 mm K-wire percutaneously 90 degrees orthogonally to these wires starting at the dorsal rim of distal radius just distal to the Lister�

Assessment of "YouTube" Content for Distal Radius Fracture Immobilization.

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Addar, Abdullah; Marwan, Yousef; Algarni, Nizar; Berry, Gregory

Distal radius fractures (DRFs) are the most common orthopedic fractures, with >70% of cases treated by closed immobilization using a short arm cast or a sugar tong splint. However, inadequate immobilization is a risk factor for loss of reduction requiring repeat reduction or surgical treatment. Therefore, education of clinical skills for appropriate immobilization of DRFs is important. With the increasing use of web-based information by medical learners, our aim was to assess the quality and quantity of videos regarding closed immobilization of DRFs on YouTube. Retrospective review of YouTube videos on distal radius fracture immobilization using specific search terms. Identified videos were analyzed for their educational value, quality of the technical skill demonstrated, and overall metrics. Educational value was scored on a 5-point scale, with "1" indicative of low quality and "5" of high quality. Not applicable. Among the 68,366 videos identified, 16 met our inclusion criteria of being in English; performed by a health care professional or institution; and with casting being the major theme of the educational information provided. Of these 16 videos, 6 had an educational value score of 4 or 5, with the remaining 10 having a score ≤3. Although immobilization was demonstrated by cast technician specialized in orthopedics, skills were also performed by orthopedic attendants, urgent care physicians, orthopedic residents, and nurse practitioners. The credentials of the performer in 3 videos were not identified. There is a need to promote high-quality educational videos produced by established medical school faculty members on open, web-based, portals. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Risk Factors Associated With Survival to Hospital Discharge of 54 Horses With Fractures of the Radius.

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Stewart, Suzanne; Richardson, Dean; Boston, Ray; Schaer, Thomas P

2015-11-01

To determine (1) survival to discharge of horses with radial fractures (excluding osteochondral fragmentation of the distal aspect of the radius and stress fractures); and (2) risk factors affecting survival to hospital discharge in conservative and surgically managed fractures. Case series. Horses (n = 54). Medical records (1990-June 2012) and radiographs of horses admitted with radial fracture were reviewed. Horses with osteochondral fragmentation of the distal aspect of the radius or stress fractures were excluded. Evaluated risk factors were age, fracture configuration, surgical repair method, surgical duration, hospitalization time, implant failure rate, and surgical site infection (SSI) rate. Of 54 horses, overall survival to discharge was 50%. Thirteen (24%) were euthanatized on admission because of (1) fracture severity; (2) presence of an open fracture; or (3) financial constraints. Fourteen (26%) horses with minimally displaced incomplete fractures were conservatively managed and 12 (86%) survived to discharge. Twenty-seven (50%) horses had surgical treatment by open reduction and internal fixation (ORIF) and 15 (56%) survived to hospital discharge. Open fractures were significantly more likely to develop SSI (P = .008), which also resulted in a 17-fold increase in implant failure (P horses with an open fracture did not survive to discharge. Outcome was also adversely affected by age (P 168 minutes (P fractures is good. Young horses have a good prognosis survival to discharge for ORIF, whereas ORIF in adult horses has a poor prognosis and SSI strongly correlates with catastrophic implant failure. © Copyright 2015 by The American College of Veterinary Surgeons.

Ipsilateral simultaneous fracture of the trochlea involving the lateral end clavicle and distal end radius: a rare combination and a unique mechanism of injury

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Gupta RK

2014-07-01

Full Text Available 【Abstract】Isolated trochlea fracture in adults is a rare surgical entity as compared to its capitellar counterpart. It has been only mentioned sporadically in the literature as case reports. Fracture of the trochlea is accompanied by other elbow injuries like elbow dislocation, capitellum fracture, ulnar fracture and extraarticular condylar fracture. Here we report a unique case of isolated displaced trochlea fracture associated with fractures of the lateral end clavicle and the distal end radius. We propose a unique mechanism for this rare combination of injuries: typical triad of injury, i.e. fracture of the distal end radius with trochlea and fracture of the lateral end of the clavicle. Nonoperative treatment is recommended for undisplaced humeral trochlea fractures; but for displaced ones, anatomical reduction and internal fixation are essential to maintain the congruous trochleacoronoid articulation and hence to maintain the intrinsic stability of the elbow. Key words: Isolated trochlea fracture; Clavicle; Radius fractures

[Injury to the Scapholunate Ligament in Distal Radius Fractures: Peri-Operative Diagnosis and Treatment Results].

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Gajdoš, R; Pilný, J; Pokorná, A

2016-01-01

PURPOSE OF THE STUDY Injury to the scapholunate ligament is frequently associated with a fracture of the distal radius. At present neither a unified concept of treatment nor a standard method of diagnosis in these concomitant injuries is available. The aim of the study was to evaluate a group of surgically treated patients with distal radius fractures in order to assess a contribution of combined conventional X-ray and intra-operative fluoroscopic examinations to the diagnosis of associated lesions and to compare short-term functional outcomes of sugically treated patients with those of patients treated conservatively. MATERIAL AND METHODS A group of patients undergoiong surgery for distal radius fractures using plate osteosynthesis was evaluated retrospectively. The peri-operative diagnosis of associated injury to the scapholunate ligament was based on pre-operative standard X-ray views and intra-operative fluoroscopy. The latter consisted of images of maximum radial and ulnar deviation as well as an image of the forearm in traction exerted manually along the long axis. All views were in postero-anterior projection. Results were read directly on the monitor of a fluoroscopic device after its calibration or were obtained by comparing the thickness of an attached Kirschner wire with the distance to be measured. Subsequently, pixels were converted to millimetres. When a scapholunate ligament injury was found and confirmed by examination of the contralateral wrist, the finding was verified by open reduction or arthroscopy. Both static and dynamic instabilities were treated together with the distal radius fracture at one-stage surgery. After surgery, the patients without ligament injury had the wrist immobilised for 4 weeks, then rehabilitation followed. In the patients with a damaged ligament, immobilisation in a short brace lasted until transarticular wires were removed. All patients were followed up for a year at least. At follow-up, the injured wrist was examined

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

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

2015-03-31

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

Reliability of radiographic measurements for acute distal radius fractures

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Watson, Narelle J.; Asadollahi, Saeed; Parrish, Frank; Ridgway, Jacqueline; Tran, Phong; Keating, Jennifer L.

2016-01-01

The management of distal radial fractures is guided by the interpretation of radiographic findings. The aim of this investigation was to determine the intra- and inter-observer reliability of eight traditionally reported anatomic radiographic parameters in adults with an acute distal radius fracture. Five observers participated. All were routinely involved in making treatment decisions based on distal radius fracture radiographs. Observers performed independent repeated measurements on 30 radiographs for eight anatomical parameters: dorsal shift (mm), intra-articular gap (mm), intra-articular step (mm), palmar tilt (degrees), radial angle (degrees), radial height (mm), radial shift (mm), ulnar variance (mm). Intraclass correlation coefficients (ICCs) and the magnitude of retest errors were calculated. Measurement reliability was summarised as high (ICC > 0.80), moderate (0.60–0.80) or low (<0.60). Intra-observer reliability was high for dorsal shift and palmar tilt; moderate for radial angle, radial height, ulnar variance and radial shift; and low for intra-articular gap and step. Inter-observer reliability was high for palmar tilt; moderate for dorsal shift, ulnar variance, radial angle and radial height; and low for radial shift, intra-articular gap and step. Error magnitude (95 % confidence interval) was within 1–2 mm for intra-articular gap and step, 2–4 mm for ulnar variance, 4–6 mm for radial shift, dorsal shift and radial height, and 6–8° for radial angle and palmar tilt. Based on previous reports of critical values for palmar tilt, ulnar variance and radial angle, error margins appear small enough for measurements to be useful in guiding treatment decisions. Our findings indicate that clinicians cannot reliably measure values ≤1 mm for intra-articular gap and step when interpreting radiographic parameters using the standardised methods investigated in this study. As a guide for treatment selection, palmar tilt, ulnar variance and radial angle

[Long-term efficacy of open reduction and internal fixation versus external fixation for unstable distal radius fractures: a meta-analysis].

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Yang, Z; Yuan, Z Z; Ma, J X; Ma, X L

2017-11-07

Objective: To make a systematic assessment of the Long-term efficacy of open reduction and internal fixation versus external fixation for unstable distal radius fractures. Methods: A computer-based online search of PubMed, ScienceDirect, EMBASE, BIOSIS, Springer and Cochrane Library were performed. The randomized and controlled trials of open reduction and internal fixation versus external fixation for unstable distal radius fractures were collected. The included trials were screened out strictly based on the criterion of inclusion and exclusion. The quality of included trials was evaluated. RevMan 5.0 was used for data analysis. Results: Sixteen studies involving 1 268 patients were included. There were 618 patients with open reduction and internal fixation and 650 with external fixation. The results of meta-analysis indicated that there were statistically significant differences with regard to the complications postoperatively (infection( I (2)=0%, RR =0.27, 95% CI 0.16-0.45, Z =4.92, P internal fixation and external fixation are effective treatment for unstable distal radius fractures. Compared with external fixation, open reduction and internal fixation provides reduced complications postoperatively, lower DASH scores and better restoration of volar tilt for treatment of distal radius fractures.

[Roof folding and rotary pushing for the treatment of back to back fractures of distal radius and ulna in children].

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Xu, Ping; Dong, Xiao-jun; Lu, Zhou-tong; Wang, Gongjun; Zhang, Han-qing; Chen, Xuan-ning; Li, Dong

2015-09-01

To evaluate the technique and the clinical effect of folding roof and rotary pushing in treatment of children with distal radius and ulna fracture of "back to back". From January 2012 to February 2014,38 children with distal radius and ulna fracture of "back to back" were treated by using the technique of folding roof and rotary pushing to reset and splint fixation including 23 males and 15 females with an average age of 9.5 years old ranging from 6 to 14 years old. Injury time was from 45 min to 3 days (averaged 1.3 days). All cases was unilateral closed fracture without symptoms of nerve injury occurred. The wrist joint anteroposterior and lateral radiographs showed double fracture of radius and ulna, and the broken end of radius was typical "back to back" displacement. The quality of reduction was assessed according to Dienst recommendation on the combination of Aro measurement, and the therapeutic effect was evaluated using standard of Anderson function. All patients were followed up from 3 to 13 months with an average of 6 months. There were no iatrogenic nerve injury. Thirty cases were treated successfully for the first time, 8 cases were again reset successfully; 28 cases were anatomical reduction, 7 cases were near anatomic reduction, 3 cases were functional reduction. At the second day 7 cases with hand and finger swelling appeared in multiple reset patients. Quality results of reduction were excellent in 33 cases, good in 5 cases. According to the standard of Anderson function evaluation, 35 cases were excellent, 3 cases were good. All fractures were healed with of deformity of wrist. Using the technique of folding roof and rotary pushing in treatment of children with distal radius and ulna fracture of "back to back" is very successful, the patient's limb function recovered well, the whole operation process is simple.

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

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

2013-12-01

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

The effects of implant composition on extensor tenosynovitis in a canine distal radius fracture model.

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Sinicropi, Stefano M; Su, Brian W; Raia, Frank J; Parisien, May; Strauch, Robert J; Rosenwasser, Melvin P

2005-03-01

Dorsal plating of distal radius fractures with titanium plates has resulted in clinically observed tenosynovitis and tendon rupture. The goal of this study was to investigate whether titanium-based implants result in more extensor tendon inflammation than matched stainless-steel implants in a canine fracture model. An osteotomy was created in the distal radius of 18 beagles and fixed with 2.7-mm 4-hole plates composed of commercially pure titanium, titanium alloy (Ti-Al6-V4), or 316L stainless steel. Animals were killed at an average of 4 months. Tendon gliding was assessed by applying a force at the extensor musculotendinous junction and noting gliding. Histologic grading (mild, moderate, severe) was based on cellular hypertrophy, hyperplasia, and leukocytic infiltration. Tendons glided freely in 100% stainless-steel specimens, 75% of titanium alloy, and 43% of commercially pure titanium groups. A severe inflammatory reaction was identified in 60% of the titanium alloy (Ti-A16-V4) group, 57% of the pure titanium group, and 0% of the stainless-steel group. Dorsal plating of the canine radius with commercially pure titanium or titanium alloy implants produced a greater inflammatory peritendinous response than matched stainless-steel implants.

Does formal education and training of staff reduce the operation rate for fractures of the distal radius?

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McDonald, Kyle; Murphy, Lynn; Gallagher, Brendan; Eames, Niall

2013-12-01

Fractures of the distal radius are one of the most common extremity fractures, and operation rates are increasing. Staff within our unit felt that formal teaching, particularly of new medical staff, with regards to fracture reduction and appropriate cast application could result in a reduction in operation rates. Retrospective data was extracted from FORD (Fracture Outcome and Research Database), including: number of fractures, number of fractures undergoing ORIF, fracture configuration, patient demographics, and mechanism of injury. All patients undergoing ORIF had their radiographs assessed by two separate reviewers. Information regarding adequate fracture reduction, adequate cast application (using Gap Index), and appropriate plaster cast moulding was recorded. Formal teaching was then given to the next group of medical staff rotating through the unit, and the same data was collected prospectively for that six-month period. Exclusion criteria included bilateral injuries, and polytrauma patients. A total of 1623 distal radial fractures were treated in our unit over the 12-month period, with 71 undergoing ORIF in the first 6 months and 39 in the second 6 months, this was statistically significant (p = 0.0009). Our study found that formal teaching and education significantly reduced the operation rate for distal radial fractures. This effect was most significant for extra-articular, dorsally angulated fractures of the distal radius. Our study proves that just 1 h of basic training at the beginning of an attachment can have significant benefits to both the unit and, more importantly, the patients. Copyright © 2013 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Effect of facility on the operative costs of distal radius fractures.

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Mather, Richard C; Wysocki, Robert W; Mack Aldridge, J; Pietrobon, Ricardo; Nunley, James A

2011-07-01

The purpose of this study was to investigate whether ambulatory surgery centers can deliver lower-cost care and to identify sources of those cost savings. We performed a cost identification analysis of outpatient volar plating for closed distal radius fractures at a single academic medical center. Multiple costs and time measures were taken from an internal database of 130 consecutive patients and were compared by venue of treatment, either an inpatient facility or an ambulatory, stand-alone surgery facility. The relationships between total cost and operative time and multiple variables, including fracture severity, patient age, gender, comorbidities, use of bone graft, concurrent carpal tunnel release, and surgeon experience, were examined, using multivariate analysis and regression modeling to identify other cost drivers or explanatory variables. The mean operative cost was considerably greater at the inpatient facility ($7,640) than at the outpatient facility ($5,220). Cost drivers of this difference were anesthesia services, post-anesthesia care unit, and operating room costs. Total surgical time, nursing time, set-up, and operative times were 33%, 109%, 105%, and 35% longer, respectively, at the inpatient facility. There was no significant difference between facilities for the additional variables, and none of those variables independently affected cost or operative time. The only predictor of cost and time was facility type. This study supports the use of ambulatory stand-alone surgical facilities to achieve efficient resource utilization in the operative treatment of distal radius fractures. We also identified several specific costs and time measurements that differed between facilities, which can serve as potential targets for tertiary facilities to improve utilization. Economic and Decisional Analysis III. Copyright © 2011 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Nerve Stimulator Guided Axillary Block in Painless Reduction of Distal Radius Fractures; a Randomized Clinical Trial

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Hossein Alimohammadi

2013-12-01

Full Text Available Introduction: Given the high prevalence of upper extremity fractures and increasing need to perform painless reduction in the emergency departments, the use of analgesic methods with fewer complications and more satisfaction appears to be essential. The aim of this study is comparison the nerve stimulator guided axillary block (NSAB with intravenous sedation in induction of analgesia for painless reduction of distal radius fractures. Methods: In the present randomized clinical trial, 60 patients (18-70 years of age suffered from distal radius fractures, were divided into two equal groups. One group received axillary nerve block by nerve stimulator guidance and the other procedural sedation and analgesia (PSA using midazolam/fentanyl. Onset of analgesia, duration of analgesic effect, total procedure time and pain scores were recorded using visual analogue scale (VAS and the outcomes were compared. Chi-squared and student t test were performed to evaluate differences between two groups. Results: Sixty patients were randomly divided into two groups (83.3% male. The mean age of patients was 31 ±0.7 years. While the onset of analgesia was significantly longer in the NSAB group, the mean total time of procedure was shorter than PSA (p<0.001. The NSAB group needed a shorter post-operative observation time (P<0.001. Both groups experienced equal pain relief before, during and after procedure (p>0.05. Conclusion: It seems that shorter post-operative monitoring time and consequently lesser total time of procedure, make nerve stimulator guided axillary block as an appropriate alternative for procedural sedation and analgesia in painless reduction of distal radius fractures in emergency department. 

The shaft fractures of the radius and ulna in children: current concepts.

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Sinikumpu, Juha-Jaakko; Serlo, Willy

2015-05-01

The incidence of forearm shaft fractures in children has increased in recent years. They are challenging to treat and they can result in several long-lasting complications. The treatment of children's fractures needs to be individualized to their needs. Nonoperative care will be satisfactory for young, preschool children and it is primarily treatment in stable fractures of children at every age. Injury mechanism must be understood to perform appropriate closed reduction. Immobilization using a long-arm cast needs to be focused against the deforming muscle forces - in particular those that rotate - in the forearm, keeping the bones in alignment until bone healing. Operative stabilization by elastic stable intramedullary nailing is the primarily method of treatment in cases of unstable fractures, in particular, in children between preschool age and adolescence. For older children near to skeletal maturity, a rigid plate and screw fixation will be justified. The most common complication after closed treatment is worsening of the alignment and need for repetitive interventions. elastic stable intramedullary nailing results usually in good outcome, and range of forearm rotation is the main feature determining the clinical result. In this article, we report the current concept of paediatric shaft fractures in the radius and ulna.

The prevalence of pain and disability one year post fracture of the distal radius in a UK population: A cross sectional survey

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Leonardi-Bee Jo

2008-09-01

Full Text Available Abstract Background A fracture of the distal radius is a commonly occurring fracture and accounts for a third of all fractures in the elderly. Thus far, one year estimates of pain and disability following a fracture of the distal radius have been reported on Canadian populations. The primary aim of this study is to investigate the prevalence of pain and disability in a UK population one year post fracture of the distal radius. Methods A cross-sectional survey was undertaken, of all subjects suffering a fracture of the distal radius between October 2005 and February 2006 in Nottingham, UK. Primary outcomes used were the VAS for pain and the DASH for disability. Prevalence of pain and disability were calculated and odds ratios presented for associations between demographics, pain and disability. Results 93/264 (35% subjects responded to the questionnaire. 6 subjects did not fulfill the inclusion criteria and were excluded from further analysis. 11% of subjects reported moderate to very severe pain. 16% of subjects reported moderate to very severe disability. Statistically significant associations were found between pain medication usage for the wrist fracture and moderate to very severe pain (OR 11.20, 95% CI 2.05 – 61.23. Moderate to very severe disability was associated with older age (OR 6.53, 95%CI 1.65 – 25.90 and pain medication usage for the wrist fracture (OR 4.75, 95% CI 1.38 – 16.37. Working was associated with a reduction in risk of moderate to very severe disability (OR 0.14, 95% CI 0.03 – 0.67. Conclusion This study demonstrates that there are a small proportion of patients who are still suffering moderate to very severe pain and disability one year post fracture of the distal radius. The study also demonstrates that there are significant associations between characteristics of the patients and the level of pain and disability. This highlights the need for further research into the most appropriate management of these patients

Arthroscopic knotless anchor repair of triangular fibrocartilage in distal radius fracture.

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García-Ruano, Á A; Najarro-Cid, F; Jiménez-Martín, A; Gómez de los Infantes-Troncoso, J G; Sicre-González, M

2015-01-01

Lesions of triangular fibrocartilage (TFC) are associated with distal radioulnar joint instability. Arthroscopic treatment of these lesions improves functional outcome of affected patients. The aim of the present work is to evaluate functional and occupational outcome of TCF repair using an arthroscopic knotless anchor device in patients with associated distal radius fracture. An observational, descriptive study was carried out between November 2011 and January 2014 including 21 patients with distal radius fracture and Palmer 1B lesions of TCF (Atzei class 2 and 3) that were treated by arthroscopic knotless anchor (PopLok® 2,8mm, ConMed, USA). Mean follow-up was 18 months. Functional (Mayo Wrist Score) and occupational outcome results were analyzed. Mean age of the group was 43.0±8.8 years, with 19% of the patients being female. There was an associated scapholunate lesion in 5 cases. Functional results reached a mean of 83.4±16.1 points onMayo Wrist Score. Mean sick-leave time was 153.16±48.5 days. Complete occupational reintegration was reached in 89.5% of cases. There were no postoperative complications. Arthroscopic knotless anchor repair of 1B TFC tears is a minimally invasive method of treatment that improves tension of fixation, avoiding subsequent loosen, in our experience, with few complications and good functional and occupational results. Copyright © 2014 SECOT. Published by Elsevier Espana. All rights reserved.

Distal radius fractures result in alterations in scapular kinematics: a three-dimensional motion analysis.

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Ayhan, Cigdem; Turgut, Elif; Baltaci, Gul

2015-03-01

Scapular motion is closely integrated with arm motion. Injury to a distal segment requires compensatory changes in the proximal segments leading to alterations in scapular motion. Since the effects of distal injuries on scapular kinematics remain unknown, in the present study we investigated the influences on scapular motion in patients with distal injuries. Sixteen subjects with a history of distal radius fracture and 20 asymptomatic healthy subjects (controls) participated in the study. Three-dimensional scapular and humeral kinematic data were collected on all 3 planes of shoulder elevation: frontal, sagittal, and scapular. All testing was performed in a single session; therefore, the sensors remained attached to the participants for all testing. The position and orientation data of the scapula at 30°, 60°, 90°, and 120° humerothoracic elevation and 120°, 90°, 60°, and 30° lowering were used for statistical comparisons. Independent samples t-test was used to compare the scapular internal/external rotation, upward/downward rotation, and anterior/posterior tilt between the affected side of subjects with a distal radius fracture and the dominant side of asymptomatic subjects at the same stage of humerothoracic elevation. Scapular internal rotation was significantly increased at 30° elevation (P=0.01), 90° elevation (P=0.03), and 30° lowering (P=0.03), and upward rotation was increased at 30° and 60° elevation (Pplane elevation. Scapular upward rotation and anterior tilt were significantly increased during 30° lowering on both the scapular (P=0.002 and 0.02, respectively) and sagittal planes (P=0.01 and 0.02. respectively). Patients with distal radius fractures exhibit altered scapular kinematics, which may further contribute to the development of secondary musculoskeletal pathologies. Copyright © 2014 Elsevier Ltd. All rights reserved.

Effects of circumferential rigid wrist orthoses in rehabilitation of patients with radius fracture at typical site

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Đurović Aleksandar

2005-01-01

Full Text Available Background. The use of orthoses is a questionable rehabilitation method for patients with the distal radius fracture at typical site. The aim of this study was to compare the effects of the rehabilitation on patients with radius fracture at the typical site, who wore circumferential static wrist orthoses, with those who did not wear them. Methods. Thirty patients were divided into 3 equal groups, 2 experimental groups, and 1 control group. The patients in the experimental groups were given the rehabilitation program of wearing serially manufactured (off-the-shelf, as well as custom-fit orthoses. Those in the control group did not wear wrist orthoses. Evaluation parameters were pain, edema, the range of the wrist motion, the quality of cylindrical, spherical, and pinch-spherical grasp, the strength of pinch and hand grasp, and patient's assessment of the effects of rehabilitation. Results. No significant difference in the effects of rehabilitation on the patients in experimental groups as opposed to control group was found. Patients in the first experimental group, and in control group were more satisfied with the effects of rehabilitation, as opposed to the patients in the second experimental group (p<0,05. Conclusion. The effects of circumferential static wrist orthoses in the rehabilitation of patients with distal radius fracture at the typical site were not clinically significant. There was no significant difference between the custom and off-the-shelf orthoses.

Immobilisation of extra-articular distal radius fractures (Colles type) in dorsiflexion. The functional and anatomical outcome.

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Baruah, Ranjit Kr; Islam, Mohibul; Haque, Russel

2015-09-01

Cast immobilisation after successful closed reduction is a standard treatment for displaced extra-articular fractures of lower end radius. The position of the wrist during immobilisation is controversial. Immobilisation in dorsiflexion prevents redisplacement after closed reduction. Our aim is to determine the effectiveness of immobilization of wrist in dorsiflexion in such cases and evaluate anatomical and functional outcome. Study included 54 patients, above 19 years of age with closed extra-articular fractures of lower end radius treated conservatively with below elbow cast application. The wrist was maintained in 15° of dorsiflexion during plaster immobilisation. At 24 weeks, functional results were evaluated with subjective symptoms and objective signs, as per modified Demerit Point Score System. Anatomical result was evaluated based on the scheme devised by Lidstrom (1959) and modified by Sarmiento et al. (1980). 76% patients had Excellent to Good subjective symptoms. Out of 42 patients that had residual dorsal angulation of less than 10°, 37 had excellent to good functional outcome. 39 of the 43 patients who had loss of radial length less than 6 mm had excellent to good functional outcome. 40 out of 49 patients having loss of radial angulation less than 9° showed excellent to good functional outcome. Functional result was directly proportional to anatomical outcome. Cast immobilization of extra articular fractures of lower end radius with wrist in dorsiflexion prevents re-displacement of the fragments resulting in satisfactory anatomical & functional outcome.

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

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

2017-06-01

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

Examination of Skill Acquisition and Grader Bias in a Distal Radius Fracture Fixation Model.

Science.gov (United States)

Putnam, Matthew D; Adams, Julie E; Lender, Paul; Van Heest, Ann E; Shanedling, Janet R; Nuckley, David J; Bechtold, Joan E

2018-03-01

Primary: Assess the ability of faculty graders to predict the objectively measured strength of distal radius fracture fixation. Secondary: Compare resident skill variation and retention related to other knowable training data. Residents were allowed 60 minutes to stabilize a standardized distal radius fracture using an assigned fixed-angle volar plate. Faculty observed and subjectively graded the residents without providing real-time feedback. Objective biomechanical evaluation (construct strength and stiffness) was compared to subjective grades. Resident-specific characteristics (sex, PGY, and ACGME case log) were also used to compare the objective data. A simulated operating room in our laboratory. Post-graduate year 2, 3, 4, and 5 orthopedic residents. Primary: Faculty were not successful at predicting objectively measured fixation, and their subjective scoring suggests confirmation bias as PGY increased. Secondary: Resident year-in-training alone did not predict objective measures (p = 0.53), but was predictive of subjective scores (p external faculty unfamiliar with tested residents, might alter these results. Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Trajectories in quality of life of patients with a fracture of the distal radius or ankle using latent class analysis

NARCIS (Netherlands)

van Son, M.A.C.; de Vries, J.; Zijlstra, W.; Roukema, J.A.; Gosens, T.; Verhofstad, M. H. J.; den Oudsten, B.L.

2017-01-01

Purpose This prospective study aimed to identify the different trajectories of quality of life (QOL) in patients with distal radius fractures (DRF) and ankle fractures (AF). Secondly, it was examined if subgroups could be characterized by sociodemographic, clinical, and psychological variables.

The International Classification of Functioning as an explanatory model of health after distal radius fracture: A cohort study

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MacDermid Joy C

2005-11-01

Full Text Available Abstract Background Distal radius fractures are common injuries that have an increasing impact on health across the lifespan. The purpose of this study was to identify health impacts in body structure/function, activity, and participation at baseline and follow-up, to determine whether they support the ICF model of health. Methods This is a prospective cohort study of 790 individuals who were assessed at 1 week, 3 months, and 1 year post injury. The Patient Rated Wrist Evaluation (PRWE, The Wrist Outcome Measure (WOM, and the Medical Outcome Survey Short-Form (SF-36 were used to measure impairment, activity, participation, and health. Multiple regression was used to develop explanatory models of health outcome. Results Regression analysis showed that the PRWE explained between 13% (one week and 33% (three months of the SF-36 Physical Component Summary Scores with pain, activities and participation subscales showing dominant effects at different stages of recovery. PRWE scores were less related to Mental Component Summary Scores, 10% (three months and 8% (one year. Wrist impairment scores were less powerful predictors of health status than the PRWE. Conclusion The ICF is an informative model for examining distal radius fracture. Difficulty in the domains of activity and participation were able to explain a significant portion of physical health. Post-fracture rehabilitation and outcome assessments should extend beyond physical impairment to insure comprehensive treatment to individuals with distal radius fracture.

The International Classification of Functioning as an explanatory model of health after distal radius fracture: A cohort study

Science.gov (United States)

Harris, Jocelyn E; MacDermid, Joy C; Roth, James

2005-01-01

Background Distal radius fractures are common injuries that have an increasing impact on health across the lifespan. The purpose of this study was to identify health impacts in body structure/function, activity, and participation at baseline and follow-up, to determine whether they support the ICF model of health. Methods This is a prospective cohort study of 790 individuals who were assessed at 1 week, 3 months, and 1 year post injury. The Patient Rated Wrist Evaluation (PRWE), The Wrist Outcome Measure (WOM), and the Medical Outcome Survey Short-Form (SF-36) were used to measure impairment, activity, participation, and health. Multiple regression was used to develop explanatory models of health outcome. Results Regression analysis showed that the PRWE explained between 13% (one week) and 33% (three months) of the SF-36 Physical Component Summary Scores with pain, activities and participation subscales showing dominant effects at different stages of recovery. PRWE scores were less related to Mental Component Summary Scores, 10% (three months) and 8% (one year). Wrist impairment scores were less powerful predictors of health status than the PRWE. Conclusion The ICF is an informative model for examining distal radius fracture. Difficulty in the domains of activity and participation were able to explain a significant portion of physical health. Post-fracture rehabilitation and outcome assessments should extend beyond physical impairment to insure comprehensive treatment to individuals with distal radius fracture. PMID:16288664

Effect of finite edge radius on ductile fracture ahead of the cutting tool edge in micro-cutting of Al2024-T3

International Nuclear Information System (INIS)

Subbiah, Sathyan; Melkote, Shreyes N.

2008-01-01

Evidence of ductile fracture leading to material separation has been reported recently in ductile metal cutting [S. Subbiah, S.N. Melkote, ASME J. Manuf. Sci. Eng. 28(3) (2006)]. This paper investigates the effect of finite edge radius on such ductile fracture. The basic question of whether such ductile fracture occurs in the presence of a finite edge radius is explored by performing a series of experiments with inserts of different edge radii at various uncut chip thickness values ranging from 15 to 105 μm. Chip-roots are obtained in these experiments using a quick-stop device and examined in a scanning electron microscope. Clear evidence of material separation is seen at the interface zone between the chip and machined surface even when the edge radius is large compared to the uncut chip thickness. Failure is seen to occur at the upper, middle, and/or the lower edges of the interface zone. Based on these observations, a hypothesis is presented for the events leading to the occurrence of this failure when cutting with an edge radius tool. Finite element simulations are performed to study the nature of stress state ahead of the tool edge with and without edge radius. Hydrostatic stress is seen to be tensile in front of the tool and hence favors the occurrence of ductile fracture leading to material separation. The stress components are, however lower than those seen with a sharp tool

Factors in secondary prevention subsequent to distal radius fracture : Focus on physical function, co-morbidity, bone mineral density and health-related quality of life

OpenAIRE

Nordvall, Helena

2009-01-01

In Sweden approximately 25000 distal radius fractures occur annually, which is 37 % of all fractures related to osteoporosis. In this thesis, risk factors for osteoporosis, bone mineral density (BMD) and health-related quality of life (the SF-36) were compared in patients who suffered a distal radius fracture after low energy trauma with a control group matched on the basis of age, gender, and municipality of residence. The aim was also to analyse, among these patients, whether a risk factor ...

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

International Nuclear Information System (INIS)

Rojas, Sandra; Bocanegra, Sergio; Suarez, Fabio

2002-01-01

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

Epidemiology of distal radius fractures in polytrauma patients and the influence of high traumatic energy transfer.

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Ferree, Steven; van der Vliet, Quirine M J; Nawijn, Femke; Bhashyam, Abhiram R; Houwert, Roderick M; Leenen, Luke P H; Hietbrink, Falco

2018-03-01

For several extremity fractures differences in morphology, incidence rate and functional outcome were found when polytrauma patients were compared to patients with an isolated injury. This is not proven for distal radius fractures (DRF). Therefore, this study aimed to analyse fracture morphology in relation to energy transfer in both poly- and mono-trauma patients with a DRF. This was a retrospective cohort study. All patients aged 16 years and older with a DRF were included. Patients with an Injury Severity Score of 16 or higher were classified as polytrauma patients. Injuries were defined as high or low energy. All DRFs were classified using the AO/OTA fracture classification system. A total of 830 patients with a DRF were included, 12% were polytrauma. The incidence rate of DRF in polytrauma patients was 3.5%. Ipsilateral upper extremity injury was found in >30% of polytrauma and high-energy monotrauma patients, compared to 5% in low-energy monotrauma patients. More type C DRF were found in polytrauma and high-energy monotrauma patients versus low-energy monotrauma patients. Operative intervention rates for all types of DRF were similar for polytrauma and high-energy monotrauma patients. Non-union rates were higher in polytrauma patients. Higher energy mechanisms of injury, in polytrauma and high-energy monotrauma patients, were associated with more severe complex articular distal radius fractures and more ipsilateral upper extremity injuries. Polytrauma and high-energy monotrauma patient have a similar fracture morphology. However, polytrauma patients have in addition to more injured body regions also more non-union related interventions than high-energy monotrauma patients. Copyright © 2018 Elsevier Ltd. All rights reserved.

Cross-education for improving strength and mobility after distal radius fractures: a randomized controlled trial.

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Magnus, Charlene R A; Arnold, Cathy M; Johnston, Geoffrey; Dal-Bello Haas, Vanina; Basran, Jenny; Krentz, Joel R; Farthing, Jonathan P

2013-07-01

To evaluate the effects of cross-education (contralateral effect of unilateral strength training) during recovery from unilateral distal radius fractures on muscle strength, range of motion (ROM), and function. Randomized controlled trial (26-wk follow-up). Hospital, orthopedic fracture clinic. Women older than 50 years with a unilateral distal radius fracture. Fifty-one participants were randomized and 39 participants were included in the final data analysis. Participants were randomized to standard rehabilitation (Control) or standard rehabilitation plus strength training (Train). Standard rehabilitation included forearm casting for 40.4±6.2 days and hand exercises for the fractured extremity. Nonfractured hand strength training for the training group began immediately postfracture and was conducted at home 3 times/week for 26 weeks. The primary outcome measure was peak force (handgrip dynamometer). Secondary outcomes were ROM (flexion/extension; supination/pronation) via goniometer and the Patient Rated Wrist Evaluation questionnaire score for the fractured arm. For the fractured hand, the training group (17.3±7.4kg) was significantly stronger than the control group (11.8±5.8kg) at 12 weeks postfracture (P<.017). There were no significant strength differences between the training and control groups at 9 (12.5±8.2kg; 11.3±6.9kg) or 26 weeks (23.0±7.6kg; 19.6±5.5kg) postfracture, respectively. Fractured hand ROM showed that the training group had significantly improved wrist flexion/extension (100.5°±19.2°) than the control group (80.2°±18.7°) at 12 weeks postfracture (P<.017). There were no significant differences between the training and control groups for flexion/extension ROM at 9 (78.0°±20.7°; 81.7°±25.7°) or 26 weeks (104.4°±15.5°; 106.0°±26.5°) or supination/pronation ROM at 9 (153.9°±23.9°; 151.8°±33.0°), 12 (170.9°±9.3°; 156.7°±20.8°) or 26 weeks (169.4°±11.9°; 162.8°±18.1°), respectively. There were no

Open segmental fracture of both bone forearm and dislocation of ipsilateral elbow with extruded middle segment radius

Directory of Open Access Journals (Sweden)

Pawan Kumar

2013-01-01

Full Text Available Extruded middle segment of radius with open segmental fracture both bone forearm and dislocation of ipsilateral elbow is a rare injury. A 12-year-old child presented to us within 4 hours following fall from tree. The child′s mother was carrying a 12-cm-long extruded soiled segment of radius. The extruded bone was thoroughly washed. The medullary cavity was properly syringed with antiseptic solution. The bone was autoclaved and put in the muscle plane of the distal forearm after debridement of the wound. After 5 days, a 2.5-mm K-wire was introduced by retrograde method into the proximal radius by passing through the extruded segment. Another 2.5-mm K-wire was passed in ulna. The limb was evaluated clinicoradiologically every 2 weeks. The wound was healed by primary intention. At 4 months, the reposed bone appeared less dense radiologically and K-wire seemed to be out of the bone. In the subsequent months, the roentgenograms show remodeling of the extruded fragment. After 20 weeks, the K-wires were removed (first ulnar and then radial. Complete union was achieved with full range of movement except loss of few degrees of extension of elbow and thumb. This case is reported to show a good outcome following successful incorporation of an extruded segment of radius in an open fracture.

Bone strength and muscle properties in postmenopausal women with and without a recent distal radius fracture.

Science.gov (United States)

Crockett, K; Arnold, C M; Farthing, J P; Chilibeck, P D; Johnston, J D; Bath, B; Baxter-Jones, A D G; Kontulainen, S A

2015-10-01

Distal radius (wrist) fracture (DRF) in women over age 50 years is an early sign of bone fragility. Women with a recent DRF compared to women without DRF demonstrated lower bone strength, muscle density, and strength, but no difference in dual-energy x-ray absorptiometry (DXA) measures, suggesting DXA alone may not be a sufficient predictor for DRF risk. The objective of this study was to investigate differences in bone and muscle properties between women with and without a recent DRF. One hundred sixty-six postmenopausal women (50-78 years) were recruited. Participants were excluded if they had taken bone-altering medications in the past 6 months or had medical conditions that severely affected daily living or the upper extremity. Seventy-seven age-matched women with a fracture in the past 6-24 months (Fx, n = 32) and without fracture (NFx, n = 45) were measured for bone and muscle properties using the nondominant (NFx) or non-fractured limb (Fx). Peripheral quantitative computed tomography (pQCT) was used to estimate bone strength in compression (BSIc) at the distal radius and tibia, bone strength in torsion (SSIp) at the shaft sites, muscle density, and area at the forearm and lower leg. Areal bone mineral density at the ultradistal forearm, spine, and femoral neck was measured by DXA. Grip strength and the 30-s chair stand test were used as estimates of upper and lower extremity muscle strength. Limb-specific between-group differences were compared using multivariate analysis of variance (MANOVA). There was a significant group difference (p lower leg, with the Fx group demonstrating 16 and 19% lower BSIc, 3 and 6% lower muscle density, and 20 and 21% lower muscle strength at the upper and lower extremities, respectively. There were no differences between groups for DXA measures. Women with recent DRF had lower pQCT-derived estimated bone strength at the distal radius and tibia and lower muscle density and strength at both extremities.

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

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Dong Wang

2018-04-01

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

The outcome of conservative treatment of adult distal radius fractures compared with the other wrist: radiological and functional evaluation

Directory of Open Access Journals (Sweden)

Mustafa Uslu

2014-09-01

Full Text Available Objective: This study was designed to evaluate anatomical and functional results of closed reduction-long arm cast treatment for distal radius fractures and compared other healthy wrist in the adults. Methods: 77 patients with distal radius fracture were treated conservatively between January 2010 and December 2010. The fractures were classified according to AO and Frykman classification system and investigated prospectively. The radiological and anatomical results were assessed by the Stewart score criteria. The functional results were assessed by Quick-Disability of Arm, Shoulder and Hand questionnaire (Q-DASH and the Stewart II score criteria. The mean follow-up of patients was 12 months. Results: The forty patients had right wrist fractured, 37 patients had left wrist fractured. According to Frykman classification 46 patients were type I-II fractured, according to AO classification 59 patients were type 23,A2,1 and 23,A2,2 fractured. According to Stewart the radiological and anatomical, the result were excellent in 57, good in 17, fair in 3. According to Stewart II functional criteria, the results were assessed excellent in 57, good in 8, fair in 12 The mean Q-DASH score was 6,37. The overall complication rate was 12.98%. Mild Carpal tunnel syndrome was observed in the two patients, ulna styloid nonunion in the four patients, pain of distal radioulnar joint in the one patient, mild carpal tunnel syndrome and tenderness of distal radioulnar joint in the three patients. Conclusion: Closed reduction and cast immobilization is still an effective and inexpensive treatment method in distal radial fractures. J Clin Exp Invest 2014; 5 (3: 403-409

Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment?

International Nuclear Information System (INIS)

Jaremko, J.L.; Lambert, R.G.W.; Rowe, B.H.; Johnson, J.A.; Majumdar, S.R.

2007-01-01

Aim: To investigate whether radiographic deformities suggesting inadequate reduction would be associated with adverse clinical outcomes. Materials and methods: Consecutive patients over 50 years of age (n = 74) with non-operatively managed distal radius fractures were enrolled in a prospective cohort study. They had radiographs at cast removal (∼6 weeks) and completed DASH (Disabilities of the Arm, Shoulder and Hand), SF-12 (health-related quality of life), and satisfaction surveys 6-months post-fracture. A reference-standard musculoskeletal radiologist, blinded to outcomes status, measured palmar (dorsal) tilt, radial angle, radial height, ulnar height, and intra-articular step and gap. Radiographic indices were correlated to each other and to the various patient-reported outcomes in univariate and multivariate regression analyses. DASH score was the primary study outcome. Results: Of the cohort studied (n = 74, mean age 68.5 years, primarily white women), 71% had at least one 'unacceptable' radiographic deformity by traditional criteria. Acceptable reduction varied from 60-99% depending on which single index was reported, and 44% of patients had more than two indices reported as unacceptable. Despite these radiographic findings, 6-months post-reduction, self-reported disability was low (DASH = 24 ± 17), health-related quality of life was near normal, and 72% were satisfied with their care. No radiographic index of wrist deformity (alone or in combination) was significantly correlated to any of the patient-reported outcomes. Conclusion: Self-reported outcomes in older adults with conservatively managed wrist fractures were not related to the 'acceptability' of radiographic fracture reduction. The proportion of acceptable reductions varied by 40% depending on which index was reported. Consequently, detailed reporting of these indices in older adults with distal radius fracture may be inefficient or perhaps even unnecessary

Do radiographic indices of distal radius fracture reduction predict outcomes in older adults receiving conservative treatment?

Energy Technology Data Exchange (ETDEWEB)

Jaremko, J.L. [Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta (Canada); Lambert, R.G.W. [Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Alberta (Canada); Rowe, B.H. [Department of Emergency Medicine, University of Alberta, Edmonton, Alberta (Canada); Department of Public Health Sciences, University of Alberta, Edmonton, Alberta (Canada); Johnson, J.A. [Department of Public Health Sciences, University of Alberta, Edmonton, Alberta (Canada); Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta (Canada); Majumdar, S.R. [Department of Public Health Sciences, University of Alberta, Edmonton, Alberta (Canada) and Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta (Canada)]. E-mail: me2.majumdar@ualberta.ca

2007-01-15

Aim: To investigate whether radiographic deformities suggesting inadequate reduction would be associated with adverse clinical outcomes. Materials and methods: Consecutive patients over 50 years of age (n = 74) with non-operatively managed distal radius fractures were enrolled in a prospective cohort study. They had radiographs at cast removal ({approx}6 weeks) and completed DASH (Disabilities of the Arm, Shoulder and Hand), SF-12 (health-related quality of life), and satisfaction surveys 6-months post-fracture. A reference-standard musculoskeletal radiologist, blinded to outcomes status, measured palmar (dorsal) tilt, radial angle, radial height, ulnar height, and intra-articular step and gap. Radiographic indices were correlated to each other and to the various patient-reported outcomes in univariate and multivariate regression analyses. DASH score was the primary study outcome. Results: Of the cohort studied (n = 74, mean age 68.5 years, primarily white women), 71% had at least one 'unacceptable' radiographic deformity by traditional criteria. Acceptable reduction varied from 60-99% depending on which single index was reported, and 44% of patients had more than two indices reported as unacceptable. Despite these radiographic findings, 6-months post-reduction, self-reported disability was low (DASH = 24 {+-} 17), health-related quality of life was near normal, and 72% were satisfied with their care. No radiographic index of wrist deformity (alone or in combination) was significantly correlated to any of the patient-reported outcomes. Conclusion: Self-reported outcomes in older adults with conservatively managed wrist fractures were not related to the 'acceptability' of radiographic fracture reduction. The proportion of acceptable reductions varied by 40% depending on which index was reported. Consequently, detailed reporting of these indices in older adults with distal radius fracture may be inefficient or perhaps even unnecessary.

WHAT IS THE BEST RADIOGRAPHIC VIEW FOR "DIE PUNCH" DISTAL RADIUS FRACTURES? A CADAVER MODEL STUDY.

Science.gov (United States)

Falcochio, Diego Figueira; Crepaldi, Bruno Eiras; Trindade, Christiano Augusto; da Costa, Antonio Carlos; Chakkour, Ivan

2012-01-01

the aim of this study is try to show the best view for distal radius fractures so called die-punch fractures. There has been used a human cadaver radius bone from the Salvador Arena Tissue Bank. This bone was cleaned up after removing the soft tissues and osteotomies created displaced lunate fossa fractures of 0, 1, 2, 3 and 5 mm. We have fixed this fragment with adhesive tape. Then the joint deviation were significantly increased with step-offs of 1 mm. Radiographs were then taken into 5 different positions: postero-anterior view, lateral view, oblique views and tangencial view for each of the deviations. The resulting lunate fossa depression in each X-ray film was analyzed by the AutoCAD 2010® software. The tangencial view was the best one to see the 1mm and 3mm bone degrees and the second one view to see the 2mm and 5 mm degrees. The pronated oblique view was the best to see the 2mm degrees and the oblique supinated view wasn't able to see the degrees between 1 and 2mm. The tangencial view was the best one to see the 1mm and 3mm bone degrees and the second one view to see the 2mm and 5 mm degrees.

Mechanism of distal radius fracture as analyzed by 3D finite element model

International Nuclear Information System (INIS)

Tomizawa, Kazuo

2007-01-01

The purpose of this study is to see the difference of distal radius fracture between normal and osteoporotic bones and in its patterns due to limb position at injury through simulation and analysis of the biomechanics using three-dimensional (3D) finite element model. CT images were taken with SIEMENS machine, of right wrist joints of 32 and 76 years old, normal healthy man and osteoporotic woman, respectively. The wrist joint angles at CT were 70 degrees both at dorsiflexion and at palmerflexion for simulating fracture at tumbling down. The 3D bone model reconstructed from CT images with Forge software (Studio PON) was trimmed to remain the distal radial-ulnar portion and proximal carpal bones to make simulation easer, and the simplified 3D model was divided to 56,622 elements and 13,274 nodal points (normal bone) or 51,760 and 12,940 (osteoporosis), respectively, in 3 areas of different bone densities calculated with Scion Image processor. This 3D finite element model was analyzed with the software ANSYS LS-DYNA 10.0 for simulating the fracture (the defined yield stress attained) by impacting the elements of carpal bones to the radial bone joint surface with a measure of Mises stress. In osteoporotic bone, fracture was found to occur at dorsal cortex closer to the joint surface. Fracture occurred at dorsal and palmer cortex at dorsiflexion and palmerflexion, respectively. (R.T.)

Radiographical measurements for distal intra-articular fractures of the radius using plain radiographs and cone beam computed tomography images

Energy Technology Data Exchange (ETDEWEB)

Suojaervi, Nora; Lindfors, N. [Helsinki University Central Hospital, Department of Hand Surgery, Helsinki (Finland); Sillat, T.; Koskinen, S.K. [HUS Helsinki Medical Imaging Center, Helsinki University Central Hospital, Department of Radiology, Helsinki (Finland)

2015-12-15

Operative treatment of an intra-articular distal radius fracture is one of the most common procedures in orthopedic and hand surgery. The intra- and interobserver agreement of common radiographical measurements of these fractures using cone beam computed tomography (CBCT) and plain radiographs were evaluated. Thirty-seven patients undergoing open reduction and volar fixation for a distal radius fracture were studied. Two radiologists analyzed the preoperative radiographs and CBCT images. Agreement of the measurements was subjected to intra-class correlation coefficient and the Bland-Altman analyses. Plain radiographs provided a slightly poorer level of agreement. For fracture diastasis, excellent intraobserver agreement was achieved for radiographs and good or excellent agreement for CBCT, compared to poor interobserver agreement (ICC 0.334) for radiographs and good interobserver agreement (ICC 0.621) for CBCT images. The Bland-Altman analyses indicated a small mean difference between the measurements but rather large variation using both imaging methods, especially in angular measurements. For most of the measurements, radiographs do well, and may be used in clinical practice. Two different measurements by the same reader or by two different readers can lead to different decisions, and therefore a standardization of the measurements is imperative. More detailed analysis of articular surface needs cross-sectional imaging modalities. (orig.)

Radiographical measurements for distal intra-articular fractures of the radius using plain radiographs and cone beam computed tomography images.

Science.gov (United States)

Suojärvi, Nora; Sillat, T; Lindfors, N; Koskinen, S K

2015-12-01

Operative treatment of an intra-articular distal radius fracture is one of the most common procedures in orthopedic and hand surgery. The intra- and interobserver agreement of common radiographical measurements of these fractures using cone beam computed tomography (CBCT) and plain radiographs were evaluated. Thirty-seven patients undergoing open reduction and volar fixation for a distal radius fracture were studied. Two radiologists analyzed the preoperative radiographs and CBCT images. Agreement of the measurements was subjected to intra-class correlation coefficient and the Bland-Altman analyses. Plain radiographs provided a slightly poorer level of agreement. For fracture diastasis, excellent intraobserver agreement was achieved for radiographs and good or excellent agreement for CBCT, compared to poor interobserver agreement (ICC 0.334) for radiographs and good interobserver agreement (ICC 0.621) for CBCT images. The Bland-Altman analyses indicated a small mean difference between the measurements but rather large variation using both imaging methods, especially in angular measurements. For most of the measurements, radiographs do well, and may be used in clinical practice. Two different measurements by the same reader or by two different readers can lead to different decisions, and therefore a standardization of the measurements is imperative. More detailed analysis of articular surface needs cross-sectional imaging modalities.

[Growth behaviour after fractures of the proximal radius: differences to the rest of the skeleton].

Science.gov (United States)

Hell, A K; von Laer, L

2014-12-01

Fractures of the proximal end of the radius in the growth phase have three characteristics: the head of the radius articulates with two joint partners and is therefore indispensable for an undisturbed function of the elbow. The blood supply of the proximal end of the radius is via periosteal vessels in the sense of a terminal circulation which makes it extremely vulnerable. Severe trauma caused either by accidents or treatment, can result in partial or complete necrosis with deformity of the head and neck region of the radius. Radioulnar synostosis and chronic epiphysiolysis are irreversible complications which can occur after excessive physiotherapy. Despite a low potency growth plate, in young patients the proximal end of the radius shows an enormous spontaneous correction of dislocations. Side to side shifts, however, will not be remodeled. Therapy should be as atraumatic as possible. Due to the blood supply situation, with the appropriate indications the spontaneous correction and a brief period of immobilization without physiotherapy should be integrated into the therapy concept. If an operation is necessary, repeated traumatic repositioning maneuvers should be avoided and in case of doubt closed or careful open repositioning can be achieved with intramedullary nailing. In order to take the special characteristics of the proximal radius into consideration, the vulnerability and correction potential must be weighed up against each other. Therapy must be as atraumatic as possible. The spontaneous correction potential should be integrated into the primary therapy without overestimating this potential with respect to the extent and age of the patient.

A retrospective, semi-quantitative image quality analysis of cone beam computed tomography (CBCT) and MSCT in the diagnosis of distal radius fractures

International Nuclear Information System (INIS)

Lang, H.; Neubauer, J.; Fritz, B.; Spira, E.M.; Strube, J.; Langer, M.; Kotter, E.

2016-01-01

To compare image quality and diagnostic validity of CBCT and MSCT for distal radius fractures. 35 CBCT and 33 MSCT scans were retrospectively reviewed with a visual grading scale regarding the depiction of cortical bone, trabecular bone, articular surfaces, and soft tissue. The extent and type of artefacts was analyzed. Agreement on AO classification and measurement of cortical disruption and length of the fracture gap was determined. Fracture reduction was evaluated in post-treatment x-rays. Statistical analysis was performed with visual grading characteristics (VGC), chi square tests, and Kendall's coefficient of concordance. CBCT performed significantly worse for cortical bone, articular surfaces, and especially soft tissue. Trabecular bone showed no significant difference. Significantly more CBCT images showed artefacts. Physics-based artefacts were the most common. CBCT scans also showed motion artefacts. There was no significant difference in agreement on AO classification. The agreement on measurements was substantial for both modalities. Slightly more fractures that had undergone MSCT imaging showed adequate reduction. This initial study of an orthopaedic extremity CBCT scanner showed that the image quality of a CBCT scanner remains inferior for most structures at standard settings. Diagnostic validity of both modalities for distal radius fractures seems similar. (orig.)

Radiographic evaluation of acute distal radius fracture stability: A comparative cadaveric study between a thermo-formable bracing system and traditional fiberglass casting.

Science.gov (United States)

Santoni, Brandon G; Aira, Jazmine R; Diaz, Miguel A; Kyle Stoops, T; Simon, Peter

2017-08-01

Distal radius fractures are common musculoskeletal injuries and many can be treated non-operatively with cast immobilization. A thermo-formable brace has been developed for management of such fractures, but no data exist regarding its comparative stabilizing efficacy to fiberglass casting. A worst-case distal radius fracture was created in 6 cadaveric forearms. A radiolucent loading fixture was created to apply cantilever bending/compression loads ranging from 4.5N to 66.7N across the simulated fracture in the: (1) non-stabilized, (2) braced; and (3) casted forearms, each forearm serving as its own control. Fracture fragment translations and rotations were measured radiographically using orthogonal radiographs and a 2D-3D, CT-based transformation methodology. Under 4.5N of load in the non-stabilized condition, average sagittal plane rotation and 3D center of mass translation of the fracture fragment were 12.3° and 5.3mm, respectively. At the 4.5N load step, fragment rotation with the brace (avg. 0.0°) and cast (0.1°) reduced sagittal plane rotation compared to the non-stabilized forearm (Pthermo-formable brace stabilized the fracture in a manner that was not radiographically or biomechanically different from traditional fiberglass casting. Study results support the use of the thermo-formable brace clinically. Copyright © 2017 Elsevier Ltd. All rights reserved.

WHAT IS THE BEST RADIOGRAPHIC VIEW FOR “DIE PUNCH” DISTAL RADIUS FRACTURES? A CADAVER MODEL STUDY

Science.gov (United States)

Falcochio, Diego Figueira; Crepaldi, Bruno Eiras; Trindade, Christiano Augusto; da Costa, Antonio Carlos; Chakkour, Ivan

2015-01-01

Objective: the aim of this study is try to show the best view for distal radius fractures so called die-punch fractures. Methods: There has been used a human cadaver radius bone from the Salvador Arena Tissue Bank. This bone was cleaned up after removing the soft tissues and osteotomies created displaced lunate fossa fractures of 0, 1, 2, 3 and 5 mm. We have fixed this fragment with adhesive tape. Then the joint deviation were significantly increased with step-offs of 1 mm. Radiographs were then taken into 5 different positions: postero-anterior view, lateral view, oblique views and tangencial view for each of the deviations. The resulting lunate fossa depression in each X-ray film was analyzed by the AutoCAD 2010® software. Results: The tangencial view was the best one to see the 1mm and 3mm bone degrees and the second one view to see the 2mm and 5 mm degrees. The pronated oblique view was the best to see the 2mm degrees and the oblique supinated view wasn't able to see the degrees between 1 and 2mm. Conclusion: The tangencial view was the best one to see the 1mm and 3mm bone degrees and the second one view to see the 2mm and 5 mm degrees. PMID:27027079

[Clinical observation on the effect of joint mobilization in treating elderly patients after distal radius fractures operation].

Science.gov (United States)

Jia, Xue-Feng; Cai, Hong-Xin; Lin, Ge-Sheng; Fang, Ji-Shi; Wang, Yong; Wu, Zhi-Yong; Tu, Xu-Hui

2017-07-25

To investigate the effect of joint mobilization on postoperative wrist joint function, pain and grip strength for elderly patients with distal radius fracture. From January 2015 to June 2016, a total of 67 elderly patients with distal radius fracture were randomly divided into routine exercise group and joint mobilization group. Among them, 37 patients in the routine exercise group underwent conventional distal radius fracture postoperative joint function exercise regimen, including 16 males and 21 females with a mean age of (67.8±3.2) years old ranging from 60 to 72 years old;the injured side was dominant in 23 cases and non-dominant in 14 cases;injury mechanism was fall in 26 cases, traffic accident in 11 cases; for AO type, 6 cases were type B3, 18 cases were type C1, 7 cases were type C2, 6 cases was type C3. Other 30 patients in the joint mobilization group underwent joint mobilization on the basis of the routine exercise group including 14 males and 16 females with a mean age of (67.1±4.0) years old ranging from 61 to 74 years old; the injured side was dominant in 21 cases and non-dominant in 9 cases;injury mechanism was fall in 25 cases, traffic accident in 5 cases;for AO type, 8 cases were type B3, 13 cases were type C1, 6 cases were type C2, 9 cases were type C3. The wrist joint activity, Gartland-Werley wrist joint function score, VAS pain score and grip strength were observed at 3 months afrer treatment. After 3 months' treatment, the VAS in the routine exercise group was higher than that of the joint mobilization group ( P joint mobilization group was higher than that in routine exercise group( P joint mobilization group( P joint mobilization group had no significant difference ( P >0.05). In the comparison of each item of Gartland-Werley, there was no significant difference between two groups in residual deformity and complication( P >0.05); the average score of subjective score, objective score and total score in routine exercise group were

Elbow dislocation with ipsilateral fracture of the distal radius associated with a brachial artery injury: A new pathological condition of traumatic origin.

Science.gov (United States)

Trigo Lahoz, L; Lamas Gomez, C; Sarasquete Reiriz, J; de Caso Rodriguez, J; Proubasta Renart, I

Elbow dislocation associated with ipsilateral fracture of the distal radius and a brachial artery injury is an uncommon traumatic entity. The two references of this injury combination appeared in 2015, although both authors did not realise that they were the first two cases published in the medical literature. Although mentioned in the text of the articles, no mention was made of the fracture of the distal radius in the titles. The purpose of this paper is to present three cases with this new traumatic pathological entity, explaining its pathogenetic mechanism, the treatment used, and the results obtained. Copyright © 2016 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.

New quantitative ultrasound techniques for bone analysis at the distal radius in hip fracture cases: differences between femoral neck and trochanteric fractures.

Science.gov (United States)

Horii, Motoyuki; Fujiwara, Hiroyoshi; Sakai, Ryo; Sawada, Koshiro; Mikami, Yasuo; Toyama, Syogo; Ozaki, Etsuko; Kuriyama, Nagato; Kurokawa, Masao; Kubo, Toshikazu

2017-01-01

Ample evidence on etiological and pathological differences between femoral neck and trochanteric fracture cases suggests the possibility of individualized treatment. There are many issues related to areal bone mineral density and other quantitative computed tomography parameters of the proximal femur. Although osteoporosis is a systemic problem, little has been reported regarding differences in bone structural parameters, including bone mineral density, between them in regions other than the proximal femur. Participants were consecutive female patients >50 years of age admitted to the Saiseikai Suita Hospital (Osaka prefecture, Japan) for their first hip fracture between January 2012 and September 2014. Cortical thickness (CoTh, mm), volumetric trabecular bone mineral density (TBD, mg/cm 3 ), and elastic modulus of trabecular bone (EMTb, GPa) were obtained as the new QUS parameters using the LD-100 system (Oyo Electric, Kyoto, Japan). The mean values of these parameters were compared between femoral neck and trochanteric fracture cases. In addition, correlations between age and each QUS parameter were investigated for each fracture type. A receiver operating characteristic (ROC) curve analysis was performed to examine the degree of effect each parameter on the fracture types. The area under the curve (AUC) for each parameter was compared to the AUC for age. There were 63 cases of femoral neck fracture (mean age, 78.2 years) and 37 cases of trochanteric fracture (mean age, 85.9 years). Mean TBD and EMTb were significantly higher for femoral neck fractures. There were significant negative correlations between QUS parameters and age for femoral neck fractures (P fractures were above those for trochanteric fractures for TBD and EMTb. AUCs were 0.72 for age, and 0.61, 0.65, and 0.65 for CoTh, TBD, and EMTb, respectively. The new QUS parameters indicated that TR fracture cases were more osteoporotic than were FN fracture cases, even at the distal radius. There might be

Accuracy of specimen-specific nonlinear finite element analysis for evaluation of distal radius strength in cadaver material.

Science.gov (United States)

Matsuura, Yusuke; Kuniyoshi, Kazuki; Suzuki, Takane; Ogawa, Yasufumi; Sukegawa, Koji; Rokkaku, Tomoyuki; Takahashi, Kazuhisa

2014-11-01

Distal radius fracture, which often occurs in the setting of osteoporosis, can lead to permanent deformity and disability. Great effort has been directed toward developing noninvasive methods for evaluating the distal radius strength, with the goal of assessing fracture risk. The aim of this study was to evaluate distal radius strength using a finite element model and to gauge the accuracy of finite element model measurement using cadaver material. Ten wrists were obtained from cadavers with a mean age of 89.5 years at death. CT images of each wrist in an extended position were obtained. CT-based finite element models were prepared with Mechanical Finder software. Fracture on the models was simulated by applying a mechanical load to the palm in a direction parallel to the forearm axis, after which the fracture load and the site at which the fracture began were identified. For comparison, the wrists were fractured using a universal testing machine and the fracture load and the site of fracture were identified. The fracture load was 970.9 N in the finite element model group and 990.0 N in the actual measurement group. The site of the initial fracture was extra-articular to the distal radius in both groups. The finite element model was predictive for distal radius fracture when compared to the actual measurement. In this study, a finite element model for evaluation of distal radius strength was validated and can be used to predict fracture risk. We conclude that a finite element model is useful for the evaluation of distal radius strength. Knowing distal radius strength might avoid distal radius fracture because appropriate antiosteoporotic treatment can be initiated.

A retrospective, semi-quantitative image quality analysis of cone beam computed tomography (CBCT) and MSCT in the diagnosis of distal radius fractures

Energy Technology Data Exchange (ETDEWEB)

Lang, H.; Neubauer, J.; Fritz, B.; Spira, E.M.; Strube, J.; Langer, M.; Kotter, E. [University Medical Center Freiburg, Department of Radiology, Freiburg (Germany)

2016-12-15

To compare image quality and diagnostic validity of CBCT and MSCT for distal radius fractures. 35 CBCT and 33 MSCT scans were retrospectively reviewed with a visual grading scale regarding the depiction of cortical bone, trabecular bone, articular surfaces, and soft tissue. The extent and type of artefacts was analyzed. Agreement on AO classification and measurement of cortical disruption and length of the fracture gap was determined. Fracture reduction was evaluated in post-treatment x-rays. Statistical analysis was performed with visual grading characteristics (VGC), chi square tests, and Kendall's coefficient of concordance. CBCT performed significantly worse for cortical bone, articular surfaces, and especially soft tissue. Trabecular bone showed no significant difference. Significantly more CBCT images showed artefacts. Physics-based artefacts were the most common. CBCT scans also showed motion artefacts. There was no significant difference in agreement on AO classification. The agreement on measurements was substantial for both modalities. Slightly more fractures that had undergone MSCT imaging showed adequate reduction. This initial study of an orthopaedic extremity CBCT scanner showed that the image quality of a CBCT scanner remains inferior for most structures at standard settings. Diagnostic validity of both modalities for distal radius fractures seems similar. (orig.)

Radiological dorsal tilt analysis of AO type A, B, and C fractures of the distal radius treated conservatively or with extra-focal K-wire plus external fixateur

Energy Technology Data Exchange (ETDEWEB)

Hoffmann, Michael [University Medical Center Hamburg-Eppendorf, Department of Trauma, Hand and Reconstructive Surgery, Hamburg (Germany); Borders General Hospital, Department for Trauma and Orthopaedic Surgery, Melrose, Roxburghshire, Scotland (United Kingdom); Schroeder, Malte; Gruber-Rathmann, Michaela; Ruecker, Andreas H. [University Medical Center Hamburg-Eppendorf, Department of Trauma, Hand and Reconstructive Surgery, Hamburg (Germany); Kossow, Kai [Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg (Germany)

2012-09-15

Fractures of the distal radius are amongst the most common injury patterns. The dorsal tilt represents an important co-factor determining functional outcome. The purpose of this study was to analyze the radiological dorsal tilt and identify critical time frames in conservative and operative treatment of distal radius fractures. Eighty-seven conservatively treated (hematoma block assisted reduction and splinting) and 37 operatively treated (reduction, extra-focal K-wire fixation, bridging external fixateur) AO type A, B, and C fractures of the distal radius in 124 females were retrospectively analyzed. The dorsal tilt at the initial, post-reduction, and 2 weeks post-reduction stages was correlated with the final radiographic outcome at 6 weeks. Mean initial dorsal tilt was 16.53 in the conservatively treated group and 26.76 in the operatively treated group. Mean dorsal tilt after 6 weeks showed significant differences from the mean initial dorsal tilt at time of presentation within both groups (both groups p < 0.000). No significant differences between the two groups were found after 6 weeks of treatment (p = 0.194) regardless of the underlying AO fracture type. Conservatively treated radius fractures showed a significantly higher slip rate within the first 2 weeks (primary slip rate), whereas the operative group presented a significantly higher slip rate between the 2-week and 6-week radiographic checks (secondary slip rate). In terms of dorsal tilt, conservative (cast immobilization) and operative (K-wire fixation plus external fixateur) treatment demonstrated no significant differences at the final radiographic examination (6 weeks) regardless of the underlying AO fracture type. Both treatment groups showed treatment-associated different primary and secondary slip rates, indicating a need for more frequent radiographic checks within these critical time frames. (orig.)

Non-operative treatment of displaced distal radius fractures leads to acceptable functional outcomes, however at the expense of 40% subsequent surgeries

NARCIS (Netherlands)

Mulders, M. A. M.; van Eerten, P. V.; Goslings, J. C.; Schep, N. W. L.

2017-01-01

Background: Although secondary displacement following closed reduction and plaster immobilisation is high, several guidelines still recommend non-operative treatment for displaced distal radius fractures with an adequate closed reduction. Purpose: The purpose of this study was to evaluate functional

Are distal radius fractures due to fragility or to falls? A consecutive case-control study of bone mineral density, tendency to fall, risk factors for osteoporosis, and health-related quality of life.

Science.gov (United States)

Nordvall, Helena; Glanberg-Persson, Gunhild; Lysholm, Jack

2007-04-01

A fracture of the distal radius is considered to indicate an increased risk of future fractures, especially a hip fracture. The main causes may be osteoporosis or a tendency to fall, separately or in combination. 93 women and 5 men with a recent radius fracture and the same number of controls were measured with a heel-DXL and asked to complete one questionnaire on their quality of life (SF-36), and one on risk factors. The mean T-score of the patients was -2.1, and for the controls it was -1.9 (p = 0.3). The patients aged over 64 years had a history of falling more often than the corresponding controls (p = 0.01), but there was no difference in T-score. By contrast, patients 45-64 years of age showed a non-significant, lower T-score (p = 0.09), but there was no difference concerning their history of falling. For all other risk factors, no differences were found between the patients and the controls. There were significant differences between the patients and the controls in some of the functions in the SF-36, due to the radius fracture. This study indicates that the underlying cause of a distal radius fracture may be different in patients aged 45-64 years and those who are more than 64 years old.

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

Science.gov (United States)

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

2017-03-01

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

Outcome of management of distal radius fractures in ...

African Journals Online (AJOL)

Background and Purpose: Distal radial fractures are common fractures of postmenopausal age group patients. They are often called fractures of osteoporosis. These fractures are considered to be one of the commonest minor injuries to cause major morbidity in the community. A lot of patient who need surgery, fail to afford ...

Bone density of the radius, spine, and proximal femur in osteoporosis

International Nuclear Information System (INIS)

Mazess, R.B.; Barden, H.; Ettinger, M.; Schultz, E.

1988-01-01

Bone mineral density (BMD) was measured in 140 normal young women (aged 20 to 39 years) and in 423 consecutive women over age 40 referred for evaluation of osteoporosis. Lumbar spine and proximal femur BMD was measured using dual-photon absorptiometry ( 153 Gd), whereas the radius shaft measurement used single-photon absorptiometry ( 125 I). There were 324 older women with no fractures, of which 278 aged 60 to 80 years served as age-matched controls. There were 99 women with fractures including 32 with vertebral and 22 with hip fractures. Subsequently, another 25 women with hip fractures had BMD measured in another laboratory; their mean BMD was within 2% of that of the original series. The mean age in both the nonfracture and fracture groups was 70 +/- 5 years. The BMD in the age-matched controls was 20% to 25% below that of normal young women for the radius, spine, and femur, but the Ward's triangle region of the femur showed even greater loss (35%). The mean BMD at all sites in the crush fracture cases was about 10% to 15% below that of age-matched controls. Spinal abnormality was best discriminated by spine and femoral measurements (Z score about 0.9). In women with hip fractures, the BMD was 10% below that of age-matched controls for the radius and the spine, and the BMD for the femoral sites was about 25% to 30% below that of age-matched control (Z score about 1.6). Femoral densities gave the best discrimination of hip fracture cases and even reflected spinal osteopenia. In contrast, neither the spine nor the radius reflected the full extent of femoral osteopenia in hip fracture

Comparison of 2D radiography and a semi-automatic CT-based 3D method for measuring change in dorsal angulation over time in distal radius fractures

Energy Technology Data Exchange (ETDEWEB)

Christersson, Albert; Larsson, Sune [Uppsala University, Department of Orthopaedics, Uppsala (Sweden); Nysjoe, Johan; Malmberg, Filip; Sintorn, Ida-Maria; Nystroem, Ingela [Uppsala University, Centre for Image Analysis, Uppsala (Sweden); Berglund, Lars [Uppsala University, Uppsala Clinical Research Centre, UCR Statistics, Uppsala (Sweden)

2016-06-15

The aim of the present study was to compare the reliability and agreement between a computer tomography-based method (CT) and digitalised 2D radiographs (XR) when measuring change in dorsal angulation over time in distal radius fractures. Radiographs from 33 distal radius fractures treated with external fixation were retrospectively analysed. All fractures had been examined using both XR and CT at six times over 6 months postoperatively. The changes in dorsal angulation between the first reference images and the following examinations in every patient were calculated from 133 follow-up measurements by two assessors and repeated at two different time points. The measurements were analysed using Bland-Altman plots, comparing intra- and inter-observer agreement within and between XR and CT. The mean differences in intra- and inter-observer measurements for XR, CT, and between XR and CT were close to zero, implying equal validity. The average intra- and inter-observer limits of agreement for XR, CT, and between XR and CT were ± 4.4 , ± 1.9 and ± 6.8 respectively. For scientific purpose, the reliability of XR seems unacceptably low when measuring changes in dorsal angulation in distal radius fractures, whereas the reliability for the semi-automatic CT-based method was higher and is therefore preferable when a more precise method is requested. (orig.)

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

Science.gov (United States)

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

2017-06-15

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

[Complications of open reduction and internal fixation versus external fixation for unstable distal radius fractures: a meta-analysis].

Science.gov (United States)

Yang, Z; Yuan, Z Z; Ma, J X; Ma, X L

2016-12-20

Objective: To make a systematic assessment of the complications of open reduction and internal fixation versus external fixation for unstable distal radius fractures. Method: A computer-based online search of PubMed, ScienceDirect, EMBASE, BIOSIS, Springer and Cochrane Library were performed.The randomized and controlled trials of open reduction and internal fixation versus external fixation for unstable distal radius fractures were collected.The included trials were screened out strictly based on the criterion of inclusion and exclusion.The quality of included trials was evaluated.RevMan 5.0 was used for data analysis. Result: A total of 17 studies involving 1 402 patients were included.There were 687 patients with open reduction and internal fixation and 715 with external fixation.The results of Meta-analysis indicated that there were statistically significant differences with regard to the postoperatively total complications, infection, malunion, tendon rupture ( I 2 =8%, RR =0.77(95% CI 0.65-0.91, Z =3.10, P 0.05). Conclusion: Postoperative complications are present in both open reduction and internal fixation and external fixation.Compared with external fixation, open reduction and internal fixation is lower in total complications postoperatively, infection and malunion, but external fixation has lower tendon rupture incidence.

[Case-control study on tibetan Baimai ointment (see symbol in text) for the treatment of wrist-dysfunction after distal radius fracture].

Science.gov (United States)

Zhang, Xing-ping; Xu, Gen-rong; Xu, Shan-qiang; Lu, Ze-ming; Huang, Lei

2014-11-01

To evaluate efficacy and safety of Baimai ointment (see symbol in text) in the treatment of wrist-dysfunction after distal radius fracture. From April, 2011 to June, 2012, 43 patients with distal radius fracture were treated with plaster fixation. All the patients were divided into two group: test group and control group. Twenty-one patients in test group and 22 in control group, and the baseline was balance (P > 0.05). The 21 patients in test group were treated with Baimai ointment (see symbol in text), fomentation, functional exercises. The 22 patients in control group were treated with placebo, fomentation, functional exercises. Foment affected side wrist with wet towel in 20 min before medication, with the temperature between 50 degrees C and 60 degrees C. Smear drugs uniformly in range of 3 cm in the vicinity of palm stripes after drying (about 3 g) and take functional exercises for the activities of wrist and hand. Continuous follow the program per 8 hours once and follow-up for 8 weeks. The Wrist's pain was assessed with VAS. The wrist's activities were measured with the protractor of orthopedic. Measure The grip strength was measured with dynamometer. The wrist's function were assessed with the table of Cooney. The test group had a significantly better results than those of control group in the extent of wrist's pain throughout the treatment (P 0.05). There were no drug adverse reactions occurred. Tibetan Baimai ointment (see symbol in text) has the treatment of wrist-dysfunction after distal radius fracture for external use, which can reduce the extent of wrist's pain, promote grip strength recovery in the middle and late of process, promote wrist's function recovery latterly, and safety for external use.

Influence of side-groove root radius on the ductile fracture toughness of miniature C(T) specimens

Energy Technology Data Exchange (ETDEWEB)

Lucon, E.; Scibetta, M.

2009-05-15

The use of miniature C(T) specimens, MC(T), for fracture toughness measurements in the upper shelf regime has been investigated at SCK-CEN since 2004, in the framework of the Electrabel/Tractebel SCK-CEN Convention (now General Framework Agreement SUEZ-SCK-CEN). This geometry has been used and validated on both unirradiated (2004-05) and irradiated (2006) materials, mainly reactor pressure vessel (RPV) steels. While side-grooved MC(T) specimens have shown in all conditions a systematically lower tearing resistance and ductile crack initiation toughness as compared to standard-size 1TC(T) samples, the only plain-sided MC(T) specimen tested in 2005 exhibited very high ductile fracture toughness, thus pointing at a strong influence of side-grooving on the upper shelf properties of MC(T) specimens. This study investigates the influence of side-grooving on the initiation toughness and tearing resistance of MC(T) specimens, as a function of the root radius of the side-groove (ranging from 0.1 to 1 mm) and in comparison with plain-sided MC(T) and reference 1TC(T) samples. The material used is the well characterized DIN 22NiMoCr37 RPV steel, which had been used in the European project which generated the famous EURO fracture toughness data set.

Ipsilateral dislocation of the radial head associated with fracture of distal end of the radius: a case report and review of the literature

Directory of Open Access Journals (Sweden)

Gupta Vinay

2013-06-01

Full Text Available 【Abstract】Dislocation of the radial head in adults is uncommon. A simultaneous dislocation of the radial head and fracture of the ipsilateral distal end of radius with no other associated injuries is extremely rare. As far as we know, such an injury after an unusual mode of injury has been seldom reported in the English literature. We report such a case without any associated injuries or comorbidity. Closed reduction was performed within two hours after injury and results were satisfactory. Immobilisation was continued for 3 weeks. Gradual mobilisation was started after removal of the plaster under the supervision of a physiotherapist. At 6 months’ follow-up, the patient had no residual pain at the elbow with full flexion & extension. Almost full supination with a restriction of last 10 degrees of pronation was achieved. There was no evidence of instability of the elbow. Key words: Radial heads; Dislocations; Radius fractures

Open reduction and internal fixation versus casting for highly comminuted and intra-articular fractures of the distal radius (ORCHID): protocol for a randomized clinical multi-center trial.

Science.gov (United States)

Bartl, Christoph; Stengel, Dirk; Bruckner, Thomas; Rossion, Inga; Luntz, Steffen; Seiler, Christoph; Gebhard, Florian

2011-03-22

Fractures of the distal radius represent the most common fracture in elderly patients, and often indicate the onset of symptomatic osteoporosis. A variety of treatment options is available, including closed reduction and plaster casting, K-wire-stabilization, external fixation and open reduction and internal fixation (ORIF) with volar locked plating. The latter is widely promoted by clinicians and hardware manufacturers. Closed reduction and cast stabilization for six weeks is a simple, convenient, and ubiquitously available intervention. In contrast, ORIF requires hospitalization, but allows for functional rehabilitation.Given the lack of randomized controlled trials, it remains unclear whether ORIF leads to better functional outcomes one year after injury than closed reduction and casting. ORCHID (Open reduction and internal fixation versus casting for highly comminuted intra-articular fractures of the distal radius) is a pragmatic, randomized, multi-center, clinical trial with two parallel treatment arms. It is planned to include 504 patients in 15 participating centers throughout Germany over a three-year period. Patients are allocated by a central web-based randomization tool.The primary objective is to determine differences in the Short Form 36 (SF-36) Physical Component Score (PCS) between volar locked plating and closed reduction and casting of intraarticular, comminuted distal radius fractures in patients > 65 years of age one year after the fracture. Secondary outcomes include differences in other SF-36 dimensions, the EuroQol-5D questionnaire, the Disability of the Arm, Shoulder, and Hand (DASH) instrument. Also, the range of motion in the affected wrist, activities of daily living, complications (including secondary ORIF and revision surgery), as well as serious adverse events will be assessed. Data obtained during the trial will be used for later health-economic evaluations. The trial architecture involves a central statistical unit, an independent

Changes in Depression, Health Anxiety, and Pain Catastrophizing Between Enrollment and 1 Month After a Radius Fracture.

Science.gov (United States)

Golkari, Sina; Teunis, Teun; Ring, David; Vranceanu, Ana-Maria

2015-01-01

To test the difference in symptoms of (1) depression, (2) health anxiety, and (3) catastrophic thinking between 1 and 6 weeks after injury to the radius. In total, 69 adult patients with a minimally displaced radial head or distal radius fracture were prospectively enrolled. After diagnosis, we recorded demographic variables, 11-point ordinal numerical pain score, and agreement with "no pain, no gain"; Disabilities of the Arms, Shoulder, and Hand (DASH) questionnaire; Center for Epidemiologic Studies Depression Scale; the Whiteley Index; and the Pain Catastrophizing Scale. In total, 55 patients (80%) returned after 1 month to reevaluate pain, Disabilities of the Arms, Shoulder, and Hand, Center for Epidemiologic Studies Depression, Whiteley Index, and Pain Catastrophizing Scale scores. Center for Epidemiologic Studies Depression scores decreased by an average of 5 ± 9 points (p psychologic measures are used as a screening tool to predict outcome after treatment, one should account for a patient's disease phase. Prognostic level I. Copyright © 2015 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

UK DRAFFT - A randomised controlled trial of percutaneous fixation with kirschner wires versus volar locking-plate fixation in the treatment of adult patients with a dorsally displaced fracture of the distal radius

Directory of Open Access Journals (Sweden)

Brown Jaclyn

2011-09-01

Full Text Available Abstract Background Fractures of the distal radius are extremely common injuries in adults. However, the optimal management remains controversial. In general, fractures of the distal radius are treated non-operatively if the bone fragments can be held in anatomical alignment by a plaster cast or orthotic. However, if this is not possible, then operative fixation is required. There are several operative options but the two most common in the UK, are Kirschner-wire fixation (K-wires and volar plate fixation using fixed-angle screws (locking-plates. The primary aim of this trial is to determine if there is a difference in the Patient-Reported Wrist Evaluation one year following K-wire fixation versus locking-plate fixation for adult patients with a dorsally-displaced fracture of the distal radius. Methods/design All adult patients with an acute, dorsally-displaced fracture of the distal radius, requiring operative fixation are potentially eligible to take part in this study. A total of 390 consenting patients will be randomly allocated to either K-wire fixation or locking-plate fixation. The surgery will be performed in trauma units across the UK using the preferred technique of the treating surgeon. Data regarding wrist function, quality of life, complications and costs will be collected at six weeks and three, six and twelve months following the injury. The primary outcome measure will be wrist function with a parallel economic analysis. Discussion This pragmatic, multi-centre trial is due to deliver results in December 2013. Trial registration Current Controlled Trials ISRCTN31379280 UKCRN portfolio ID 8956

Open reduction and internal fixation versus casting for highly comminuted and intra-articular fractures of the distal radius (ORCHID: protocol for a randomized clinical multi-center trial

Directory of Open Access Journals (Sweden)

Seiler Christoph

2011-03-01

Full Text Available Abstract Background Fractures of the distal radius represent the most common fracture in elderly patients, and often indicate the onset of symptomatic osteoporosis. A variety of treatment options is available, including closed reduction and plaster casting, K-wire-stabilization, external fixation and open reduction and internal fixation (ORIF with volar locked plating. The latter is widely promoted by clinicians and hardware manufacturers. Closed reduction and cast stabilization for six weeks is a simple, convenient, and ubiquitously available intervention. In contrast, ORIF requires hospitalization, but allows for functional rehabilitation. Given the lack of randomized controlled trials, it remains unclear whether ORIF leads to better functional outcomes one year after injury than closed reduction and casting. Methods/Design ORCHID (Open reduction and internal fixation versus casting for highly comminuted intra-articular fractures of the distal radius is a pragmatic, randomized, multi-center, clinical trial with two parallel treatment arms. It is planned to include 504 patients in 15 participating centers throughout Germany over a three-year period. Patients are allocated by a central web-based randomization tool. The primary objective is to determine differences in the Short Form 36 (SF-36 Physical Component Score (PCS between volar locked plating and closed reduction and casting of intraarticular, comminuted distal radius fractures in patients > 65 years of age one year after the fracture. Secondary outcomes include differences in other SF-36 dimensions, the EuroQol-5D questionnaire, the Disability of the Arm, Shoulder, and Hand (DASH instrument. Also, the range of motion in the affected wrist, activities of daily living, complications (including secondary ORIF and revision surgery, as well as serious adverse events will be assessed. Data obtained during the trial will be used for later health-economic evaluations. The trial architecture

[Frequency of diagnosis of postmenopausal osteoporosis of the spine, distant radius and extravertebral fractures in women with normal body mass, overweight and obesity].

Science.gov (United States)

Popov, A A; Izmozherova, N V; Fominykh, M I; Tagil'tseva, N V; Kozulina, E V; Gavrilova, E I

2008-01-01

To assess features and peculiarities of postmenopausal osteoporosis (OP) in women with normal body mass, overweight and obesity. Dual energy X-ray absorptiometry of the lumbal spine (Lunar DPX) and distal radius X-ray absorptiometry (DTX 200) were performed during cross-section study of 730 symptomatic postmenopausal women. OP was diagnosed in 253 (34.7%) women, 30.5% of them had normal body mass, 43.2% had overweight and 26.3% were obese. Among them 227 had atraumatic fractures at the age over 50 years. Obese OP patients had significantly higher frequency of arterial hypertension, chronic heart failure, osteoarthritis and glucose metabolism disorders than osteoporotic patients with normal body mass. Fracture frequency did not differ between groups with normal body mass, overweight and obesity. Excessive body mass did not decrease fracture risk in women with postmenopausal OP.

Equine ulnar fracture repair with locking compression plates can be associated with inadvertent penetration of the lateral cortex of the radius.

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Kuemmerle, Jan M; Kühn, Karolin; Bryner, Marco; Fürst, Anton E

2013-10-01

To evaluate if the use of locking head screws (LHS) in the distal holes of a locking compression plate (LCP) applied to the caudal aspect of the ulna to treat equine ulnar fractures is associated with a risk of injury to the lateral cortex of the radius. Controlled laboratory study. Cadaveric equine forelimbs (n = 8 pair). After transverse ulnar osteotomy, osteosynthesis was performed with a narrow 10-13 hole 4.5/5.0 LCP applied to the caudal aspect of each ulna. The distal 3 holes were filled with 4.5 mm cortex screws (CS) in 1 limb (group 1) and with 5.0 mm LHS contralaterally (group 2). CS were inserted in an angle deemed appropriate by the surgeon and LHS were inserted perpendicular to the plate. Implant position and injury to the lateral cortex of the radius were assessed by radiography, CT, and limb dissection. In group 1, injury of the lateral radius cortex did not occur. In group 2, 4 limbs and 6/24 LHS were associated with injury of the lateral radius cortex by penetration of a LHS. This difference was statistically significant. CS were inserted with a mean angle of 17.6° from the sagittal plane in a caudolateral-craniomedial direction. Use of LHS in the distal part of a LCP applied to the caudal aspect of the ulna is associated with a risk of inadvertent injury to the lateral cortex of the radius. © Copyright 2013 by The American College of Veterinary Surgeons.

Linear intra-bone geometry dependencies of the radius: Radius length determination by maximum distal width

International Nuclear Information System (INIS)

Baumbach, S.F.; Krusche-Mandl, I.; Huf, W.; Mall, G.; Fialka, C.

2012-01-01

Purpose: The aim of the study was to investigate possible linear intra-bone geometry dependencies by determining the relation between the maximum radius length and maximum distal width in two independent populations and test for possible gender or age effects. A strong correlation can help develop more representative fracture models and osteosynthetic devices as well as aid gender and height estimation in anthropologic/forensic cases. Methods: First, maximum radius length and distal width of 100 consecutive patients, aged 20–70 years, were digitally measured on standard lower arm radiographs by two independent investigators. Second, the same measurements were performed ex vivo on a second cohort, 135 isolated, formalin fixed radii. Standard descriptive statistics as well as correlations were calculated and possible gender age influences tested for both populations separately. Results: The radiographic dataset resulted in a correlation of radius length and width of r = 0.753 (adj. R 2 = 0.563, p 2 = 0.592) and side no influence on the correlation. Radius length–width correlation for the isolated radii was r = 0.621 (adj. R 2 = 0.381, p 2 = 0.598). Conclusion: A relatively strong radius length–distal width correlation was found in two different populations, indicating that linear body proportions might not only apply to body height and axial length measurements of long bones but also to proportional dependency of bone shapes in general.

It is not just comfort: waterproof casting increases physical functioning in children with minimally angulated distal radius fractures.

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Silva, Mauricio; Avoian, Tigran; Warnock, Robert Sean; Sadlik, Gal; Ebramzadeh, Edward

2017-09-01

Waterproof casting has been reported to increase patient comfort and satisfaction, and decrease skin irritation. There are no available data on the influence of waterproof casting materials on physical function in pediatric patients. Our aim was to determine whether the use of waterproof casting would result in faster recovery of physical function while maintaining similar clinical outcomes as those obtained with nonwaterproof materials. Twenty-six children with nonangulated or minimally angulated distal radius fractures were assigned randomly to initially receive a short-arm cast made of one of two optional materials: a hybrid mesh material with a waterproof lining or fiberglass with a nonwaterproof skin protector. Two weeks later, the initial cast was removed and replaced with a short-arm cast made of the alternative option. We compared the rate of fracture displacement, physical function, pain, skin changes, itchiness, and patient satisfaction. No evidence of displacement was found in either group. The mean Activities Scale for Kids - Performance (ASK-P) (physical function) score was 10% higher during the period of time when a waterproof cast was used (P=0.04). When a waterproof cast was used during the first 2 weeks of treatment, the mean total ASK-P scores were 23% higher than that when a nonwaterproof one was used during the same period of time (P=0.003). Patients who received a waterproof cast as the initial treatment reported lower functional scores overall and in almost every domain of the ASK-P once they were in a nonwaterproof one; similarly, those who received a nonwaterproof cast as the initial treatment reported higher functional scores overall and in every domain of the ASK-P once they were in a waterproof cast. Compared with a nonwaterproof cast, the use of waterproof casting resulted in comparable levels of pain, itchiness, skin irritability, and overall patient satisfaction. The results of this randomized, cross-over trial suggest that the use of

Recommendation for measuring clinical outcome in distal radius fractures: a core set of domains for standardized reporting in clinical practice and research.

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Goldhahn, Jörg; Beaton, Dorcas; Ladd, Amy; Macdermid, Joy; Hoang-Kim, Amy

2014-02-01

Lack of standardization of outcome measurement has hampered an evidence-based approach to clinical practice and research. We adopted a process of reviewing evidence on current use of measures and appropriate theoretical frameworks for health and disability to inform a consensus process that was focused on deriving the minimal set of core domains in distal radius fracture. We agreed on the following seven core recommendations: (1) pain and function were regarded as the primary domains, (2) very brief measures were needed for routine administration in clinical practice, (3) these brief measures could be augmented by additional measures that provide more detail or address additional domains for clinical research, (4) measurement of pain should include measures of both intensity and frequency as core attributes, (5) a numeric pain scale, e.g. visual analogue scale or visual numeric scale or the pain subscale of the patient-reported wrist evaluation (PRWE) questionnaires were identified as reliable, valid and feasible measures to measure these concepts, (6) for function, either the Quick Disability of the arm, shoulder and hand questionnaire or PRWE-function subscale was identified as reliable, valid and feasible measures, and (7) a measure of participation and treatment complications should be considered core outcomes for both clinical practice and research. We used a sound methodological approach to form a comprehensive foundation of content for outcomes in the area of distal radius fractures. We recommend the use of symptom and function as separate domains in the ICF core set in clinical research or practice for patients with wrist fracture. Further research is needed to provide more definitive measurement properties of measures across all domains.

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

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

2018-05-25

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

Volar plating for distal radius fractures--do not trust the image intensifier when judging distal subchondral screw length.

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Park, Derek H; Goldie, Boyd S

2012-09-01

The use of the volar plate to treat distal radius fractures is increasing but despite the theoretical advantages of a volar approach there have been reports of extensor tendon ruptures due to prominent screw tips protruding past the dorsal cortex. The valley in the intermediate column between Lister tubercle and the sigmoid notch of the distal radius makes it difficult to rely on fluoroscopy to judge screw length. Our aim was to quantify the dimensions of this valley and to demonstrate the danger of relying on intraoperative image intensification fluoroscopy to determine lengths of distal screws. We measured the depth of this valley in the intermediate column of the distal radius in 33 patients with computed tomographic (9 patients) or magnetic resonance image (24 patients) scans of the wrist. There was a consistent valley in all images examined [average 1.8 mm (95% confidence interval, 1.6-2.0 mm)]. Thirty-nine percent of wrists had a valley depth of at least 2 mm. Standard lateral views or rotation of the forearm to obtain oblique views does not identify prominent screw tips; and whatever the rotation of the forearm, screw tips protruding beyond dorsal cortex may look as if it is within the bone when in fact it is out. When drilling we suggest noting the depth at which the drill bit just penetrates dorsal cortex and routinely downsize the distal screw length by 2 mm. We caution against relying on flourosocopy when judging the length of the distal subchondral screws.

Occupational therapy and Colles' fractures.

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Christensen, O M; Kunov, A; Hansen, F F; Christiansen, T C; Krasheninnikoff, M

2001-01-01

In this randomized trial, we enrolled 30 patients treated for a distal radius Colles' type fracture. The fractures were reduced if necessary and fixed in a below-elbow plaster cast for 5 weeks. One group consisting of 14 patients received instructions for shoulder; elbow and finger exercise and the other group consisting of 16 patients had occupational therapy. At 5 weeks, 3 and 9 months we measured the functional scores. There were no statistically significant differences between the groups at any time. It seems that for non-surgically treated patients with a distal radius fracture only instructions are necessary.

Perbandingan Fungsi Extremitas Atas pada Fraktur Metafise Distal Radius Intraartikuler Usia Muda Antara Tindakan Operatif Dan Non Operatif dengan Penilaian Klinis Quickdash Score

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Edi Burhan

2014-01-01

Full Text Available AbstrakFraktur metafise distal radius merupakan fraktur dengan insiden tertinggi kedua pada usia tua di luar fraktur daerah panggul. Di Rumah Sakit Dr. M. Djamil Padang terdapat 122 dari 612 kasus fraktur radius, antara Januari 2011 – Juni 2012. Tujuan utama terapi ini adalah pengembalian permukaan sendi ke posisi anatomis dengan fiksasi yang stabil dan pengembalian fungsi extremitas atas semaksimal mungkin. Metode: Penelitian ini berupa penelitian retrospektif yang dilakukan di poliklinik orthopaedi RSUP Dr M Djamil Padang pada bulan November-Desember 2012 pada pasien fraktur metafise distal radius intraartikuler usia muda yang mendapat tindakan operatif dibandingkan dengan kelompok non-operatif dengan penilaian klinis Quick DASH Score. Sampel yang digunakan sebanyak 30 orang dari 55 orang yang memenuhi kriteria inklusi. Hasil: Ada hubungan yang bermakna antara fungsi extremitas atas dengan penilaian Quick DASH Score antara tindakan operatif pada fraktur distal radius intraartikuler usia muda dengan tindakan non-operatif (p Fisher = 0,010. Tidak terdapat hubungan bermakna antara Quick DASH Score dengan jenis kelamin dan diagnosa kanan atau kiri. Pembahasan: Terdapat perbedaan yang bermakna antara pasien fraktur metafise distal radius intraartikuler pada usia muda yang mendapat tindakan operatif berupa ORIF dengan yang mendapatkan tindakan non-operatif berupa pemasangan Gips.Kata kunci: Fraktur Metafise Distal Radius, Tindakan Operatif dan Non Operatif, Quick Dash ScoreAbstractFracture metafise distal radius is fracture with second highest incident on old age besides a fracture in the pelvic area. In the Dr. M. Djamil Hospital found 122 from 612 cases fracture of radius from january 2011 to june 2012. The main purpose therapy is restore the joint in the surface position anatomically by fixation a stable and restore the function upper extremitas over their best. Method: This study is a retrospective conducted at the Orthopaedi clinic of Dr M

Cuttable plate fixation for small breed dogs with radius and ulna fractures: Retrospective study of 31 dogs.

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Watrous, Gwyneth K; Moens, Noel M M

2017-04-01

This retrospective study evaluated complication rates for radius and ulna fractures in small breed dogs in which 1.5 mm to 2.7 mm cuttable bone plates were used for internal fixation. The medical records of all cases from 2004 to 2011 that were presented to our clinic were reviewed. Inclusion criteria were: dogs with body weight dogs met the inclusion criteria. Of 25 dogs that were available for follow-up, all achieved union, minor complications occurred in 9, and major complications occurred in 8. External coaptation was responsible for complications in 8 cases and the need for coaptation needs to be investigated. Excluding minor complications, 32% of patients required at least 1 additional surgery or additional hospitalization. All but 2 of the dogs returned to full function. The 1.5 mm straight plate was successfully used in all dogs with a body weight of 0.9 to 2.6 kg.

[Unidirectional versus multidirectional palmar locking osteosynthesis of unstable distal radius fractures: comparative analysis with LDR 2.4 mm versus 2.7 mm matrix-Smartlock].

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Hakimi, M; Jungbluth, P; Gehrmann, S; Nowak, J; Windolf, J; Wild, M

2010-03-01

Due to advances in the development of the unidirectional locking plates there is now an increased use of multidirectional palmar locking plates in the treatment of distal radius factures. The purpose of this study was to evaluate a possible improvement of the treatment and results. This prospective cohort study investigated 40 patients with C1 and C2 Colles' fractures who had been treated with unidirectional and multidirectional locking plates. The average time for the follow-up examinations was 12.3 months (range 12-15 months) after surgery. The intra-operative functional (neutral-zero method), radiological and subjective (DASH score, VAS) results were evaluated. The intra-operative fluoroscopy time of the unidirectional group was 58 s shorter compared to the multidirectional group. All fractures healed without any complication. The radiological, subjective (DASH score) and objective results for both groups were good and showed no differences. Unidirectional palmar locking plates are equally suited for the therapy of C1 and C2 fractures as multidirectional palmar locking plates but multidirectional plates require a longer fluoroscopy time.

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

African Journals Online (AJOL)

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

Biomechanics of the Proximal Radius Following Drilling of the Bicipital Tuberosity to Mimic Cortical Button Distal Biceps Repair Technique.

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Oak, Nikhil R; Lien, John R; Brunfeldt, Alexander; Lawton, Jeffrey N

2018-05-01

A fracture through the proximal radius is a theoretical concern after cortical button distal biceps fixation in an active patient. The permanent, nonossified cortical defect and medullary tunnel is at risk during a fall eliciting rotational and compressive forces. We hypothesized that during simulated torsion and compression, in comparison with unaltered specimens, the cortical button distal biceps repair model would have decreased torsional and compressive strength and would fracture in the vicinity of the bicipital tuberosity bone tunnel. Sixteen fourth-generation composite radius Sawbones models were used in this controlled laboratory study. A bone tunnel was created through the bicipital tuberosity to mimic the exact bone tunnel, 8 mm near cortex and 3.2 mm far cortex, made for the BicepsButton distal biceps tendon repair. The radius was then prepared and mounted on either a torsional or compression testing device and compared with undrilled control specimens. Compression tests resulted in average failure loads of 9015.2 N in controls versus 8253.25 N in drilled specimens ( P = .074). Torsional testing resulted in an average failure torque of 27.3 Nm in controls and 19.3 Nm in drilled specimens ( P = .024). Average fracture angle was 35.1° in controls versus 21.1° in drilled. Gross fracture patterns were similar in compression testing; however, in torsional testing all fractures occurred through the bone tunnel in the drilled group. There are weaknesses in the vicinity of the bone tunnel in the proximal radius during biomechanical stress testing which may not be clinically relevant in nature. In cortical button fixation, distal biceps repairs creates a permanent, nonossified cortical defect with tendon interposed in the bone tunnel, which can alter the biomechanical properties of the proximal radius during compressive and torsional loading.

Fractal analysis of bone architecture at distal radius

International Nuclear Information System (INIS)

Tomomitsu, Tatsushi; Mimura, Hiroaki; Murase, Kenya; Sone, Teruki; Fukunaga, Masao

2005-01-01

Bone strength depends on bone quality (architecture, turnover, damage accumulation, and mineralization) as well as bone mass. In this study, human bone architecture was analyzed using fractal image analysis, and the clinical relevance of this method was evaluated. The subjects were 12 healthy female controls and 16 female patients suspected of having osteoporosis (age range, 22-70 years; mean age, 49.1 years). High-resolution CT images of the distal radius were acquired and analyzed using a peripheral quantitative computed tomography (pQCT) system. On the same day, bone mineral densities of the lumbar spine (L-BMD), proximal femur (F-BMD), and distal radius (R-BMD) were measured by dual-energy X-ray absorptiometry (DXA). We examined the correlation between the fractal dimension and six bone mass indices. Subjects diagnosed with osteopenia or osteoporosis were divided into two groups (with and without vertebral fracture), and we compared measured values between these two groups. The fractal dimension correlated most closely with L-BMD (r=0.744). The coefficient of correlation between the fractal dimension and L-BMD was very similar to the coefficient of correlation between L-BMD and F-BMD (r=0.783) and the coefficient of correlation between L-BMD and R-BMD (r=0.742). The fractal dimension was the only measured value that differed significantly between both the osteopenic and the osteoporotic subjects with and without vertebral fracture. The present results suggest that the fractal dimension of the distal radius can be reliably used as a bone strength index that reflects bone architecture as well as bone mass. (author)

Treatment of reducible unstable fractures of the distal radius: randomized clinical study comparing the locked volar plate and external fixator methods: study protocol.

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Raduan Neto, Jorge; de Moraes, Vinicius Ynoe; Gomes Dos Santos, João B; Faloppa, Flávio; Belloti, João Carlos

2014-03-05

Various treatments are available for reducible unstable fractures of the distal radius, such as closed reduction combined with fixation by external fixator (EF), and rigid internal fixation using a locked volar plate (VP). Although there are studies comparing these methods, there is no conclusive evidence indicating which treatment is best. The hypothesis of this study is that surgical treatment with a VP is more effective than EF from the standpoint of functional outcome (patient-reported). The study is randomized clinical trial with parallel groups and a blinded evaluator and involves the surgical interventions EF and VP. Patients will be randomly assigned (assignment ratio 1:1) using sealed opaque envelopes. This trial will include consecutive adult patients with an acute (up to 15 days) displaced, unstable fracture of the distal end of the radius of type A2, A3, C1, C2 or C3 by the Arbeitsgemeinschaft für Osteosynthesefragen-Association for the Study of Internal Fixation classification and type II or type III by the IDEAL32 classification, without previous surgical treatments of the wrist. The surgical intervention assigned will be performed by three surgical specialists familiar with the techniques described. Evaluations will be performed at 2, and 8 weeks, 3, 6 and 12 months, with the primary outcomes being measured by the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and measurement of pain (Visual Analog Pain Scale and digital algometer). Secondary outcomes will include radiographic parameters, objective functional evaluation (goniometry and dynamometry), and the rate of complications and method failure according to the intention-to-treat principle. Final postoperative evaluations (6 and 12 months) will be performed by independent blinded evaluators. For the Student's t-test, a difference of 10 points in the DASH score, with a 95% confidence interval, a statistical power of 80%, and 20% sampling error results in 36 patients per group

Design and evaluation of a portable intra-operative unified-planning-and-guidance framework applied to distal radius fracture surgery.

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Magaraggia, Jessica; Wei, Wei; Weiten, Markus; Kleinszig, Gerhard; Vetter, Sven; Franke, Jochen; John, Adrian; Egli, Adrian; Barth, Karl; Angelopoulou, Elli; Hornegger, Joachim

2017-01-01

During a standard fracture reduction and fixation procedure of the distal radius, only fluoroscopic images are available for planning of the screw placement and monitoring of the drill bit trajectory. Our prototype intra-operative framework integrates planning and drill guidance for a simplified and improved planning transfer. Guidance information is extracted using a video camera mounted onto a surgical drill. Real-time feedback of the drill bit position is provided using an augmented view of the planning X-rays. We evaluate the accuracy of the placed screws on plastic bones and on healthy and fractured forearm specimens. We also investigate the difference in accuracy between guided screw placement versus freehand. Moreover, the accuracy of the real-time position feedback of the drill bit is evaluated. A total of 166 screws were placed. On 37 plastic bones, our obtained accuracy was [Formula: see text] mm, [Formula: see text] and [Formula: see text] in tip position and orientation (azimuth and elevation), respectively. On the three healthy forearm specimens, our obtained accuracy was [Formula: see text] mm, [Formula: see text] and [Formula: see text]. On the two fractured specimens, we attained: [Formula: see text] mm, [Formula: see text] and [Formula: see text]. When screw plans were applied freehand (without our guidance system), the achieved accuracy was [Formula: see text] mm, [Formula: see text], while when they were transferred under guidance, we obtained [Formula: see text] mm, [Formula: see text]. Our results show that our framework is expected to increase the accuracy in screw positioning and to improve robustness w.r.t. freehand placement.

Paediatric post-traumatic cortical defects of the distal radius

International Nuclear Information System (INIS)

Roach, Richard T.; Summers, Bruce N.; Cassar-Pullicino, Victor

2002-01-01

Paediatric post-traumatic cortical defects, although rare, are predominately seen affecting the distal radius following a greenstick or torus fracture. We review the literature and present a further two cases supported by CT and MRI. Images from an acute greenstick fracture are also presented to help understand the pathogenesis. Defects are typically solitary on plain radiographs and are usually noticed late, proximal to the site of compression. They are non-expansile in an otherwise healthy child. CT and MRI may reveal smaller multiple subperiosteal defects. Typical defects require no further management other than reassurance and advice that they may occasionally cause discomfort but resolve with time. (orig.)

Evaluation of sarcopenia in patients with distal radius fractures.

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Roh, Young Hak; Koh, Young Do; Noh, Jung Ho; Gong, Hyun Sik; Baek, Goo Hyun

2017-12-01

Sarcopenia is more prevalent in patients with distal radius fracture (DRF) than in age- and sex-matched controls. Lower appendicular mass index in men and weaker grip strength in both men and women increase the likelihood of DRF. Sarcopenia is a core component of physical frailty that predisposes older people to falls and negatively impacts the activities of daily living. The objectives of this study were to compare the prevalence of sarcopenia in patients with DRF with that in age- and sex-matched controls without DRF; and evaluate the association between sarcopenia and the occurrence of DRF. We prospectively recruited 132 patients over 50 years of age who sustained DRF due to fall and 132 age- and sex-matched controls without DRF. A definition of sarcopenia was based on the consensus of the Asian Working Group for Sarcopenia. Sarcopenic components including appendicular lean body mass, grip strength, and gait speed were compared between the two groups. Other factors assessed for the occurrence of DRF were age, gender, body mass index (BMI), lumbar, and hip bone mineral density (BMD) values. A conditional logistic regression analysis was conducted to evaluate the associations between sarcopenia and the occurrence of DRF. A total of 39 (30%) of 132 DRF patients were sarcopenic, whereas 23 (17%) of the 132 controls were within the sarcopenic criteria (p = 0.048). The patient group had significantly lower lean body mass and weaker grip strength than those of the control group. However, there was no significant difference in gait speed between the two groups. According to regression analysis, lower appendicular mass index in men was associated with an increased incidence of DRF (odds ratio [OR] = 0.84, 95% confidence interval [CI] = 0.72, 0.95) while weaker grip strength and lower total hip BMD values were associated with the occurrence of DRF in both men (OR = 0.77, 95% CI = 0.63, 0.92; and OR = 0.79, 95% CI = 0.64, 0.94, respectively) and women (OR�

Teaching the Basics: Development and Validation of a Distal Radius Reduction and Casting Model.

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Seeley, Mark A; Fabricant, Peter D; Lawrence, J Todd R

2017-09-01

Approximately one-third of reduced pediatric distal radius fractures redisplace, resulting in further treatment. Two major modifiable risk factors for loss of reduction are reduction adequacy and cast quality. Closed reduction and immobilization of distal radius fractures is an Accreditation Council for Graduate Medical Education residency milestone. Teaching and assessing competency could be improved with a life-like simulation training tool. Our goal was to develop and validate a realistic distal radius fracture reduction and casting simulator as determined by (1) a questionnaire regarding the "realism" of the model and (2) the quantitative assessments of reduction time, residual angulation, and displacement. A distal radius fracture model was created with radiopaque bony segments and articulating elbows and shoulders. Simulated periosteum and internal deforming forces required proper reduction and casting techniques to achieve and maintain reduction. The forces required were estimated through an iterative process through feedback from experienced clinicians. Embedded monofilaments allowed for quantitative assessment of residual displacement and angulation through the use of fluoroscopy. Subjects were asked to perform closed reduction and apply a long arm fiberglass cast. Primary performance variables assessed included reduction time, residual angulation, and displacement. Secondary performance variables consisted of number of fluoroscopic images, casting time, and cast index (defined as the ratio of the internal width of the forearm cast in the sagittal plane to the internal width in the coronal plane at the fracture site). Subject grading was performed by two blinded reviewers. Interrater reliability was nearly perfect across all measurements (intraclass correlation coefficient range, 0.94-0.99), thus disagreements in measurements were handled by averaging the assessed values. After completion the participants answered a Likert-based questionnaire regarding the

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

Directory of Open Access Journals (Sweden)

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.

Reabilitação das fraturas do rádio distal Rehabilitation of distal radius fractures

Directory of Open Access Journals (Sweden)

Patrícia Silva Hampe Barbosa

2009-01-01

Full Text Available O objetivo deste estudo foi avaliar a evidência do efeito e eleição da conduta terapêutica nas fraturas do rádio distal. A revisão sistemática utilizou as bases de dados PubMed, Lilacs, Pedro, Cochrane, Scielo, OTseeker, sem restrições de período de publicação, com as seguintes palavras chaves: fraturas do rádio, reabilitação, terapia ocupacional, fisioterapia, incluindo línguas inglesa, espanhola, francesa e portuguesa. Os estudos encontrados foram avaliados independentemente pelos dois autores utilizando critérios da escala PEDro. Estudos não experimentais foram incluídos em busca de esclarecimentos sobre a reabilitação. Foram encontrados 22 estudos, sendo 14 ensaios clínicos controlados randomizados (ECRs. Dentre eles, quatro compararam mobilização precoce com tratamento convencional apresentando evidência moderada a favor da primeira; sete confrontaram tratamento baseado em exercícios domiciliares com tratamento em consultório apontando evidência conflitiva (um deles também comprovou eficácia de mobilização acessória passiva; e três analisaram eficácia de procedimentos terapêuticos: campo eletromagnético pulsado, drenagem linfática, ultra-som, indicando evidências limitadas. Os nove estudos não experimentais encontrados não apresentaram informações suficientes sobre os questionamentos desta pesquisa. Observou-se uma tendência dos autores em utilizar os princípios gerais da reabilitação ao elaborar condutas terapêuticas, mas os procedimentos utilizados não estão bem atestados pela literatura.The aim of this study was to assess the evidence regarding the adoption and effectiveness of therapeutic procedures employed for rehabilitation of distal radius fractures. This systematic review used the following databases: PubMed, Lilacs, PEDro, Cochrane, Scielo and OTseeker, without time restrictions. The following keywords were searched for: distal radius fracture, rehabilitation, occupational therapy

Evaluation of scale effects on hydraulic characteristics of fractured rock using fracture network model

International Nuclear Information System (INIS)

Ijiri, Yuji; Sawada, Atsushi; Uchida, Masahiro; Ishiguro, Katsuhiko; Umeki, Hiroyuki; Sakamoto, Kazuhiko; Ohnishi, Yuzo

2001-01-01

It is important to take into account scale effects on fracture geometry if the modeling scale is much larger than the in-situ observation scale. The scale effect on fracture trace length, which is the most scale dependent parameter, is investigated using fracture maps obtained at various scales in tunnel and dam sites. We found that the distribution of fracture trace length follows negative power law distribution in regardless of locations and rock types. The hydraulic characteristics of fractured rock is also investigated by numerical analysis of discrete fracture network (DFN) model where power law distribution of fracture radius is adopted. We found that as the exponent of power law distribution become larger, the hydraulic conductivity of DFN model increases and the travel time in DFN model decreases. (author)

Isolated fracture of pisiform: case report of a rare injury of wrist

African Journals Online (AJOL)

Arun Kumar Agnihotri

ABSTRACT: Isolated fracture of the pisiform is an extremely rare injury. Generally fractures of the pisiform are associated with fractures of other carpal bones or the distal radius. Fractures of the carpals and metacarpals account for roughly 6% of all fractures. The average incidence of pisiform fractures is 0.2% of all carpal ...

Computer simulation of ductile fracture

International Nuclear Information System (INIS)

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

1979-01-01

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

Angular deformation of radius and ulna treated by dynamic percutaneus osteogenesis distraction. Case report

International Nuclear Information System (INIS)

Rezende, C.M.F.; Melo, E.G.; Lamas, M.C.S.; Silva, C.A.

2000-01-01

The clinical exam of a male mongrel dog, 4-month-old, and 5.7kg of live weight, showed that the dog supported with the elbows and it was observed accentuated bilateral rotacional deformity of the radius and ulna. Radiographs of the radius and ulna revealed proximal fracture of the radius. After clinical and radiographic evaluation it was indicated the corrective osteotomy and distraction osteogenesis of the left foremember. The surgical procedure consisted in osteotomy in the diaphysis of the radius and ulna, and the utilization of external fixators composed by four Kirschner’s pins and two metallic thread bars, configuring a fixator type II, bilateral uniplanar dynamic. Before the fixation of the pins with acrylic, the fractured bony fragments were separated in approximately 0.5cm. Starting 10 days post surgery, the radial osteotomy site was distracted at a rate of 1.0mm every day for 30 days. The consolidation of the osteotomy site was observed radiographically 67 days after the intervention, when the fixator was removed. Similar procedure was accomplished in the right foremember at the age of 16 months. At this moment, it was necessary to remove a coins bony of approximately 1.0cm for correction of the limb angulation. At present, the dog shows normal function and support of the left foremember and light valgus deformity of the right foremember due to the broken implants [pt

Daily number of fractures is associated with road temperature in an urban area

DEFF Research Database (Denmark)

Jantzen, Christopher; Jørgensen, Henrik L; Thomsen, Morten

2014-01-01

winters. MATERIAL AND METHODS: Retrospective data collection was conducted on all patients treated at Bispebjerg Hospital, Denmark, for a humeral, ankle, distal radius or hip fracture during the periods October to April 2009/2010 and 2010/2011. Patients were grouped according to age into the following......,938 fractures) were treated during the study periods. The daily number of distal radius, humeral and ankle fractures increased significantly with decreasing road surface temperature and the presence of IA. For hip fractures no significant association was found. Decreasing temperature was associated......INTRODUCTION: Different factors related to winter are known to influence the fracture incidence, but little is known about the effect of road surface temperature. This study examines the association between road surface temperature and the daily number of fractures in an urban area during two...

Two new methods for the determination of hydraulic fracture ...

African Journals Online (AJOL)

2008-09-15

Sep 15, 2008 ... Flow is radial and divergent. • There is only a single fracture within the test segment. • The fracture and rock mass are rigid and the matrix is imper- meable. • The fracture aperture varies along the radius and is radically symmetrical about the borehole. • Advection, dispersion and diffusion are negligible due ...

Effect of low appendicular lean mass, grip strength, and gait speed on the functional outcome after surgery for distal radius fractures.

Science.gov (United States)

Roh, Young Hak; Noh, Jung Ho; Gong, Hyun Sik; Baek, Goo Hyun

2017-12-01

Patients with low appendicular lean mass plus slow gait speed or weak grip strength are at risk for poor functional recovery after surgery for distal radius fracture, even when they have similar radiologic outcomes. Loss of skeletal muscle mass and consequent loss in muscle function associate with aging, and this condition negatively impacts the activities of daily living and increases elderly individuals' frailty to falls. Thus, patients with low appendicular lean mass would show different functional recovery compared to those without this condition after surgery for distal radius fracture (DRF). This study compares the functional outcomes after surgery for DRF in patients with or without low appendicular lean mass plus slowness or weakness. A total of 157 patients older than 50 years of age with a DRF treated via volar plate fixation were enrolled in this prospective study. A definition of low appendicular lean mass with slowness or weakness was based on the consensus of the Asian Working Group for Sarcopenia. The researchers compared functional assessments (wrist range of motion and Michigan Hand Questionnaire [MHQ]) and radiographic assessments (radial inclination, volar tilt, ulnar variance, and articular congruity) 12 months after surgery between patients with and without low appendicular lean mass plus slowness or weakness. Multivariable regression analyses were performed to determine whether appendicular lean mass, grip strength, gait speed, patient demographic, or injury characteristics accounted for the functional outcomes. Patients with low appendicular lean mass plus slowness or weakness showed a significantly lower recovery of MHQ score than those in the control group throughout 12 months. There was no significant difference in the range of motion between the groups. The radiologic outcomes showed no significant difference between groups in terms of volar tilt, radial inclination, or ulnar variance. According to multivariable regression analysis

Distal radius fracture arthroscopic intraarticular displacement measurement after open reduction and internal fixation from a volar approach.

Science.gov (United States)

Ono, Hiroshi; Furuta, Kazuhiko; Fujitani, Ryotaro; Katayama, Takeshi; Akahane, Manabu

2010-07-01

The purpose of this study was to assess articular surface reduction arthroscopically after volar locked-plate fixation of distal radius fractures (DRFs) via fluoroscopyguided open reduction/internal fixation. We also aimed to develop preoperative radiographic criteria to help assist in determining which DRFs may need arthroscopic evaluation. A total of 31 consecutive patients with DRF were prospectively enrolled. Posteroanterior (PA) and lateral radiographs as well as axial, coronal, and sagittal CT scans were obtained just after attempted reduction of the DRF. The widest articular displacement at the radiocarpal joint surface of the distal radius (preopD) was then measured using a digital radiography imaging system. The DRF was reduced under fluoroscopy, and a volar locked plate was applied. The degree of residual articular displacement was then measured arthroscopically, and the maximum displacement (postopD) was measured with a calibrated probe. Of the 31 patients, 7 had an arthroscopically assessed maximum postopD of > or = 2 mm after internal fixation. The correlation coefficients between each preopD and postopD of all radiographs and CTs were statistically significant. The cutoff values were 0.5 mm for PA radiographs, 2.10 mm for lateral radiographs, 2.15 mm for axial CT scans, 3.15 mm for coronal CT scans, and 1.20 mm for sagittal CT scans. All cutoff values for PA and lateral radiographs and for axial, coronal, and sagittal CT scans were unsuitable as screening criteria for arthroscopic reduction of DRF because of their low sensitivities and specificities. The cutoff value of the new preopD (the sum of the preopDs determined by lateral radiography and coronal CT scan) was 5.80 mm, and its sensitivity and specificity were 100% and 83.3%, respectively. Because a new preopD cutoff value of 5.80 mm is a good indicator for residual articular displacement after internal fixation of >2 mm, it is also a good indicator for the need for arthroscopic evaluation after

Distal radius fracture arthroscopic intraarticular displacement measurement after open reduction and internal fixation from a volar approach

International Nuclear Information System (INIS)

Ono, Hiroshi; Furuta, Kazuhiko; Fujitani, Ryotaro; Katayama, Takeshi; Akahane, Manabu

2010-01-01

The purpose of this study was to assess articular surface reduction arthroscopically after volar locked-plate fixation of distal radius fractures (DRFs) via fluoroscopy-guided open reduction/internal fixation. We also aimed to develop preoperative radiographic criteria to help assist in determining which DRFs may need arthroscopic evaluation. A total of 31 consecutive patients with DRF were prospectively enrolled. Posteroanterior (PA) and lateral radiographs as well as axial, coronal, and sagittal CT scans were obtained just after attempted reduction of the DRF. The widest articular displacement at the radiocarpal joint surface of the distal radius (preopD) was then measured using a digital radiography imaging system. The DRF was reduced under fluoroscopy, and a volar locked plate was applied. The degree of residual articular displacement was then measured arthroscopically, and the maximum displacement (postopD) was measured with a calibrated probe. Of the 31 patients, 7 had an arthroscopically assessed maximum postopD of ≥2 mm after internal fixation. The correlation coefficients between each preopD and postopD of all radiographs and CTs were statistically significant. The cutoff values were 0.5 mm for PA radiographs, 2.10 mm for lateral radiographs, 2.15 mm for axial CT scans, 3.15 mm for coronal CT scans, and 1.20 mm for sagittal CT scans. All cutoff values for PA and lateral radiographs and for axial, coronal, and sagittal CT scans were unsuitable as screening criteria for arthroscopic reduction of DRF because of their low sensitivities and specificities. The cutoff value of the new preopD (the sum of the preopDs determined by lateral radiography and coronal CT scan) was 5.80 mm, and its sensitivity and specificity were 100% and 83.3%, respectively. Because a new preopD cutoff value of 5.80 mm is a good indicator for residual articular displacement after internal fixation of >2 mm, it is also a good indicator for the need for arthroscopic evaluation after

Fracture Risk Assessment in Chronic Kidney Disease, Prospective Testing Under Real World Environments (FRACTURE: a prospective study

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West Sarah L

2010-08-01

Full Text Available Abstract Background Chronic kidney disease (CKD is associated with an increased risk of fracture. Decreased bone mass and disruption of microarchitecture occur early in the course of CKD and worsens with the progressive decline in renal function so that at the time of initiation of dialysis at least 50% of patients have had a fracture. Despite the excess fracture risk, and the associated increases in morbidity and mortality, little is known about the factors that are associated with an increase in fracture risk. Our study aims to identify prognostic factors for bone loss and fractures in patients with stages 3 to 5 CKD. Methods This prospective study aims to enroll two hundred and sixty men and women with stages 3 to 5 CKD. Subjects will be followed for 24 months and we will examine the ability of: 1 bone mineral density by dual x-ray absorptiometry at the spine, hip, and radius; 2 volumetric bone density by high resolution peripheral quantitated computed tomography at the radius and tibia; 3 serum markers of bone turnover; 4 bone formation rate by bone biopsy; and 5 muscle strength and balance to predict spine and non-spine fractures, identified by self-report and/or vertebral morphometry. All measurements will be obtained at baseline, at 12 and at 24 months with the exception of bone biopsy, which will be measured once at 12 months. Subjects will be contacted every 4 months to determine if there have been incident fractures or falls. Discussion This study is one of the first that aims to identify risk factors for fracture in early stage CKD patients. Ultimately, by identifying risk factors for fracture and targeting treatments in this group-before the initiation of renal replacement therapy - we will reduce the burden of disease due to fractures among patients with CKD.

[True/Flex intramedullary nailing for forearm shaft fractures. Long-term results].

Science.gov (United States)

Trlica, J; Počepcov, I; Kočí, J; Frank, M; Holeček, T; Dědek, T

2012-01-01

Presentation of technical experience and the clinical and functional results of intramedullary fixation of forearm shaft fractures. Between January 1994 and December 2009, a total of 96 patients with 144 radial and/or ulnar fractures (ulna, 33; radius,15; both, 48) were treated by nailing (True/Flex®). According to the AO classification there were 22-A, 22-B and 22-C type fractures in 39 (41%), 44 (46%) and 13 (13%).cases, respectively. Of these, 82 (85%) were closed (types: 0, 48; I, 33; II, 1) and 14 (15%) were open (types: I, 13; II, 1; III, 0) fractures. Seventy-eight patients (81%) were followed up and their functional outcomes were evaluated according to the criteria of Anderson et al. The average interval between the operation and final follow-up was 28 months (15 to 96 months) The average time to surgery was 2.2 days (0 to 25 days). Early complications were recorded in 4% of the patients (1x bursitis olecrani; 1x end cup replacement; 1x bending of nails) and late complications in 15% (5x non-union; 2x delay union; 4x bursitis olecrani; 1x ruptured tendon). Bone healing was achieved in 95% of the cases and took on average 16 weeks (7 to 34 weeks). No infection, refracture or synostosis occurred. Primary loss of reduction was recorded in four cases due to distraction in one, bent nails in two and a wrong size of the implant in one; secondary loss of reduction was found in three cases, with two cases of radius shortening and one 10°malrotation. No primary malrotation was recorded, but secondary loss of alignment was seen in the distal part of the radius and the proximal part of the ulna. Functional results according to the Anderson criteria were excellent and good in 87% of the cases. Intramedullary mailing provides good stability to mid- and distal-third shaft fractures of the ulna and mid- and proximalthird shaft fractures of the radius, particularly in AO type A and type B fractures. The technical aspects of the method are analysed in detail in this paper

Development of stress-modified fracture strain criterion for ductile fracture of API X65 steel

International Nuclear Information System (INIS)

Oh, Chang Kyun; Kim, Yun Jae; Park, Jin Moo; Kim, Woo Sik; Baek, Jong Hyun

2005-01-01

This paper presents a stress-modified fracture strain for API X65 steel used for gas pipeline, as a function of stress triaxiality. To determine the stress-modified fracture strain, tension test of bars with four different notch radii, made of API X65 steel, is firstly performed, from which true fracture strains are determined as a function of notch radius. Then detailed elastic-plastic, large strain Finite Element (FE) analyses are performed to estimate variations of stress triaxiality in the notched bars with load. Combining experimental with FE results provides the true fracture strain as a function of stress triaxiality, which is regarded as a criterion of ductile fracture. Application of the developed stress-modified fracture strain to failure prediction of gas pipes made of API X65 steel with various types of defects is discussed

Indentation deformation and fracture of thin polystyrene films

International Nuclear Information System (INIS)

Li Min; Palacio, Manuel L.; Barry Carter, C.; Gerberich, William W.

2002-01-01

Nanoindentation-induced deformation and fracture of thin polystyrene (PS) films on glass substrates were characterized using visible-light microscopy and atomic force microscopy (AFM). Two film thicknesses, 2 and 3.5 μm were studied. It was difficult to induce delamination in the 2-μm film while the 3.5-μm film delaminated easily under indentation loads of 150 mN and higher. AFM cross-section analysis of the deformation and fracture geometry revealed that the ratio of the delamination radius to contact radius was between 3 and 4. Analysis of the fracture surface on the glass side indicates that substrate cracking acts as a trigger for initiation and propagation of interfacial cracks. Crack-arrest marks and process-zone marks were also observed by AFM imaging. The interfacial fracture toughness, or practical work of adhesion, was evaluated following two methods based on the indentation-induced delamination and a process-zone analysis. The fracture toughness was found to be approximately 0.6 J/m 2 for the 3.5-μm PS film on glass. AFM examination of the glass surface after indentation also showed fine flow lines around the indentation impression, indicating plastic deformation of glass

Indentation deformation and fracture of thin polystyrene films

Energy Technology Data Exchange (ETDEWEB)

Li Min; Palacio, Manuel L.; Barry Carter, C.; Gerberich, William W

2002-09-02

Nanoindentation-induced deformation and fracture of thin polystyrene (PS) films on glass substrates were characterized using visible-light microscopy and atomic force microscopy (AFM). Two film thicknesses, 2 and 3.5 {mu}m were studied. It was difficult to induce delamination in the 2-{mu}m film while the 3.5-{mu}m film delaminated easily under indentation loads of 150 mN and higher. AFM cross-section analysis of the deformation and fracture geometry revealed that the ratio of the delamination radius to contact radius was between 3 and 4. Analysis of the fracture surface on the glass side indicates that substrate cracking acts as a trigger for initiation and propagation of interfacial cracks. Crack-arrest marks and process-zone marks were also observed by AFM imaging. The interfacial fracture toughness, or practical work of adhesion, was evaluated following two methods based on the indentation-induced delamination and a process-zone analysis. The fracture toughness was found to be approximately 0.6 J/m{sup 2} for the 3.5-{mu}m PS film on glass. AFM examination of the glass surface after indentation also showed fine flow lines around the indentation impression, indicating plastic deformation of glass.

A case report of an isolated fracture through the radial bicipital tuberosity

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Kanta Imao

Full Text Available Introduction: Generally, anatomical reduction of shaft fractures through operative treatment is necessary to restore the anatomical relationship of the forearm bones. However, a number of nerves and vessels are located in the proximal radius, which complicates surgery. In this study, we aimed to reduce postoperative complications by using a posterior approach. Presentation of case: We describe an isolated fracture through the radial bicipital tuberosity in a 69-year-old man caused by direct blunt force and our management of the fracture. The patient underwent an operation for the fracture under brachial plexus block. The injury was explored using the posterior approach, and plate fixation was performed after confirming the absence of obstacles to rotation on pronation and supination. One year later, the patient did not have any difficulties in activities of daily living. Discussion: Since an isolated fracture through the radial bicipital tuberosity is more distal than the radial head and neck and more proximal than a common radius diaphysis fracture, we had to consider a different operative approach. The nerve and blood vessels of the forearm, such as the radial nerve and artery, run in a complicated fashion around the proximal radius; thus, we chose the posterior approach because of its simpler surgical technique and lower complication risk, compared with the anterior approach. Conclusion: Surgeons can obtain a favorable treatment result using the posterior approach to the fracture and reduce complications by ensuring with rigid fixation using a locking plate. Keywords: Radial bicipital tuberosity, Posterior approach, Posterior interosseous nerve, Shaft fracture

Occupational therapy and Colles' fractures

OpenAIRE

Christensen, O.M.; Kunov, A.; Hansen, F.F.; Christiansen, T.C.; Krasheninnikoff, M.

2000-01-01

In this randomized trial, we enrolled 30 patients treated for a distal radius Colles' type fracture. The fractures were reduced if necessary and fixed in a below-elbow plaster cast for 5 weeks. One group consisting of 14 patients received instructions for shoulder; elbow and finger exercise and the other group consisting of 16 patients had occupational therapy. At 5 weeks, 3 and 9 months we measured the functional scores. There were no statistically significant differences between the groups ...

Preliminary experience with biodegradable implants for fracture fixation

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Dhillon Mandeep

2008-01-01

Full Text Available Background: Biodegradable implants were designed to overcome the disadvantages of metal-based internal fixation devices. Although they have been in use for four decades internationally, many surgeons in India continue to be skeptical about the mechanical strength of biodegradable implants, hence this study. Materials and Methods: A prospective study was done to assess the feasibility and surgeon confidence level with biodegradable implants over a 12-month period in an Indian hospital. Fifteen fractures (intra-articular, metaphyseal or small bone fractures were fixed with biodegradable implants. The surgeries were randomly scheduled so that different surgeons with different levels of experience could use the implants for fixation. Results: Three fractures (one humeral condyle, two capitulum, were supplemented by additional K-wires fixation. Trans-articular fixator was applied in two distal radius and two pilon fractures where bio-pins alone were used. All fractures united, but in two cases the fracture displaced partially during the healing phase; one fibula due to early walking, and one radius was deemed unstable even after bio-pin and external fixator. Conclusions: Biodegradable -implants are excellent for carefully selected cases of intra-articular fractures and some small bone fractures. However, limitations for use in long bone fractures persist and no great advantage is gained if a "hybrid" composite is employed. The mechanical properties of biopins and screws in isolation are perceived to be inferior to those of conventional metal implants, leading to low confidence levels regarding the stability of reduced fractures; these implants should be used predominantly in fracture patterns in which internal fixation is subjected to minimal stress.

Fracture Mechanics Assessment for Different Notch Sizes Using Finite Element Analysis Based on Ductile Failure Simulation

Energy Technology Data Exchange (ETDEWEB)

Bae, Keun Hyung; Jeon, Jun Young; Han, Jae Jun; Nam, Hyun Suk; Lee, Dae Young; Kim, Yun Jae [Korea Univ., Seoul (Korea, Republic of)

2016-08-15

In this study, notch defects are evaluated using fracture mechanics. To understand the effects of notch defects, FE analysis is conducted to predict the limit load and J-integral for middle-cracked and single-edge cracked plates with various sizes of notch under tension and bending. As the radius of the notch increases, the energy release rate also increases, although the limit load remains constant. The values of fracture toughness(J{sub IC}) of SM490A are determined for various notch radii through FE simulation instead of conducting an experiment. As the radius of the notch increases, the energy release rate also increases, together with a more significant increase in fracture toughness. To conclude, as the notch radius increases, the resistance to crack propagation also increases.

Fracture toughness evaluation of small notched specimen in consideration of notch effect and loading rate

International Nuclear Information System (INIS)

Lee, Baik Woo; Kwon, Dong Il; Jang, Jae Il

2000-01-01

Notch effect and loading rate dependency on fracture toughness were considered when evaluating fracture toughness of small notched specimens using the instrumented impact test. Notch effect was analyzed into stress redistribution effect and stress relaxation with a viewpoint of stress triaxiality. Stress redistribution effect was corrected by introducing effective crack length, which was the sum of actual crack length and plastic zone size. Stress relaxation effect was also corrected using elastic stress concentration factor, which would decrease if plastic deformation occurred. As a result, corrected fracture toughness of the notched specimen was very consistent with the reference fracture toughness obtained using precracked specimen. In addition, limiting notch root radius, below which fracture toughness was independent of notch radius, was observed and discussed. Loading rate dependency on fracture toughness, which was obtained from the static three point bending test and the instrumented impact test, was also discussed with stress field in plastic zone ahead of a notch and fracture based on stress control mechanism. (author)

Post-surgical rehabilitative approach to fragility fractures.

Science.gov (United States)

Gimigliano, F; Iolascon, G; Riccio, I; Frizzi, L; Gimigliano, R

2013-10-01

Osteoporosis is a skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fracture. The most frequent sites of fragility fractures are the hip, the distal radius, the spine, the proximal humerus, and the ankle. In most cases, a surgical approach with subsequent rehabilitative treatment is required. The general aims of rehabilitation are to increase functioning and improve patients' activities, participation level, and quality of life.

Simulation of complex fracture networks influenced by natural fractures in shale gas reservoir

Directory of Open Access Journals (Sweden)

Zhao Jinzhou

2014-10-01

Full Text Available When hydraulic fractures intersect with natural fractures, the geometry and complexity of a fracture network are determined by the initiation and propagation pattern which is affected by a number of factors. Based on the fracture mechanics, the criterion for initiation and propagation of a fracture was introduced to analyze the tendency of a propagating angle and factors affecting propagating pressure. On this basis, a mathematic model with a complex fracture network was established to investigate how the fracture network form changes with different parameters, including rock mechanics, in-situ stress distribution, fracture properties, and frac treatment parameters. The solving process of this model was accelerated by classifying the calculation nodes on the extending direction of the fracture by equal pressure gradients, and solving the geometrical parameters prior to the iteration fitting flow distribution. With the initiation and propagation criterion as the bases for the propagation of branch fractures, this method decreased the iteration times through eliminating the fitting of the fracture length in conventional 3D fracture simulation. The simulation results indicated that the formation with abundant natural fractures and smaller in-situ stress difference is sufficient conditions for fracture network development. If the pressure in the hydraulic fractures can be kept at a high level by temporary sealing or diversion, the branch fractures will propagate further with minor curvature radius, thus enlarging the reservoir stimulation area. The simulated shape of fracture network can be well matched with the field microseismic mapping in data point range and distribution density, validating the accuracy of this model.

Distal radius plate of CFR-PEEK has minimal effect compared to titanium plates on bone parameters in high-resolution peripheral quantitative computed tomography: a pilot study.

Science.gov (United States)

de Jong, Joost J A; Lataster, Arno; van Rietbergen, Bert; Arts, Jacobus J; Geusens, Piet P; van den Bergh, Joop P W; Willems, Paul C

2017-02-27

Carbon-fiber-reinforced poly-ether-ether-ketone (CFR-PEEK) has superior radiolucency compared to other orthopedic implant materials, e.g. titanium or stainless steel, thus allowing metal-artifact-free postoperative monitoring by computed tomography (CT). Recently, high-resolution peripheral quantitative CT (HRpQCT) proved to be a promising technique to monitor the recovery of volumetric bone mineral density (vBMD), micro-architecture and biomechanical parameters in stable conservatively treated distal radius fractures. When using HRpQCT to monitor unstable distal radius fractures that require volar distal radius plating for fixation, radiolucent CFR-PEEK plates may be a better alternative to currently used titanium plates to allow for reliable assessment. In this pilot study, we assessed the effect of a volar distal radius plate made from CFR-PEEK on bone parameters obtained from HRpQCT in comparison to two titanium plates. Plates were instrumented in separate cadaveric human fore-arms (n = 3). After instrumentation and after removal of the plates duplicate HRpQCT scans were made of the region covered by the plate. HRpQCT images were visually checked for artifacts. vBMD, micro-architectural and biomechanical parameters were calculated, and compared between the uninstrumented and instrumented radii. No visible image artifacts were observed in the CFR-PEEK plate instrumented radius, and errors in bone parameters ranged from -3.2 to 2.6%. In the radii instrumented with the titanium plates, severe image artifacts were observed and errors in bone parameters ranged between -30.2 and 67.0%. We recommend using CFR-PEEK plates in longitudinal in vivo studies that monitor the healing process of unstable distal radius fractures treated operatively by plating or bone graft ingrowth.

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.

External fixation is more suitable for intra-articular fractures of the distal radius in elderly patients

Science.gov (United States)

Ma, Chuang; Deng, Qiang; Pu, Hongwei; Cheng, Xinchun; Kan, Yuhua; Yang, Jing; Yusufu, Aihemaitijiang; Cao, Li

2016-01-01

The purpose of this study was to compare the functional outcomes, psychological impact, and complication rates associated with external fixation and volar or dorsal plating in relation to the functional parameters following treatment of intra-articular fractures of the distal radius (IFDR) in patients older than 65 years. We hypothesized that using volar or dorsal plating would improve functional outcomes, but that it would be associated with more complications and equivalent functional outcomes when compared with the external fixation group. A total of 123 consecutive patients suffering from IFDR were recruited into the study. The patients were measured for clinical, radiological, and psychosocial functioning outcomes and were followed up after 1 week and 3, 6 and 12 months. After 3 months, the plating group had better pronation (P=0.001), supination, (P=0.047) and extension (P=0.043) scores. These differences were somewhat attenuated by 6 months and disappeared at 1 year. The plating group had a greater occurrence of wound infection (P=0.043), tendonitis, (P=0.024) and additional surgery compared with the external fixation group. The only TNO-AZL Adult Quality of Life scores in the plating group that were lower than those in the external fixation group were in the “gross motor” category (walking upstairs, bending over, walking 500 yards; P=0.023). Internal fixation was more advantageous than external fixation in the early rehabilitation period; after 1 year the outcomes were similar. The plating group showed significantly higher levels of wound infection and tendonitis and had a greater need for additional surgeries. PMID:27408765

Stress fractures in athletes

International Nuclear Information System (INIS)

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

2002-01-01

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

[Clinical randomized controlled trial on ultrashort wave and magnetic therapy for the treatment of early stage distal radius fractures].

Science.gov (United States)

Wang, Guan-Jie; Liu, Jia

2012-07-01

To explore the effect of application of ultrashort wave and magnetic therapy instrument on the swelling regression in distal radius fractures treated by splint external fixation in initial stage. From March 2007 to May 2010,90 patients with distal radial fracture were treated by manual reduction and splint external fixation. After manual reduction and small splints external fixation, these patients were randomly divided into electrical physical therapy group, western medicine group and the control group by the order of calling number, with 30 cases each group. In control group, there were 9 males and 21 females with an average age of (61.29 +/- 1.97) years, the patients raised and exercise the limb and fingers only. The other two groups also carried out this treatment. In electrical physical therapy group, there were 9 males and 21 females with an average age of (62.37 +/- 2.48) years, the patients were treated with ultrashort wave and magnetic therapy instrument for early intervention, once a day, 5 days for a course of treatment and three cycle were operated. In western medicine group,there were 8 males and 22 females with an average age of (60.12 +/- 2.87) years, the patients were injected with beta-aescin (20 mg, intravenous injection,once a day) for 5 days, followed by Danshen injection (20 ml, intravenous injection, once a day) for 10 days. The limb swelling of patients were assessed every day for 20 days after manual reduction and small splints external fixation. The time of swelling regression in electrical physical therapy group, western medicine group and the control group were respectively (9.62 +/- 3.32), (10.05 +/- 3.05) and (14.57 +/- 2.93) days. Both of that in electrical physical therapy group and western medicine group were shorter than that in the control group (P0.05). The effective rate of swelling regression in electrical physical therapy group, western medicine group and the control group were 86.67%, 80.00%, 46.66% respectively. There was no

Notch constraint effects on the dynamic fracture toughness of an unaged beta titanium alloy

International Nuclear Information System (INIS)

Rack, H.J.

1975-01-01

The influence of notch included angle and root radius on the apparent dynamic fracture toughness of an unaged metastable beta titanium alloy, Ti--3Al--8V--6Cr--4Zr--4Mo, has been examined. The apparent fracture toughness, K/sub Id/(rho), increases with both notch radius, rho and included angle, ω. These results have been compared with the theoretical predictions of Tetelman, et al. and Smith. The comparisons show that neither theory accurately describes the effect of varying notch constraint on the apparent dynamic fracture toughness. Although preliminary considerations indicate that qualitative descriptions of notch acuity effects may be given by recent finite element analysis of the stress and strain distributions below a notch root, there is presently no quantitative basis for determining the true dynamic fracture toughness of materials from the results of blunt notch experiments. (auth)

Mode II brittle fracture: recent developments

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A. Campagnolo

2017-10-01

Full Text Available Fracture behaviour of V-notched specimens is assessed using two energy based criteria namely the averaged strain energy density (SED and Finite Fracture Mechanics (FFM. Two different formulations of FFM criterion are considered for fracture analysis. A new formulation for calculation of the control radius Rc under pure Mode II loading is presented and used for prediction of fracture behaviour. The critical Notch Stress Intensity Factor (NSIF at failure under Mode II loading condition can be expressed as a function of notch opening angle. Different formulations of NSIFs are derived using the three criteria and the results are compared in the case of sharp V-notched brittle components under in-plane shear loading, in order to investigate the ability of each method for the fracture assessment. For this purpose, a bulk of experimental data taken from the literature is employed for the comparison among the mentioned criteria

Fractured long bones in a term infant delivered by cesarian section

International Nuclear Information System (INIS)

Kaplan, M.; Dollberg, M.; Wajntraub, G.; Itzchaki, M.

1987-01-01

A term infant was delivered uneventfully by repeat cesarian section. At the age of 1 week there was clinical and radiographic evidence of fractures of the left tibia and right radius. The fractures most likely occurred during the cesarian section. Birth trauma should not be excluded on the basis of cesarian section delivery. (orig.)

Effects of root radius, stress, crack growth and rate on fracture instability

Energy Technology Data Exchange (ETDEWEB)

McClintock, F A

1965-01-01

Of various criteria for fracture at the root of a notch, the energy, local stress, and displacement criteria have limited validity. More appropriate is the history of both stress and strain over a small region ahead of the crack, as required for fracture by the coalescence of holes. Expressions are given for crack initiation, growth, and subsequent instability in anti-plane strain of a nonhardening material. Instability is shown to depend primarily on those strain increments arising from crack growth at constant load rather than on those from increasing load at constant crack length. Thus final instability conditions are similar for single and double- ended cracks, round notches, and cracks cut under constant load. Round notches may give instability, restabilization and final instability. The growth and coalescence of holes in front of a crack in a linearly viscous material is studied for both tensile and anti-plant-strain cracks. The absence of residual strain eliminates instability, but the crack continually accelerates. (26 refs.)

A prospective study on the effectiveness of cotton versus waterproof cast padding in maintaining the reduction of pediatric distal forearm fractures.

Science.gov (United States)

Robert, Christopher E; Jiang, Jimmy J; Khoury, Joseph G

2011-03-01

Distal forearm fractures, one of the most common fractures seen in the pediatric population, are regularly treated by closed reduction and casting. Our study investigates the effectiveness of Gore-Tex-lined casting in maintaining the reduction of 100% displaced distal forearm fractures compared with traditional cotton-lined casts. We screened all patients from February 2007 to July 2009 who presented to Children's Hospital in Birmingham, AL with a distal radius fracture. Only patients with 100% displaced distal radius fractures were eligible to be assigned to either the cotton-lined or Gore-Tex-lined cast groups. Power analysis was performed to identify an adequate patient sample size. The mean maximum change between initial post-reduction x-rays and follow-up x-rays for anterior-posterior (AP) angulation, AP displacement, lateral angulation, and lateral displacement of the radius were calculated for both cotton and Gore-Tex groups. The rate of subsequent intervention and/or unacceptable results for each group was also analyzed. Seven hundred and twenty-two patients were treated with distal radius fractures at our hospital with 59 patients eligible for inclusion in our study. Thirty-six of our patients were treated with cotton-lined casts, and 23 patients were treated with Gore-Tex-lined cast. The mean maximum change in AP angulation, AP displacement, lateral angulation, and lateral displacement of the radius after initial reduction was 9.2 degrees, 6.9%, 13.9 degrees, and 13.6%, respectively, for the cotton-lined cast group and 7.7 degrees, 6.1%, 14.6 degrees, and 9.6%, respectively, for the Gore-Tex-lined cast group. There were no statistical differences between the means of the 4 measurements (P=0.33, 0.69, 0.73, and 0.10, respectively). There were also no significant differences between groups for final AP and lateral angulation and displacement. Subgroup analysis showed no significant differences in all measurements between cotton and Gore-Tex groups. Gore

Evaluation of fracture mode for local wall-thinned pipes

International Nuclear Information System (INIS)

Herman, Irwan; Suzuki, Tomohisa; Sato, Yasumoto; Meshii, Toshiyuki

2007-01-01

In this study, by referring to our burst pressure tests results, firstly, the effects of flaw length δ z and pipe size (mean radius R) on burst pressure p f were investigated by using Finite Element Method (FEM). Then, fracture mode evaluation was made by using history data of strain ratio ε z /ε θ along with load increment. Furthermore, the effect of flaw depth t 1 on fracture mode was studied and finally, the evaluation method of fracture mode for local wall-thinned pipes was introduced. (author)

Testing the validity of preventing chronic regional pain syndrome with vitamin C after distal radius fracture. [Corrected].

Science.gov (United States)

Malay, Sunitha; Chung, Kevin C

2014-11-01

The American Academy of Orthopaedic Surgeons recommends the use of vitamin C to prevent complex regional pain syndrome (CRPS) for patients with distal radius fractures (DRFs). We hypothesized that the evidence for supporting this recommendation is weak, based on epidemiological principles of association and causality. The specific aim of this project was to test the validity of this recommendation. We conducted a literature review to retrieve articles reporting on the use of vitamin C to prevent CRPS. Data collected included sample size, study design type, dose of vitamin C used, and outcome measures of association expressed as relative risk (RR) and odds ratio. We then applied Hill criteria to evaluate the relationship between vitamin C and CRPS. We obtained 225 articles from the database search. After the exclusion of duplicates, unrelated articles, editorial letters, and commentaries, we found 4 articles and 1 systematic review relevant to our topic. Six of the 9 Hill criteria were met, and an earlier meta-analysis showed a quantified reduction in CRPS risk. However, criteria like biological plausibility, specificity, and coherence were not met. The number of causal/association criteria met was adequate to support the scientific premise of the effect of vitamin C in preventing CRPS after DRF. Furthermore, vitamin C administration is of relatively low cost and has few complications unless administered in large doses. Owing to sufficient epidemiological evidence availability, the American Academy of Orthopaedic Surgeons recommendation of vitamin C to prevent CRPS has practical merit. Therapeutic II. Copyright © 2014 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Analysis of Flow Behavior for Acid Fracturing Wells in Fractured-Vuggy Carbonate Reservoirs

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Mingxian Wang

2018-01-01

Full Text Available This study develops a mathematical model for transient flow analysis of acid fracturing wells in fractured-vuggy carbonate reservoirs. This model considers a composite system with the inner region containing finite number of artificial fractures and wormholes and the outer region showing a triple-porosity medium. Both analytical and numerical solutions are derived in this work, and the comparison between two solutions verifies the model accurately. Flow behavior is analyzed thoroughly by examining the standard log-log type curves. Flow in this composite system can be divided into six or eight main flow regimes comprehensively. Three or two characteristic V-shaped segments can be observed on pressure derivative curves. Each V-shaped segment corresponds to a specific flow regime. One or two of the V-shaped segments may be absent in particular cases. Effects of interregional diffusivity ratio and interregional conductivity ratio on transient responses are strong in the early-flow period. The shape and position of type curves are also influenced by interporosity coefficients, storativity ratios, and reservoir radius significantly. Finally, we show the differences between our model and the similar model with single fracture or without acid fracturing and further investigate the pseudo-skin factor caused by acid fracturing.

Transfixation pinning and casting of radial-ulnar fractures in calves: A review of three cases

OpenAIRE

St-Jean, Guy; Debowes, Richard M.

1992-01-01

We reviewed the medical records of three calves with radial-ulnar fractures which were reduced and stabilized by transfixation pinning and casting. Multiple Steinmann pins were placed transversely through proximal and distal fracture fragments and the pin ends were incorporated in fiberglass cast material after fracture reduction. Cast material was placed from proximal to distal radius and served as an external frame to maintain pin position and fracture reduction.

Patient-specific distal radius locking plate for fixation and accurate 3D positioning in corrective osteotomy.

Science.gov (United States)

Dobbe, J G G; Vroemen, J C; Strackee, S D; Streekstra, G J

2014-11-01

Preoperative three-dimensional planning methods have been described extensively. However, transferring the virtual plan to the patient is often challenging. In this report, we describe the management of a severely malunited distal radius fracture using a patient-specific plate for accurate spatial positioning and fixation. Twenty months postoperatively the patient shows almost painless reconstruction and a nearly normal range of motion.

Changing incidence and residual lifetime risk of common osteoporosis-related fractures

DEFF Research Database (Denmark)

Lauritzen, J B; Schwarz, Peter; Lund, B

1993-01-01

1735 fractures of the distal radius, 747 fractures of the proximal humerus, 878 cervical and 635 trochanteric hip fractures were included. In men 273 cervical and 232 trochanteric hip fractures were included. The fractures were registered during the period 1976 to 1984 and changes in age.......05) during the observation period, while no significant decrease was found in the incidence of trochanteric fractures. No significant changes in incidence were observed in women with radial or humeral fractures, or in men with hip fractures. A women 60 years old with a life expectancy of 81 years had......Changes in incidence and lifetime risk of fractures are of major importance in the epidemiology of osteoporosis. We focused on hip fractures in women and men and on radial and humeral fractures in women. The study subjects comprised 4500 women and men 20 years old or more with fractures. In women...

[Comparative study on the strength of different mechanisms of operation of multidirectionally angle-stable distal radius plates].

Science.gov (United States)

Rausch, S; Hoffmeier, K; Gueorguiev, B G; Klos, K; Gras, F; Hofmann, G O; Mückley, T

2011-12-01

Polyaxial angle-stable plating is thought to be particularly beneficial in the management of complex intra-articular fractures of the distal radius. The present study was performed to investigate the strength of polyaxial locking interfaces of distal radius plates. We tested the polyaxial interfaces of 3 different distal radius plates (2.4 mm Variable Angle LCP Two-Column Volar Distal Radius Plate, Synthes, Palmar Classic, Königsee Implantate and VariAx Plate Stryker). The strength of 0° and 10° screw locking angle was obtained during static loading. The strength of Palmar Classic with a 0° locking angle is significantly the best of all tested systems. With a 10° locking angle there is no significant difference between Palmar Classic, Two column Plate and VariAx Plate. The strength of polyaxial interfaces differs between the tested systems. A reduction of ultimate strength is due to increases of screw locking angle. The design of polyaxial locking interfaces should be investigated in human bone models. © Georg Thieme Verlag KG Stuttgart · New York.

Study protocol: non-displaced distal radial fractures in adult patients: three weeks vs. five weeks of cast immobilization: a randomized trial.

Science.gov (United States)

Bentohami, Abdelali; de Korte, Niels; Sosef, Nico; Goslings, Johan Carel; Bijlsma, Taco; Schep, Niels

2014-01-20

Up to 30% of patients suffer from long-term functional restrictions following conservative treatment of distal radius fractures. Whether duration of cast immobilisation influences functional outcome remains unclear. The aim of the study is to evaluate whether the duration of immobilization of non or minimally displaced distal radial fractures can be safely reduced. We will compare three weeks of plaster cast immobilization with five weeks of plaster cast immobilization in adult patient with non or minimally displaced distal radial fractures. a prospective randomized clinical trial. adult (>18 years) (independent in activities of daily living) patients with a non/minimal displaced distal radius fracture (dorsal angulation 15°, ulnar positive variance immobilization versus five weeks of plaster cast immobilization.Main study parameters: primary outcome parameters: Patient related wrist evaluation (PRWE) Quick Disability of Arm, Shoulder and Hand (QUICKDASH) score after a one year follow-up, and secondary parameters: range of motion, pain level (VAS) and complications. The expectation of this study is that shorter duration of plaster cast immobilisation is beneficial for the patient with a distal radius fracture. This risk of specific complications is low and generally similar in both treatment options. Moreover, the burden of the study is not much higher compared to standard treatment. Follow-up is standardized according to current trauma guidelines. Literature indicates that both treatment options from the study are accepted for displaced distal radius fractures. No clear advantage for one treatment options is found at present in the literature, although there is no level I evidence present. This trial will provide level-1 evidence for the comparison of consolidation and functional outcome between two treatment options for non-displaced distal radial fractures. The gathered data may support the development of a clinical guideline for conservative treatment of

Pathological fracture in non-ossifying fibroma with histological features simulating aneurysmal bone cyst

International Nuclear Information System (INIS)

Hoeffel, C.; Mainard, L.; Hoeffel, J.C.; Panuel, M.; Plenat, F.

1999-01-01

A 12-year-old-girl presented with a fracture of an osteolytic lesion of the distal radius. A 7-year-old girl presented with a fracture of an osteolytic lesion of the femoral shaft. In both cases it was a non-ossifying fibroma with fracture misdiagnosed at pathology as aneurysmal bone cyst. Fractures through non-ossifying fibromas may alter the histological pattern of the initial lesion in two ways: firstly, by the presence of blood pigments due to the fracture, and secondly, by formation of new bone. Radiological-pathological correlation is essential to avoid histological errors after pathological fracture in a non-ossifying fibroma. (orig.)

Incidence of Treatment for Infection of Buried Versus Exposed Kirschner Wires in Phalangeal, Metacarpal, and Distal Radial Fractures.

Science.gov (United States)

Ridley, Taylor J; Freking, Will; Erickson, Lauren O; Ward, Christina Marie

2017-07-01

To determine whether there is a difference in the incidence of infection between exposed and buried K-wires when used to treat phalangeal, metacarpal, and distal radius fractures. We conducted a retrospective review identifying all patients aged greater than 16 years who underwent fixation of phalangeal, metacarpal, or distal radius fractures with K-wires between 2007 and 2015. We recorded patient demographic data, fracture location, number of K-wires used, whether K-wires were buried or left exposed, and duration of K-wire placement. A total of 695 patients met inclusion criteria. Surgeons buried K-wires in 207 patients and left K-wires exposed in 488. Infections occurred more frequently in exposed K-wire cases than in buried K-wire ones. Subgroup analysis based on fracture location revealed a significantly increased risk of being treated for infection when exposed K-wires were used for metacarpal fractures. Patients with exposed K-wires for fixation of phalangeal, metacarpal, or distal radius fractures were more likely to be treated for a pin-site infection than those with K-wires buried beneath the skin. Metacarpal fractures treated with exposed K-wires were 2 times more likely to be treated for a pin-site infection (17.6% of exposed K wire cases vs 8.7% of buried K wire cases). Therapeutic IV. Copyright © 2017 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Exercise-induced rib stress fractures: influence of reduced bone mineral density

DEFF Research Database (Denmark)

Vinther, Anders; Kanstrup, Inge-Lis; Christiansen, Erik

2005-01-01

study investigated BMD in seven Danish national team rowers with previous rib stress fracture (RSF) and 7 controls (C) matched for gender, age, height, weight and training experience. Total body scan and specific scans of the lumbar spine (L2-L4), femoral neck and distal radius were performed using......Exercise-induced rib stress fractures have been reported frequently in elite rowers during the past decade. The etiology of rib stress fractures is unclear, but low bone mineral density (BMD) has been suggested to be a potential risk factor for stress fractures in weight-bearing bones. The present...... density may be a potential risk factor for the development of exercise-induced rib stress fractures in elite rowers....

Screw elastic intramedullary nail for the management of adult forearm fractures

Directory of Open Access Journals (Sweden)

Wasudeo Gadegone

2012-01-01

Full Text Available Background: The failure of the conventional nailing of both forearm bones or isolated fractures of radius and ulna pose a potential problem of nail migration and rotational instability, despite the best reduction. The purpose of this paper is to evaluate the results of screw elastic intramedullary nail for the treatment of adult diaphyseal fractures of both forearm bones, which effectively addresses the problems associated with the conventional nailing systems for the forearm fractures. Materials and Methods: Seventy-six adults with forearm fractures (radius and ulna or isolated fracture of the single bone were retrospectively evaluated. Fifty males and 26 females with the mean age of 38 years (range, 18-70 years underwent closed reduction and screw intramedullary nail fixation. Ten patients required limited open reduction. The fractures were classified according to the AO/OTA system. The average followup was 12 months (range, 6 to 18 months. Results: The mean surgical time was 45 minutes (35 to 65 minutes. The meantime to union was 14 weeks (10-21 weeks. The results were graded as excellent in 50, good in 18 patients, and acceptable in eight patients, using the criteria of Grace and Eversman. We had superficial infection in three cases, one case of delayed infection, painful bursa in two cases, delayed union in two cases, malunion with dislocation of the DRUJ in two cases, injury to the extensor tendon of the thumb in one case, and one case of incomplete radioulnar synostosis. Conclusion: Closed reduction and internal fixation of forearm fractures by screw intramedullary nails reestablishes the near normal relationship of the fractured fragments. Screw intramedullary nail effectively controls both rotatory forces and the migration of the nail. It produces excellent clinical results in isolated fractures of either bones, as well as both bones of the forearm in adults.

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

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Thomas Gausepohl

2017-02-01

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

High-resolution-cone beam tomography analysis of bone microarchitecture in patients with acromegaly and radiological vertebral fractures.

Science.gov (United States)

Maffezzoni, Filippo; Maddalo, Michele; Frara, Stefano; Mezzone, Monica; Zorza, Ivan; Baruffaldi, Fabio; Doglietto, Francesco; Mazziotti, Gherardo; Maroldi, Roberto; Giustina, Andrea

2016-11-01

Vertebral fractures are an emerging complication of acromegaly but their prediction is still difficult occurring even in patients with normal bone mineral density. In this study we evaluated the ability of high-resolution cone-beam computed tomography to provide information on skeletal abnormalities associated with vertebral fractures in acromegaly. 40 patients (24 females, 16 males; median age 57 years, range 25-72) and 21 healthy volunteers (10 females, 11 males; median age 60 years, range: 25-68) were evaluated for trabecular (bone volume/trabecular volume ratio, mean trabecular separation, and mean trabecular thickness) and cortical (thickness and porosity) parameters at distal radius using a high-resolution cone-beam computed tomography system. All acromegaly patients were evaluated for morphometric vertebral fractures and for mineral bone density by dual-energy X-ray absorptiometry at lumbar spine, total hip, femoral neck, and distal radius. Acromegaly patients with vertebral fractures (15 cases) had significantly (p acromegaly patients did not have significant differences in bone density at either skeletal site. Patients with acromegaly showed lower bone volume/trabecular volume ratio (p = 0.003) and mean trabecular thickness (p acromegaly. High-resolution cone-beam computed tomography at the distal radius may be useful to evaluate and predict the effects of acromegaly on bone microstructure.

Evaluation of an Image-Based Tool to Examine the Effect of Fracture Alignment and Joint Congruency on Outcomes after Wrist Fracture.

Science.gov (United States)

Lalone, Emily A; Grewal, Ruby; King, Graham W; MacDermid, Joy C

2015-01-01

Some mal-alignment of the wrist occurs in up to 71% of patients following a distal radius fracture. A multiple case study was used to provide proof of principle of an image-based technique to investigate the evolution and impact of post-traumatic joint changes at the distal radioulnar joint. Participants who had a unilateral distal radius fracture who previously participated in a prospective study were recruited from a single tertiary hand center. Long term follow-up measures of pain, disability, range of motion and radiographic alignment were obtained and compared to joint congruency measures. The inter-bone distance, a measure of joint congruency was quantified from reconstructed CT bone models of the distal radius and ulna and the clinical outcome was quantified using the patient rated wrist evaluation. In all four cases, acceptable post-reduction alignment and minimal pain/disability at 1-year suggested good clinical outcomes. However, 10 years following injury, 3 out of 4 patients had radiographic signs of degenerative changes occurring in their injured wrist (distal radioulnar joint/radio-carpal joint). Proximity maps displaying inter-bone distances showed asymmetrical congruency between wrists in these three patients. The 10-year PRWE (patient rated wrist evaluation) varied from 4 to 60, with 3 reporting minimal pain/disability and one experiencing high pain/disability. These illustrative cases demonstrate long-term joint damage post-fracture is common and occurs despite positive short-term clinical outcomes. Imaging and functional outcomes are not necessarily correlated. A novel congruency measure provides an indicator of the overall impact of joint mal-alignment that can be used to determine predictors of post-traumatic arthritis and is viable for clinical or large cohort studies.

Diabetes and change in bone mineral density at the hip, calcaneus, spine, and radius in older women

Directory of Open Access Journals (Sweden)

Ann V. Schwartz

2013-05-01

Full Text Available Older women with type 2 diabetes mellitus (DM have higher bone mineral density (BMD but also have higher rates of fracture compared to those without DM. Limited evidence suggests that DM may also be associated with more rapid bone loss. To determine if bone loss rates differ by DM status in older women, we analyzed BMD data in the Study of Osteoporotic Fractures (SOF between 1986 and 1998. SOF participants were women >65 years at baseline who were recruited from four regions in the U.S. DM was ascertained by self-report. BMD was measured with dual x-ray absorptiometry (DXA at baseline and at least one follow-up visit at the hip (N=6624 and calcaneus (N=6700 and, on a subset of women, at the spine (N=396 and distal radius (N=306. Annualized percent change in BMD was compared by DM status, using random effects models. Of 6,867 women with at least one follow-up DXA scan, 409 had DM at baseline. Mean age was 70.8 (SD 4.7 years. Baseline BMD was higher in women with DM at all measured sites. In models adjusted for age and clinic, women with prevalent DM lost bone more rapidly than those without DM at the femoral neck (-0.96% vs. -0.59% per year, p < 0.001, total hip (-0.98% vs. -0.70% per year, p<0.001, calcaneus (-1.64% vs. -1.40% per year, p=0.005, and spine (-0.33% vs. +0.33% per year, p=0.033, but not at the distal radius (-0.97% vs. -0.90% per year, p=0.91. These findings suggest that despite higher baseline BMD, older women with DM experience more rapid bone loss than those without DM at the hip, spine and calcaneus, but not the radius. Higher rates of bone loss may partially explain higher fracture rates in older women with DM.

Influence of the geometry of curved artificial canals on the fracture of rotary nickel-titanium instruments subjected to cyclic fatigue tests.

Science.gov (United States)

Lopes, Hélio P; Vieira, Márcia V B; Elias, Carlos N; Gonçalves, Lucio S; Siqueira, José F; Moreira, Edson J L; Vieira, Victor T L; Souza, Letícia C

2013-05-01

This study evaluated the influence of different features of canal curvature geometry on the number of cycles to fracture of a rotary nickel-titanium endodontic instrument subjected to a cyclic fatigue test. BioRaCe BR4C instruments (FKG Dentaire, La Chaux-de Fonds, Switzerland) were tested in 4 grooves simulating curved metallic artificial canals, each one measuring 1.5 mm in width, 20 mm in total length, and 3.5 mm in depth with a U-shaped bottom. The parameters of curvature including the radius and arc lengths and the position of the arc differed in the 4 canal designs. Fractured surfaces and helical shafts of the separated instruments were analyzed by scanning electron microscopy. The Student's t test showed that a significantly lower number of cycles to fracture values were observed for instruments tested in canals with the smallest radius, the longest arc, and the arc located in the middle portion of the canal. Scanning electron microscopic analysis of the fracture surfaces revealed morphologic characteristics of ductile fracture. Plastic deformation was not observed in the helical shaft of the fractured instruments. Curvature geometry including the radius and arc lengths and the position of the arc along the root canal influence the number of cycles to fracture of rotary nickel-titanium instruments subjected to flexural load. Copyright © 2013 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

A new method for classifying distal radius fracture: the IDEAL classification Um novo método de classificação para as fraturas da extremidade distal do rádio – a classificação IDEAL

Directory of Open Access Journals (Sweden)

João Carlos Belloti

2013-01-01

Full Text Available OBJECTIVES: To describe the new IDEAL method from classifying distal radius fractures. METHODS: IDEAL classification system is based on the most important literature evidences about clinical and radiographic characteristics that influence in the treatment and prognosis for patients that suffered from a distal radius fractures. In this method, we classify the fracture in patients first consultation, in which we collect demographical (age and trauma energy and radiographic characteristics ( fracture deviation, articular fracture, and associated lesions. For each feature a score is attributed for grouping purposes. Group I - Stable fractures, good prognosis; Group II - potentially unstable fractures, commonly treated by surgical methods. Prognosis depends on surgeons' success after method choice. Group III - complex and instable fractures, poor outcome is expected. CONCLUSION: IDEAL classification staging rationale was presented, which is based on the best available evidence. The evidence of its scientific plausibility will be settled with the assessment of the classification reliability and its capacity to aid in therapeutical decisions and as a tool to predict prognosis. Further studies are under development to support these properties. OBJETIVOS: Descrição do método de Classificação IDEAL - para as fraturas da extremidade distal do rádio. MÉTODOS: O sistema de classificação IDEAL fundamenta-se nas principais evidências da literatura sobre fatores clínicos e radiográficos que influenciam o tratamento e prognóstico das fraturas do rádio distal. Classificamos as fraturas no atendimento inicial do paciente mediante a verificação de dois dados epidemiológicos e três dados radiográficos: Idade do paciente, energia do trauma, desvio dos fragmentos, incongruência articular e lesões associadas. RESULTADOS: Conforme a pontuação obtida, agrupamos os casos em três grupos: Grupo I - fraturas estáveis com bom prognóstico, Grupo II

Prior ankle fractures in postmenopausal women are associated with low areal bone mineral density and bone microstructure alterations.

Science.gov (United States)

Biver, E; Durosier, C; Chevalley, T; Herrmann, F R; Ferrari, S; Rizzoli, R

2015-08-01

In a cross-sectional analysis in postmenopausal women, prior ankle fractures were associated with lower areal bone mineral density (BMD) and trabecular bone alterations compared to no fracture history. Compared to women with forearm fractures, microstructure alterations were of lower magnitude. These data suggest that ankle fractures are another manifestation of bone fragility. Whether ankle fractures represent fragility fractures associated with low areal bone mineral density (aBMD) and volumetric bone mineral density (vBMD) and/or bone microstructure alterations remains unclear, in contrast to the well-recognised association between forearm fractures and osteoporosis. The objective of this study was to investigate aBMD, vBMD and bone microstructure in postmenopausal women with prior ankle fracture in adulthood, compared with women without prior fracture or with women with prior forearm fractures, considered as typically of osteoporotic origin. In a cross-sectional analysis in the Geneva Retirees Cohort study, 63 women with ankle fracture and 59 with forearm fracture were compared to 433 women without fracture (mean age, 65 ± 1 years). aBMD was measured by dual-energy X-ray absorptiometry; distal radius and tibia vBMD and bone microstructure were measured by high-resolution peripheral quantitative computed tomography. Compared with women without fracture, those with ankle fractures had lower aBMD, radius vBMD (-7.9%), trabecular density (-10.7%), number (-7.3%) and thickness (-4.6%) and higher trabecular spacing (+14.5%) (P ankle fractures were 2.2 and 1.6, respectively, vs 2.2 and 2.7 for forearm fracture, respectively (P ≤ 0.001 for all). Compared to women with forearm fractures, those with ankle fractures had similar spine and hip aBMD, but microstructure alterations of lower magnitude. Women with ankle fractures have lower aBMD and vBMD and trabecular bone alterations, suggesting that ankle fractures are another manifestation of bone fragility.

Late leaflet fracture and embolization of a Duromedics mitral prosthesis.

Science.gov (United States)

Sudo, K; Sasagawa, N; Ide, H; Nunokawa, M; Fujiki, T; Tonari, K

2000-08-01

A case of leaflet fracture and embolization of a mitral prosthetic valve is described. A 54-year-old man had received mitral valve replacement with an Edwards-Duromedics 29M prosthetic valve, at 10 years ago. Emergency mitral valve replacement was performed because the patient had severe congestive left heart failure with severe acute mitral regurgitation caused by a fracture in one of the mitral valve leaflets. The leaflet, which was fractured into 2 pieces, was removed from the right common iliac artery at 3 months after valve replacement. Visual inspection revealed that the leaflet contained a midline fracture. The fracture originated within a cavitary erosion pit near the major radius of the leaflet. The patient recovered from acute renal failure, requiring hemodialysis for 80 days, and is currently without complaints. We have used a Duromedics mitral valve in 11 patients, from April 1987 to April 1988. No subsequent valve failure has occurred. The diagnosis, treatment and cause of a mechanical valve fracture are discussed.

Antero-medial approach to the wrist: anatomic basis and new application in cases of fracture of the lunate facet.

Science.gov (United States)

Uzel, A-P; Bulla, A; Laurent-Joye, M; Caix, P

2011-08-01

The Henry approach is the classical anterolateral surgical exposure of the volar aspect of the distal radius. This approach does not allow good access to the medial side of the volar distal radius (lunate facet) and the distal radio-ulnar joint, unless it is extended proximally, retracting the tendons and the median nerve medially, which can cause some trauma. The purpose of our study was to investigate the anatomic basis and to outline the advantages of the unusual anteromedial approach, reporting our experience in the treatment of 4 distal radius fractures, with a 90° or 180° twist of the lunate facet, and 10 wrist dissections on cadavers. The average follow-up was 68.8 months (range 18 to 115 months). In our series, this approach did not cause any nerve injuries or any sensory loss of the distal forearm and the palm. All the fractures of the lunate facet and of the radial styloid process healed. One patient with an ulnar styloid process fracture associated showed pseudarthrosis, but with no instability of the distal radio-ulnar joint or pain on the ulnar side. Using the criteria of Green and O'Brien, modified by Cooney, the results were: excellent in two cases, good in one case, and average in another. The evaluation of arthritis according to Knirk and Jupiter's classification showed grade 0 in three cases and grade 3 in one case with osteochondral sclerosis. We showed that the anteromedial approach is reliable and convenient in the case of fractures situated in the antero-medial portion of the radius, for the double objective of reducing the fracture under direct control and checking the congruence of the distal radio-ulnar joint.

Injuries of the scapholunate and lunotriquetral ligaments as well as the TFCC in intra-articular distal radius fractures. Prevalence assessed with MDCT arthrography

Energy Technology Data Exchange (ETDEWEB)

Klempka, A.; Wagner, M.; Fodor, S.; Schmitt, R. [Cardiovascular Center Bad Neustadt an der Saale, Department of Diagnostic and Interventional Radiology, Bad Neustadt an der Saale (Germany); Prommersberger, K.J. [Clinic for Hand Surgery, Bad Neustadt an der Saale (Germany); Uder, M. [Friedrich-Alexander-University Erlangen-Nuernberg (FAU), Department of Diagnostic Radiology, Erlangen (Germany)

2016-03-15

To evaluate the prevalence of injuries of the scapholunate and lunotriquetral interosseous ligaments (SLIL, LTIL) as well as the triangular fibrocartilage complex (TFCC) in intra-articular distal radius fractures (iaDRF). Two hundred and thirty-three patients with acute iaDRF underwent MDCT arthrography. The SLIL and LTIL were described as normal, partially or completely ruptured. Major injuries of the SLIL were defined as completely ruptured dorsal segments, those of the LTIL as completely ruptured palmar segments. The TFCC was judged as normal or injured. Interobserver variability was calculated. Injury findings were correlated with the types of iaDRF (AO classification). In 159 patients (68.2 %), no SLIL injuries were seen. Minor SLIL injuries were detected in 54 patients (23.2 %), major injuries in 20 patients (8.6 %). No correlation was found between the presence of SLIL lesions and the types of iaDRF. Minor LTIL injuries were seen in 23 patients (9.9 %), major injuries in only 5 patients (2.2 %). The TFCC was altered in 141 patients (60.5 %). Interobserver variability was high for MDCT arthrography in assessing SLIL and TFC lesions, and fair for LTIL lesions. In iaDRF, prevalence of major injuries of the most relevant SLIL is about 9 % as evaluated with CT arthrography. (orig.)

The effect of electric discharge machined notches on the fracture toughness of several structural alloys

International Nuclear Information System (INIS)

Joyce, J.A.; Link, R.E.

1993-09-01

Recent computational studies of the stress and strain fields at the tip of very sharp notches have shown that the stress and strain fields are very weakly dependent on the initial geometry of the notch once the notch has been blunted to a radius that is 6 to 10 times the initial root radius. It follows that if the fracture toughness of a material is sufficiently high so that fracture initiation does not occur in a specimen until the crack-tip opening displacement (CTOD) reaches a value from 6 to 10 times the size of the initial notch tip diameter, then the fracture toughness will be independent of whether a fatigue crack or a machined notch served as the initial crack. In this experimental program the fracture toughness (J Ic and J resistance (J-R) curve, and CTOD) for several structure alloys was measured using specimens with conventional fatigue cracks and with EDM machined notches. The results of this program have shown, in fact, that most structural materials do not achieve initiation CTOD values on the order of 6 to 10 times the radius of even the smallest EDM notch tip presently achievable. It is found furthermore that tougher materials do not seem to be less dependent on the type of notch tip present. Some materials are shown to be much more dependent on the type of notch tip used, but no simple pattern is found that relates this observed dependence to the material strength toughness, or strain hardening rate

A trans-ethnic genome-wide association study identifies gender-specific loci influencing pediatric aBMD and BMC at the distal radius.

Science.gov (United States)

Chesi, Alessandra; Mitchell, Jonathan A; Kalkwarf, Heidi J; Bradfield, Jonathan P; Lappe, Joan M; McCormack, Shana E; Gilsanz, Vicente; Oberfield, Sharon E; Hakonarson, Hakon; Shepherd, John A; Kelly, Andrea; Zemel, Babette S; Grant, Struan F A

2015-09-01

Childhood fractures are common, with the forearm being the most common site. Genome-wide association studies (GWAS) have identified more than 60 loci associated with bone mineral density (BMD) in adults but less is known about genetic influences specific to bone in childhood. To identify novel genetic factors that influence pediatric bone strength at a common site for childhood fractures, we performed a sex-stratified trans-ethnic genome-wide association study of areal BMD (aBMD) and bone mineral content (BMC) Z-scores measured by dual energy X-ray absorptiometry at the one-third distal radius, in a cohort of 1399 children without clinical abnormalities in bone health. We tested signals with P BMC-Z). Signals at the CPED1-WNT16-FAM3C locus have been previously associated with BMD at other skeletal sites in adults and children. Our result at the distal radius underscores the importance of this locus at multiple skeletal sites. The 9p21.3 locus is within a gene desert, with the nearest gene flanking each side being MIR31HG and MTAP, neither of which has been implicated in BMD or BMC previously. These findings suggest that genetic determinants of childhood bone accretion at the radius, a skeletal site that is primarily cortical bone, exist and also differ by sex. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

A position statement of the Traumatology Society of Slovenia on the treatment of fragility fractures of the pelvic ring

Directory of Open Access Journals (Sweden)

Drago Brilej

2016-11-01

Full Text Available Because of the ageing crisis in western world the fragility fractures of the pelvic ring joint the big four group of typical fractures in osteoporotic elderly patients: fractures of the proximal femur, fractures of the proximal humerus, fractures of the distal radius and thoracic and lumbar low energy spinal fractures. All these fractures are the result of low energy with the typical fall of the patient from the standing height. The Slovenian recommendations include Rommens classification for non-displaced and displaced fractures of the anterial and posterial pelvic ring with the operative indications. The recommendations were launched at the Slovenian society of trauma surgeons meeting in November 7th, 2015.

Ever-changing proton radius?

Energy Technology Data Exchange (ETDEWEB)

Mihovilovic, Miha [Institut fuer Kernphysik, Johannes-Gutenberg-Universitaet, Mainz (Germany)

2016-07-01

The discrepancy between the proton charge radius extracted from the muonic hydrogen Lamb shift measurement and the presently best value obtained from elastic scattering experiments remains unexplained and represents a burning problem of today's nuclear physics. Therefore, several new experiments are underway, committed to provide new insight into the problem. High-precision electron scattering experiments are in progress at the Jefferson Lab and the Mainz Microtron. As a counterpart to these measurements, a muon-proton scattering experiment is envisioned at the Paul Scherrer Institute. Together with the nuclear scattering experiments, new atomic measurements are underway at the Max Planck Institute in Garching, which aim to further improve also the spectroscopic results on electronic hydrogen. These experiments are complemented by extensive theoretical efforts focused on studying various processes contributing to the atomic Lamb shift measurements that could explain the difference, as well as on pursuing different ways to interpret nuclear form-factor measurements, which could lead to a consistent value of the radius. In this presentation the currently best proton radius measurements are summarized, and the importance of the observed inconsistency between the hydrogen and the muonic-hydrogen data is discussed. Selected new experiments dedicated to remeasuring the radius are described, and the results of the MAMI experiment are presented.

Puzzling out the proton radius puzzle

Directory of Open Access Journals (Sweden)

Mihovilovič Miha

2014-01-01

Full Text Available The discrepancy between the proton charge radius extracted from the muonic hydrogen Lamb shift measurement and the best present value obtained from the elastic scattering experiments, remains unexplained and represents a burning problem of today’s nuclear physics: after more than 50 years of research the radius of a basic constituent of matter is still not understood. This paper presents a summary of the best existing proton radius measurements, followed by an overview of the possible explanations for the observed inconsistency between the hydrogen and the muonic-hydrogen data. In the last part the upcoming experiments, dedicated to remeasuring the proton radius, are described.

Puzzling out the proton radius puzzle

Energy Technology Data Exchange (ETDEWEB)

Mihovilovič, M.; Merkel, H.; Weber, A. [Institut für Kernphysik, Johannes Gutenberg-Universität Mainz, Johann-Joachim-Becher-Weg 45, 55128 Mainz (Germany)

2016-01-22

The discrepancy between the proton charge radius extracted from the muonic hydrogen Lamb shift measurement and the best present value obtained from the elastic scattering experiments, remains unexplained and represents a burning problem of today’s nuclear physics: after more than 50 years of research the radius of a basic constituent of matter is still not understood. This paper presents a summary of the best existing proton radius measurements, followed by an overview of the possible explanations for the observed inconsistency between the hydrogen and the muonic-hydrogen data. In the last part the upcoming experiments, dedicated to remeasuring the proton radius, are described.

Nuclear charge radius of $^{12}$Be

CERN Document Server

Krieger, Andreas; Bissell, Mark L; Frömmgen, Nadja; Geppert, Christopher; Hammen, Michael; Kreim, Kim; Kowalska, Magdalena; Krämer, Jörg; Neff, Thomas; Neugart, Rainer; Neyens, Gerda; Nörtershäuser, Wilfried; Novotny, Christian; Sanchez, Rodolfo; Yordanov, Deyan T

2012-01-01

The nuclear charge radius of $^{12}$Be was precisely determined using the technique of collinear laser spectroscopy on the $2s_{1/2}\\rightarrow 2p_{1/2, 3/2}$ transition in the Be$^{+}$ ion. The mean square charge radius increases from $^{10}$Be to $^{12}$Be by $\\delta ^{10,12} = 0.69(5)$ fm$^{2}$ compared to $\\delta ^{10,11} = 0.49(5)$ fm$^{2}$ for the one-neutron halo isotope $^{11}$Be. Calculations in the fermionic molecular dynamics approach show a strong sensitivity of the charge radius to the structure of $^{12}$Be. The experimental charge radius is consistent with a breakdown of the N=8 shell closure.

Propagation of fractures from an interface in a Brazilian test specimen

CSIR Research Space (South Africa)

Malan, DF

1994-12-01

Full Text Available by Berenbaum and Brodie \\[4\\]. If a circular disc of radius R and unit thickness is compressed across a diameter by line loads W as shown in Fig. 2(a), the stresses on this diameter are given by Jaeger and Cook \\[5\\] as W ~' ~R (1) - W(3R z + x 2) a.... SIMULATION OF FRACTURE GROWTH Numerical simulation of fracture growth using small- strain dislocation theory has been reported by a number of workers, for example Cornet \\[11\\], Sun et al. \\[12\\] and Thomas and Pollard \\[13\\]. The technique used...

Size-corrected BMD decreases during peak linear growth: implications for fracture incidence during adolescence.

Science.gov (United States)

Faulkner, Robert A; Davison, K Shawn; Bailey, Donald A; Mirwald, Robert L; Baxter-Jones, Adam D G

2006-12-01

Peak adolescent fracture incidence at the distal end of the radius coincides with a decline in size-corrected BMD in both boys and girls. Peak gains in bone area preceded peak gains in BMC in a longitudinal sample of boys and girls, supporting the theory that the dissociation between skeletal expansion and skeletal mineralization results in a period of relative bone weakness. The high incidence of fracture in adolescence may be related to a period of relative skeletal fragility resulting from dissociation between bone expansion and bone mineralization during the growing years. The aim of this study was to examine the relationship between changes in size-corrected BMD (BMDsc) and peak distal radius fracture incidence in boys and girls. Subjects were 41 boys and 46 girls measured annually (DXA; Hologic 2000) over the adolescent growth period and again in young adulthood. Ages of peak height velocity (PHV), peak BMC velocity (PBMCV), and peak bone area (BA) velocity (PBAV) were determined for each child. To control for maturational differences, subjects were aligned on PHV. BMDsc was calculated by first regressing the natural logarithms of BMC and BA. The power coefficient (pc) values from this analysis were used as follows: BMDsc = BMC/BA(pc). BMDsc decreased significantly before the age of PHV and then increased until 4 years after PHV. The peak rates in radial fractures (reported from previous work) in both boys and girls coincided with the age of negative velocity in BMDsc; the age of peak BA velocity (PBAV) preceded the age of peak BMC velocity (PBMCV) by 0.5 years in both boys and girls. There is a clear dissociation between PBMCV and PBAV in boys and girls. BMDsc declines before age of PHV before rebounding after PHV. The timing of these events coincides directly with reported fracture rates of the distal end of the radius. Thus, the results support the theory that there is a period of relative skeletal weakness during the adolescent growth period caused, in

Complications and functional outcome after internal fixation of dorsally displaced distal radial fractures

DEFF Research Database (Denmark)

Bove, Jeppe; Viberg, Bjarke; Wied Greisen, Pernille

Background: Recently there has been an increasing interest in open reduction and internal fixation of distal radius fractures. Even so further studies are still needed. Purpose: To document the functional outcome and identify complica- tions among patients treated with a volar locking plate (DVR...

Computer-assisted versus non-computer-assisted preoperative planning of corrective osteotomy for extra-articular distal radius malunions: a randomized controlled trial

Directory of Open Access Journals (Sweden)

Stockmans Filip

2010-12-01

Full Text Available Abstract Background Malunion is the most common complication of distal radius fracture. It has previously been demonstrated that there is a correlation between the quality of anatomical correction and overall wrist function. However, surgical correction can be difficult because of the often complex anatomy associated with this condition. Computer assisted surgical planning, combined with patient-specific surgical guides, has the potential to improve pre-operative understanding of patient anatomy as well as intra-operative accuracy. For patients with malunion of the distal radius fracture, this technology could significantly improve clinical outcomes that largely depend on the quality of restoration of normal anatomy. Therefore, the objective of this study is to compare patient outcomes after corrective osteotomy for distal radius malunion with and without preoperative computer-assisted planning and peri-operative patient-specific surgical guides. Methods/Design This study is a multi-center randomized controlled trial of conventional planning versus computer-assisted planning for surgical correction of distal radius malunion. Adult patients with extra-articular malunion of the distal radius will be invited to enroll in our study. After providing informed consent, subjects will be randomized to two groups: one group will receive corrective surgery with conventional preoperative planning, while the other will receive corrective surgery with computer-assisted pre-operative planning and peri-operative patient specific surgical guides. In the computer-assisted planning group, a CT scan of the affected forearm as well as the normal, contralateral forearm will be obtained. The images will be used to construct a 3D anatomical model of the defect and patient-specific surgical guides will be manufactured. Outcome will be measured by DASH and PRWE scores, grip strength, radiographic measurements, and patient satisfaction at 3, 6, and 12 months

Early functional postoperative therapy of distal radius fracture with a dynamic orthosis: results of a prospective randomized cross-over comparative study.

Directory of Open Access Journals (Sweden)

Fabian M Stuby

Full Text Available This study was conducted according to GCP criteria as a prospective randomized cross-over study. The primary goal of the study was to determine clinical findings and patient satisfaction with postoperative treatment. 29 patients with a distal radius fracture that was surgically stabilized from volar and who met the inclusion criteria were enrolled over a 12-month period. Each patient randomly received either a dorsal plaster splint or a vacuum-fit flexible but blocked orthosis applied postoperatively in the operating theatre to achieve postoperative immobilization. After one week all patients were crossed over to the complementary device maintaining the immobilization until end of week 2. After week 2 both groups were allowed to exercise wrist mobility with a physiotherapist, in the orthosis group the device was deblocked, thus allowing limited wrist mobility. After week 4 the devices were removed in both groups. Follow-up exams were performed after postoperative weeks 1, 2, 4 and 12.Results were determined after week 1 and 2 using SF 36 and a personally compiled questionnaire; after weeks 4 and 12 with a clinical check-up, calculation of ROM and the DASH Score. Comparison of the two groups showed a significant difference in ROM for volar flexion after 4 weeks, but no significant differences in DASH Score, duration of disability or x-ray findings. With regard to satisfaction with comfort and hygiene, patients were significantly more satisfied with the dynamic orthosis, and 23 of the 29 patients would prefer the flexible vacuum orthosis in future.German Clinical Trials Register (DRKS DRKS00006097.

Complications associated with distraction plate fixation of wrist fractures.

Science.gov (United States)

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

2010-05-01

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

Spectral radius of graphs

CERN Document Server

Stevanovic, Dragan

2015-01-01

Spectral Radius of Graphs provides a thorough overview of important results on the spectral radius of adjacency matrix of graphs that have appeared in the literature in the preceding ten years, most of them with proofs, and including some previously unpublished results of the author. The primer begins with a brief classical review, in order to provide the reader with a foundation for the subsequent chapters. Topics covered include spectral decomposition, the Perron-Frobenius theorem, the Rayleigh quotient, the Weyl inequalities, and the Interlacing theorem. From this introduction, the

Percutaneous treatment of insufficiency fractures. Principles, technique and review of literature

International Nuclear Information System (INIS)

Beall, Douglas P.; Datir, Abhijit; D'Souza, Sharon L.; D'Souza, Logan S.; Gunda, Divya; Morelli, John; Johnson, Michael Brandon; Nabavizadeh, Nima

2010-01-01

Insufficiency fractures of the pelvis, sacrum, spine, and long bones are painful, debilitating, and are common consequences of osteoporosis. Conventional treatment for these fractures varies from conservative therapy to surgery with plate and screw fixation. The former fails to address the underlying problem of fracture and frequently does not alleviate symptoms, while the latter is invasive and not always possible in older populations with low bone density and numerous co-morbidities. Osseous augmentation with polymethylmethacrylate (PMMA) has been used for over two decades to treat fractures related to osteoporosis, but has not been commonly used to treat fractures outside of the vertebral bodies. Osseous augmentation with PMMA is an image-guided procedure and various techniques have been utilized to treat fracture in different locations. We describe various techniques for image-guided osseous augmentation and treatment of insufficiency fractures with bothPMMA and allograft bone for fractures of the pelvis including sacrum, acetabulum, pubic symphysis, pubic rami ilium; appendicular skeleton including distal radius, proximal femur, and vertebral body. We also describe the potential risks and complications associated with percutaneous treatment of insufficiency fractures and techniques to avoid the pitfalls of the various procedures. We will present the process for patient follow-up and data regarding the pre- and postprocedure pain response in patients undergoing treatment for pelvic insufficiency fractures. (orig.)

Prevalence of silent vertebral fractures detected by vertebral fracture assessment in young Portuguese men with hyperthyroidism.

Science.gov (United States)

Barbosa, Ana Paula; Rui Mascarenhas, Mário; Silva, Carlos Francisco; Távora, Isabel; Bicho, Manuel; do Carmo, Isabel; de Oliveira, António Gouveia

2015-02-01

Hyperthyroidism is a risk factor for reduced bone mineral density (BMD) and osteoporotic fractures. Vertebral fracture assessment (VFA) by dual-energy X-ray absorptiometry (DXA) is a radiological method of visualization of the spine, which enables patient comfort and reduced radiation exposure. This study was carried out to evaluate BMD and the prevalence of silent vertebral fractures in young men with hyperthyroidism. We conducted a cross-sectional study in a group of Portuguese men aged up to 50 years and matched in hyperthyroidism (n=24) and control (n=24) groups. A group of 48 Portuguese men aged up to 50 years was divided and matched in hyperthyroidism (n=24) and control (n=24) groups. BMD (g/cm(2)) at L1-L4, hip, radius 33%, and whole body as well as the total body masses (kg) were studied by DXA. VFA was used to detect fractures and those were classified by Genant's semiquantitative method. No patient had previously been treated for hyperthyroidism, osteoporosis, or low bone mass. Adequate statistical tests were used. The mean age, height, and total fat mass were similar in both groups (P≥0.05). The total lean body mass and the mean BMD at lumbar spine, hip, and whole body were significantly decreased in the hyperthyroidism group. In this group, there was also a trend for an increased prevalence of reduced BMD/osteoporosis and osteoporotic vertebral fractures. The results obtained using VFA technology (confirmed by X-ray) suggest that the BMD changes in young men with nontreated hyperthyroidism may lead to the development of osteoporosis and vertebral fractures. This supports the pertinence of using VFA in the routine of osteoporosis assessment to detect silent fractures precociously and consider early treatment. © 2015 European Society of Endocrinology.

The proton radius puzzle

Science.gov (United States)

Bonesini, Maurizio

2017-12-01

The FAMU (Fisica degli Atomi Muonici) experiment has the goal to measure precisely the proton Zemach radius, thus contributing to the solution of the so-called proton radius "puzzle". To this aim, it makes use of a high-intensity pulsed muon beam at RIKEN-RAL impinging on a cryogenic hydrogen target with an high-Z gas admixture and a tunable mid-IR high power laser, to measure the hyperfine (HFS) splitting of the 1S state of the muonic hydrogen. From the value of the exciting laser frequency, the energy of the HFS transition may be derived with high precision ( 10-5) and thus, via QED calculations, the Zemach radius of the proton. The experimental apparatus includes a precise fiber-SiPMT beam hodoscope and a crown of eight LaBr3 crystals and a few HPGe detectors for detection of the emitted characteristic X-rays. Preliminary runs to optimize the gas target filling and its operating conditions have been taken in 2014 and 2015-2016. The final run, with the pump laser to drive the HFS transition, is expected in 2018.

Critical cladding radius for hybrid cladding modes

Science.gov (United States)

Guyard, Romain; Leduc, Dominique; Lupi, Cyril; Lecieux, Yann

2018-05-01

In this article we explore some properties of the cladding modes guided by a step-index optical fiber. We show that the hybrid modes can be grouped by pairs and that it exists a critical cladding radius for which the modes of a pair share the same electromagnetic structure. We propose a robust method to determine the critical cladding radius and use it to perform a statistical study on the influence of the characteristics of the fiber on the critical cladding radius. Finally we show the importance of the critical cladding radius with respect to the coupling coefficient between the core mode and the cladding modes inside a long period grating.

An iterative algorithm for calculating stylus radius unambiguously

International Nuclear Information System (INIS)

Vorburger, T V; Zheng, A; Renegar, T B; Song, J-F; Ma, L

2011-01-01

The stylus radius is an important specification for stylus instruments and is commonly provided by instrument manufacturers. However, it is difficult to measure the stylus radius unambiguously. Accurate profiles of the stylus tip may be obtained by profiling over an object sharper than itself, such as a razor blade. However, the stylus profile thus obtained is a partial arc, and unless the shape of the stylus tip is a perfect sphere or circle, the effective value of the radius depends on the length of the tip profile over which the radius is determined. We have developed an iterative, least squares algorithm aimed to determine the effective least squares stylus radius unambiguously. So far, the algorithm converges to reasonable results for the least squares stylus radius. We suggest that the algorithm be considered for adoption in documentary standards describing the properties of stylus instruments.

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

Science.gov (United States)

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

2017-02-01

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

Strain-dependent partial slip on rock fractures under seismic-frequency torsion

Science.gov (United States)

Saltiel, Seth; Bonner, Brian P.; Ajo-Franklin, Jonathan B.

2017-05-01

Measurements of nonlinear modulus and attenuation of fractures provide the opportunity to probe their mechanical state. We have adapted a low-frequency torsional apparatus to explore the seismic signature of fractures under low normal stress, simulating low effective stress environments such as shallow or high pore pressure reservoirs. We report strain-dependent modulus and attenuation for fractured samples of Duperow dolomite (a carbon sequestration target reservoir in Montana), Blue Canyon Dome rhyolite (a geothermal analog reservoir in New Mexico), and Montello granite (a deep basement disposal analog from Wisconsin). We use a simple single effective asperity partial slip model to fit our measured stress-strain curves and solve for the friction coefficient, contact radius, and full slip condition. These observations have the potential to develop into new field techniques for measuring differences in frictional properties during reservoir engineering manipulations and estimate the stress conditions where reservoir fractures and faults begin to fully slip.

Oil shale in situ research and development. Final report, August 1, 1977--December 22, 1978. [Hydraulic fractures; explosive rubblization

Energy Technology Data Exchange (ETDEWEB)

Jensen, H.B.

1978-01-01

The selected Site Section 17 was prepared for hydraulic fracturing and explosive rubblization, and these operations accomplished. This report presents the field and laboratory preparations for the fracturing, rubblization, and evaluation operations. A series of four, parallel, hydraulically induced fractures was created during the first year. The evaluation tests showed the following about the four hydraulic fractures: (1) They were horizontal and narrow, that is, as large as 0.05 inches thick within a 50-foot radius and as small as 0.0011 inches thick for the average of all four fractures over the entire radius. (2) They extended at least 113 feet to the outer ring of production wells in a southeasterly direction. (3) They extended out beyond the outer ring of production wells in a northwesterly direction. (4) They had some degree of communication with the naturally fractured aquifer lying about them. And, (5), they had no significant communication with naturally fractured aquifer lying below them. The rubblization event took place on 21 August 1978, early in the second year of the contract. An evaluation of the areal extent, thickness, porosity, interconnectivity, and the influence of the explosion upon the adjacent aquifers was determined. The dynamic tests showed that the explosive slurry was loaded into the four hydraulic features and that detonation occurred simultaneously. The postrubblization evaluation demonstrated that: (1) There were four layers of damage of less than two-feet thick each, (2) massive permeability was apparent from all production wells, and (3) the permeability is in the form of block, open cracks rather than porous medium.

Scattering of elastic waves on fractures randomly distributed in a three-dimensional medium

Science.gov (United States)

Strizhkov, S. A.; Ponyatovskaya, V. I.

1985-02-01

The purpose of this work is to determine the variation in basic characteristics of the wave field formed in a jointed medium, such as the intensity of fluctuations of amplitude, correlation radius, scattering coefficient and frequency composition of waves, as functions of jointing parameters. Fractures are simulated by flat plates randomly distributed and chaotically oriented in a three-dimensional medium. Experiments were performed using an alabaster model, a rectangular block measuring 50 x 50 x 120 mm. The plates were introduced into liquid alabaster which was then agitated. Models made in this way contain randomly distributed and chaotically oriented fractures. The influence of these fractures appears as fluctuations in the wave field formed in the medium. The data obtained in experimental studies showed that the dimensions of heterogeneities determined by waves in the jointed medium and the dimensions of the fractures themselves coincide only if the distance between fractures is rather great. If the distance between fractures is less than the wavelength, the dimensions of the heterogeneities located by the wave depend on wavelength.

Extending Topological Approaches to Microseismic-Derived 3D Fracture Networks

Science.gov (United States)

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

2017-12-01

Fracture topology is important for determining the fluid-flow characteristics of a fracture network. In most unconventional petroleum applications, flow through subsurface fracture networks is the primary source of production, as matrix permeability is often in the nanodarcy range. Typical models of reservoir discrete fracture networks (DFNs) are constructed using fracture orientation and average spacing, without consideration of how the connectivity of the fracture network aids the percolation of hydrocarbons back to the wellbore. Topological approaches to DFN characterization have been developed and extensively used in analysis of outcrop data and aerial photography. Such study of the surface expression of fracture networks is straight-forward, and the physical form of the observed fractures is directly reflected in the parameters used to describe the topology. However, this analysis largely ignores the three-dimensional nature of natural fracture networks, which is difficult to define accurately in geological studies. SMTI analysis of microseismic event distributions can produce DFNs, where each event is represented by a penny-shaped crack with radius and orientation determined from the frequency content of the waveforms and assessment of the slip instability of the potential fracture planes, respectively. Analysis of the geometric relationships between a set of fractures can provide details of intersections between fractures, and thus the topological characteristics of the fracture network. Extension of existing 2D topology approaches to 3D fracture networks is non-trivial. In the 2D case, a fracture intersection is a single point (node), and branches connect adjacent nodes along fractures. For the 3D case, intersection "nodes" become lines, and connecting nodes to find branches becomes more complicated. There are several parameters defined in 2D topology to quantify the connectivity of the fracture network. Equivalent quantities must be defined and calibrated

On the proton radius problem

OpenAIRE

Giannini, M. M.; Santopinto, E.

2013-01-01

The recent values of the proton charge radius obtained by means of muonic-hydrogen laser spectroscopy are about $4\\%$ different from the electron scattering data. It has been suggested that the proton radius is actually measured in different frames and that, starting from a non relativistic quark model calculation, the Lorentz transformation of the form factors accounts properly for the discepancy. We shall show that the relation between the charge radii measured in different frames can be de...

Understanding the mass-radius relation for sub-Neptunes: radius as a proxy for composition

Energy Technology Data Exchange (ETDEWEB)

Lopez, Eric D.; Fortney, Jonathan J. [Department of Astronomy and Astrophysics, University of California, Santa Cruz, CA 95064 (United States)

2014-09-01

Transiting planet surveys like Kepler have provided a wealth of information on the distribution of planetary radii, particularly for the new populations of super-Earth- and sub-Neptune-sized planets. In order to aid in the physical interpretation of these radii, we compute model radii for low-mass rocky planets with hydrogen-helium envelopes. We provide model radii for planets 1-20 M {sub ⊕}, with envelope fractions 0.01%-20%, levels of irradiation 0.1-1000 times Earth's, and ages from 100 Myr to 10 Gyr. In addition we provide simple analytic fits that summarize how radius depends on each of these parameters. Most importantly, we show that at fixed H/He envelope fraction, radii show little dependence on mass for planets with more than ∼1% of their mass in their envelope. Consequently, planetary radius is to a first order a proxy for planetary composition, i.e., H/He envelope fraction, for Neptune- and sub-Neptune-sized planets. We recast the observed mass-radius relationship as a mass-composition relationship and discuss it in light of traditional core accretion theory. We discuss the transition from rocky super-Earths to sub-Neptune planets with large volatile envelopes. We suggest ∼1.75 R {sub ⊕} as a physically motivated dividing line between these two populations of planets. Finally, we discuss these results in light of the observed radius occurrence distribution found by Kepler.

Recombination radius of a Frenkel pair and capture radius of a self-interstitial atom by vacancy clusters in bcc Fe

International Nuclear Information System (INIS)

Nakashima, Kenichi; Stoller, Roger E; Xu, Haixuan

2015-01-01

The recombination radius of a Frenkel pair is a fundamental parameter for the object kinetic Monte Carlo (OKMC) and mean field rate theory (RT) methods that are used to investigate irradiation damage accumulation in irradiated materials. The recombination radius in bcc Fe has been studied both experimentally and numerically, however there is no general consensus about its value. The detailed atomistic processes of recombination also remain uncertain. Values from 1.0a 0 to 3.3a 0 have been employed as a recombination radius in previous studies using OKMC and RT. The recombination process of a Frenkel pair is investigated at the atomic level using the self-evolved atomistic kinetic Monte Carlo (SEAKMC) method in this paper. SEAKMC calculations reveal that a self-interstitial atom recombines with a vacancy in a spontaneous reaction from several nearby sites following characteristic pathways. The recombination radius of a Frenkel pair is estimated to be 2.26a 0 by taking the average of the recombination distances from 80 simulation cases. In addition, we apply these procedures to the capture radius of a self-interstitial atom by a vacancy cluster. The capture radius is found to gradually increase with the size of the vacancy cluster. The fitting curve for the capture radius is obtained as a function of the number of vacancies in the cluster. (paper)

Neck osteotomy for malunion of neglected radial neck fractures in children: a report of 2 cases.

Science.gov (United States)

Ceroni, Dimitri; Campos, José; Dahl-Farhoumand, Agnes; Holveck, Jérôme; Kaelin, André

2010-01-01

Radial neck fractures are a common injury in children as a result of a fall on an extended and supinated outstretched hand. We present 2 cases of osteotomy of the neck of the radius performed in 2 children with neglected radial neck fractures. Preoperatively, both patients complained of pain and severely reduced mobility of the elbow. Surgery was performed at 6 weeks and 3 months, respectively, after the initial injury and the 2 children were reviewed at 6 and 16 months follow-up. Osteotomies healed within the usual time and no avascular necrosis of the radial head, proximal radioulnar synostosis, or myositis ossificans were observed. The Mayo Elbow Performance Index Score improved significantly after the operation with the 2 patients rated as excellent. In this small series, we present a novel technique of proximal osteotomy of the radius to correct this deformity in children. Case series, level IV evidence.

Pediatric elbow fractures: a new angle on an old topic

Energy Technology Data Exchange (ETDEWEB)

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

2016-01-15

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

Developing a Fracture Model of the Granite Rocks Around the Research Tunnel at the Mizunami Underground Research Laboratory in Central Japan

Science.gov (United States)

Kalinina, E.; Hadgu, T.; Wang, Y.

2017-12-01

The Mizunami Underground Research Laboratory (MIU) is located in Tono area in Central Japan. It is operated by the Japan Atomic Energy Agency (JAEA) with the main purpose of providing scientific basis for the research and development of technologies needed for deep geological disposal of radioactive waste in fractured crystalline rocks. The current work is focused on the research and experiments in the tunnel located at 500 m depth. The data collected in the tunnel and exploratory boreholes were shared with the participants of the DEvelopment of COupled models and their VALidation against EXperiments (DECOVALEX), an international research and model comparison collaboration. This study describes the development of the fracture model representing granite rocks around the research tunnel. The model domain is 100x150x100m with the main experimental part of the tunnel, Closure Test Drift, located approximately in the center. The major input data were the fracture traces measured on the tunnel walls (total of 2,023 fractures), fractures observed in the horizontal borehole parallel to the tunnel, and the packer tests conducted in this borehole and one vertical borehole located within the modeling domain. 78 fractures (the ones with the inflow) in the tunnel were incorporated in the development of the fracture model. Fracture size was derived from the fracture trace analysis. It was shown that the fracture radius followed lognormal distributions. Fracture transmissivity was estimated from an analytical solution of inflow into the tunnel through an individual fracture and the total measured inflow into the tunnel. 16 fractures were incorporated in the model along the horizontal borehole. The packer test data in the different well intervals were used to estimate the range in fracture transmissivity. A relationship between the fracture transmissivity and fracture radius was developed. The fractures in the tunnel and borehole were used to derive fracture orientation and

FUNCTIONAL RECOVERY AFTER MINIMALLY INVASIVE OSTEOSYNTHESIS IN FRACTURES OF THE SHAFT OF THE RADIUS AND ULNA

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A. N. Chelnokov

2016-01-01

Full Text Available Introduction. Closed intramedullary nailing and external fixation are minimally invasive treatment options in radial and ulnar shaft fractures. We found no comparative studies of these methods in the current literature. Objective. A comparative analysis of both methods in radial and ulnar shaft fractures treated by closed intramedullary nailing and external fixation. Material and methods. 63 patients with forearm shaft fractures treated by closed intramedullary nailing (group I; 24 patients treated by external fixation (group II. All patients were operated within 30 days after injury. Postoperatively, all patients were evaluated clinically (range of motion of elbow and wrist, rotation of the forearm and radiologically. Disability of the Arm, Shoulder and Hand (DASH score was used to assess the functional status and quality of life. Results. The average time of radiological bone union in the group I and group II was 12,6 ± 1,4 weeks. and 12,7 ± 0,6 weeks, accordingly. Statistically significant differences in range of motion in the elbow and wrist occurred in 1 month after the surgery with the advantage in Group I. Restoration of rotation was faster in Group I up to 1 year after surgery. DASH scores in 2 month after the surgery were 11,2±1,96 in the nailing group (as in healthy population and 45,2±6,7 in the external fixation group. In 6 months after surgery the subjective assessment of the quality of life did not differ in both groups. Conclusion. Both minimally invasive methods of surgical stabilization provide restoration of anatomy of the forearm and complete functional recovery in final outcome, but closed intramedullary nailing results with significantly more rapid restoration of range of motions and quality of life measures.

Experimental and numerical study of radial lateral fracturing for coalbed methane

International Nuclear Information System (INIS)

Fu, Xuan; Li, Gensheng; Huang, Zhongwei; Liang, Yuesong; Xu, Zhengming; Jin, Xiao

2015-01-01

Drilling ultra-short radius horizontal laterals in a vertical well and then operating hydraulic fracturing (radial lateral fracturing, abbreviated as RLF) is proposed as a prospective novel method to increase the single-well productivity for coalbed methane (CBM) development. The objective of this article is to find the best fracture network profile RLF can generate and what kind of formation is suitable for this fracturing technique. Experiments using a true tri-axial fracturing simulation system are designed to analyse the influence of different lateral length, count and azimuth on the fracturing initiation and propagation. A numerical simulation is also carried out to study the sensitivity of the coal integrity and in situ stress state on the fracture initiation type. Our work shows that: the best effect of RLF is achieved when it initiates from the bedding plane where the laterals lie and forms a fracture network with one main horizontal fracture connecting multiple vertical fractures; the breakdown and injection pressure will be decreased by increasing the lateral length and count; increasing the lateral length can enlarge the horizontal fracture area; the optimal lateral design for horizontal initiation is four laterals with the phase of 90° and each lateral is at 45° from the horizontal stress; RLF is suitable for the intact coal seams in which cracks or cleats are not well developed and the overburden stress should be close to or less than the maximum horizontal stress. This paper will provide the experimental support and theoretical bases for CBM RLF design. (paper)

Comminuted fracture of the accessory carpal bone removed via an arthroscopic-assisted arthrotomy

Science.gov (United States)

Bonilla, Alvaro G.; Santschi, Elizabeth M.

2015-01-01

A 16-year-old American paint horse gelding was presented for evaluation of a left forelimb lameness grade III/V. Radiographs and computed tomography revealed a comminuted fracture of the accessory carpal bone involving the entire articulation with the distal radius and the proximal aspect of the articulation with the ulnar carpal bone. Multiple fragments were present in the palmar pouch of the antebrachiocarpal joint. An arthroscopic-assisted open approach was necessary to remove all fractured fragments. Subsequently the horse was re-admitted for lameness and was treated successfully with antibiotics and long-term supportive bandaging. PMID:25694665

Comminuted fracture of the accessory carpal bone removed via an arthroscopic-assisted arthrotomy.

Science.gov (United States)

Bonilla, Alvaro G; Santschi, Elizabeth M

2015-02-01

A 16-year-old American paint horse gelding was presented for evaluation of a left forelimb lameness grade III/V. Radiographs and computed tomography revealed a comminuted fracture of the accessory carpal bone involving the entire articulation with the distal radius and the proximal aspect of the articulation with the ulnar carpal bone. Multiple fragments were present in the palmar pouch of the antebrachiocarpal joint. An arthroscopic-assisted open approach was necessary to remove all fractured fragments. Subsequently the horse was re-admitted for lameness and was treated successfully with antibiotics and long-term supportive bandaging.

Field assessment of the use of borehole pressure transients to measure the permeability of fractured rock masses

International Nuclear Information System (INIS)

Forster, C.B.; Gale, J.E.

1981-06-01

A field experiment to evaluate the transient pressure pulse technique as a method of determining the in-situ hydraulic conductivity of low permeability fractured rock was made. The experiment attempted to define: the radius of influence of a pressure pulse-test in fractured rock and the correlation between pressure-pulse tests and steady-state flow tests performed in five boreholes drilled in fractured granite. Twenty-five test intervals, 2 to 3 m in length, were isolated in the boreholes, using air-inflated packers. During pressure pulse and steady-state tests, pressures were monitored in both the test and observation cavities. Rock-mass conductivities were calculated from steady-state test results and were found to range from less than 10 - 11 to 10 - 7 cm/sec. However, there was no consistent correlation between the steady-state conductivity and the pressure pulse decay characteristics of individual intervals. These conflicting test results can be attributed to the following factors: differences in volumes of rock affected by the test techniques; effects of equipment configuration and compliance; and complexity of the fracture network. Although the steady-state flow tests indicate that hydraulic connections exist between most of the test cavities, no pressure responses were noted in the observation cavities (located at least 0.3 m from the test cavities) during the pulse tests. This does not mean, however, that the pressure-pulse radius of influence is <0.3 m, because the observation cavities were too large (about 7 liters). The lack of correlation between steady-state conductivities and the corresponding pressure pulse decay times does not permit use of existing single-fracture type curves to analyze pulse tests performed in multiple-fracture intervals. Subsequent work should focus on the detailed interpretation of field results with particular reference to the effects of the fracture system at the test site

A Maximum Radius for Habitable Planets.

Science.gov (United States)

Alibert, Yann

2015-09-01

We compute the maximum radius a planet can have in order to fulfill two constraints that are likely necessary conditions for habitability: 1- surface temperature and pressure compatible with the existence of liquid water, and 2- no ice layer at the bottom of a putative global ocean, that would prevent the operation of the geologic carbon cycle to operate. We demonstrate that, above a given radius, these two constraints cannot be met: in the Super-Earth mass range (1-12 Mearth), the overall maximum that a planet can have varies between 1.8 and 2.3 Rearth. This radius is reduced when considering planets with higher Fe/Si ratios, and taking into account irradiation effects on the structure of the gas envelope.

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

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Sindhuja G

2017-06-01

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

Low volumetric BMD is linked to upper-limb fracture in pubertal girls and persists into adulthood: a seven-year cohort study.

Science.gov (United States)

Cheng, Sulin; Xu, Leiting; Nicholson, Patrick H F; Tylavsky, Frances; Lyytikäinen, Arja; Wang, Qingju; Suominen, Harri; Kujala, Urho M; Kröger, Heikki; Alen, Markku

2009-09-01

The aetiology of increased incidence of fracture during puberty is unclear. This study aimed to determine whether low volumetric bone mineral density (vBMD) in the distal radius is associated with upper-limb fractures in growing girls, and whether any such vBMD deficit persists into adulthood. Fracture history from birth to 20 years was obtained and verified by medical records in 1034 Finnish girls aged 10-13 years. Bone density and geometry at distal radius, biomarkers and lifestyle/behavioural factors were assessed in a subset of 396 girls with a 7.5-year follow-up. We found that fracture incidence peaked during puberty (relative risk 3.1 at age of 8-14 years compared to outside this age window), and 38% of fractures were in the upper-limb. Compared to the non-fracture cohort, girls who sustained upper-limb fracture at ages 8-14 years had lower distal radial vBMD at baseline (258.9+/-37.5 vs. 287.5+/-34.1 mg/cm(3), p=0.001), 1-year (252.0+/-29.3 vs. 282.6+/-33.5 mg/cm(3), p=0.001), 2-year (258.9+/-32.2 vs. 289.9+/-40.1 mg/cm(3), p=0.003), and 7-year follow-ups (early adulthood, 307.6+/-35.9 vs. 343.6+/-40.9 mg/cm(3), p=0.002). There was a consistent trend towards larger bone cross-sectional area in the fracture cohort compared to non-fracture. In a logistic regression model, lower vBMD (p=0.001) was the only significant predictor of upper-limb fracture during the period of 8-14 years. Our results indicate that low BMD is an important factor underlying elevated upper-limb fracture risk during puberty, and that low BMD in pubertal girls with fracture persists into adulthood. Hence low vBMD during childhood is not a transient deficit. Methods to monitor vBMD and to maximise bone mineral accrual and reduce risks of falling in childhood should be developed.

Effect of helium bubbles at grain boundaries on the fracture characteristics of high-density 238PuO2

International Nuclear Information System (INIS)

Sisson, R.D.; McDonell, W.R.

1976-01-01

Helium bubbles that formed at grain boundaries in high density (greater than 92 percent of theoretical) 238 PuO 2 shards did not affect the room temperature fracture behavior as observed by scanning electron microscopy. Fracture was predominantly by brittle transgranular cleavage with only infrequent intergranular failure observed. Pores (approximately 5 μm dia) that formed within the grains during the sintering process, rather than helium bubbles, initiated fractures. Helium bubbles were observed occasionally on the fracture surfaces of 20-month-old shards that had been heated to 1600 0 C for 8 h and subsequently crushed at room temperature. The average radius of these bubbles was approximately 1 μm. These bubbles were not interconnected, but were sometimes aligned in stringers

Low levels of 25-hydroxyvitamin D are associated with the occurrence of concomitant upper limb fractures in older women who sustain a fall-related fracture of the hip.

Science.gov (United States)

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

2011-01-01

To investigate the association between serum levels of 25-hydroxyvitamin D and the occurrence of simultaneous fractures of the upper limb in older women who sustain a fall-related fracture of the hip. Cross-sectional study. We investigated 472 of 480 white women consecutively admitted to a rehabilitation hospital because of a fall-related hip fracture. Twenty-seven (5.7%) of the 472 women sustained a concomitant upper-limb fracture of either distal radius (20 women) or proximal humerus (seven women). We assessed serum levels of 25-hydroxyvitamin D 14.2 ± 4.1 (mean ± SD) days after surgical repair of the hip fracture in the 472 women by an immunoenzymatic assay. Twenty-five-hydroxyvitamin D levels were significantly lower in the 27 women with concomitant fractures of both hip and upper limb than in the remaining 445 hip-fracture women: mean ± SD values were 6.5 ± 5.0 ng/ml and 11.7 ± 10.4 ng/ml respectively in the two groups (mean difference between groups 5.2 ng/ml: 95% CI 1.2-9.2; p=0.011). Low levels of 25-hydroxyvitamin D were significantly associated with concomitant fractures of the upper limb (p=0.017), after adjustment for eight potential confounders including age, height, weight, hip-fracture type, cognitive impairment, neurologic impairment, previous hip fracture, and previous upper-limb fracture. Low levels of 25-hydroxyvitamin D were significantly associated with concomitant upper-limb fractures in our sample of older women with a fall-related fracture of the hip. Preventing vitamin D deficiency may lower the incidence of simultaneous fractures due to a singe fall in elderly women. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Finite-Larmor-radius stability theory of EBT plasmas

International Nuclear Information System (INIS)

Berk, H.L.; Cheng, C.Z.; Rosenbluth, M.N.; Van Dam, J.W.

1982-11-01

An eikonal ballooning-mode formalism is developed to describe curvature-driven modes of hot electron plasmas in bumpy tori. The formalism treats frequencies comparable to the ion-cyclotron frequency, as well as arbitrary finite Larmor radius and field polarization, although the detailed analysis is restricted to E/sub parallel/ = 0. Moderate hot-electron finite-Larmor-radius effects are found to lower the background beta core limit, whereas strong finite-Lamor-radius effects produce stabilization

Impact of double-tiered subchondral support procedure with a polyaxial locking plate on the stability of distal radius fractures using fresh cadaveric forearms: Biomechanical and radiographic analyses.

Science.gov (United States)

Tsutsui, Sadaaki; Kawasaki, Keikichi; Yamakoshi, Ken-Ichi; Uchiyama, Eiichi; Aoki, Mitsuhiro; Inagaki, Katsunori

2016-09-01

The present study compared the changes in biomechanical and radiographic properties under cyclic axial loadings between the 'double-tiered subchondral support' (DSS) group (wherein two rows of screws were used) and the 'non-DSS' (NDSS) group (wherein only one row of distal screws was used) using cadaveric forearm models of radius fractures fixed with a polyaxial locking plate. Fifteen fresh cadaveric forearms were surgically operated to generate an Arbeitsgemeinschaft für Osteosynthesefragen (AO) type 23-C2 fracture model with the fixation of polyaxial volar locking plates. The model specimens were randomized into two groups: DSS (n = 7) and NDSS (n = 8). Both the groups received 4 locking screws in the most distal row, as is usually applied, whereas the DSS group received 2 additional screws in the second row inserted at an inclination of about 15° to support the dorsal aspect of the dorsal subchondral bone. Cyclic axial compression test was performed (3000 cycles; 0-250 N; 60 mm/min) to measure absolute rigidity and displacement, after 1, 1000, 2000 and 3000 cycles, and values were normalized relative to cycle 1. These absolute and normalized values were compared between those two groups. Radiographic images were taken before and after the cyclic loading to measure changes in volar tilt (ΔVT) and radial inclination (ΔRI). The DSS group maintained significantly higher rigidity and lower displacement values than the NDSS group during the entire loading period. Radiographic analysis indicated that the ΔVT values of the DSS group were lower than those of the NDSS group. In contrast, the fixation design did not influence the impact of loading on the ΔRI values. Biomechanical and radiographic analyses demonstrated that two rows of distal locking screws in the DSS procedure conferred higher stability than one row of distal locking screws. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

Rheological Characteristics of Cement Grout and its Effect on Mechanical Properties of a Rock Fracture

Science.gov (United States)

Liu, Quansheng; Lei, Guangfeng; Peng, Xingxin; Lu, Chaobo; Wei, Lai

2018-02-01

Grouting reinforcement, which has an obvious strengthening effect on fractured rock mass, has been widely used in various fields in geotechnical engineering. The rheological properties of grout will greatly affect its diffusion radius in rock fractures, and the water-cement ratio is an important factor in determining the grouting flow patterns. The relationship between shear stress and shear rate which could reflect the grout rheological properties, the effects of water-cement ratio, and temperature on the rheological properties of grouting was studied in the laboratory. Besides, a new method for producing fractured rock specimens was proposed and solved the problem of producing natural fractured rock specimens. To investigate the influences of grouting on mechanical properties of a rock fracture, the fractured rock specimens made using the new method were reinforced by grouting on the independent designed grouting platform, and then normal and tangential mechanical tests were carried out on fractured rock specimens. The results showed that the mechanical properties of fractured rock mass are significantly improved by grouting, the peak shear strength and residual strength of rock fractures are greatly improved, and the resistance to deformation is enhanced after grouting. Normal forces affect the tangential behavior of the rock fracture, and the tangential stress strength increases with normal forces. The strength and stability of fractured rock mass are increased by grouting reinforcement.

Correlation between quarter-point angle and nuclear radius

Science.gov (United States)

Ma, Wei-Hu; Wang, Jian-Song; Mukherjee, S.; Wang, Qi; Patel, D.; Yang, Yan-Yun; Ma, Jun-Bing; Ma, Peng; Jin, Shi-Lun; Bai, Zhen; Liu, Xing-Quan

2017-04-01

The correlation between quarter-point angle of elastic scattering and nuclear matter radius is studied systematically. Various phenomenological formulae with parameters for nuclear radius are adopted and compared by fitting the experimental data of quarter point angle extracted from nuclear elastic scattering reaction systems. A parameterized formula related to binding energy is recommended, which gives a good reproduction of nuclear matter radii of halo nuclei. It indicates that the quarter-point angle of elastic scattering is quite sensitive to the nuclear matter radius and can be used to extract the nuclear matter radius. Supported by National Natural Science Foundation of China (U1432247, 11575256), National Basic Research Program of China (973 Program)(2014CB845405 and 2013CB83440x) and (SM) Chinese Academy of Sciences President’s International Fellowship Initiative (2015-FX-04)

Numerical Analysis of AHSS Fracture in a Stretch-bending Test

Science.gov (United States)

Luo, Meng; Chen, Xiaoming; Shi, Ming F.; Shih, Hua-Chu

2010-06-01

Advanced High Strength Steels (AHSS) are increasingly used in the automotive industry due to their superior strength and substantial weight reduction advantage. However, their limited ductility gives rise to numerous manufacturing issues. One of them is the so-called `shear fracture' often observed on tight radii during stamping processes. Since traditional approaches, such as the Forming Limit Diagram (FLD), are unable to predict this type of fracture, efforts have been made to develop failure criteria that can predict shear fractures. In this paper, a recently developed Modified Mohr-Coulomb (MMC) ductile fracture criterion[1] is adopted to analyze the failure behavior of a Dual Phase (DP) steel sheet during stretch bending operations. The plasticity and ductile fracture of the present sheet are fully characterized by the Hill'48 orthotropic model and the MMC fracture model respectively. Finite Element models with three different element types (3D, shell and plane strain) were built for a Stretch Forming Simulator (SFS) test and numerical simulations with four different R/t ratios (die radius normalized by sheet thickness) were performed. It has been shown that the 3D and shell element models can accurately predict the failure location/mode, the upper die load-displacement responses as well as the wall stress and wrap angle at the onset of fracture for all R/t ratios. Furthermore, a series of parametric studies were conducted on the 3D element model, and the effects of tension level (clamping distance) and tooling friction on the failure modes/locations were investigated.

Open Fracture of the Forearm Bones due to Horse Bite

Directory of Open Access Journals (Sweden)

John Ashutosh Santoshi

2014-01-01

Full Text Available Introduction: Fractures have been described mainly following falling accidents in horse-related injuries. Horse bites are uncommon accidents. We present a case of open fracture of the forearm due to horse bite. Case Report: A 35-year-old male farm-worker presented to the emergency room with alleged history of horse bite to the right forearm about 2 hours prior to presentation while feeding the horse. There was deformity of the forearm with multiple puncture wounds, deep abrasions and small lacerations on the distal-third of the forearm. Copious irrigation with normal saline was done and he was administered anti-tetanus and post-exposure rabies prophylaxis. Prophylactic antibiotic therapy was commenced. Radiographs revealed fracture of radius and ulna in the mid-shaft region. He underwent emergency wound debridement, and the ulna was stabilised with an intra-medullary square nail. Seventy-two hours later, he underwent re-debridement and conversion osteosynthesis. He had an uneventful recovery and at three-month follow-up, the fractures had healed radiographically in anatomic alignment. At two-year follow-up, he is doing well, is pain free and has a normal range of motion compared to the contralateral side. Conclusion: Horse bites behave as compound fractures however rabies prophylaxis will be needed and careful observation is needed. Early radical debridement, preliminary skeletal stabilisation, re-debridement and conversion osteosynthesis to plate, and antibiotic prophylaxis were the key to the successful management of our patient. Keywords: Horse; animal bite; forearm; open fracture

Echinococcal disease of the bone: An unusual cause of a pathological fracture

Directory of Open Access Journals (Sweden)

Matthew Goodier

2010-12-01

Full Text Available Echinococcosis is caused by the larva of the tapeworm, Echinococcus granulosus or Echinococcus multiloccularis and is endemic in many rural areas of Southern Africa. Echinococcosis of the bone is an unusual manifestation of echinococcal disease and a rare cause of a lytic lesion of bone. This report describes a 30-yr old female who presented with an Echinococcal cyst of the right radius complicated by a pathological fracture.

Does osteoporosis increase complication risk in surgical fracture treatment? A protocol combining new endpoints for two prospective multicentre open cohort studies

Directory of Open Access Journals (Sweden)

Marent Marta

2010-11-01

Full Text Available Abstract Background With an ever-increasing elderly population, orthopaedic surgeons are faced with treating a high number of fragility fractures. Biomechanical tests have demonstrated the potential role of osteoporosis in the increased risk of fracture fixation complications, yet this has not been sufficiently proven in clinical practice. Based on this knowledge, two clinical studies were designed to investigate the influence of local bone quality on the occurrence of complications in elderly patients with distal radius and proximal humerus fractures treated by open reduction and internal fixation. Methods/Design The studies were planned using a prospective multicentre open cohort design and included patients between 50 and 90 years of age. Distal radius and proximal humerus fractures were treated with locking compression 2.4 mm and proximal humerus internal locking plates, respectively. Follow-up examinations were planned for 6 weeks, 3 and 12 months as well as a telephone interview at 6 months. The primary outcome focuses on the occurrence of at least one local bone quality related complication. Local bone quality is determined by measuring bone mineral density and bone mineral content at the contralateral radius. Primary complications are categorised according to predefined factors directly related to the bone/fracture or the implant/surgical technique. Secondary outcomes include the documentation of soft tissue/wound or general/systemic complications, clinical assessment of range of motion, and patient-rated evaluations of upper limb function and quality of life using both objective and subjective measures. Discussion The prospective multicentre open cohort studies will determine the value of local bone quality as measured by bone mineral density and content, and compare the quality of local bone of patients who experience a complication (cases following surgery with that of patients who do not (controls. These measurements are novel and

Fracture behavior of circumferentially surface-cracked elbows. Technical report, October 1993--March 1996

International Nuclear Information System (INIS)

Kilinski, T.; Mohan, R.; Rudland, D.; Fleming, M.

1996-12-01

This report presents the results from Task 2 of the Second International Piping Integrity Research Group (IPIRG-2) program. The focus of the Task 2 work was directed towards furthering the understanding of the fracture behavior of long-radius elbows. This was accomplished through a combined analytical and experimental program. J-estimation schemes were developed for both axial and circumferential surface cracks in elbows. Large-scale, quasi-static and dynamic, pipe-system, elbow fracture experiments under combined pressure and bending loads were performed on elbows containing an internal surface crack at the extrados. In conjunction with the elbow experiments, material property data were developed for the A106-90 carbon steel and WP304L stainless steel elbow materials investigated. A comparison of the experimental data with the maximum stress predictions using existing straight pipe fracture prediction analysis methods, and elbow fracture prediction methods developed in this program was performed. This analysis was directed at addressing the concerns regarding the validity of using analysis predictions developed for straight pipe to predict the fracture stresses of cracked elbows. Finally, a simplified fitting flaw acceptance criteria incorporating ASME B2 stress indices and straight pipe, circumferential-crack analysis was developed

Fracture behavior of circumferentially surface-cracked elbows. Technical report, October 1993--March 1996

Energy Technology Data Exchange (ETDEWEB)

Kilinski, T.; Mohan, R.; Rudland, D.; Fleming, M. [and others

1996-12-01

This report presents the results from Task 2 of the Second International Piping Integrity Research Group (IPIRG-2) program. The focus of the Task 2 work was directed towards furthering the understanding of the fracture behavior of long-radius elbows. This was accomplished through a combined analytical and experimental program. J-estimation schemes were developed for both axial and circumferential surface cracks in elbows. Large-scale, quasi-static and dynamic, pipe-system, elbow fracture experiments under combined pressure and bending loads were performed on elbows containing an internal surface crack at the extrados. In conjunction with the elbow experiments, material property data were developed for the A106-90 carbon steel and WP304L stainless steel elbow materials investigated. A comparison of the experimental data with the maximum stress predictions using existing straight pipe fracture prediction analysis methods, and elbow fracture prediction methods developed in this program was performed. This analysis was directed at addressing the concerns regarding the validity of using analysis predictions developed for straight pipe to predict the fracture stresses of cracked elbows. Finally, a simplified fitting flaw acceptance criteria incorporating ASME B2 stress indices and straight pipe, circumferential-crack analysis was developed.

Numerical Radius Inequalities for Finite Sums of Operators

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Mirmostafaee Alireza Kamel

2014-12-01

Full Text Available In this paper, we obtain some sharp inequalities for numerical radius of finite sums of operators. Moreover, we give some applications of our result in estimation of spectral radius. We also compare our results with some known results.

Risks of all-cause and site-specific fractures among hospitalized patients with COPD

Science.gov (United States)

Liao, Kuang-Ming; Liang, Fu-Wen; Li, Chung-Yi

2016-01-01

Abstract Patients with chronic obstructive pulmonary disease (COPD) have a high prevalence of osteoporosis. The clinical sequel of osteoporosis is fracture. Patients with COPD who experience a fracture also have increased morbidity and mortality. Currently, the types of all-cause and site-specific fracture among patients with COPD are unknown. Thus, we elucidated the all-cause and site-specific fractures among patients with COPD. A retrospective, population-based, cohort study was conducted utilizing the Taiwan Longitudinal Health Insurance Database. Patients with COPD were defined as those who were hospitalized with an International Classification of Diseases, Ninth Revision, Clinical Modification code of 490 to 492 or 496 between 2001 and 2011. The index date was set as the date of discharge. The study patients were followed from the index date to the date when they sought care for any type of fracture, date of death, date of health insurance policy termination, or the last day of 2013. The types of fracture analyzed in this study included vertebral, rib, humeral, radial and ulnar/wrist, pelvic, femoral, and tibial and fibular fractures. The cohort consisted of 11,312 patients with COPD. Among these patients, 1944 experienced fractures. The most common site-specific fractures were vertebral, femoral, rib, and forearm fractures (radius, ulna, and wrist) at 32.4%, 31%, 12%, and 11.8%, respectively. The adjusted hazard ratios of fracture were 1.71 [95% confidence interval (95% CI) = 1.56–1.87] for female patient with COPD and 1.50 (95% CI = 1.39–1.52) for patients with osteoporosis after covariate adjustment. Vertebral and hip fractures are common among patients with COPD, especially among males with COPD. Many comorbidities contribute to the high risk of fracture among patients with COPD. PMID:27749576

A Mathematical Pressure Transient Analysis Model for Multiple Fractured Horizontal Wells in Shale Gas Reservoirs

Directory of Open Access Journals (Sweden)

Yan Zeng

2018-01-01

Full Text Available Multistage fractured horizontal wells (MFHWs have become the main technology for shale gas exploration. However, the existing models have neglected the percolation mechanism in nanopores of organic matter and failed to consider the differences among the reservoir properties in different areas. On that account, in this study, a modified apparent permeability model was proposed describing gas flow in shale gas reservoirs by integrating bulk gas flow in nanopores and gas desorption from nanopores. The apparent permeability was introduced into the macroseepage model to establish a dynamic pressure analysis model for MFHWs dual-porosity formations. The Laplace transformation and the regular perturbation method were used to obtain an analytical solution. The influences of fracture half-length, fracture permeability, Langmuir volume, matrix radius, matrix permeability, and induced fracture permeability on pressure and production were discussed. Results show that fracture half-length, fracture permeability, and induced fracture permeability exert a significant influence on production. A larger Langmuir volume results in a smaller pressure and pressure derivative. An increase in matrix permeability increases the production rate. Besides, this model fits the actual field data relatively well. It has a reliable theoretical foundation and can preferably describe the dynamic changes of pressure in the exploration process.

Treatment outcomes of intertrochanteric femur fractures treated with DLT™ nail

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Mehmet Arıcan

2015-12-01

Full Text Available Objective: Intramedullary nails frequently use in proximal femur fractures. In this study, 49 patients with intertrochanteric fractures were evaluated clinical and radiological results treated with dyna locking trochanteric (DLT™ nail retrospectively. Methods: Twenty-two (44.9% patients were male and 27 (55.1% patients were female. Mean age was 74.29±1.98 (28-99 years and Followed up for a mean of 14.35±3.43 (9-24 months. Thirty-seven (75.6% of the fractures resulted from simple falls while 6 (12.2% caused from traffic accidents and 6 (12.2% fall down from height. There were 24 (49.0% left and 25 (51.0% right lower extremities fractured. According to Orthopaedic Trauma Association classification system; 21 (42.9%, 21 (42.9% and 7 (14.2% fractures were classified as 31A1, 31A2, and 31A3 respectively. One (2.0% patient had claviculae fracture, 3 (6.1% patients had radius distal fracture and 1 (2.0% patient had total knee arthroplasty. After surgery, X-ray was used for radiological results and functional outcomes were evaluated according to the Harris hip scoring system. Results: The average waiting time for the surgery was 2.02±0.18 (1-7 days and hospitalization time was 6.23±0.29 (4-15 days. Mean fracture healing time was 11.74±1.82 (8-15 weeks. Three patients had screw cut-out in the follow-up time and performed hemiarthroplasty. The average Harris hip score was 88.02±1.21 (42-97 points and included 29 (59.2% excellent cases, 17 (34.7% good and 3 (6.1% poor. Conclusion: DLT ™ nail is a safe and successful method because of low complication rates, and capability of detection.

Power decoding Reed-Solomon codes up to the Johnson radius

DEFF Research Database (Denmark)

Rosenkilde, Johan Sebastian Heesemann

2018-01-01

Power decoding, or "decoding using virtual interleaving" is a technique for decoding Reed-Solomon codes up to the Sudan radius. Since the method's inception, it has been an open question if it is possible to use this approach to decode up to the Johnson radius - the decoding radius of the Guruswami...

Digital Tomosynthesis to Evaluate Fracture Healing: Prospective Comparison With Radiography and CT.

Science.gov (United States)

Ha, Alice S; Lee, Amie Y; Hippe, Daniel S; Chou, Shinn-Huey S; Chew, Felix S

2015-07-01

Radiography, currently the standard for postoperative fracture imaging, is limited by overlapping bone and hardware. Tomosynthesis has the benefit of level-by-level imaging without the disadvantages of metal artifacts, increased radiation, and higher costs of CT, the current problem-solving tool. The purpose of this study was to compare tomosynthesis with radiography for evaluating fracture healing. In a prospective study, patients within 1 year of wrist hardware fixation underwent radiography, tomosynthesis, and CT, and the images were interpreted by three readers. The diagnostic accuracy of radiology and tomosynthesis was assessed with ROC curves, and interreader agreement was assessed with Cohen kappa. Fracture scores were correlated with Disabilities of the Arm, Shoulder, and Hand (DASH) and pain scores. The study participants were 49 patients with 51 fractures. The most common fracture sites were distal radius (43%), scaphoid (18%), and metacarpals (18%). Rates of cortex obscuration by hardware were 2% for CT, 8% for tomosynthesis, and 15% for radiography (p tomosynthesis than with radiography (AUC, 0.84 vs 0.76, p = 0.01). Inter-reader agreement was moderate for both radiography and tomosynthesis (κ = 0.44 vs 0.55, p = 0.051). There was no significant correlation between fracture scores and DASH scores. There was significant correlation between reported pain levels and both tomosynthesis (r = 0.28, p = 0.03) and CT (r = 0.29, p = 0.04) fracture scores. Tomosynthesis provides diagnostic information superior to that of ra diography in postoperative evaluation of wrist fractures with lower cost and radiation than CT and should be considered in fracture follow-up imaging of other bones.

Intermediate-Scale Hydraulic Fracturing in a Deep Mine - kISMET Project Summary 2016

Energy Technology Data Exchange (ETDEWEB)

Oldenburg, C. M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Dobson, P. F. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wu, Y. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Cook, P. J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Kneafsey, T. J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Nakagawa, S. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Ulrich, C. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Siler, D. L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Guglielmi, Y. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Ajo-Franklin, J. B. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Rutqvist, J. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Daley, T. M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Birkholzer, J. T. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Wang, H. F. [Univ. of Wisconsin, Madison, WI (United States); Lord, N. E. [Univ. of Wisconsin, Madison, WI (United States); Haimson, B. C. [Univ. of Wisconsin, Madison, WI (United States); Sone, H. [Univ. of Wisconsin, Madison, WI (United States); Vigilante, P. [Univ. of Wisconsin, Madison, WI (United States); Roggenthen, W. M. [South Dakota School of Mines and Technology, Rapid City, SD (United States); Doe, T. W. [Golder Associates Inc., Toronto, ON (Canada); Lee, M. Y. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Ingraham, M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Huang, H. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Mattson, E. D. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Zhou, J. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Johnson, T. J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Morris, J. P. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); White, J. A. [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Johnson, P. A. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Coblentz, D. D. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States); Heise, J. [Stanford Underground Research Facility, Lead, SD (United States); Zoback, M. D. [Stanford Univ., CA (United States)

2016-11-04

In support of the U.S. DOE SubTER Crosscut initiative, we established a field test facility in a deep mine and designed and carried out in situ hydraulic fracturing experiments in the crystalline rock at the site to characterize the stress field, understand the effects of rock fabric on fracturing, and gain experience in monitoring using geophysical methods. The project also included pre- and post-fracturing simulation and analysis, laboratory measurements and experiments, and we conducted an extended analysis of the local stress state using previously collected data. Some of these activities are still ongoing. The kISMET (permeability (k) and Induced Seismicity Management for Energy Technologies) experiments meet objectives in SubTER’s “stress” pillar and the “new subsurface signals” pillar. The kISMET site was established in the West Access Drift of SURF 4850 ft (1478 m) below ground (on the 4850L) in phyllite of the Precambrian Poorman Formation. We drilled and cored five near-vertical boreholes in a line on 3 m spacing, deviating the two outermost boreholes slightly to create a five-spot pattern around the test borehole centered in the test volume at ~1528 m (5013 ft). Laboratory measurements of core from the center test borehole showed P-wave velocity heterogeneity along each core indicating strong, fine-scale (~1 cm or smaller) changes in the mechanical properties of the rock. The load-displacement record on the core suggests that the elastic stiffness is anisotropic. Tensile strength ranges between 3-7.5 MPa and 5-12 MPa. Permeability measurements are planned, as are two types of laboratory miniature hydraulic fracturing experiments to investigate the importance of rock fabric (anisotropy and heterogeneity) on near-borehole hydraulic fracture generation. Pre-fracturing numerical simulations with INL’s FALCON discrete element code predicted a fracture radius of 1.2 m for a corresponding injection volume of 1.2 L for the planned fractures, and

Effect of Asparagus racemosus on fracture healing in rabbits: a radiographic and angiographic study

International Nuclear Information System (INIS)

Singh, Sunil; Singh, H.N.; Gangwar, A.K.; Devi, Kh. Sangeeta; Waghay, J.Y.

2009-01-01

New Zealand white rabbits (18) were randomly divided into groups I and II (control) having 9 animals in each group. The fracture of ulna was created in each animal under general anaesthesia using thiopental sodium (2.5%). Radius acted as a natural splint. The animals of group I were fed with powdered Asparagus racemosus along with rabbit feed throughout the study period. However, in group II animals only powdered rabbit feed was given. Healing at the fracture site was assessed by plain radiography and angiography at 7th, 14th, 21st and 28th day interval. Radiographical observation revealed a well organized and dense callus at 21st day in animals of group I whereas in animals of group II, callus of slightly less radiographic density was observed at this interval. Angiographic observation revealed hypervascularity at the fracture site at 7th and 14th day interval in group I animals. On day 14, in group II animals major vessels lack continuity along with reduced vascularity around the fracture site. The results of present study suggest that feeding of dry root powder of Asparagus racemosus promotes early fracture healing in rabbits

Study protocol: non-displaced distal radial fractures in adult patients: three weeks vs. five weeks of cast immobilization: a randomized trial

NARCIS (Netherlands)

Bentohami, Abdelali; de Korte, Niels; Sosef, Nico; Goslings, Johan Carel; Bijlsma, Taco; Schep, Niels

2014-01-01

Up to 30% of patients suffer from long-term functional restrictions following conservative treatment of distal radius fractures. Whether duration of cast immobilisation influences functional outcome remains unclear. The aim of the study is to evaluate whether the duration of immobilization of non or

Spectroscopy of muonic atoms and the proton radius puzzle

Science.gov (United States)

Antognini, Aldo

2017-09-01

We have measured several 2 S -2 P transitions in muonic hydrogen (μp), muonic deuterium (μd) and muonic helium ions (μ3He, μ4He). From muonic hydrogen we extracted a proton charge radius 20 times more precise than obtained from electron-proton scattering and hydrogen high-precision laser spectroscopy but at a variance of 7 σ from these values. This discrepancy is nowadays referred to as the proton radius puzzle. New insight has been recently provided by the first determination of the deuteron charge radius from laser spectroscopy of μd. The status of the proton charge radius puzzle including the new insights obtained by μd spectroscopy will be discussed. Work supported by the Swiss National Science Foundation SNF-200021-165854 and the ERC CoG. #725039.

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

Directory of Open Access Journals (Sweden)

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.

Transfixation pinning and casting of radial-ulnar fractures in calves: A review of three cases.

Science.gov (United States)

St-Jean, G; Debowes, R M

1992-04-01

We reviewed the medical records of three calves with radial-ulnar fractures which were reduced and stabilized by transfixation pinning and casting. Multiple Steinmann pins were placed transversely through proximal and distal fracture fragments and the pin ends were incorporated in fiberglass cast material after fracture reduction. Cast material was placed from proximal to distal radius and served as an external frame to maintain pin position and fracture reduction.At the time of injury, the calves ranged in age from one day to two months and weighed from 37-102 kg. Two fractures were comminuted and one was transverse. All fractures were closed. After surgery, all calves could walk within 24 hours. Radiographic and clinical evidence of fracture healing was present five to seven weeks (mean 6) after surgery. At that time, the pins and cast material were removed. Return to normal function was rapid and judged to be excellent at follow-up evaluation five to nine months later.Advantages of transfixation pinning and casting in management of radial-ulnar fractures include flexibility in pin positioning, adequate maintenance of reduction, early return to weight-bearing status, preservation of joint mobility, and ease of ambulation. The inability to adjust fixation and alignment after cast application is a disadvantage of this technique compared with other external fixators. We concluded that transfixation pinning is a useful means of stabilizing radial-ulnar fractures in pediatric bovine patients.

Finite Larmor radius stabilization of ballooning modes in tokamaks

International Nuclear Information System (INIS)

Tsang, K.T.

1980-07-01

A ballooning mode equation that includes full finite Larmor radius effects has been derived from the Vlasov equation for a circular tokamak equilibrium. Numerical solution of this equation shows that finite Larmor radius effects are stabilizing

MUSE: Measuring the proton radius with muon-proton scattering

Energy Technology Data Exchange (ETDEWEB)

Bernauer, Jan Christopher [Massachusetts Institute of Technology, Cambridge (United States)

2014-07-01

The proton radius has been measured so far using electron-proton scattering, electronic Hydrogen spectroscopy and muonic Hydrogen spectroscopy, the latter producing a much more accurate, but seven sigma different, result, leading to the now famous proton radius puzzle. The MUSE collaboration aims to complete the set of measurements by using muon scattering to determine the proton radius and to shed light on possible explanations of the discrepancy. The talk gives an overview of the experiment motivation and design and a status report on the progress.

Reliability and validity of selected measures associated with increased fall risk in females over the age of 45 years with distal radius fracture - A pilot study.

Science.gov (United States)

Mehta, Saurabh P; MacDermid, Joy C; Richardson, Julie; MacIntyre, Norma J; Grewal, Ruby

2015-01-01

Clinical measurement. This study examined test-retest reliability and convergent/divergent construct validity of selected tests and measures that assess balance impairment, fear of falling (FOF), impaired physical activity (PA), and lower extremity muscle strength (LEMS) in females >45 years of age after the distal radius fracture (DRF) population. Twenty one female participants with DRF were assessed on two occasions. Timed Up and Go, Functional Reach, and One Leg Standing tests assessed balance impairment. Shortened Falls Efficacy Scale, Activity-specific Balance Confidence scale, and Fall Risk Perception Questionnaire assessed FOF. International Physical Activity Questionnaire and Rapid Assessment of Physical Activity were administered to assess PA level. Chair stand test and isometric muscle strength testing for hip and knee assessed LEMS. Intraclass correlation coefficients (ICC) examined the test-retest reliability of the measures. Pearson correlation coefficients (r) examined concurrent relationships between the measures. The results demonstrated fair to excellent test-retest reliability (ICC between 0.50 and 0.96) and low to moderate concordance between the measures (low if r ≤ 0.4; moderate if r = 0.4-0.7). The results provide preliminary estimates of test-retest reliability and convergent/divergent construct validity of selected measures associated with increased risk for falling in the females >45 years of age after DRF. Further research directions to advance knowledge regarding fall risk assessment in DRF population have been identified. Copyright © 2015 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

Interpretation of fracture system geometry using well test data

International Nuclear Information System (INIS)

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

1990-11-01

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

Upper pinch radius limit in EXTRAP

International Nuclear Information System (INIS)

Lehnert, B.

1989-12-01

A simple static equilibrium model of the Z-pinch is considered where a hot plasma core is surrounded by a cold-mantle (gas blanket). The pinch radius, defined as the radial extension of the fully ionized plasma core, is uniquely determined by the plasma particle. momentum and heat balance equations. In Extrap configurations an octupole field is introduced which imposes a magnetic separatrix on Z-pinch geometry. This makes the conditions for Extrap equilibrium 'overdetermined' when the characteristic pinch radium given by the plasma parameters tends to exceed the characteristic radius of the magnetic separatrix. In this case no conventional pinch equilibrium can exist, and part of the current which is forced into the plasma discharge by external sources must be channelled outside of the separatrix, i.e. into the surrounding support structure of the Extrap conductors and the vessel walls. A possibly existing bootstrap current in the plasma boundary layer is further expected to be 'scraped off' in this case. The present paper gives some illustrations of the marginal case of this upper pinch radius limit, in a state where the pinch current is antiparallel to the external rod currents which generate the octupole field. (authors)

Study Application of RADIUS Protocol on Ethernet

Institute of Scientific and Technical Information of China (English)

GUO Fang; YANG Huan-yu; LI Hong

2004-01-01

This paper presents how to apply the RADIUS (Remote Authentication Dial In User Service)protocol ,which is generally applied to dial-up network, to the authentication & charge of Broad Band accessing control system on Ethernet. It is provided that the Broad Band accessing control system included a self-designed communication protocol is used in communicating between an terminal user and Network Access Server .The interface module on the servers side and the Radius system is also given in this article.

Influence of cyclical fatigue on torsional fracture morphology in endodontic instruments.

Science.gov (United States)

Lopreite, Gustavo; Basilaki, Jorge; Hecht, Pedro

2013-01-01

Cyclical fatigue may influence the appearance and propagation of the type of fracture of an endodontic instrument. The aim of this study was to assess the influence of cyclic fatigue on morphological features of torsional fracture in Pathfile nickel-titanium rotary instruments for surgical preparation in endodontics. Thirty new Pathfile instruments (Dentsply- Maillefer. Ballaigues-Switzerland) diameter .13 and taper .02 were randomly divided into 5 groups (n = 6). Twenty-four of them were subject to cyclical fatigue by continuous rotation using a stainless steel cylinder with internal bore 0.5 mm, length 25 mm, with a curve of 45 degrees and radius 8 mm at 5 mm from the tip, at 300 rpm and 1 Ncm torque for different times: A: 15 sec, B: 75 sec, C: 150 sec and D: 300 sec, while the fifth group was kept as a control (group N). As a second step, the instruments were rotated at 2 rpm and 1 Ncm torque, with their apical 3 mm fixed in a resin block until they suffered torsional fracture. The fracture surfaces were analyzed using a conventional high-vacuum scanning electron microscope (Phillips mod. 515) at 400x. All instruments had ductile fracture areas of different sizes. The ductile fracture areas were measured as percentages of the total area of the instrument by means of Golden Ratio (Softonic) software for measuring images. The data obtained were analyzed statistically using one-way variance analysis followed by Tukey's multiple comparison test. There were significant differences among groups regarding cyclic fatigue time and fragile fracture area (P fatigue to which the rotating PathFile instrument is subject significantly increases the percentage of ductile fracture area produced by torsion.

Generalized spectral radius and its max algebra version

Czech Academy of Sciences Publication Activity Database

Müller, Vladimír; Peperko, A.

2013-01-01

Roč. 439, č. 4 (2013), s. 1006-1016 ISSN 0024-3795 R&D Projects: GA ČR GA201/09/0473; GA AV ČR IAA100190903 Institutional support: RVO:67985840 Keywords : generalized spectral radius * joint spectral radius * Berger-Wang formula Subject RIV: BA - General Mathematics Impact factor: 0.983, year: 2013 http://www.sciencedirect.com/science/article/pii/S0024379512007380

On tidal radius determination for a globular cluster

International Nuclear Information System (INIS)

Ninkovic, S.

1985-01-01

A tidal radius determination for a globular cluster based on its density minimum, which is caused by the galactic tidal forces and derivable from a model of the Galaxy, is proposed. Results obtained on the basis of the Schmidt model for two clusters are in a satisfactory agreement with those obtained earlier by means of other methods. A mass determination for the clusters through the tidal radius, when the latter one is identified with the cluster perigalactic distance, yields unusually large mass values. Probably, the tidal radius should be identified with the instantaneous galactocentric distance. Use of models more recent than the Schmidt one indicates that a globular cluster may contain a significant portion of an invisible interstellar matter. (author)

Coulomb corrections to scattering length and effective radius

International Nuclear Information System (INIS)

Mur, V.D.; Kudryavtsev, A.E.; Popov, V.S.

1983-01-01

The problem considered is extraction of the ''purely nuclear'' scattering length asub(s) (corresponding to the strong potential Vsub(s) at the Coulomb interaction switched off) from the Coulomb-nuclear scattering length asub(cs), which is an object of experimental measurement. The difference between asub(s) and asub(cs) is especially large if the potential Vsub(s) has a level (real or virtual) with an energy close to zero. For this case formulae are obtained relating the scattering lengths asub(s) and asub(cs), as well as the effective radii rsub(s) and rsub(cs). The results are extended to states with arbitrary angular momenta l. It is shown that the Coulomb correction is especially large for the coefficient with ksup(2l) in the expansion of the effective radius; in this case the correction contains a large logarithm ln(asub(B)/rsub(0)). The Coulomb renormalization of other terms in the effective radius espansion is of order (rsub(0)/asub(B)), where r 0 is the nuclear force radius, asub(B) is the Bohr radius. The obtained formulae are tried on a number of model potentials Vsub(s), used in nuclear physics

Two surgical approaches to fracture malunion repair.

Science.gov (United States)

Rahal, Sheila C; Teixeira, Carlos R; Pereira-Júnior, Oduvaldo C M; Vulcano, Luiz C; Aguiar, Antonio J A; Rassy, Fabrício B

2008-12-01

Two birds were presented with malunion fractures. The first was a young toco toucan (Ramphastos toco) with malunion of the tarsometatarsus that was treated by an opening-wedge corrective osteotomy and an acrylic-pin external skeletal fixator (type II) to stabilize the osteotomy. The second bird was an adult southern caracara (Caracara plancus) with radial and ulnar malunion that was treated by closing-wedge osteotomies. Stabilization of the osteotomy sites was accomplished through a bone plate fixed cranially on the ulna with 6 cortical screws and an interfragmentary single wire in radius. In both cases, the malunion was corrected, but the manus of the southern caracara was amputated because of carpal joint luxation that induced malposition of the feathers.

Is warfarin usage a risk factor for osteoporotic fractures? A cohort study in the emergency department

Directory of Open Access Journals (Sweden)

Genady Drozdinsky

2017-04-01

Full Text Available Background Several studies have examined the association between warfarin sodium use and risk of osteoporotic fractures with conflicting results. Our study addresses this question, for the first time regarding patients attending emergency department (ED. Aims The aim of this study was to retrospectively detect whether there is higher rate of usage of warfarin sodium in patients with osteoporotic fractures attending an ED. Methods This is a retrospective study from patients' computerized charts. All individuals >65 years old who had an osteoporotic fracture and attended an ED in a tertiary hospital were compared with a similar group of elderly individuals >65 years old without an osteoporotic fracture who attended the ED for a cause other than an osteoporotic fracture. Results This study included 328 patients who were evaluated in the years 2005–2016. Overall, 164 individuals with a typical osteoporotic fracture (hip -66 patients (40 per cent, spine- 92 patients (56 per cent, humerus -4 patients (2 per cent, radius -13 patients (8 per cent were identified and compared with a matched group of elderly individuals who were evaluated in the ED for other complaints. Warfarin sodium was used in 61 individuals (19 per cent in the entire cohort, 34 in the fracture group and 27 in the non-fracture group (p=0.324. Conclusion In elderly patients, attending an ED, warfarin sodium use does not seem to be a risk factor for an osteoporotic fracture

The creep bending of short radius pipe bends

International Nuclear Information System (INIS)

Spence, John

1975-01-01

In existing and proposed liquid metal fast breeder reactor design the pipework has considerable importance. Parts of the LMFBR include thin walled short radius bends which are expected to operate in the creep regime. In linear elasticity it is known that the assumption of long radius bends is not too severe as far as the flexibility characteristics are concerned although some modifications are necessary for accurate determination of the stresses. No data exists for nonlinear creep. Current work is aimed at elucidating the effect of the various assumptions common to linear elastic theory in so far as they affect the creep characteristics of bends on systems. Herein an energy based analysis using a simple n power constitutive law for stationary creep is employed to derive basic design data for flexibilities and stresses which will be necessary before complete systems can be assessed for creep. The analysis shows on comparison with the long radius work that the assumption of R>r is not much more restrictive in creep than for linear elasticity. Flexibilities for short radius bends appear to be well approximated by the long radius values. Thus the attractive reference stress information already derived may be used directly to find deformations without a complete knowledge of the constitutive relationship. However, stresses are somewhat different. Fortunately the maximum deviation occurs at relatively low levels of stress, the peak stresses being in fair agreement. When n=1 the present results reduce essentially to those obtained from existing linear elastic theory

Short-term effects of teriparatide versus placebo on bone biomarkers, structure, and fracture healing in women with lower-extremity stress fractures: A pilot study.

Science.gov (United States)

Almirol, Ellen A; Chi, Lisa Y; Khurana, Bharti; Hurwitz, Shelley; Bluman, Eric M; Chiodo, Christopher; Matzkin, Elizabeth; Baima, Jennifer; LeBoff, Meryl S

2016-09-01

In this pilot, placebo-controlled study, we evaluated whether brief administration of teriparatide (TPTD) in premenopausal women with lower-extremity stress fractures would increase markers of bone formation in advance of bone resorption, improve bone structure, and hasten fracture healing according to magnetic resonance imaging (MRI). Premenopausal women with acute lower-extremity stress fractures were randomized to injection of TPTD 20-µg subcutaneous (s.c.) (n = 6) or placebo s.c. (n = 7) for 8 weeks. Biomarkers for bone formation N-terminal propeptide of type I procollagen (P1NP) and osteocalcin (OC) and resorption collagen type-1 cross-linked C-telopeptide (CTX) and collagen type 1 cross-linked N-telopeptide (NTX) were measured at baseline, 4 and 8 weeks. The area between the percent change of P1NP and CTX over study duration is defined as the anabolic window. To assess structural changes, peripheral quantitative computed topography (pQCT) was measured at baseline, 8 and 12 weeks at the unaffected tibia and distal radius. The MRI of the affected bone assessed stress fracture healing at baseline and 8 weeks. After 8 weeks of treatment, bone biomarkers P1NP and OC increased more in the TPTD- versus placebo-treated group (both p ≤ 0.01), resulting in a marked anabolic window (p ≤ 0.05). Results from pQCT demonstrated that TPTD-treated women showed a larger cortical area and thickness compared to placebo at the weight bearing tibial site, while placebo-treated women had a greater total tibia and cortical density. No changes at the radial sites were observed between groups. According to MRI, 83.3% of the TPTD- and 57.1% of the placebo-treated group had improved or healed stress fractures (p = 0.18). In this randomized, pilot study, brief administration of TPTD showed anabolic effects that TPTD may help hasten fracture healing in premenopausal women with lower-extremity stress fractures. Larger prospective studies are warranted to determine

Semi-analytical solutions for flow to a well in an unconfined-fractured aquifer system

Science.gov (United States)

Sedghi, Mohammad M.; Samani, Nozar

2015-09-01

Semi-analytical solutions of flow to a well in an unconfined single porosity aquifer underlain by a fractured double porosity aquifer, both of infinite radial extent, are obtained. The upper aquifer is pumped at a constant rate from a pumping well of infinitesimal radius. The solutions are obtained via Laplace and Hankel transforms and are then numerically inverted to time domain solutions using the de Hoog et al. algorithm and Gaussian quadrature. The results are presented in the form of dimensionless type curves. The solution takes into account the effects of pumping well partial penetration, water table with instantaneous drainage, leakage with storage in the lower aquifer into the upper aquifer, and storativity and hydraulic conductivity of both fractures and matrix blocks. Both spheres and slab-shaped matrix blocks are considered. The effects of the underlying fractured aquifer hydraulic parameters on the dimensionless drawdown produced by the pumping well in the overlying unconfined aquifer are examined. The presented solution can be used to estimate hydraulic parameters of the unconfined and the underlying fractured aquifer by type curve matching techniques or with automated optimization algorithms. Errors arising from ignoring the underlying fractured aquifer in the drawdown distribution in the unconfined aquifer are also investigated.

Emprego de fixador externo circular no tratamento de complicações de fraturas do rádio e ulna em cães de raças pequenas Use of circular external fixator in the treatment of fracture complications of radius and ulna in small breed dogs

Directory of Open Access Journals (Sweden)

Sheila Canevese Rahal

2005-10-01

Full Text Available O objetivo deste estudo foi avaliar o método de Ilizarov no tratamento de complicações de fraturas do rádio e ulna em cães de raças pequenas. Um fixador de Ilizarov miniatura composto por anéis de alumínio e hastes de aço foi usado em três cães da raça poodle miniatura (casos 1, 2 e 3 e em um pinscher (caso 4. Os cães 1 e 4 apresentavam consolidação atrasada das porções médio-distal e distal, respectivamente, devido a prévio tratamento com tala externa. Foi aplicada uma montagem constituída por dois anéis proximais e um distal. Ambas as fraturas consolidaram, sendo que a do poodle apresentou leve desvio cranial das extremidades fraturadas. Os outros dois casos (2 e 3 consistiam de fraturas previamente tratadas por procedimento cirúrgico. O caso 2 apresentava rotação lateral do membro torácico e não-união do aspecto distal da diáfise radial com presença de pino intramedular e dois fios de cerclagem. O pino intramedular e um dos fios de cerclagem foram removidos e realizou-se a derrotação do foco da fratura. O aparelho foi montado como nos casos 1 e 4. A consolidação da fratura foi obtida com moderado desvio caudal do eixo ósseo. No caso 3, havia reabsorção óssea na diáfise do rádio e ulna devido ao emprego inadequado de fixador externo resina-pino. Empregou-se o transporte ósseo com o fixador de Ilizarov para induzir a regeneração óssea. Entretanto, este foi interrompido por falta de resposta. Manteve-se o fixador e o defeito ósseo foi tratado com enxerto esponjoso autólogo e biomateriais. A ulna ocupou parte do defeito segmentar do rádio. Foi possível concluir que o método de Ilizarov pode ser usado no tratamento de consolidação atrasada e não-união, mas o fixador externo circular é de difícil aplicação em cães de raças pequenas.The aim of this study was to evaluate the Ilizarov’s method for treating complications of radius and ulna fractures in small breed dogs. A miniature Ilizarov�

Semi-analytical solution of flow to a well in an unconfined-fractured aquifer system separated by an aquitard

Science.gov (United States)

Sedghi, Mohammad M.; Samani, Nozar; Barry, D. A.

2018-04-01

Semi-analytical solutions are presented for flow to a well in an extensive homogeneous and anisotropic unconfined-fractured aquifer system separated by an aquitard. The pumping well is of infinitesimal radius and screened in either the overlying unconfined aquifer or the underlying fractured aquifer. An existing linearization method was used to determine the watertable drainage. The solution was obtained via Laplace and Hankel transforms, with results calculated by numerical inversion. The main findings are presented in the form of non-dimensional drawdown-time curves, as well as scaled sensitivity-dimensionless time curves. The new solution permits determination of the influence of fractures, matrix blocks and watertable drainage parameters on the aquifer drawdown. The effect of the aquitard on the drawdown response of the overlying unconfined aquifer and the underlying fractured aquifer was also explored. The results permit estimation of the unconfined and fractured aquifer hydraulic parameters via type-curve matching or coupling of the solution with a parameter estimation code. The solution can also be used to determine aquifer hydraulic properties from an optimal pumping test set up and duration.

The use of small (2.7 mm) screws for arthroscopically guided repair of carpal chip fractures.

Science.gov (United States)

Wright, I M; Smith, M R W

2011-05-01

Removal of large chip fractures of the carpal bones and the osteochondral deficits that result, have been associated with a worse prognosis than removal of small fragments in similar locations. Reducing the articular defects by repair of large osteochondral fragments may have advantages over removal. Horses with osteochondral chip fractures that were of sufficient size and infrastructure to be repaired with small (2.7 mm diameter) AO/ASIF cortex screws were identified and repair effected by arthroscopically guided internal fixation. Thirty-three horses underwent surgery to repair 35 fractures of the dorsodistal radial carpal bone (n = 25), the dorsal margin of the radial facet of the third carpal bone (n = 9) and the intermediate facet of the distal radius (n = 1). There were no surgical complications and fractures healed satisfactorily in 26 of 28 horses and 23 horses returned to racing performance. Arthroscopically guided repair of carpal chip fractures with small diameter cortex screws is technically feasible and experiences with 33 cases suggest that this may have advantages over fragment removal in managing such cases. Surgeons treating horses with large chip fractures of the carpal bones should consider arthroscopically guided internal fixation as an alternative to removal. © 2010 EVJ Ltd.

DML and Foil Measurements of ETA Beam Radius

International Nuclear Information System (INIS)

Nexsen, W; Weir, J

2005-01-01

Simultaneous measurements of the ETA beam radius have been made with a quartz foil and a diamagnetic loop (DML). While the measurements agreed at some settings they diverged at others. While the DML measures the rms radius of the total beam, the foil measures mainly the core and the divergence can be explained by the presence of a low density halo. Evidence of such a halo from other measurements is presented

Risk factors for cervical and trochanteric hip fractures in elderly women: a population-based 10-year follow-up study.

Science.gov (United States)

Jokinen, Heikki; Pulkkinen, Pasi; Korpelainen, Juha; Heikkinen, Jorma; Keinänen-Kiukaanniemi, Sirkka; Jämsä, Timo; Korpelainen, Raija

2010-07-01

We evaluated the contribution of lifestyle-related factors, calcaneal ultrasound, and radial bone mineral density (BMD) to cervical and trochanteric hip fractures in elderly women in a 10-year population-based cohort study. The study population consisted of 1,681 women (age range 70-73 years). Seventy-two percent (n = 1,222) of them participated in the baseline measurements. Calcaneal ultrasound was assessed with a quantitative ultrasound device. BMD measurements were performed at the distal and ultradistal radius by dual-energy X-ray absorptiometry. Forward stepwise logistic regression analysis was used to find the most predictive variables for hip fracture risk. During the follow-up, 53 of the women had hip fractures, including 32 cervical and 21 trochanteric ones. The fractured women were taller and thinner and had lower calcaneal ultrasound values than those without fractures. High body mass index (BMI) was a protective factor against any hip fractures, while low functional mobility was a risk factor of hip fractures. Specifically, high BMI protected against cervical hip fractures, while low physical activity was a significant predictor of these fractures. Similarly, high BMI protected against trochanteric fractures, whereas low functional mobility and high coffee consumption were significant predictors of trochanteric fractures. Cervical and trochanteric hip fractures seem to have different risk factors. Therefore, fracture type should be taken into account in clinical fracture risk assessment and preventative efforts, including patient counseling. However, the study is not conclusive due to the limited number of observed fractures during follow-up, and the results have to be confirmed in future studies.

CURBSIDE CONSULTATION IN FRACTURE MANAGEMENT: 49 CLINICAL QUESTIONS

Directory of Open Access Journals (Sweden)

Walter W. Virkus

2008-12-01

Full Text Available DESCRIPTION: A user-friendly, unique resource for the treatment of fractures designed in a casual questions and answers format which provides basic knowledge, current information and evidence based expert advices enhanced by images and diagrams and supported by ref-erences.PURPOSE: Designing this book the editor has aimed to prepare not only a source of current knowledge and opin-ions by experienced authors in fracture management for decision making in daily practice but also a brief refer-ence and useful educational resource in orthopedic trauma surgery.FEATURES: Three Sections are composed of 49 sub-jects in a form of the answers of frequently asked ques-tions richly illustrated by images and diagrams and in-cluding references at the end of each subject.The Section I is “UPPER EXTREMITIES” including: Neck fracture; Humerus shaft fracture; Management of radial nerve palsy associated with humeral fracture; Clavicle fractures; Elbow fractures in children; Fasciot-omy technic of the forearm; Distal radius fracture; Indica-tions of radial head replacement, Femur and humeral shaft fractures; Treatment of posterolateral elbow dislocation; The Section II is “LOWER EXTREMITIES” including : Femur fractures; Pelvic fractures; Life threatening pelvic fractures; Decision for surgical treatment in pelvic frac-tures; Treatment of anterior fracture of femoral head and hip joint incongruity; Management of a displaced femoral neck fracture in young patient in ER; Elder patients with displaced femoral head fracture; Patella and tibial plateau fractures; Criteria for compartment syndromes in the tibia; Tricks in nailing proximal and distal tibial fractures; Surgical management of distal tibia spiral fracture in middle aged women; Pilon fracture; Management of syn-desmotic screws in adult patient; The management of minimally displaced posterior malleol in three malleolar fractures; Postoperative management of bimalleolar frac-tures; Management of minimally

Variational principles for the spectral radius of functional operators

International Nuclear Information System (INIS)

Antonevich, A B; Zajkowski, K

2006-01-01

The spectral radius of a functional operator with positive coefficients generated by a set of maps (a dynamical system) is shown to be a logarithmically convex functional of the logarithms of the coefficients. This yields the following variational principle: the logarithm of the spectral radius is the Legendre transform of a convex functional T defined on a set of vector-valued probability measures and depending only on the original dynamical system. A combinatorial construction of the functional T by means of the random walk process corresponding to the dynamical system is presented in the subexponential case. Examples of the explicit calculation of the functional T and the spectral radius are presented.

Solar radius change between 1925 and 1979

Science.gov (United States)

Sofia, S.; Dunham, D. W.; Dunham, J. B.; Fiala, A. D.

1983-01-01

From an analysis of numerous reports from different locations on the duration of totality of the solar eclipses on January 24, 1925, and February 26, 1979, it is found that the solar radius at the earlier date was 0.5 arcsec (or 375 km) larger than at the later date. The correction to the standard solar radius found for each eclipse is different when different subsets of the observations are used (for example, edge of path of totality timings compared with central timings). This is seen as suggesting the existence of systematic inaccuracies in our knowledge of the lunar figure. The differences between the corrections for both eclipses, however, are very similar for all subsets considered, indicating that changes of the solar size may be reliably inferred despite the existence of the lunar figure errors so long as there is proper consideration of the distribution of the observations. These results are regarded as strong evidence in support of the occurrence of solar radius changes on shorter than evolutionary time scales.

Solar radius change between 1925 and 1979

International Nuclear Information System (INIS)

Sofia, S.; Fiala, A.D.

1983-01-01

By analysing numerous reports, from different locations, on the duration of totality of the solar eclipses on 24 January 1925, and on 26 February 1979, it was found that the solar radius at the earlier date was 0.5 arc s, or 375 km larger than at the later date. The correction to the standard solar radius found for each eclipse was different when different subsets of the observations were used (for example, edge of path of totality timings compared with central timings), suggesting the existence of systematic inaccuracies in our knowledge of the lunar figure. However, the differences between the corrections for both eclipses were very similar for all subsets considered, indicating that changes of the solar size may be reliably inferred despite the existence of the lunar figure errors, as long as the proper consideration is made of the distribution of the observations. It is considered that these results are strong evidence in support of the occurrence of solar radius changes on shorter than evolutionary time scales. (author)

Electric arc radius and characteristics

International Nuclear Information System (INIS)

Fang, T.M.

1980-01-01

The heat transfer equation of an arc discharge has been solved. The arc is assumed to be a cylinder with negligible axial variation and the dominant heat transfer process is conduction radially inside the column and radiation/convection at the outside edge. The symmetric consideration allows a simple one-dimensional formulation. By taking into account proper variation of the electrical conductivity as function of temperature, the heat balance equation has been solved analytically. The radius of the arc and its current-field characteristics have also been obtained. The conventional results that E approx. I 0 5385 and R approx. I 0 7693 with E being the applied field, I the current, and R the radius of the cylindrical arc, have been proved to be simply limiting cases of our more general characteristics. The results can be applied quite widely including, among others, the neutral beam injection project in nuclear fusion and MHD energy conversion

The earth's radius and the G variation

International Nuclear Information System (INIS)

Canuto, V.M.; City Coll., New York

1981-01-01

It has been assumed that if the gravitational constant G was larger in the past, the Earth's radius had to be smaller. The assertion holds provided the input from microphysics (in particular the equation of state) is independent of G. While this is true for some theories of gravity with variable G it is not so in the scale covariant theory, where the pressure can be affected by a variable G in a way that, for a constant mass of the Earth, a larger G in the past implies a larger Earth's radius. Comparison with recent palaeomagnetic data is presented. (author)

Risk of fracture with thiazolidinediones: an individual patient data meta-analysis

Directory of Open Access Journals (Sweden)

Marloes T Bazelier

2013-02-01

Full Text Available Background: The use of thiazolidinediones (TZDs has been associated with increased fracture risks. Our aim was to estimate the risk of fracture with TZDs in three different healthcare registries, using exactly the same study design, and to perform an individual patient data meta-analysis of these three studies. Methods: Population-based cohort studies were performed utilizing the British General Practice Research Database (GPRD, the Dutch PHARMO Record Linkage System, and the Danish National Health Registers. In all three databases, the exposed cohort consisted of all patients (aged 18+ with at least one prescription of antidiabetic (AD medication. Cox proportional hazards models were used to estimate hazard ratios (HRs of fracture. The total period of follow-up for each patient was divided into periods of current exposure and past exposure, with patients moving between current and past use.Results: In all three registries, the risk of fracture was increased for women who were exposed to TZDs: HR 1.48 [1.37-1.60] in GPRD, HR 1.35 [1.15-1.58] in PHARMO and HR 1.22 [1.03-1.44] in Denmark. Combining the data in an individual patient data meta-analysis resulted, for women, in a 1.4-fold increased risk of any fracture for current TZD users versus other AD drug users (adj. HR 1.44 [1.35-1.53]. For men, there was no increased fracture risk (adj. HR 1.05 [0.96-1.14]. Risks were increased for fractures of the radius/ulna, humerus, tibia/fibula, ankle and foot, but not for hip/femur or vertebral fractures. Current TZD users with more than 25 TZD presciptions ever before had a 1.6-fold increased risk of fracture compared with other AD drug users (HR 1.59 [1.46-1.74].Conclusion: In this study, we consistently found a 1.2- to 1.5-fold increased risk of fractures for women using TZDs, but not for men, across three different healthcare registries. TZD users had an increased risk for fractures of the extremities, and risks further increased for prolonged users

Mass-Radius diagram for compact stars

International Nuclear Information System (INIS)

Carvalho, G A; Jr, R M Marinho; Malheiro, M

2015-01-01

The compact stars represent the final stage in the evolution of ordinary stars, they are formed when a star ceases its nuclear fuel, in this point the process that sustain its stability will stop. After this, the internal pressure can no longer stand the gravitational force and the star colapses [2]. In this work we investigate the structure of these stars which are described by the equations of Tolman-Openheimer-Volkof (TOV) [1]. These equations show us how the pressure varies with the mass and radius of the star. We consider the TOV equations for both relativistic and non-relativistic cases. In the case of compact stars (white dwarfs and neutron stars) the internal pressure that balances the gravitational pressure is essentialy the pressure coming from the degeneracy of fermions. To have solved the TOV equations we need a equation of state that shows how this internal pressure is related to the energy density or mass density. Instead of using politropic equations of state we have solved the equations numericaly using the exact relativistic energy equation for the model of fermion gas at zero temperature. We obtain results for the mass-radius relation for white dwarfs and we compared with the results obtained using the politropic equations of state. In addition we discussed a good fit for the mass-radius relation. (paper)

Does bone measurement on the radius indicate skeletal status. Concise communication

International Nuclear Information System (INIS)

Mazess, R.B.; Peppler, W.W.; Chesney, R.W.; Lange, T.A.; Lindgren, U.; Smith, E. Jr.

1984-01-01

Single-photon (I-125) absorptiometry was used to measure bone mineral content (BMC) of the distal third of the radius, and dual-photon absorptiometry (Gd-153) was used to measure total-body bone mineral (TBBM), as well as the BMC of major skeletal regions. Measurements were done in normal females, normal males, osteoporotic females, osteoporotic males, and renal patients. The BMC of the radius predicted TBBM well in normal subjects, but was less satisfactory in the patient groups. The spinal BMC was predicted with even lower accuracy from radius measurement. The error in predicting areal density (bone mass per unit projected skeletal area) of the lumbar and thoracic spine from the radius BMC divided by its width was smaller, but the regressions differed significantly among normals, osteoporotics, and renal patients. There was a preferential spinal osteopenia in the osteoporotic group and in about half of the renal patients. Bone measurements on the radius can indicate overall skeletal status in normal subjects and to a lesser degree in patients, but these radius measurements are inaccurate, even on the average, as an indicator of spinal state

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

Science.gov (United States)

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

2018-02-01

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

The surface and interior evolution of Ceres revealed by fractures and secondary crater chains

Science.gov (United States)

Scully, Jennifer E. C.; Buczkowski, Debra; Schmedemann, Nico; King, Scott; O'Brien, David P.; Castillo-Rogez, Julie; Raymond, Carol; Marchi, Simone; Russell, Christopher T.; Mitri, Giuseppe; Bland, Michael T.

2016-10-01

Dawn became the first spacecraft to visit and orbit Ceres, a dwarf planet and the largest body in the asteroid belt (radius ~470 km) (Russell et al., 2016). Before Dawn's arrival, telescopic observations and thermal evolution modeling indicated Ceres was differentiated, with an average density of 2,100 kg/m3 (e.g. McCord & Sotin, 2005; Castillo-Rogez & McCord, 2010). Moreover, pervasive viscous relaxation in a water-ice-rich outer layer was predicted to erase most features on Ceres' surface (Bland, 2013). However, a full understanding of Ceres' surface and interior evolution remained elusive. On the basis of global geologic mapping, we identify prevalent ≥1 km wide linear features that formed: 1) as the surface expression of subsurface fractures, and 2) as material ejected during impact-crater formation impacted and scoured the surface, forming secondary crater chains. The formation and preservation of these linear features indicates Ceres' outer layer is relatively strong, and is not dominated by viscous relaxation as predicted. The fractures also give us insights into Ceres' interior: their spacing indicates the fractured layer is ~30 km thick, and we interpret the fractures formed because of uplift and extension induced by an upwelling region, which is consistent with geodynamic modeling (King et al., 2016). In addition, we find that some secondary crater chains do not form radial patterns around their source impact craters, and are located in a different hemisphere from their source impact craters, because of Ceres' fast rotation (period of ~9 hours) and relatively small radius. Our results show Ceres has a surface and outer layer with characteristics that are different than predicted, and underwent complex surface and interior evolution. Our fuller understanding of Ceres, based on Dawn data, gives us important insights into the evolution of bodies in the asteroid belt, and provides unique constraints that can be used to evaluate predictions of the surface

Orthopedic infections in equine long bone fractures and arthrodeses treated by internal fixation: 192 cases (1990-2006).

Science.gov (United States)

Ahern, Benjamin J; Richardson, Dean W; Boston, Raymond C; Schaer, Thomas P

2010-07-01

To determine the rate of postoperative infection (POI) for internal fixation repaired equine long bone fractures and arthrodeses and identify associated risk factors. Case series. Horses (n=192) with fracture repair of the third metacarpal and metatarsal bones, radius, ulna, humerus, tibia, and femur, or arthrodesis with internal fixation. Medical records (1990-2006) were reviewed for signalment, anatomic location, fracture classification and method of repair, technique and surgical duration, bacterial species isolated, postoperative care, onset of POI, and outcome. Of 192 horses (171 [89%] closed, 21 [11%] open fractures), 157 (82%) were discharged from the hospital. Infection occurred in 53 (28% horses), of which 31 (59%) were discharged. Repairs without POI were 7.25 times more likely to be discharged from the hospital. Closed fractures were 4.23 times more likely to remain uninfected and 4.59 times more likely to be discharged from the hospital compared with open fractures. Closed reduction and internal fixation was associated with a 2.5-fold reduction in rate of POI and a 5.9 times greater chance for discharge from the hospital compared with open reduction and internal fixation. Females had a strong trend for increased POI when compared with colts and stallion but not geldings. Overall rate of POI was 28%. Fracture classification, method of repair, gender, and surgical duration were significant risk factors.

THE SIZE-VIRIAL RADIUS RELATION OF GALAXIES

International Nuclear Information System (INIS)

Kravtsov, Andrey V.

2013-01-01

I use the abundance matching ansatz, which has proven to be successful in reproducing galaxy clustering and other statistics, to derive estimates of the virial radius, R 200 , for galaxies of different morphological types and a wide range of stellar masses. I show that over eight orders of magnitude in stellar mass galaxies of all morphological types follow an approximately linear relation between half-mass radius of their stellar distribution, r 1/2 , and virial radius, r 1/2 ≈ 0.015 R 200 , with scatter of ≈0.2 dex. Such scaling is in remarkable agreement with the expectation of models that assume that galaxy sizes are controlled by halo angular momentum, r 1/2 ∝λR 200 , where λ is the spin of galaxy parent halo. The scatter about the relation is comparable with the scatter expected from the distribution of λ. Moreover, I show that when the stellar and gas surface density profiles of galaxies of different morphological types are rescaled by the radius r n = 0.015 R 200 , the rescaled profiles follow approximately universal exponential (for late types) and de Vaucouleurs (for early types) form with scatter of only ≈30%-50% at R ≈ 1-3r n . Remarkably, both late- and early-type galaxies have similar mean stellar surface density profiles at R ∼> 1r n . The main difference between their stellar distributions is thus at R n . The results of this study imply that galaxy sizes and radial distribution of baryons are shaped primarily by properties of their parent halos and that the sizes of both late-type disks and early-type spheroids are controlled by halo angular momentum.

A simple model for enamel fracture from margin cracks.

Science.gov (United States)

Chai, Herzl; Lee, James J-W; Kwon, Jae-Young; Lucas, Peter W; Lawn, Brian R

2009-06-01

We present results of in situ fracture tests on extracted human molar teeth showing failure by margin cracking. The teeth are mounted into an epoxy base and loaded with a rod indenter capped with a Teflon insert, as representative of food modulus. In situ observations of cracks extending longitudinally upward from the cervical margins are recorded in real time with a video camera. The cracks appear above some threshold and grow steadily within the enamel coat toward the occlusal surface in a configuration reminiscent of channel-like cracks in brittle films. Substantially higher loading is required to delaminate the enamel from the dentin, attesting to the resilience of the tooth structure. A simplistic fracture mechanics analysis is applied to determine the critical load relation for traversal of the margin crack along the full length of the side wall. The capacity of any given tooth to resist failure by margin cracking is predicted to increase with greater enamel thickness and cuspal radius. Implications in relation to dentistry and evolutionary biology are briefly considered.

Synthetical optimization of hydraulic radius and acoustic field for thermoacoustic cooler

International Nuclear Information System (INIS)

Kang Huifang; Li Qing; Zhou Gang

2009-01-01

It is well known that the acoustic field and the hydraulic radius of the regenerator play key roles in thermoacoustic processes. The optimization of hydraulic radius strongly depends on the acoustic field in the regenerator. This paper investigates the synthetical optimization of hydraulic radius and acoustic field which is characterized by the ratio of the traveling wave component to the standing wave component. In this paper, we discussed the heat flux, cooling power, temperature gradient and coefficient of performance of thermoacoustic cooler with different combinations of hydraulic radiuses and acoustic fields. The calculation results show that, in the cooler's regenerator, due to the acoustic wave, the heat is transferred towards the pressure antinodes in the pure standing wave, while the heat is transferred in the opposite direction of the wave propagation in the pure traveling wave. The better working condition for the regenerator appears in the traveling wave phase region of the like-standing wave, where the directions of the heat transfer by traveling wave component and standing wave component are the same. Otherwise, the small hydraulic radius is not a good choice for acoustic field with excessively high ratio of traveling wave, and the small hydraulic radius is only needed by the traveling wave phase region of like-standing wave.

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

International Nuclear Information System (INIS)

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

2012-01-01

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

Paratrooper's ankle fracture: posterior malleolar fracture.

Science.gov (United States)

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

2015-03-01

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

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

Science.gov (United States)

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

2012-01-01

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

Rational functions with maximal radius of absolute monotonicity

KAUST Repository

Loczi, Lajos

2014-05-19

We study the radius of absolute monotonicity R of rational functions with numerator and denominator of degree s that approximate the exponential function to order p. Such functions arise in the application of implicit s-stage, order p Runge-Kutta methods for initial value problems and the radius of absolute monotonicity governs the numerical preservation of properties like positivity and maximum-norm contractivity. We construct a function with p=2 and R>2s, disproving a conjecture of van de Griend and Kraaijevanger. We determine the maximum attainable radius for functions in several one-parameter families of rational functions. Moreover, we prove earlier conjectured optimal radii in some families with 2 or 3 parameters via uniqueness arguments for systems of polynomial inequalities. Our results also prove the optimality of some strong stability preserving implicit and singly diagonally implicit Runge-Kutta methods. Whereas previous results in this area were primarily numerical, we give all constants as exact algebraic numbers.

ULNAR NEURITIS ASSOCIATED WITH GUN STOCK DEFORMITY FOLLOWING SUPRACONDYLAR FRACTURE OF HUMERUS

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Sunita Morhan

2014-04-01

Full Text Available Background: This case report describes a patient who was referred to physiotherapist from a hand surgeon. Among the fractures around the elbow joint, radial head fracture and fracture of distal end of radius are common among adults. The occurrence of Supracondylar fractures are more commonly seen in children when compared to adults. One of the complications of this fracture is malunion resulting in Gun stock deformity. The main Purpose of this case report is to explore, 1. The complication associated with gunstock deformity 2. Chances of iatrogenic nerve injury after manipulation under anesthesia. 3.Long term supervised rehabilitation approach. Case Description: A 40 years old male patient referred to our Physiotherapy department by a hand surgeon. After the initial evaluation, findings revealed limitation in right elbow movement and tingling and numbness sensation in little and half of ring fingers in his right side. This patient underwent ulnar nerve transposition surgery followed by rehabilitation. His physiotherapy session includes electrotherapeutic agents for pain relief, passive mobilization of elbow and strengthening program for his flexors and extensors of elbow for a period of one year. Outcome: The outcome of the long term rehabilitation approach for a patient with ulnar neuropathy secondary to gunstock deformity after ulnar nerve transposition surgery is good. The patients tingling and numbness decreased and the range of elbow movement improved significantly. Discussion: Most common complications of fracture of distal end of humerus include malunion,ischemic contracture and nerve injuries. The relative incidence of iatrogenic nerve injuries associatedwith this fracture has been reported as being 2%-6%. Nerve injuries after Supracondylar humeral fractures occur primarily due to tenting or entrapment of the nerve on the sharp proximal humeral fragment, while iatrogenic injuries occur either during closed manipulation or percutaneous

Studying the proton 'radius' puzzle with μp elastic scattering

International Nuclear Information System (INIS)

Gilman, R.

2013-01-01

The disagreement between the proton radius determined from muonic hydrogen and from electronic measurements is called the proton radius puzzle. The resolution of the puzzle remains unclear and appears to require new experimental results. An experiment to measure muon-proton elastic scattering is presented here

Spectral Radius and Hamiltonicity of Graphs

Czech Academy of Sciences Publication Activity Database

Fiedler, Miroslav; Nikiforov, V.

2010-01-01

Roč. 432, č. 9 (2010), s. 2170-2173 ISSN 0024-3795 Institutional research plan: CEZ:AV0Z10300504 Keywords : Hamiltonian cycle * Hamiltonian path * spectral radius Subject RIV: BA - General Mathematics Impact factor: 1.005, year: 2010

Application of FIB technique to introduction of a notch into a carbon fiber for direct measurement of fracture toughness

International Nuclear Information System (INIS)

Ogihara, S; Imafuku, Y; Yamamoto, R; Kogo, Y

2009-01-01

For the direct measurement of the fracture toughness of the carbon fiber, a new technique was proposed and examined its applicability. At first, machining condition of the notch was examined. The notch was introduced using focused ion beam (FIB). The ion beam can be electronically scanned to introduce a sharp notch on the carbon fiber. Notches with various notch width and length were introduced by changing beam and scanning conditions. Tensile tests on notched carbon fibers were carried out following the test method for carbon fiber monofilaments. Fractured specimens were successfully corrected without secondary damage using protection films. SEM observations revealed that a crack propagated from a notch-tip, and notch size was able to be determined successfully. Effect of notch root radius was also examined to investigate the validity of the fracture toughness obtained by this method.

Avaliação da força de preensão e funcionalidade após fratura distal de rádio/Evaluation of strength and functionality after distal radius fracture

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Bruno Goto Kimura

2017-09-01

Full Text Available Esse estudo teve objetivo avaliar se existe diferença em relação a força de preensão e funcionalidade de pacientes com fratura distal de rádio em relação ao gênero e ao tipo de tratamento (conservador e cirúrgico. Os pacientes recrutados para este estudo foram divididos em dois grupos, grupo de homens (G1 e grupo de mulheres (G2. Todos os voluntários realizaram uma única avaliação da força de preensão palmar e a avaliação funcional pelos questionários Disability of the Arm, Shoulder and Hand (DASH e Patient Rated Wrist Evaluation (PRWE.Os valores de força de preensão foram significativamente (p<0,000 menores no grupo de mulheres 5,42 (±3,42 e no tratamento conservador 5,20 (±4,91 quando comparados aos homens 16,01 (±6,86 e ao tratamento cirúrgico 12,28 (±7,56. Enquanto que os valores de incapacidade, avaliados pelos questionários DASH e PRWE, foram maiores no grupo de mulheres e pacientes que realizaram tratamento conservador, porém não foram encontradas diferenças significativas. As fraturas distais de rádio se não reabilitadas precocemente podem comprometer a amplitude de movimento, a força muscular, a precisão, a destreza e controle dos movimentos. Neste caso, os questionários de funcionalidade são um parâmetro importante que refletem o desempenho do indivíduo durante a realização de atividades de vida diária, sendo que quanto pior os escores, pior o desempenho e autonomia desses pacientes. Nesse estudo, podemos concluir que o gênero e o tipo de tratamento influenciaram na diminuição da força de preensão e na maior incapacidade funcional na avaliação inicial após 45 dias da fratura. AbstractThis study had the objective of evaluating whether there is a difference in the grip strength and functionality of patients with distal radius fracture in relation to gender and type of treatment (conservative and surgical. The patients recruited for this study were divided into two groups, group of men (G1

Fracture Mechanics

International Nuclear Information System (INIS)

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

1992-08-01

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

Solar Radius at Subterahertz Frequencies and Its Relation to Solar Activity

Science.gov (United States)

Menezes, Fabian; Valio, Adriana

2017-12-01

The Sun emits radiation at several wavelengths of the electromagnetic spectrum. In the optical band, the solar radius is 695 700 km, and this defines the photosphere, which is the visible surface of the Sun. However, as the altitude increases, the electromagnetic radiation is produced at other frequencies, causing the solar radius to change as a function of wavelength. These measurements enable a better understanding of the solar atmosphere, and the radius dependence on the solar cycle is a good indicator of the changes that occur in the atmospheric structure. We measure the solar radius at the subterahertz frequencies of 0.212 and 0.405 THz, which is the altitude at which these emissions are primarily generated, and also analyze the radius variation over the 11-year solar activity cycle. For this, we used radio maps of the solar disk for the period between 1999 and 2017, reconstructed from daily scans made by the Solar Submillimeter-wave Telescope (SST), installed at El Leoncito Astronomical Complex (CASLEO) in the Argentinean Andes. Our measurements yield radii of 966.5'' ±2.8'' for 0.2 THz and 966.5'' ±2.7'' for 0.4 THz. This implies a height of 5.0 ±2.0 ×106 m above the photosphere. Furthermore, we also observed a strong anticorrelation between the radius variation and the solar activity at both frequencies.

Thoughts on the so-called 'radius-capitellum axis'

International Nuclear Information System (INIS)

Schild, H.; Mueller, H.A.; Wagner, H.; Baetz, W.; Mainz Univ.

1982-01-01

We have studied 438 patients radiologically in order to observe the so-called 'radius-capitellum axis'. In about a quarter of people with normal elbows the axis passes lateral to the middle portion of the capitellum, so that even when there is marked deviation, there is no certainty that the humero-radial joint is abnormal. Deviation of the axis can be caused by changes in the shape of the capitellum or of the radius, or by distension of the capsule of the elbow joint, or by various changes in muscular pull. (orig.) [de

Thoughts on the so-called radius-capitellum axis

Energy Technology Data Exchange (ETDEWEB)

Schild, H; Mueller, H A; Wagner, H; Baetz, W

1982-02-01

We have studied 438 patients radiologically in order to observe the so-called 'radius-capitellum axis'. In about a quarter of people with normal elbows the axis passes lateral to the middle portion of the capitellum, so that even when there is marked deviation, there is no certainty that the humero-radial joint is abnormal. Deviation of the axis can be caused by changes in the shape of the capitellum or of the radius, or by distension of the capsule of the elbow joint, or by various changes in muscular pull.

The PRad experiment and the proton radius puzzle

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Gasparian Ashot

2014-06-01

Full Text Available New results from the recent muonic hydrogen experiments seriously questioned our knowledge of the proton charge radius, rp. The new value, with its unprecedented less than sub-percent precision, is currently up to eight standard deviation smaller than the average value from all previous experiments, triggering the well-known “proton charge radius puzzle” in nuclear and atomic physics. The PRad collaboration is currently preparing a novel, magnetic-spectrometer-free ep scattering experiment in Hall B at JLab for a new independent rp measurement to address this growing “puzzle” in physics.

Underground nuclear explosions. Study of the cavity radius

International Nuclear Information System (INIS)

Michaud, L.

1968-11-01

An underground nuclear explosion creates a cavity due to the expansion of the surrounding medium vaporized by the shot. The cavity radius is related to the energy of explosion and to the overburden pressure of the medium. The introduction of new elements such as the environment of the device (in a deep hole or in a tunnel) and the cohesion of the medium leads to a relationship which determines this radius. The known French and American underground explosions performed in various media, energy and overburden conditions, satisfy this relationship with a good precision. (author) [fr

Mass-Radius Relations of Z and Higgs-Like Bosons

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Lehnert B.

2014-01-01

Full Text Available Relations between the rest mass and the effective radius are deduced for the Z boson and the experimentally discovered Higgs-like boson, in terms of a revised quantum electrodynamic (RQED theory. The latter forms an alternative to the Standard Model of elementary particles. This results in an effective radius of the order of 10 E-18 m for a rest mass of 125 GeV.

On joint numerical radius II

Czech Academy of Sciences Publication Activity Database

Drnovšek, R.; Müller, Vladimír

2014-01-01

Roč. 62, č. 9 (2014), s. 1197-1204 ISSN 0308-1087 R&D Projects: GA ČR GA201/09/0473; GA AV ČR IAA100190903 Institutional support: RVO:67985840 Keywords : joint numerical range * numerical radius Subject RIV: BA - General Mathematics Impact factor: 0.738, year: 2014 http://www.tandfonline.com/doi/abs/10.1080/03081087.2013.816303

Variable radius cartography - History and perspectives of a new discipline

Science.gov (United States)

Scalera, Giancarlo

2014-05-01

The map that Toscanelli sent to Columbus was an unconscious application of cartography at a smaller radius than the real. The first really conscious attempts to represent the geography of Earth on globes of radius less than the current one occurred after the formulation of the concept of expanding Earth through geological time. The American chemist and geologist Richard Owen (1810-1890) in his book Key to the geology of the globe (1857) described the principles of what he himself called Anatomical Geology, with the Earth growing as a biological organism. The book contained a global paleogeographic map of the Earth that would have had a radius of about 4000 kilometers. In 1928 J.A.H. Kerkhoff (under the pseudonym Aero-dilettant) published a series of paleogeographic globes on which the modern oceans disappeared. With the same artisan methods of transfer continental outlines from a sphere to a smaller one, in 1933 O.C. Hilgenberg represented three different geological epochs, and, later, for the first time mapped paleopoles with their site-pole segments of meridian. Even today the traditional method of Hilgenberg is followed by senior researchers (Klaus Vogel, 2003) and younger geologists (James Maxlow). In England Hugh Owen applied the methods of traditional cartography to the variable radius one. His Atlas of Continental Displacement was in the 70s and 80s, for this discipline, a real milestone. While in the field of constant radius paleogeography the adherents to plate tectonics created many computer codes of automatic mapping (Bullard et al., 1965; Smith & Hallam, 1970; Scotese et al., 1979; and many others), in the variable radius field few tried to reach the same task. In 1972 in United States a first very simple attempt (but was not further developed) came from a private, R.B. Perry, followed by the still not-computerized Atlas of Owen, and both them constituted inspiration for the construction of a FORTRAN variable radius mapping code at INGV, with which it

Effects of corner radius on periodic nanoantenna for surface-enhanced Raman spectroscopy

International Nuclear Information System (INIS)

Chao, Bo-Kai; Lin, Shih-Che; Nien, Li-Wei; Hsueh, Chun-Hway; Li, Jia-Han

2015-01-01

Corner radius is a concept to approximate the fabrication limitation due to the effective beam broadening at the corner in using electron-beam lithography. The purpose of the present study is to investigate the effects of corner radius on the electromagnetic field enhancement and resonance wavelength for three periodic polygon dimers of bowtie, twin square, and twin pentagon. The enhancement factor of surface-enhanced Raman spectroscopy due to the localized surface plasmon resonances in fabricated gold bowtie nanostructures was investigated using both Raman spectroscopy and finite-difference time-domain simulations. The simulated enhancement factor versus corner radius relation was in agreement with measurements and it could be fitted by a power-law relation. In addition, the resonance wavelength showed blue shift with the increasing corner radius because of the distribution of concentrated charges in a larger area. For different polygons, the corner radius instead of the tip angle is the dominant factor of the electromagnetic field enhancement because the surface charges tend to localize at the corner. Greater enhancements can be obtained by having both the smaller gap and sharper corner although the corner radius effect on intensity enhancement is less than the gap size effect. (paper)

The Surface and Interior Evolution of Ceres Revealed by Analysis of Fractures and Secondary Crater Chains Using Dawn Data

Science.gov (United States)

Scully, J. E. C.; Buczkowski, D.; King, S. D.; Castillo, J. C.; Schmedemann, N.; Raymond, C. A.; O'Brien, D. P.; Marchi, S.; Russell, C. T.; Mitri, G.; Bland, M. T.

2016-12-01

Dawn is the first spacecraft to visit and orbit Ceres, a dwarf planet and the largest body in the asteroid belt (radius 470 km) (Russell et al., 2016). Previously, telescopic observations and thermal evolution modeling indicated Ceres was at least partially differentiated, with a density of 2,100 kg/m3 (e.g. Drummond et al., 2014; Castillo-Rogez & McCord, 2010). Moreover, models of crater retention predicted that pervasive viscous relaxation in a water-ice-rich outer layer could erase most surface features (Bland, 2013). However, a full understanding of Ceres' surface and interior evolution remained elusive until Dawn explored Ceres. Here we present a global geologic map of Ceres' ≥1 km wide linear features, which we interpret as: 1) the surface expression of subsurface fractures, and 2) secondary crater chains formed when material ejected during impact-crater formation impacts and scours the surface. The formation and preservation of these linear features indicate Ceres' outer layer is relatively strong, and not dominated by viscous relaxation as predicted (Buczkowski et al., 2016). The fractures (called the Samhain Catenae) give us insights into the interior. Based on a fracture spacing to fractured layer thickness ratio of 1 (Bai & Pollard, 2000), the spacing of the Samhain Catenae indicates that the outer, fractured layer is 88 km thick. Moreover, consistent with geodynamic modeling (King et al., 2016), we interpret the Samhain Catenae formed because of uplift and extension induced by an upwelling region. Unlike many cerean secondary crater chains, the Junina Catenae secondary crater chains are not radial to their source impact crater(s). On account of Ceres' fast rotation (period of 9 hours) and relatively small radius, modeling indicates that the Junina Catenae originated from the Urvara/Yalode impact craters, which are located in a different hemisphere. Our results show Ceres has different surface and interior characteristics than predicted, and underwent

The separatrix radius measurement of field-reversed configuration plasma in FRX-L

International Nuclear Information System (INIS)

Zhang, Shouyin; Tejero, Erik M.; Taccetti, Jose Martin; Wurden, Glen A.; Intrator, Thomas; Waganaar, William J.

2004-01-01

Magnetic pick-up coils and single turn flux loops are installed on the FRX-L device. The combination of the two measurements provides the excluded flux radius that approximates the separatrix radius of the field-reversed configuration plasma. Arrays of similar probes are used to map out local magnetic field dynamics beyond both ends of the theta-coil confinement region to help understand the effects of cusp locations on flux trapping during the FRC formation process. Details on the probe design and system calibrations are presented. The overall system calibration of excluded flux radius measurement is examined by replacing FRC plasma with a known radius aluminum conductor cylinder.

The radius of the quiescent neutron star in the globular cluster M13

Science.gov (United States)

Shaw, A. W.; Heinke, C. O.; Steiner, A. W.; Campana, S.; Cohn, H. N.; Ho, W. C. G.; Lugger, P. M.; Servillat, M.

2018-06-01

X-ray spectra of quiescent low-mass X-ray binaries containing neutron stars can be fit with atmosphere models to constrain the mass and the radius. Mass-radius constraints can be used to place limits on the equation of state of dense matter. We perform fits to the X-ray spectrum of a quiescent neutron star in the globular cluster M13, utilizing data from ROSAT, Chandra, and XMM-Newton, and constrain the mass-radius relation. Assuming an atmosphere composed of hydrogen and a 1.4 M⊙ neutron star, we find the radius to be R_NS=12.2^{+1.5}_{-1.1} km, a significant improvement in precision over previous measurements. Incorporating an uncertainty on the distance to M13 relaxes the radius constraints slightly and we find R_NS=12.3^{+1.9}_{-1.7} km (for a 1.4M⊙ neutron star with a hydrogen atmosphere), which is still an improvement in precision over previous measurements, some of which do not consider distance uncertainty. We also discuss how the composition of the atmosphere affects the derived radius, finding that a helium atmosphere implies a significantly larger radius.

Diagnostic accuracy of ultrasound in upper and lower extremity long bone fractures of emergency department trauma patients.

Science.gov (United States)

Frouzan, Arash; Masoumi, Kambiz; Delirroyfard, Ali; Mazdaie, Behnaz; Bagherzadegan, Elnaz

2017-08-01

Long bone fractures are common injuries caused by trauma. Some studies have demonstrated that ultrasound has a high sensitivity and specificity in the diagnosis of upper and lower extremity long bone fractures. The aim of this study was to determine the accuracy of ultrasound compared with plain radiography in diagnosis of upper and lower extremity long bone fractures in traumatic patients. This cross-sectional study assessed 100 patients admitted to the emergency department of Imam Khomeini Hospital, Ahvaz, Iran with trauma to the upper and lower extremities, from September 2014 through October 2015. In all patients, first ultrasound and then standard plain radiography for the upper and lower limb was performed. Data were analyzed by SPSS version 21 to determine the specificity and sensitivity. The mean age of patients with upper and lower limb trauma were 31.43±12.32 years and 29.63±5.89 years, respectively. Radius fracture was the most frequent compared to other fractures (27%). Sensitivity, specificity, positive predicted value, and negative predicted value of ultrasound compared with plain radiography in the diagnosis of upper extremity long bones were 95.3%, 87.7%, 87.2% and 96.2%, respectively, and the highest accuracy was observed in left arm fractures (100%). Tibia and fibula fractures were the most frequent types compared to other fractures (89.2%). Sensitivity, specificity, PPV and NPV of ultrasound compared with plain radiography in the diagnosis of upper extremity long bone fractures were 98.6%, 83%, 65.4% and 87.1%, respectively, and the highest accuracy was observed in men, lower ages and femoral fractures. The results of this study showed that ultrasound compared with plain radiography has a high accuracy in the diagnosis of upper and lower extremity long bone fractures.

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

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Yuwei Li

2018-05-01

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

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

Directory of Open Access Journals (Sweden)

Pincus, Steven

2009-11-01

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

The relationship between diameter and taper of nickel-titanium rotary instruments on the torsional resistance to fracture

Directory of Open Access Journals (Sweden)

Erick Miranda Souza

Full Text Available Objective: To evaluate the resistance to fracture of rotary Ni-Ti files of various diameters and tapers after torsional stress simulation. Methods: Profile (Dentsply Maillerfer, Ballaigues, Suíça instruments sizes 15 to 40, taper 0.04 and 0.06 were used. Ten instruments of each size and taper were tested, totaling 120 files. The maximum torque (Tmax until fracture was determined in accordance with the ANSI / ADA Protocol Nº 28 . The maximum force was converted into maximum torque using the formula: Tmax = Loadmax x RadiusResults: The diameter (p<0.001 and taper (p<0.001 influenced the maximum torque to fracture. With the increase in diameter and taperthere was a gradual increase in the maximum torque. Using the multiple regression method an equation relating the maximum torque to the diameter (D and the taper (T was found: Tmax = -1.4 + 0.08D + 10.5T. Conclusion: The increase in diameter and taper promoted an increase in resistance to torsion. The variation of the taper from 0.04 to 0.06 in instruments with the same diameter increased resistance to fracture by torsion by around 25%.

The influence of chamfering and corner radiusing on the discharge coefficient of rotating axial orifices

International Nuclear Information System (INIS)

Idris, A; Pullen, K

2013-01-01

The effects of chamfering and corner radiusing on the discharge coefficient of rotating axial orifices are presented in this paper. Both experimental and CFD results show that chamfering and corner radiusing improve the discharge coefficient of rotating orifices. For non-inclined rotating orifices, the discharge coefficient reduces with increasing speed, but chamfered and radiused orifices manage to have higher discharge coefficient (C d ) than the straight edge orifices. Comparing between chamfering and corner radiusing, the radiused corner orifice has the highest C d at every rotational speed. This is because the inlet radius helps guiding the flow into the orifice and avoiding flow separation at the inlet.

On the determination of the proton RMS-radius from electron scattering data

International Nuclear Information System (INIS)

Borkowski, F.; Simon, G.G.; Walther, V.H.; Wendling, R.D.

1975-01-01

It is shown that the proton rms radius should be determined from fiting a polynomial of second order to the low-q 2 form factors. The commonly used polynomial of first yields radius values which are too small. The proton rms radius has been redetermined from an analysis of the electron scattering data measured at three laboratories. The best fit value is [r 2 sub(E)]sup(1/2) = 0.87 +- 0.02 fm. (orig.) [de

Monteggia fracture dislocation equivalents - analysis of eighteen cases treated by open reduction and internal fixation

Directory of Open Access Journals (Sweden)

Singh Ajay Pal

2012-02-01

fracture dislocation equivalents are rare injuries and pre-surgery recognition by radiographs and 3-D CT helps make optimal plan. The poor results usually relate to intraarticular damage, coronoid fractures and comminution of the ulna and radial head fractures. Key words: Monteggia’s fracture; Radius fracture; Ulna

Bimalleolar ankle fracture with proximal fibular fracture

NARCIS (Netherlands)

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

2005-01-01

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

Effects of consolidation temperature, strength and microstructure on fracture toughness of nanostructured ferritic alloys

International Nuclear Information System (INIS)

Miao, P.; Odette, G.R.; Yamamoto, T.; Alinger, M.; Hoelzer, D.; Gragg, D.

2007-01-01

Fully consolidated nanostructured ferritic alloys (NFAs) were prepared by attritor milling pre-alloyed Fe-14Cr-3W-0.4Ti and 0.3 wt% Y 2 O 3 powders, followed by hot isostatic pressing (HIPing) at 1000 o C or 1150 o C at 200 MPa for 4 h. Transmission electron microscopy (TEM) revealed similar bimodal distributions of fine and coarse ferrite grains in both cases. However, as expected, the alloy microhardness decreased with increasing in HIPing temperature. Three point bend tests on single edge notched specimens, with a nominal root radius ρ = 0.15 mm, were used to measure the notch fracture toughness, K ρ , as a function of test temperature. The K ρ curves were found to be similar for both processing conditions. It appears that the coarser ferrite grains control cleavage fracture, in a way that is independent of alloy strength and HIPing temperature

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

Science.gov (United States)

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

2016-01-01

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

Results of Closed Intramedullary Nailing using Talwarkar Square Nail in Adult Forearm Fractures

Directory of Open Access Journals (Sweden)

Nadeem A Lil

2012-07-01

Full Text Available The aim of the study was to evaluate results of closed intramedullary nailing using Talwarkar square nails in adult forearm fractures. We prospectively evaluated 34 patients with both bone forearm fractures. The average time to union was 12.8 (SD +3.2 weeks with cast support for a mean of 8.2 weeks. Union was achieved in 31 out of 34 patients. Using the Grace and Eversmann rating system, 17 patients were excellent, 10 were good, and 4 had an acceptable result. Three patients had non-unions, 2 for the radius and one for the ulna. There were two cases of superficial infection, one subject had olecranon bursitis, and one case of radio-ulnar synostosis. Complication rates associated with the use of square nails were lower compared to plate osteosynthesis and locked intramedullary nails. To control rotation post- operatively, there is a need for application of an above-elbow cast after nailing.

Elastic-plastic Fracture Mechanics Assessment of nozzle corners submitted to thermal shock loading

International Nuclear Information System (INIS)

Chapuliot, S.; Marie, S.

2016-01-01

This paper focuses on the development of a simplified analytical scheme for the elastic-plastic Fracture Mechanics Assessment of large nozzle corners. Within that frame, following the specific numerical effort performed for the definition of a Stress Intensity Factor compendium, complementary elastic-plastic developments are proposed here for the consideration of the thermal shock loading in the elastic-plastic domain: this type of loading is a major loading for massive structures such as nozzle corners of large components. Thus, an important numerical was performed in order to extend the applicability domain of existing analytical schemes to those complex geometries. The final formulation is a simple one, applicable to a large variety of materials and geometrical configurations as long as the structure is large and the defect remains small in comparison to the internal radius of the nozzle. - Highlights: • Fracture Mechanics Assessment of large nozzle corners. • Elastic-plastic Stress Intensity Factor determination under thermal shock loading. • Semi-analytical schemes for J calculation.

Human Fertility Increases with the Marital-radius

DEFF Research Database (Denmark)

Labouriau, Rodrigo; Amorim, António

2008-01-01

We report a positive association between marital radius (distance between mates' birthplaces) and fertility detected in a large population. Spurious association due to socioeconomic factors is discarded by a conditional analysis involving income, education, and urbanicity. Strong evidence...

Correction of the exciton Bohr radius in monolayer transition metal dichalcogenides

Science.gov (United States)

Li, Run-Ze; Dong, Xi-Ying; Li, Zhi-Qing; Wang, Zi-Wu

2018-07-01

We theoretically investigate the correction of exciton Bohr radius in monolayer transition metal dichalcogenides (TMDCs) on different polar substrates arising from the exciton-optical phonon coupling, in which both the intrinsic longitudinal optical phonon and surface optical phonon modes couple with the exciton are taken into account. We find that the exciton Bohr radius is enlarged markedly due to these coupling. Moreover, it can be changed on a large scale by modulating the polarizability of polar substrate and the internal distance between the monolayer TMDCs and polar substrate. Theoretical result provides a potential explanation for the variation of the exciton Bohr radius in experimental measurement.

Nonlinear buckling analyses of a small-radius carbon nanotube

International Nuclear Information System (INIS)

Liu, Ning; Li, Min; Jia, Jiao; Wang, Yong-Gang

2014-01-01

Carbon nanotube (CNT) was first discovered by Sumio Iijima. It has aroused extensive attentions of scholars from all over the world. Over the past two decades, we have acquired a lot of methods to synthesize carbon nanotubes and learn their many incredible mechanical properties such as experimental methods, theoretical analyses, and computer simulations. However, the studies of experiments need lots of financial, material, and labor resources. The calculations will become difficult and time-consuming, and the calculations may be even beyond the realm of possibility when the scale of simulations is large, as for computer simulations. Therefore, it is necessary for us to explore a reasonable continuum model, which can be applied into nano-scale. This paper attempts to develop a mathematical model of a small-radius carbon nanotube based on continuum theory. An Isotropic circular cross-section, Timoshenko beam model is used as a simplified mechanical model for the small-radius carbon nanotube. Theoretical part is mainly based on modified couple stress theory to obtain the numerical solutions of buckling deformation. Meanwhile, the buckling behavior of the small radius carbon nanotube is simulated by Molecular Dynamics method. By comparing with the numerical results based on modified couple stress theory, the dependence of the small-radius carbon nanotube mechanical behaviors on its elasticity constants, small-size effect, geometric nonlinearity, and shear effect is further studied, and an estimation of the small-scale parameter of a CNT (5, 5) is obtained

Nonlinear buckling analyses of a small-radius carbon nanotube

Energy Technology Data Exchange (ETDEWEB)

Liu, Ning, E-mail: liuxiao@ase.buaa.edu.cn; Li, Min; Jia, Jiao [School of Aeronautic Science and Engineering, Beihang University, Beijing 100091 (China); Wang, Yong-Gang [Department of Applied Mechanics, China Agricultural University, Beijing 100083 (China)

2014-04-21

Carbon nanotube (CNT) was first discovered by Sumio Iijima. It has aroused extensive attentions of scholars from all over the world. Over the past two decades, we have acquired a lot of methods to synthesize carbon nanotubes and learn their many incredible mechanical properties such as experimental methods, theoretical analyses, and computer simulations. However, the studies of experiments need lots of financial, material, and labor resources. The calculations will become difficult and time-consuming, and the calculations may be even beyond the realm of possibility when the scale of simulations is large, as for computer simulations. Therefore, it is necessary for us to explore a reasonable continuum model, which can be applied into nano-scale. This paper attempts to develop a mathematical model of a small-radius carbon nanotube based on continuum theory. An Isotropic circular cross-section, Timoshenko beam model is used as a simplified mechanical model for the small-radius carbon nanotube. Theoretical part is mainly based on modified couple stress theory to obtain the numerical solutions of buckling deformation. Meanwhile, the buckling behavior of the small radius carbon nanotube is simulated by Molecular Dynamics method. By comparing with the numerical results based on modified couple stress theory, the dependence of the small-radius carbon nanotube mechanical behaviors on its elasticity constants, small-size effect, geometric nonlinearity, and shear effect is further studied, and an estimation of the small-scale parameter of a CNT (5, 5) is obtained.

Nuclear charge radius of 11Li

International Nuclear Information System (INIS)

Sanchez, Rodolfo; Noertershaeuser, Wilfried; Dax, Andreas; Ewald, Guido; Goette, Stefan; Kirchner, Reinhard; Kluge, H.-Juergen; Kuehl, Thomas; Wojtaszek, Agnieszka; Bushaw, Bruce A.; Drake, Gordon W. F.; Yan Zongchao; Zimmermann, Claus; Albers, Daniel; Behr, John; Bricault, Pierre; Dilling, Jens; Dombsky, Marik; Lassen, Jens; Phil Levy, C. D.

2006-01-01

We have determined the nuclear charge radius of 11 Li by high-precision laser spectroscopy. The experiment was performed at the TRIUMF-ISAC facility where the 7 Li- 11 Li isotope shift (IS) was measured in the 2s → 3s electronic transition using Doppler-free two-photon spectroscopy with a relative accuracy better than 10 -5 . The accuracy for the IS of the other lithium isotopes was also improved. IS's are mainly caused by differences in nuclear mass, but changes in proton distribution also give small contributions. Comparing experimentally measured IS with advanced atomic calculation of purely mass-based shifts, including QED and relativistic effects, allows derivation of the nuclear charge radii. The radii are found to decrease monotonically from 6 Li to 9 Li, and then increase with 11 Li about 11% larger than 9 Li. These results are a benchmark for the open question as to whether nuclear core excitation by halo neutrons is necessary to explain the large nuclear matter radius of 11 Li; thus, the results are compared with a number of nuclear structure models.

Finite-Larmor-radius effects on z-pinch stability

Science.gov (United States)

Scheffel, Jan; Faghihi, Mostafa

1989-06-01

The effect of finite Larmor radius (FLR) on the stability of m = 1 small-axial-wavelength kinks in a z-pinch with purely poloidal magnetic field is investigated. We use the incompressible FLR MHD model; a collisionless fluid model that consistently includes the relevant FLR terms due to ion gyroviscosity, Hall effect and electron diamagnetism. With FLR terms absent, the Kadomtsev criterion of ideal MHD, 2r dp/dr + m2B2/μ0 ≥ 0 predicts instability for internal modes unless the current density is singular at the centre of the pinch. The same result is obtained in the present model, with FLR terms absent. When the FLR terms are included, a normal-mode analysis of the linearized equations yields the following results. Marginally unstable (ideal) modes are stabilized by gyroviscosity. The Hall term has a damping (but not absolutely stabilizing) effect - in agreement with earlier work. On specifying a constant current and particle density equilibrium, the effect of electron diamagnetism vanishes. For a z-pinch with parameters relevant to the EXTRAP experiment, the m = 1 modes are then fully stabilized over the crosssection for wavelengths λ/a ≤ 1, where a denotes the pinch radius. As a general z-pinch result a critical line-density limit Nmax = 5 × 1018 m-1 is found, above which gyroviscous stabilization near the plasma boundary becomes insufficient. This limit corresponds to about five Larmor radii along the pinch radius. The result holds for wavelengths close to, or smaller than, the pinch radius and for realistic equilibrium profiles. This limit is far below the required limit for a reactor with contained alpha particles, which is in excess of 1020 m-1.

Finite-Larmor-radius effects on z-pinch stability

Energy Technology Data Exchange (ETDEWEB)

Scheffel, J.; Faghihi, M. (Royal Inst. of Tech., Stockholm (Sweden))

1989-06-01

The effect of finite Larmor radius (FLR) on the stability of m = 1 small-axial-wavelength kinks in a z-pinch with purely poloidal magnetic field is investigated. The incompressible FLR MHD model is used; a collisionless fluid model that consistently includes the relevant FLR terms due to ion gyroviscosity, Hall effect and electron diamagnetism. With FLR terms absent, the Kadomtsev criterion of ideal MHD, 2rdp/dr+m{sup 2}B{sup 2}/{mu}{sub 0}{ge}0 predicts instability for internal modes unless the current density is singular at the centre of the pinch. The same result is obtained in the present model, with FLR terms absent. When the LFR terms are included, a normal-mode analysis of the linearized equations yields the following results. Marginally unstable (ideal) modes are stabilized by gyroviscosity. The Hall term has a damping (but no absolutely stabilizing) effect - in agreement with earlier work. On specifying a constant current and particle density equilibrium, the effect of electron diamagnetism vanishes. For a z-pinch with parameters relevant to the EXTRAP experiment, the m = 1 modes are then fully stabilized over the cross-section for wavelengths {lambda}/{alpha}{le}1, where {alpha} denotes the pinch radius. As a general z-pinch result a critical line-density limit ''N''{sub max}=5x10{sup 18}m{sup -1} is found, above which gyroviscous stabilization near the plasma boundary becomes insufficient. This limit corresponds to about five Larmor radii along the pinch radius. The result holds for wavelengths close to, or smaller than, the pinch radius and for realistic equilibrium profiles. This limit is far below the required limit for a reactor with contained alpha particles, which is in excess of 10{sup 20} m{sup -1}. (author).

Finite-Larmor-radius effects on z-pinch stability

International Nuclear Information System (INIS)

Scheffel, J.; Faghihi, M.

1989-01-01

The effect of finite Larmor radius (FLR) on the stability of m = 1 small-axial-wavelength kinks in a z-pinch with purely poloidal magnetic field is investigated. The incompressible FLR MHD model is used; a collisionless fluid model that consistently includes the relevant FLR terms due to ion gyroviscosity, Hall effect and electron diamagnetism. With FLR terms absent, the Kadomtsev criterion of ideal MHD, 2rdp/dr+m 2 B 2 /μ 0 ≥0 predicts instability for internal modes unless the current density is singular at the centre of the pinch. The same result is obtained in the present model, with FLR terms absent. When the LFR terms are included, a normal-mode analysis of the linearized equations yields the following results. Marginally unstable (ideal) modes are stabilized by gyroviscosity. The Hall term has a damping (but no absolutely stabilizing) effect - in agreement with earlier work. On specifying a constant current and particle density equilibrium, the effect of electron diamagnetism vanishes. For a z-pinch with parameters relevant to the EXTRAP experiment, the m = 1 modes are then fully stabilized over the cross-section for wavelengths λ/α≤1, where α denotes the pinch radius. As a general z-pinch result a critical line-density limit ''N'' max =5x10 18 m -1 is found, above which gyroviscous stabilization near the plasma boundary becomes insufficient. This limit corresponds to about five Larmor radii along the pinch radius. The result holds for wavelengths close to, or smaller than, the pinch radius and for realistic equilibrium profiles. This limit is far below the required limit for a reactor with contained alpha particles, which is in excess of 10 20 m -1 . (author)

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

Science.gov (United States)

Reesink, Heidi L

2017-08-01

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

Influences on the radius of the auroral oval

Directory of Open Access Journals (Sweden)

S. E. Milan

2009-07-01

Full Text Available We examine the variation in the radius of the auroral oval, as measured from auroral images gathered by the Imager for Magnetopause-to-Aurora Global Exploration (IMAGE spacecraft, in response to solar wind inputs measured by the Advanced Composition Explorer (ACE spacecraft for the two year interval June 2000 to May 2002. Our main finding is that the oval radius increases when the ring current, as measured by the Sym-H index, is intensified during geomagnetic storms. We discuss our findings within the context of the expanding/contracting polar cap paradigm, in terms of a modification of substorm onset conditions by the magnetic perturbation associated with the ring current.

kISMET: Stress analysis and intermediate-scale hydraulic fracturing at the Sanford Underground Research Facility

Science.gov (United States)

Dobson, P. F.; Oldenburg, C. M.; Wu, Y.; Cook, P. J.; Kneafsey, T. J.; Nakagawa, S.; Ulrich, C.; Siler, D. L.; Guglielmi, Y.; Ajo Franklin, J. B.; Rutqvist, J.; Daley, T. M.; Birkholzer, J. T.; Wang, H. F.; Lord, N.; Haimson, B. C.; Sone, H.; Vigilante, P.; Roggenthen, W.; Doe, T.; Lee, M.; Ingraham, M. D.; Huang, H.; Mattson, E.; Johnson, T. C.; Zhou, J.; Zoback, M. D.; Morris, J.; White, J. A.; Johnson, P. A.; Coblentz, D. D.; Heise, J.

2017-12-01

solutions suggest that the fracture radius of the large fracture (stimulation test) was more than 6 m, depending on the unknown amount of leak-off. Currently kISMET team members are analyzing a large number of borehole breakouts recorded in nearby boreholes at SURF to generate a more complete picture of the stress field and its variations at SURF.

Influence of asymmetrical drawing radius deviation in micro deep drawing

Science.gov (United States)

Heinrich, L.; Kobayashi, H.; Shimizu, T.; Yang, M.; Vollertsen, F.

2017-09-01

Nowadays, an increasing demand for small metal parts in electronic and automotive industries can be observed. Deep drawing is a well-suited technology for the production of such parts due to its excellent qualities for mass production. However, the downscaling of the forming process leads to new challenges in tooling and process design, such as high relative deviation of tool geometry or blank displacement compared to the macro scale. FEM simulation has been a widely-used tool to investigate the influence of symmetrical process deviations as for instance a global variance of the drawing radius. This study shows a different approach that allows to determine the impact of asymmetrical process deviations on micro deep drawing. In this particular case the impact of an asymmetrical drawing radius deviation and blank displacement on cup geometry deviation was investigated for different drawing ratios by experiments and FEM simulation. It was found that both variations result in an increasing cup height deviation. Nevertheless, with increasing drawing ratio a constant drawing radius deviation has an increasing impact, while blank displacement results in a decreasing offset of the cups geometry. This is explained by different mechanisms that result in an uneven cup geometry. While blank displacement leads to material surplus on one side of the cup, an unsymmetrical radius deviation on the other hand generates uneven stretching of the cups wall. This is intensified for higher drawing ratios. It can be concluded that the effect of uneven radius geometry proves to be of major importance for the production of accurately shaped micro cups and cannot be compensated by intentional blank displacement.

Testing the white dwarf mass-radius relationship with eclipsing binaries

Science.gov (United States)

Parsons, S. G.; Gänsicke, B. T.; Marsh, T. R.; Ashley, R. P.; Bours, M. C. P.; Breedt, E.; Burleigh, M. R.; Copperwheat, C. M.; Dhillon, V. S.; Green, M.; Hardy, L. K.; Hermes, J. J.; Irawati, P.; Kerry, P.; Littlefair, S. P.; McAllister, M. J.; Rattanasoon, S.; Rebassa-Mansergas, A.; Sahman, D. I.; Schreiber, M. R.

2017-10-01

We present high-precision, model-independent, mass and radius measurements for 16 white dwarfs in detached eclipsing binaries and combine these with previously published data to test the theoretical white dwarf mass-radius relationship. We reach a mean precision of 2.4 per cent in mass and 2.7 per cent in radius, with our best measurements reaching a precision of 0.3 per cent in mass and 0.5 per cent in radius. We find excellent agreement between the measured and predicted radii across a wide range of masses and temperatures. We also find the radii of all white dwarfs with masses less than 0.48 M⊙ to be fully consistent with helium core models, but they are on average 9 per cent larger than those of carbon-oxygen core models. In contrast, white dwarfs with masses larger than 0.52 M⊙ all have radii consistent with carbon-oxygen core models. Moreover, we find that all but one of the white dwarfs in our sample have radii consistent with possessing thick surface hydrogen envelopes (10-5 ≥ MH/MWD ≥ 10-4), implying that the surface hydrogen layers of these white dwarfs are not obviously affected by common envelope evolution.

Neutron charge radius and the neutron electric form factor

International Nuclear Information System (INIS)

Gentile, T. R.; Crawford, C. B.

2011-01-01

For nearly forty years, the Galster parametrization has been employed to fit existing data for the neutron electric form factor, G E n , vs the square of the four-momentum transfer, Q 2 . Typically this parametrization is constrained to be consistent with experimental data for the neutron charge radius. However, we find that the Galster form does not have sufficient freedom to accommodate reasonable values of the radius without constraining or compromising the fit. In addition, the G E n data are now at sufficient precision to motivate a two-parameter fit (or three parameters if we include thermal neutron data). Here we present a modified form of a two-dipole parametrization that allows this freedom and fits both G E n (including recent data at both low and high four-momentum transfer) and the charge radius well with simple, well-defined parameters. Analysis reveals that the Galster form is essentially a two-parameter approximation to the two-dipole form but becomes degenerate if we try to extend it naturally to three parameters.

Acetabular Fracture

Directory of Open Access Journals (Sweden)

Chad Correa

2017-09-01

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

Intergranular fracture stress and phosphorus grain boundary segregation of a Mn-Ni-Mo steel

International Nuclear Information System (INIS)

Naudin, C.; Frund, J.M.; Pineau, A.

1999-01-01

Nuclear Reactor Pressure Vessel (RPV) steel A508 class 3 which is a low alloyed steel is not usually sensitive to reversible temper embrittlement when properly heat treated. However heterogeneous zones may be present in particular near the inner side of the vessel. These zones result from the segregation of the alloying elements (C, Mn, Ni, Mo) and impurities (S, P) taking place during solidification of the material. They are called segregated zones (or ghost lines). They can reach 2 mm thick along the radius and 30 mm long through the circumferential direction. Their susceptibility to reversible temper embrittlement is mainly due to grain boundary phosphorus segregation triggering brittle intergranular fracture when the material is tested at low temperature. In this material like in other steels the influence of some other alloying elements (Mo, Mn...) is clearly significant and should also be taken into account. But phosphorus effect has proved to be predominant. The aim of the present study is therefore to find out a quantitative relationship between grain boundary phosphorus segregation and critical intergranular fracture stress. A synthetic steel with a chemical composition representative of an average segregated zone was prepared for the present study. A number of heat treatments were applied to reach different embrittlement conditions. Then brittle fracture properties were obtained by performing cryogenic fracture tests on notched tensile specimens while the corresponding grain boundary phosphorus levels were measured by Auger electron spectroscopy. Systematic fractographic observations were carried out. Moreover an attempt to determine the influence of temperature on the critical intergranular fracture stress was made

[Matrimonial radius and anthropologic differentiation of the population of the Peloponnese, Greece].

Science.gov (United States)

Pitsios, T K

1983-09-01

Mean matrimonial radius (MMR) and mean breeding radius (MBR) were studied in the population of the Peloponnese (Greece). The historical and geographical causes of these important genetical variables are discussed considering, too, their effects on the anthropological differentiation of this population.

Validation of favor code linear elastic fracture solutions for finite-length flaw geometries

International Nuclear Information System (INIS)

Dickson, T.L.; Keeney, J.A.; Bryson, J.W.

1995-01-01

One of the current tasks within the US Nuclear Regulatory Commission (NRC)-funded Heavy Section Steel Technology Program (HSST) at Oak Ridge National Laboratory (ORNL) is the continuing development of the FAVOR (Fracture, analysis of Vessels: Oak Ridge) computer code. FAVOR performs structural integrity analyses of embrittled nuclear reactor pressure vessels (RPVs) with stainless steel cladding, to evaluate compliance with the applicable regulatory criteria. Since the initial release of FAVOR, the HSST program has continued to enhance the capabilities of the FAVOR code. ABAQUS, a nuclear quality assurance certified (NQA-1) general multidimensional finite element code with fracture mechanics capabilities, was used to generate a database of stress-intensity-factor influence coefficients (SIFICs) for a range of axially and circumferentially oriented semielliptical inner-surface flaw geometries applicable to RPVs with an internal radius (Ri) to wall thickness (w) ratio of 10. This database of SIRCs has been incorporated into a development version of FAVOR, providing it with the capability to perform deterministic and probabilistic fracture analyses of RPVs subjected to transients, such as pressurized thermal shock (PTS), for various flaw geometries. This paper discusses the SIFIC database, comparisons with other investigators, and some of the benchmark verification problem specifications and solutions

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

Science.gov (United States)

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

1997-04-01

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

Allogenic bone rods with freeze drying and gamma rays irradiation for treatment of fracture

International Nuclear Information System (INIS)

Zhou Zhenbin

1999-01-01

Opened reduction and internal fixation are the usual treatment of fracture, but both methods need a second operation for removal implants. The benefits of the bone rods are that they can avoid the removement of internal fixation and will be absorbed spontaneously. The bone rods are made of allogeneic compact bones with freeze-drying and gamma rays irradiation supplied by Shanxi Provincial Tissue Bank. The purpose of this study is to evaluate allograft reaction, the stability of the internal fixation, osteoinduction in the treatment of fracture using allogeneic bone rods with freeze drying and gamma rays irradiation. From May 1997 to May 1998, fourteen cases (male 12, female 2) of treatment were reviewed. The mean age was 37.3 (21-5 1). There were 3 medial malleolus fractures, 7 tibia and fibula fractures, 1 ulna and radius fracture, 1 lateral condyle of humerus fracture. The clinical results were satisfactory. Because the strength of the bone rods are weaker than that of screws, the bone rods are only indicated in the fixation of cancellous bones fracture and unloaded bone fracture. It can be used as a supplementary fixation of loaded bone. It is not indicated for fixation of comminuted fracture. More than two bone rods may be used in the fixation of fracture in order to get stability of the fracture and decrease stress between rods which will prevent the break of the bone rods. Allogeneic bone rods with freeze-drying and gamma rays irradiation can be used as implants of non-immunogenicity. There are no allograft reactions in all cases (including fever, leukocytosis, exudation or swelling in the wound). Although plenty of experimental studies have showed that freeze drying with gamma rays irradiation (below 50 KGy) would not destroy BMP of bone allograft, but there is no osteoinduction in our cases. The healing of a fracture and bridging external callus are similar as other operations. This new technique may have the following advantages compare with the screws: 1

Thermoplastic Micromodel Investigation of Two-Phase Flows in a Fractured Porous Medium

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Shao-Yiu Hsu

2017-01-01

Full Text Available In the past few years, micromodels have become a useful tool for visualizing flow phenomena in porous media with pore structures, e.g., the multifluid dynamics in soils or rocks with fractures in natural geomaterials. Micromodels fabricated using glass or silicon substrates incur high material cost; in particular, the microfabrication-facility cost for making a glass or silicon-based micromold is usually high. This may be an obstacle for researchers investigating the two-phase-flow behavior of porous media. A rigid thermoplastic material is a preferable polymer material for microfluidic models because of its high resistance to infiltration and deformation. In this study, cyclic olefin copolymer (COC was selected as the substrate for the micromodel because of its excellent chemical, optical, and mechanical properties. A delicate micromodel with a complex pore geometry that represents a two-dimensional (2D cross-section profile of a fractured rock in a natural oil or groundwater reservoir was developed for two-phase-flow experiments. Using an optical visualization system, we visualized the flow behavior in the micromodel during the processes of imbibition and drainage. The results show that the flow resistance in the main channel (fracture with a large radius was higher than that in the surrounding area with small pore channels when the injection or extraction rates were low. When we increased the flow rates, the extraction efficiency of the water and oil in the mainstream channel (fracture did not increase monotonically because of the complex two-phase-flow dynamics. These findings provide a new mechanism of residual trapping in porous media.

X-ray Spectroscopy of the Virgo Cluster out to the Virial Radius

OpenAIRE

Urban, O.; Werner, N.; Simionescu, A.; Allen, S. W.; Böhringer, H.

2011-01-01

We present results from the analysis of a mosaic of thirteen XMM-Newton pointings covering the Virgo Cluster from its center northwards out to a radius r~1.2 Mpc (~4.5 degrees), reaching the virial radius and beyond. This is the first time that the properties of a modestly sized (M_vir~1.4e14 M_sun, kT~2.3 keV), dynamically young cluster have been studied out to the virial radius. The density profile of the cluster can be described by a surprisingly shallow power-law with index 1.21+/-0.12. I...

Possibility to determine the radius of accretion disk by gravitational waves

International Nuclear Information System (INIS)

Sotani, H; Saijo, M

2007-01-01

We investigate gravitational waves from a dust disk around a Schwarzschild black hole to focus on whether we can extract any of its physical properties from a direct detection of gravitational waves. We adopt a black hole perturbation approach in a time domain, which is a satisfactory approximation to illustrate a dust disk in a supermassive black hole. We find that we can determine the radius of the disk by using the power spectrum of gravitational waves and that our method to extract the radius works for a disk of arbitrary density distribution. Therefore we believe a possibility exists for determining the radius of the disk from a direct observation of gravitational waves detected by the Laser Interferometer Space Antenna

On the charge radius of the neutrino

CERN Document Server

Bernabeu, J; Papavassiliou, J; Vidal, J

2000-01-01

Using the pinch technique we construct at one-loop order a neutrino charge radius, which is finite, depends neither on the gauge-fixing parameter nor on the gauge-fixing scheme employed, and is process-independent. This definition stems solely from an effective proper photon-neutrino one-loop vertex, with no reference to box or self-energy contributions. The role of the $WW$ box in this construction is critically examined. In particular it is shown that the exclusion of the effective WW box from the definition of the neutrino charge radius is not a matter of convention but is in fact dynamically realized when the target-fermions are right-handedly polarized. In this way we obtain a unique decomposition of effective self-energies, vertices, and boxes, which separately respect electroweak gauge invariance. We elaborate on the tree-level origin of the mechanism which enforces at one-loop level massive cancellations among the longitudinal momenta appearing in the Feynman diagrams, and in particular those associat...

Constraining the mass and radius of neutron stars in globular clusters

Science.gov (United States)

Steiner, A. W.; Heinke, C. O.; Bogdanov, S.; Li, C. K.; Ho, W. C. G.; Bahramian, A.; Han, S.

2018-05-01

We analyse observations of eight quiescent low-mass X-ray binaries in globular clusters and combine them to determine the neutron star mass-radius curve and the equation of state of dense matter. We determine the effect that several uncertainties may have on our results, including uncertainties in the distance, the atmosphere composition, the neutron star maximum mass, the neutron star mass distribution, the possible presence of a hotspot on the neutron star surface, and the prior choice for the equation of state of dense matter. The distance uncertainty is implemented in a new Gaussian blurring method that can be directly applied to the probability distribution over mass and radius. We find that the radius of a 1.4 solar mass neutron star is most likely from 10 to 14 km and that tighter constraints are only possible with stronger assumptions about the nature of the neutron stars, the systematics of the observations, or the nature of dense matter. Strong phase transitions in the equation of state are preferred, and in this case, the radius is likely smaller than 12 km. However, radii larger than 12 km are preferred if the neutron stars have uneven temperature distributions.

Ballistic fractures: indirect fracture to bone.

Science.gov (United States)

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

2011-11-01

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

Hydraulic fracture propagation modeling and data-based fracture identification

Science.gov (United States)

Zhou, Jing

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

Atomic radii for atoms with the 6s shell outermost: The effective atomic radius and the van der Waals radius from 55Cs to 80Hg

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Hiroshi Tatewaki

2015-06-01

Full Text Available We consider, for atoms from 55Cs to 80Hg, the effective atomic radius (rear, which is defined as the distance from the nucleus at which the magnitude of the electric field is equal to that in He at one half of the equilibrium bond length of He2. The values of rear are about 50% larger than the mean radius of the outermost occupied orbital of 6s, . The value of rear decreases from 55Cs to 56Ba and undergoes increases and decreases with rising nuclear charge from 57La to 70Y b. In fact rear is understood as comprising two interlaced sequences; one consists of 57La, 58Ce, and 64Gd, which have electronic configuration (4fn−1(5d1(6s2, and the remaining atoms have configuration (4fn(6s2. The sphere defined by rear contains 85%–90% of the 6s electrons. From 71Lu to 80Hg the radius rear also involves two sequences, corresponding to the two configurations 5dn+16s1 and 5dn6s2. The radius rear according to the present methodology is considerably larger than rvdW obtained by other investigators, some of who have found values of rvdW close to .

Pulsed electromagnetic field during cast immobilization in postmenopausal women with Colles’ fracture

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Lazović Milica

2012-01-01

Full Text Available Introduction. Although Colles’ fracture i.e. a dorsally displaced distal radius fracture (DRF is one of the most common fractures, there is no enough evidence to determine the best form of rehabilitation. Objective. To assess whether the use of pulsed electromagnetic field (PEMF therapy during cast immobilization of DRF provides beneficial effects on pain, edema, wrist range of motion and function, as well as on the frequency of complications immediately after cast removal. Methods. The prospective randomized controlled study included 60 women over the age of 55 years with extra-articular displaced DRF treated with reduction and cast immobilization. The patients were alternately allocated to either a PEMF group (n=30, received 10 days of PEMF therapy during immobilization, or a control group (n=30, without PEMF therapy. Pain, function, hand circumference, wrist and forearm range of motion and frequency of complications for each patient was evaluated within two to three days of cast removal. Results. Better mean values for the majority of examined parameters were recorded in the PEMF group than in the control group, but the difference was statistically significant just for edema (p<0.001, flexion, extension and supination range (p<0.01. Conclusion. During immobilization PEMF therapy in DRF patients gave better results immediately after cast removal in terms of edema and wrist range of motion (ROM.

Experimental and numerical investigation of laser forming of cylindrical surfaces with arbitrary radius of curvature

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Mehdi Safari

2016-09-01

Full Text Available In this work, laser forming of cylindrical surfaces with arbitrary radius of curvature is investigated experimentally and numerically. For laser forming of cylindrical surfaces with arbitrary radius of curvature, a new and comprehensive method is proposed in this paper. This method contains simple linear irradiating lines and using an analytical method, required process parameters for laser forming of a cylindrical surface with a specific radius of curvature is proposed. In this method, laser output power, laser scanning speed and laser beam diameter are selected based on laser machine and process limitations. As in the laser forming of a cylindrical surface, parallel irradiating lines are needed; therefore key parameter for production of a cylindrical surface with a specific radius of curvature is the number of irradiating lines. Hence, in the proposed analytical method, the required number of irradiating lines for production of a cylindrical surface with a specific radius of curvature is suggested. Performance of the proposed method for production of cylindrical surface with a specific radius of curvature is verified with experimental tests. The results show that using proposed analytical method, cylindrical surfaces with any radius of curvature can be produced successfully.

Reconstruction of lower end of radius using vascularized upper end of fibula

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Koul Ashok

2007-01-01

Full Text Available Background: Giant cell tumor is a fairly common locally invasive tumor in young adults. The lower end of the radius is the second commonest site for this tumor. The most common treatment for this tumor is curettage with or without bone grafting but it carries a significant rate of recurrence. Excision is the treatment of choice, especially for cases in which the cortex has been breached. After excision of the distal end of the radius, different procedures have been described to reconstruct the defect of distal radius. These include partial arthrodesis and hemiarthroplasty using the upper end of the fibula. The upper end of the fibula has a morphological resemblance to the lower end of the radius and has been used to replace the latter. Traditionally it was used as a ′free′ (non-vascularized graft. More recently the upper end of the fibula has been transferred as a vascularized transfer for the same purpose. Though vascularized transfer should be expected to be more physiological, its superiority over the technically simpler non-vascularized transfer has not been conclusively proven. Materials and Methods: Two patients are presented who had giant cell tumor of distal radius. They underwent wide local excision and reconstruction with free vascularized upper end of the fibula. Result: Follow-up period was two and a half years and 12 months respectively. Both patients have returned to routine work. One patient has excellent functional result and the other has a good result. Conclusion: Vascularized upper end of fibula transfer is a reliable method of reconstruction for loss of the distal end of the radius that restores local anatomy and physiology.

Study on the Matching Relationship between Polymer Hydrodynamic Characteristic Size and Pore Throat Radius of Target Block S Based on the Microporous Membrane Filtration Method

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Li Yiqiang

2014-01-01

Full Text Available The concept of the hydrodynamic characteristic size of polymer was proposed in this study, to characterize the size of aggregates of many polymer molecules in the polymer percolation process. The hydrodynamic characteristic sizes of polymers used in the target block S were examined by employing microporous membrane filtration method, and the factors were studied. Natural core flow experiments were conducted in order to set up the flow matching relationship plate. According to the flow matching plate, the relationship between the hydrodynamic characteristic size of polymer and pore throat radius obtained from core mercury injection data was found. And several suitable polymers for different reservoirs permeability were given. The experimental results of microporous membrane filtration indicated that the hydrodynamic characteristic size of polymer maintained a good nonlinear relationship with polymer viscosity; the value increased as the molecular weight and concentration of the polymer increased and increased as the salinity of dilution water decreased. Additionally, the hydrodynamic characteristic size decreased as the pressure increased, so the hydrodynamic characteristic size ought to be determined based on the pressure of the target block. In the core flow studies, good matching of polymer and formation was identified as polymer flow pressure gradient lower than the fracture pressure gradient of formation. In this case, good matching that was the pore throat radius should be larger than 10 times the hydrodynamic characteristic size of polymer in this study. Using relationship, more matching relationship between the hydrodynamic characteristic sizes of polymer solutions and the pore throat radius of target block was determined.

Study of the external parameters influence on the channel discharge radius in Hg lamps

International Nuclear Information System (INIS)

Cristea, M.

2000-01-01

In this paper, the plasma electric conductivity and the channel radius for high-pressure mercury arc discharge are calculated. The examined model emphasizes some correlations between various external parameters (current intensity, silicon tube diameter and working pressure) and the channel discharge radius. After model validation, the temperature distribution in the discharge zone is obtained and then the electrons and ions distribution, the electric carriers mobility and the electric conductivity for different lamp characteristics are calculated. The applied numerical simulation shows a linear increase of the channel radius with the tube radius Rw increasing, and a very week pressure dependence (in the range 0.5 - 5 atm.)

Distinguishing stress fractures from pathologic fractures: a multimodality approach

International Nuclear Information System (INIS)

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

2005-01-01

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

Prediction of minimum UO2 particle size based on thermal stress initiated fracture model

International Nuclear Information System (INIS)

Corradini, M.

1976-08-01

An analytic study was employed to determine the minimum UO 2 particle size that could survive fragmentation induced by thermal stresses in a UO 2 -Na Fuel Coolant Interaction (FCI). A brittle fracture mechanics approach was the basis of the study whereby stress intensity factors K/sub I/ were compared to the fracture toughness K/sub IC/ to determine if the particle could fracture. Solid and liquid UO 2 droplets were considered each with two possible interface contact conditions; perfect wetting by the sodium or a finite heat transfer coefficient. The analysis indicated that particles below the range of 50 microns in radius could survive a UO 2 -Na fuel coolant interaction under the most severe temperature conditions without thermal stress fragmentation. Environmental conditions of the fuel-coolant interaction were varied to determine the effects upon K/sub I/ and possible fragmentation. The underlying assumptions of the analysis were investigated in light of the analytic results. It was concluded that the analytic study seemed to verify the experimental observations as to the range of the minimum particle size due to thermal stress fragmentation by FCI. However the method used when the results are viewed in light of the basic assumptions indicates that the analysis is crude at best, and can be viewed as only a rough order of magnitude analysis. The basic complexities in fracture mechanics make further investigation in this area interesting but not necessarily fruitful for the immediate future

Measurements of the Minimum Bending Radius of Small Diameter Scintillating Plastic Fibres

CERN Document Server

Gruber, Lukas; Vaananen, Mika Petteri; Gavardi, Laura

2018-01-01

The minimum bending radius of plastic fibres is an important parameter as it determines the geometrical flexibility of the fibres during long-term storage or installation and usage inside detectors. The following document describes measurements of the minimum bending radius of round scintillating plastic fibres with small diameter performed in the context of the LHCb SciFi Tracker project. The experimental set-up is based on measuring the light output of a bent fibre in response to 1 MeV electrons over several days. The results suggest that the 250 μm diameter fibres can be bent to a radius of about 10 mm without damaging and losing light.

Double segmental tibial fractures - an unusual fracture pattern

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Bali Kamal

2012-02-01

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

Feasibility of a reduction protocol in the emergency department for diaphyseal forearm fractures in children.

Science.gov (United States)

Pesenti, S; Litzelmann, E; Kahil, M; Mallet, C; Jehanno, P; Mercier, J-C; Ilharreborde, B; Mazda, K

2015-09-01

Diaphyseal forearm fractures are very common pediatric traumas. At present, distal radius metaphyseal fractures are often successfully treated with closed reduction by emergency physicians. However, the management of diaphyseal fractures remains controversial. The purpose of this study was to analyze the results of diaphyseal forearm fractures in the emergency department (ED) in children. In a prospective 2-year-study, all closed diaphyseal forearm fractures in patients under 15, with an angle of >15° and treated by closed reduction in the ED were included. Fractures with overlapping fragments were excluded. Reduction was performed by an emergency physician, with a standardized analgesic protocol (painkillers and nitrous oxide). Clinical tolerance was checked within the first 24hours, and the radiographic stability of reduction was assessed at days 8 and 15. Initial and final follow-up radiographs were analyzed. Elbow and wrist range of motion was assessed at the final follow-up. Sixty patients (41 boys and 19 girls) were included. Mean age was 5.2 years old (±3). At initial evaluation, the maximum angle was 30° (±11.3). After reduction, the maximum angle was significantly reduced (30° vs. 5°, P<0.001). Mean immobilization in a cast was 11.7 weeks (±2). There were no cast related complications in any of these children. There was no surgery for secondary displacement. Full range of motion was obtained in all patients at the final follow-up. The outcome of conservative treatment of closed diaphyseal forearm fractures, without overlapping fragments was excellent. However, reduction is usually performed in the operating room by orthopedic surgeons under general anesthesia and requires hospitalization, which is very expensive. The results of this study show that high quality care may be obtained in the ED by a trained and experienced team. These results are similar to those for distal metaphyseal fractures, which could extend the indications for reduction in the

Comparison of Diagnostic Accuracy of Radiation Dose-Equivalent Radiography, Multidetector Computed Tomography and Cone Beam Computed Tomography for Fractures of Adult Cadaveric Wrists.

Science.gov (United States)

Neubauer, Jakob; Benndorf, Matthias; Reidelbach, Carolin; Krauß, Tobias; Lampert, Florian; Zajonc, Horst; Kotter, Elmar; Langer, Mathias; Fiebich, Martin; Goerke, Sebastian M

2016-01-01

To compare the diagnostic accuracy of radiography, to radiography equivalent dose multidetector computed tomography (RED-MDCT) and to radiography equivalent dose cone beam computed tomography (RED-CBCT) for wrist fractures. As study subjects we obtained 10 cadaveric human hands from body donors. Distal radius, distal ulna and carpal bones (n = 100) were artificially fractured in random order in a controlled experimental setting. We performed radiation dose equivalent radiography (settings as in standard clinical care), RED-MDCT in a 320 row MDCT with single shot mode and RED-CBCT in a device dedicated to musculoskeletal imaging. Three raters independently evaluated the resulting images for fractures and the level of confidence for each finding. Gold standard was evaluated by consensus reading of a high-dose MDCT. Pooled sensitivity was higher in RED-MDCT with 0.89 and RED-MDCT with 0.81 compared to radiography with 0.54 (P = radiography (P radiography. Readers are more confident in their reporting with the cross sectional modalities. Dose equivalent cross sectional computed tomography of the wrist could replace plain radiography for fracture diagnosis in the long run.

Ankle fracture spur sign is pathognomonic for a variant ankle fracture.

Science.gov (United States)

Hinds, Richard M; Garner, Matthew R; Lazaro, Lionel E; Warner, Stephen J; Loftus, Michael L; Birnbaum, Jacqueline F; Burket, Jayme C; Lorich, Dean G

2015-02-01

The hyperplantarflexion variant ankle fracture is composed of a posterior tibial lip fracture with posterolateral and posteromedial fracture fragments separated by a vertical fracture line. This infrequently reported injury pattern often includes an associated "spur sign" or double cortical density at the inferomedial tibial metaphysis. The objective of this study was to quantitatively establish the association of the ankle fracture spur sign with the hyperplantarflexion variant ankle fracture. Our clinical database of operative ankle fractures was retrospectively reviewed for the incidence of hyperplantarflexion variant and nonvariant ankle fractures as determined by assessment of injury radiographs, preoperative advanced imaging, and intraoperative observation. Injury radiographs were then evaluated for the presence of the spur sign, and association between the spur sign and variant fractures was analyzed. The incidence of the hyperplantarflexion variant fracture among all ankle fractures was 6.7% (43/640). The spur sign was present in 79% (34/43) of variant fractures and absent in all nonvariant fractures, conferring a specificity of 100% in identifying variant fractures. Positive predictive value and negative predictive value were 100% and 99%, respectively. The ankle fracture spur sign was pathognomonic for the hyperplantarflexion variant ankle fracture. It is important to identify variant fractures preoperatively as patient positioning, operative approach, and fixation construct of variant fractures often differ from those employed for osteosynthesis of nonvariant fractures. Identification of the spur sign should prompt acquisition of advanced imaging to formulate an appropriate operative plan to address the variant fracture pattern. Level III, retrospective comparative study. © The Author(s) 2014.

Association of Ipsilateral Rib Fractures With Displacement of Midshaft Clavicle Fractures.

Science.gov (United States)

Stahl, Daniel; Ellington, Matthew; Brennan, Kindyle; Brennan, Michael

2017-04-01

To determine whether the presence of ipsilateral rib fractures affects the rate of a clavicle fracture being unstable (>100% displacement). A retrospective review from 2002-2013 performed at a single level 1 trauma center evaluated 243 midshaft clavicle fractures. Single Level 1 trauma center. These fractures were subdivided into those with ipsilateral rib fractures (CIR; n = 149) and those without ipsilateral rib fractures (CnIR; n = 94). The amount of displacement was measured on the initial injury radiograph and subsequent follow-up radiographs. Fractures were classified into either 100% displacement, based on anteroposterior radiographs. Ipsilateral rib fractures were recorded based on which number rib was fractured and the total number of fractured ribs. One hundred sixteen (78%) of the CIR group and 51 (54%) of the CnIR group were found to have >100% displacement at follow-up (P = 0.0047). Seventy-two percent of the CIR group demonstrated progression from 100% displacement of the fracture compared with only 54% of the CnIR group (P fracture to >100% was 4.08 (P = 0.000194) when ribs 1-4 were fractured and not significant for rib fractures 5-8 or 9-12. The presence of concomitant ipsilateral rib fractures significantly increases the rate of midshaft clavicle fractures being >100% displaced. In addition, a fracture involving the upper one-third of the ribs significantly increases the rate of the clavicle fracture being >100% displaced on early follow-up. Clavicle fractures with associated ipsilateral rib fractures tend to demonstrate an increased amount of displacement on follow-up radiographs compared with those without ipsilateral rib fractures. Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence.

Treatment of a forelimb fracture and rehabilitation of a free-ranging Iberian Wolf (Canis lupus signatus

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Filipe C. Silva

2016-05-01

Full Text Available Abstract: The surgical treatment of an exposed compounded comminuted fracture of the right radius and ulna in a free-ranging adult female Iberian Wolf (Canis lupus signatus with an osteosynthesis plate and screws and subsequent post-operative care are described. The evolution of the fracture healing was very similar to those expected in a dog of the same size. The prompt surgical intervention and a proper housing, feeding and wound management adapted to a free-ranging wolf, in view to reduce manipulation and post-operative complications, allowed the subsequent rehabilitation and release of the animal. After 10th post-operative weeks the wolf was fitted with a Global Positioning System (GPS for wildlife tracking collar and released in the same area where it has been caught. GPS telemetry data showed that the animal covered increasingly large distances confirming a complete functionality of the right thoracic limb and its successfully return to the wild. This report could constitute the first detailed report of a long bone fracture treatment in a free-ranging wolf and its successfully rehabilitation, release and adaptation to the wild.

OpenACC directive-based GPU acceleration of an implicit reconstructed discontinuous Galerkin method for compressible flows on 3D unstructured grids

Energy Technology Data Exchange (ETDEWEB)

Lou, Jialin [North Carolina State Univ., Raleigh, NC (United States); Xia, Yidong [Idaho National Lab. (INL), Idaho Falls, ID (United States); Luo, Lixiang [North Carolina State Univ., Raleigh, NC (United States); Luo, Hong [North Carolina State Univ., Raleigh, NC (United States); Edwards, Jack [North Carolina State Univ., Raleigh, NC (United States); Mueller, Frank [North Carolina State Univ., Raleigh, NC (United States)

2016-09-01

In this study, we use a combination of modeling techniques to describe the relationship between fracture radius that might be accomplished in a hypothetical enhanced geothermal system (EGS) and drilling distance required to create and access those fractures. We use a combination of commonly applied analytical solutions for heat transport in parallel fractures and 3D finite-element method models of more realistic heat extraction geometries. For a conceptual model involving multiple parallel fractures developed perpendicular to an inclined or horizontal borehole, calculations demonstrate that EGS will likely require very large fractures, of greater than 300 m radius, to keep interfracture drilling distances to ~10 km or less. As drilling distances are generally inversely proportional to the square of fracture radius, drilling costs quickly escalate as the fracture radius decreases. It is important to know, however, whether fracture spacing will be dictated by thermal or mechanical considerations, as the relationship between drilling distance and number of fractures is quite different in each case. Information about the likelihood of hydraulically creating very large fractures comes primarily from petroleum recovery industry data describing hydraulic fractures in shale. Those data suggest that fractures with radii on the order of several hundred meters may, indeed, be possible. The results of this study demonstrate that relatively simple calculations can be used to estimate primary design constraints on a system, particularly regarding the relationship between generated fracture radius and the total length of drilling needed in the fracture creation zone. Comparison of the numerical simulations of more realistic geometries than addressed in the analytical solutions suggest that simple proportionalities can readily be derived to relate a particular flow field.

The effect of adhesion on the contact radius in atomic force microscopy indentation

International Nuclear Information System (INIS)

Sirghi, L; Rossi, F

2009-01-01

The effect of adhesion on nanoscale indentation experiments makes the interpretation of force-displacement curves acquired in these experiments very difficult. The indentation force results from the addition of adhesive and elastic forces at the indenter-sample contact. The evolution of the two forces during the indentation is determined by the variation of the indenter-sample contact radius. In the present work the variation of contact radius during atomic force microscopy (AFM) indentation of elastic and adhesive samples with conical indenters (AFM tips) is indirectly determined by measurements of the contact dynamic stiffness. For weak sample deformations, the contact radius is determined mainly by the adhesion force and indenter apex radius. For strong sample deformations, the contact radius increases linearly with the increase of the indenter displacement, the slope of this linear dependence being in agreement with Sneddon's theory of indentation (Sneddon 1965 Int. J. Eng. Sci. 3 47). Based on these results, a theoretical expression of indentation force dependence on displacement is found. This expression allows for determination of the thermodynamic work of adhesion at the indenter-sample interface and the sample elasticity modulus.

Flow characteristics through a single fracture of artificial fracture system

International Nuclear Information System (INIS)

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

2001-04-01

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

A Rare Nasal Bone Fracture: Anterior Nasal Spine Fracture

Directory of Open Access Journals (Sweden)

Egemen Kucuk

2014-04-01

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

The white dwarf mass-radius relation with Gaia, Hubble and FUSE

Science.gov (United States)

Joyce, Simon R. G.; Barstow, Martin A.; Casewell, Sarah L.; Holberg, Jay B.; Bond, Howard E.

2018-04-01

White dwarfs are becoming useful tools for many areas of astronomy. They can be used as accurate chronometers over Gyr timescales. They are also clues to the history of star formation in our galaxy. Many of these studies require accurate estimates of the mass of the white dwarf. The theoretical mass-radius relation is often invoked to provide these mass estimates. While the theoretical mass-radius relation is well developed, observational tests of this relation show a much larger scatter in the results than expected. High precision observational tests to confirm this relation are required. Gaia is providing distance measurements which will remove one of the main source of uncertainty affecting most previous observations. We combine Gaia distances with spectra from the Hubble and FUSE satelites to make precise tests of the white dwarf mass-radius relation.

Aplikasi Pencarian Tempat Wisata Berbasiskan GPS dengan Metode Radius dan Rating

Directory of Open Access Journals (Sweden)

Budi Yulianto

2015-03-01

Full Text Available Tourist place navigation application becomes more important for travelers, especially backpackers. Previous research had produced applications which can only show the route from the position of traveler to tourist place with map shown. The goal of the research is to use the radius and rating method that is still rare in the community to navigate tourist place. Output of the research is a GPS-based application that can display the search results of tourist sites based on rating and radius method, route from the traveler to the destination place, and description of the place. Development method used waterfall that contained user requirement, analysis, design, coding and testing, implementation, and maintenance. Conclusion of the research has shown that the developed application provided convenience in searching tourist places based on radius and rating, displaying route, and description of tourist places.

Prevalence of osteoporosis and incidence of hip fracture in women - secular trends over 30 years

Directory of Open Access Journals (Sweden)

Sernbo Ingemar

2010-03-01

Full Text Available Abstract Background The number of hip fractures during recent decades has been reported to be increasing, partly because of an increasing proportion of elderly women in the society. However, whether changes in hip fracture annual incidence in women are attributable to secular changes in the prevalence of osteoporosis is unclear. Methods Bone mineral density was evaluated by single-photon absorptiometry at the distal radius in 456 women aged 50 years or above and living in the same city. The measurements were obtained by the same densitometer during three separate time periods: 1970-74 (n = 106, 1987-93 (n = 175 and 1998-1999 (n = 178, and the age-adjusted prevalence of osteoporosis in these three cohorts was calculated. Additionally, all hip fractures sustained in the target population of women aged 50 years or above between 1967 and 2001 were registered, whereupon the crude and the age-adjusted annual incidence of hip fractures were calculated. Results There was no significant difference in the age-adjusted prevalence of osteoporosis when the three cohorts were compared (P = 1.00. The crude annual incidence (per 10,000 women of hip fracture in the target population increased by 110% from 40 in 1967 to 84 in 2001. The overall trend in the crude incidence between 1967 and 2001 was increasing (1.58 per 10,000 women per year; 95 percent confidence interval, 1.17 to 1.99, whereas the age-adjusted incidence was stable over the same period (0.22 per 10,000 women per year; 95 percent confidence interval, -0.16 to 0.60. Conclusions The increased number of hip fracture in elderly women is more likely to be attributable to demographic changes in the population than to secular increase in the prevalence of osteoporosis.

Artificial gravity: head movements during short-radius centrifugation

NARCIS (Netherlands)

Young, L. R.; Hecht, H.; Lyne, L. E.; Sienko, K. H.; Cheung, C. C.; Kavelaars, J.

2001-01-01

Short-radius centrifugation is a potential countermeasure to long-term weightlessness. Unfortunately, head movements in a rotating environment induce serious discomfort, non-compensatory vestibulo-ocular reflexes, and subjective illusions of body tilt. In two experiments we investigated the effects

Fracture of the styloid process associated with the mandible fracture

Directory of Open Access Journals (Sweden)

K N Dubey

2013-01-01

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

Coupled processes in single fractures, double fractures and fractured porous media

International Nuclear Information System (INIS)

Tsang, C.F.

1986-12-01

The emplacement of a nuclear waste repository in a fractured porous medium provides a heat source of large dimensions over an extended period of time. It also creates a large cavity in the rock mass, changing significantly the stress field. Such major changes induce various coupled thermohydraulic, hydromechanic and hydrochemical transport processes in the environment around a nuclear waste repository. The present paper gives, first, a general overview of the coupled processes involving thermal, mechanical, hydrological and chemical effects. Then investigations of a number of specific coupled processes are described in the context of fluid flow and transport in a single fracture, two intersecting fractures and a fractured porous medium near a nuclear waste repository. The results are presented and discussed

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

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Tabet A. Al-Sadek

2016-11-01

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

Facial Fractures.

Science.gov (United States)

Ghosh, Rajarshi; Gopalkrishnan, Kulandaswamy

2018-06-01

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

QED confronts the radius of the proton

CERN Document Server

De Rujula, A

2011-01-01

Recent results on muonic hydrogen [1] and the ones compiled by CODATA on ordinary hydrogen and $ep$-scattering [2] are $5\\sigma$ away from each other. Two reasons justify a further look at this subject: 1) One of the approximations used in [1] is not valid for muonic hydrogen. This amounts to a shift of the proton's radius by $\\sim 3$ of the standard deviations of [1], in the "right" direction of data-reconciliation. In field-theory terms, the error is a mismatch of renormalization scales. Once corrected, the proton radius "runs", much as the QCD coupling "constant" does. 2) The result of [1] requires a choice of the "third Zemach moment". Its published independent determination is based on an analysis with a $p$-value --the probability of obtaining data with equal or lesser agreement with the adopted (fit form-factor) hypothesis-- of $3.92\\times 10^{-12}$. In this sense, this quantity is not empirically known. Its value would regulate the level of "tension" between muonic- and ordinary-hydrogen results, curr...

Chance Fracture Secondary to a Healed Kyphotic Compression Osteoporotic Fracture

Directory of Open Access Journals (Sweden)

Teh KK

2009-11-01

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

Hip Fracture

Science.gov (United States)

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

Mercury's radius change estimates revisited using high incidence angle MESSENGER data

Science.gov (United States)

Di Achille, G.; Popa, C.; Massironi, M.; Ferrari, S.; Mazzotta Epifani, E.; Zusi, M.; Cremonese, G.; Palumbo, P.

2012-04-01

Estimates of Mercury's radius decrease obtained using the amount of strain recorded by tectonics on the planet range from 0.5 km to 2 km. These latter figures appear too low with respect to the radius contraction (up to 5-6 km) predicted by the most accredited studies based on thermo-mechanical evolution models. For this reason, it has been suggested that there may be hidden strain accommodated by features yet unseen on Mercury. Indeed, as it has been already cautioned by previous studies, the identification of tectonic features on Mercury might be largely biased by the lighting geometry of the used basemaps. This limitation might have affected the results of the extrapolations for estimating the radius change. In this study, we mapped tectonic features at the terminator thus using images acquired at high sun incidence angle (>50°) that represents the optimal condition for their observation. In fact, images with long shadows enhance the topography and texture of the surface and are ideal to detect tectonic structures. This favorable illumination conditions allowed us to infer reliable measurements of spatial distribution (i.e. frequency, orientation, and areal density) of tectonic features which can be used to estimate the average contractional strain and planetary radius decrease. We digitized tectonic structures within a region extending for an area of about 12 million sq. km (~16% of planet's surface). More than 1300 tectonic lineaments were identified and interpreted to be compressional features (i.e. lobate scarps, wrinkle ridges, and high relief ridges) with a total length of more than 12300 km. Assuming that the extensional strain is negligible within the area, the average contractional strain calculated for the survey area is ~0.21-0.28% (~0.24% for θ=30°). This strain, extrapolated to the entire surface, corresponds to a contraction in radius of about 2.5-3.4 km (~2.9 km for θ=30°). Interestingly, the values of contractional strain and radius decrease

Ankle fractures have features of an osteoporotic fracture.

Science.gov (United States)

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

2013-11-01

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

Relation between second-order moment radius of focal spot and near field distribution of laser beam

International Nuclear Information System (INIS)

Gao Xueyan; Su Yi; Ye Yidong; Guan Youguang

2011-01-01

In order to analyze the effect of aberration of amplitude and phase of laser beam on second-order moment radius of focal spot, based on the Fraunhofer formula for light wave scalar diffraction theory and the definition of second-order moment radius, the general expression for focal spot second-order moment radius depending on the complex amplitude of near field is derived. The second-order moment radius of the focal spot depending on intensity distribution and phase distribution of near field is derived, and its clear physical meaning is described. The second-order moment radius and the divergence angle of focal spot may be easily calculated with the second-order moment radius expression of focal spot. At last, the divergence angles of focal spots of several kinds of Gaussian laser beams are calculated directly, and the results are in accordance with those in the related references. (authors)

High-rate deformation and fracture of steel 09G2S

Science.gov (United States)

Balandin, Vl. Vas.; Balandin, Vl. Vl.; Bragov, A. M.; Igumnov, L. A.; Konstantinov, A. Yu.; Lomunov, A. K.

2014-11-01

The results of experimental and theoretical studies of steel 09G2S deformation and fracture laws in a wide range of strain rates and temperature variations are given. The dynamic deformation curves and the ultimate characteristics of plasticity in high-rate strain were determined by the Kolsky method in compression, extension, and shear tests. The elastoplastic properties and spall strength were studied by using the gaseous gun of calibre 57 mm and the interferometer VISAR according to the plane-wave experiment technique. The data obtained by the Kolsky method were used to determine the parameters of the Johnson-Cook model which, in the framework of the theory of flow, describes how the yield surface radius depends on the strain, strain rate, and temperature.

Maximum wind radius estimated by the 50 kt radius: improvement of storm surge forecasting over the western North Pacific

Science.gov (United States)

Takagi, Hiroshi; Wu, Wenjie

2016-03-01

Even though the maximum wind radius (Rmax) is an important parameter in determining the intensity and size of tropical cyclones, it has been overlooked in previous storm surge studies. This study reviews the existing estimation methods for Rmax based on central pressure or maximum wind speed. These over- or underestimate Rmax because of substantial variations in the data, although an average radius can be estimated with moderate accuracy. As an alternative, we propose an Rmax estimation method based on the radius of the 50 kt wind (R50). Data obtained by a meteorological station network in the Japanese archipelago during the passage of strong typhoons, together with the JMA typhoon best track data for 1990-2013, enabled us to derive the following simple equation, Rmax = 0.23 R50. Application to a recent strong typhoon, the 2015 Typhoon Goni, confirms that the equation provides a good estimation of Rmax, particularly when the central pressure became considerably low. Although this new method substantially improves the estimation of Rmax compared to the existing models, estimation errors are unavoidable because of fundamental uncertainties regarding the typhoon's structure or insufficient number of available typhoon data. In fact, a numerical simulation for the 2013 Typhoon Haiyan as well as 2015 Typhoon Goni demonstrates a substantial difference in the storm surge height for different Rmax. Therefore, the variability of Rmax should be taken into account in storm surge simulations (e.g., Rmax = 0.15 R50-0.35 R50), independently of the model used, to minimize the risk of over- or underestimating storm surges. The proposed method is expected to increase the predictability of major storm surges and to contribute to disaster risk management, particularly in the western North Pacific, including countries such as Japan, China, Taiwan, the Philippines, and Vietnam.

Synchronous Multicentric Giant Cell Tumour of Distal Radius and Sacrum with Pulmonary Metastases

Directory of Open Access Journals (Sweden)

Varun Sharma Tandra

2015-01-01

Full Text Available Giant cell tumour (GCT is an uncommon primary bone tumour, and its multicentric presentation is exceedingly rare. We report a case of a 45-year-old female who presented to us with GCT of left distal radius. On the skeletal survey, osteolytic lesion was noted in her right sacral ala. Biopsy confirmed both lesions as GCT. Pulmonary metastasis was also present. Resection-reconstruction arthroplasty for distal radius and thorough curettage and bone grafting of the sacral lesion were done. Multicentric GCT involving distal radius and sacrum with primary sacral involvement is not reported so far to our knowledge.

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

OpenAIRE

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

2015-01-01

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

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

Science.gov (United States)

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

2015-01-01

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

Bounds of the Spectral Radius and the Nordhaus-Gaddum Type of the Graphs

Directory of Open Access Journals (Sweden)

Tianfei Wang

2013-01-01

Full Text Available The Laplacian spectra are the eigenvalues of Laplacian matrix L(G=D(G-A(G, where D(G and A(G are the diagonal matrix of vertex degrees and the adjacency matrix of a graph G, respectively, and the spectral radius of a graph G is the largest eigenvalue of A(G. The spectra of the graph and corresponding eigenvalues are closely linked to the molecular stability and related chemical properties. In quantum chemistry, spectral radius of a graph is the maximum energy level of molecules. Therefore, good upper bounds for the spectral radius are conducive to evaluate the energy of molecules. In this paper, we first give several sharp upper bounds on the adjacency spectral radius in terms of some invariants of graphs, such as the vertex degree, the average 2-degree, and the number of the triangles. Then, we give some numerical examples which indicate that the results are better than the mentioned upper bounds in some sense. Finally, an upper bound of the Nordhaus-Gaddum type is obtained for the sum of Laplacian spectral radius of a connected graph and its complement. Moreover, some examples are applied to illustrate that our result is valuable.

Relationships between fractures

Science.gov (United States)

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

2018-01-01

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

Rational functions with maximal radius of absolute monotonicity

KAUST Repository

Loczi, Lajos; Ketcheson, David I.

2014-01-01

-Kutta methods for initial value problems and the radius of absolute monotonicity governs the numerical preservation of properties like positivity and maximum-norm contractivity. We construct a function with p=2 and R>2s, disproving a conjecture of van de Griend

Thrombocytopenia-absent radius syndrome: a clinical genetic study.

NARCIS (Netherlands)

Greenhalgh, K.L.; Howell, R.; Bottani, A.; Ancliff, P.J.; Brunner, H.G.; Verschuuren-Bemelmans, C.C.; Vernon, E.; Brown, K.W.; Newbury-Ecob, R.

2002-01-01

The thrombocytopenia-absent radius (TAR) syndrome is a congenital malformation syndrome characterised by bilateral absence of the radii and a thrombocytopenia. The lower limbs, gastrointestinal, cardiovascular, and other systems may also be involved. Shaw and Oliver in 1959 were the first to

Thrombocytopenia-absent radius syndrome : a clinical genetic study

NARCIS (Netherlands)

Greenhalgh, KL; Howell, RT; Bottani, A; Ancliff, PJ; Brunner, HG; Verschuuren-Bemelmans, CC; Vernon, E; Brown, KW; Newbury-Ecob, RA

2002-01-01

The thrombocytopenia-absent radius (TAR) syndrome is a congenital malformation syndrome characterised by bilateral absence of the radii and a thrombocytopenia. The lower limbs, gastrointestinal, cardiovascular, and other systems may also be involved. Shaw and Oliver in 1959 were the first to

A Non-Interfering Beam Radius Diagnostic Suitable For Induction Linacs

International Nuclear Information System (INIS)

Nexsen, W E

2005-01-01

High current electron induction linacs operate in a parameter regime that allows the use of a diamagnetic loop (DML) to measure the beam magnetic moment. Under certain easily met conditions the beam radius can be derived from the moment measurement. The DML has the advantage over the present methods of measuring beam radius in that it is an electrical measurement with good time resolution that does not interfere with the beam transport. I describe experiments on the LLNL accelerators, ETA-II and FXR that give confidence in the use of a DML as a beam diagnostic

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

Directory of Open Access Journals (Sweden)

Gultekin Gulbahar

2015-01-01

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

Proximal femoral fractures.

Science.gov (United States)

Webb, Lawrence X

2002-01-01

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

Fracture mechanisms and fracture control in composite structures

Science.gov (United States)

Kim, Wone-Chul

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

Falling Down on the Job: Evaluation and Treatment of Fall Risk Among Older Adults With Upper Extremity Fragility Fractures.

Science.gov (United States)

McDonough, Christine M; Colla, Carrie H; Carmichael, Donald; Tosteson, Anna N A; Tosteson, Tor D; Bell, John-Erik; Cantu, Robert V; Lurie, Jonathan D; Bynum, Julie P W

2017-03-01

Clinical practice guidelines recommend fall risk assessment and intervention for older adults who sustain a fall-related injury to prevent future injury and mobility decline. The aim of this study was to describe how often Medicare beneficiaries with upper extremity fracture receive evaluation and treatment for fall risk. Observational cohort. Participants were fee-for-service beneficiaries age 66 to 99 treated as outpatients for proximal humerus or distal radius/ulna ("wrist") fragility fractures. -Participants were studied using Carrier and Outpatient Hospital files. The proportion of patients evaluated or treated for fall risk up to 6 months after proximal humerus or wrist fracture from 2007-2009 was examined based on evaluation, treatment, and diagnosis codes. Time to evaluation and number of treatment sessions were calculated. Logistic regression was used to analyze patient characteristics that predicted receiving evaluation or treatment. Narrow (gait training) and broad (gait training or therapeutic exercise) definitions of service were used. There were 309,947 beneficiaries who sustained proximal humerus (32%) or wrist fracture (68%); 10.7% received evaluation or treatment for fall risk or gait issues (humerus: 14.2%; wrist: 9.0%). Using the broader definition, the percentage increased to 18.5% (humerus: 23.4%; wrist: 16.3%). Factors associated with higher likelihood of services after fracture were: evaluation or treatment for falls or gait prior to fracture, more comorbidities, prior nursing home stay, older age, humerus fracture (vs wrist), female sex, and white race. Claims analysis may underestimate physician and physical therapist fall assessments, but it is not likely to qualitatively change the results. A small proportion of older adults with upper extremity fracture received fall risk assessment and treatment. Providers and health systems must advance efforts to provide timely evidence-based management of fall risk in this population. © 2017

Study on Oneself Developed to Apparatus Position of Measurement of BMD in the Distal Radius

International Nuclear Information System (INIS)

Han, Man Seok; Song, Jae Yong; Lee, Hyun Kuk; Yu, Se Jong; Kim, Yong Kyun

2009-01-01

The aim of this study was to evaluate the difference of bone mineral density according to distal radius rotation and to develop the supporting tool to measure rotation angles. CT scanning and the measurement of BMD by DXA of the appropriate position of the forearm were performed on 20 males. Twenty healthy volunteers without any history of operations, anomalies, or trauma were enrolled. The CT scan was used to evaluate the cross sectional structure and the rotation angle on the horizontal plane of the distal radius. The rotational angle was measured by the m-view program on the PACS monitor. The DXA was used in 20 dried radii of cadaveric specimens in pronation and supination with five and ten degrees, respectively, including a neutral position (zero degrees) to evaluate the changes of BMD according to the rotation. The mean rotation angle of the distal radius on CT was 7.4 degrees of supination in 16 cases (80%), 3.3 degrees of pronation in three cases (15%), and zero degree of neutral in one case (9%), respectively. The total average rotation angle in 20 people was 5.4 degrees of supination. In the cadaveric study, the BMD of the distal radius was different according to the rotational angles. The lowest BMD was obtained at 3.3 degrees of supination. In the case of the measurement of BMD in the distal radius with a neutral position, the rotational angle of the distal radius is close to supination. Pronation is needed for the constant measurement of BMD in the distal radius with the rotation angle measuring at the lowest BMD and about five degrees of pronation of the distal radius is recommended.

Statistical geological discrete fracture network model. Forsmark modelling stage 2.2

Energy Technology Data Exchange (ETDEWEB)

Fox, Aaron; La Pointe, Paul [Golder Associates Inc (United States); Simeonov, Assen [Swedish Nuclear Fuel and Waste Management Co., Stockholm (Sweden); Hermanson, Jan; Oehman, Johan [Golder Associates AB, Stockholm (Sweden)

2007-11-15

. These models describe fracture intensity and size as a single range from borehole to outcrop scale; and - the combined outcrop scale and tectonic fault models (OSM+TFM), where separate distributions for size and intensity describe the fractures observed at outcrop scale (largely joints) and the features observed at regional scales (lineaments that are largely faults or deformation zones). Fracture intensity and fracture size are not rigidly coupled. The stochastic intensity model is build using power laws, and combines fracture intensity data from outcrops (P21) and boreholes (P10) to simultaneously match both data sets. Intensity statistics are presented for each fracture set in each domain, and the spatial variation of intensity described as a function of lithology or as a gamma distribution where possible. This report also describes the sources of uncertainty in the methodologies, data, and analyses used to build the version 2.2 geological DFN, and offers insight as to the potential magnitudes of their effects on downstream models. The outputs of the geological DFN modeling process are recommended parameters or statistical distributions describing fracture set orientations, radius sizes, volumetric intensities, spatial correlations and models, and other parameters necessary to build stochastic models (lithology and scaling corrections, termination matrices)

Statistical geological discrete fracture network model. Forsmark modelling stage 2.2

International Nuclear Information System (INIS)

Fox, Aaron; La Pointe, Paul; Simeonov, Assen; Hermanson, Jan; Oehman, Johan

2007-11-01

. These models describe fracture intensity and size as a single range from borehole to outcrop scale; and - the combined outcrop scale and tectonic fault models (OSM+TFM), where separate distributions for size and intensity describe the fractures observed at outcrop scale (largely joints) and the features observed at regional scales (lineaments that are largely faults or deformation zones). Fracture intensity and fracture size are not rigidly coupled. The stochastic intensity model is build using power laws, and combines fracture intensity data from outcrops (P21) and boreholes (P10) to simultaneously match both data sets. Intensity statistics are presented for each fracture set in each domain, and the spatial variation of intensity described as a function of lithology or as a gamma distribution where possible. This report also describes the sources of uncertainty in the methodologies, data, and analyses used to build the version 2.2 geological DFN, and offers insight as to the potential magnitudes of their effects on downstream models. The outputs of the geological DFN modeling process are recommended parameters or statistical distributions describing fracture set orientations, radius sizes, volumetric intensities, spatial correlations and models, and other parameters necessary to build stochastic models (lithology and scaling corrections, termination matrices)

Utility of radius bone densitometry for the treatment of osteoporosis with once-weekly teriparatide therapy

Directory of Open Access Journals (Sweden)

Harumi Nakayama

2018-03-01

Full Text Available Objectives: As clinics that treat patients with osteoporosis do not usually have central dual-energy X-ray absorptiometry (DXA, bone density is often measured with radial DXA. However, no long-term evidence exists for radius bone density outcomes following treatment with once-weekly teriparatide in actual medical treatment. Methods: We evaluated changes in bone density at 6-, 12-, and 18-month intervals using radial DXA in patients treated with once-weekly teriparatide for more than 6 months. Results: A significant increase in bone mineral density (BMD was observed at the 1/3 and 1/10 radius sites 12 months after the initiation of once-weekly teriparatide. We also observed that the rate of change in BMD was greater at the distal 1/10 radius than at the 1/3 radius. Conclusions: Considering these points, the effect of once-weekly teriparatide therapy can be observed at the radius. In clinics that do not have central DXA, but instead have radial DXA, these findings can help to evaluate the effect of once-weekly teriparatide treatment on osteoporosis. Keywords: Once-weekly teriparatide, Osteoporosis, Radius, Dual-energy X-ray absorptiometry

Effect of plastic strain on elastic-plastic fracture toughness of SM490 carbon steel. Assessment by stress-based criterion for ductile crack initiation

International Nuclear Information System (INIS)

Kamaya, Masayuki

2012-01-01

Although the plastic strain induced in materials increases the mechanical strength, it may reduce the fracture toughness. In this study, the change in fracture toughness of SM490 carbon steel due to pre-straining was investigated using a stress-based criterion for ductile crack initiation. The specimens with blunt notch of various radiuses were used in addition to those with conventional fatigue pre-cracking. The degree of applied plastic strain was 5%, 10% or 20%. The fracture toughness was largest when the induced plastic strain was 5%, although it decreased for the plastic strains of 10% and 20%. The stress and strain distributions near the crack tip of fracture toughness test specimens was investigated by elastic-plastic finite element analyses using a well-correlated stress-strain curve for large strain. It was shown that the critical condition at the onset of the ductile crack was better correlated with the equivalent stress than the plastic strain at the crack tip. By using the stress-based criterion, which was represented by the equivalent stress and stress triaxiality, the change in the fracture toughness due to pre-straining could be reasonably explained. Based on these results, it was concluded that the stress-based criterion should be used for predicting the ductile crack initiation. (author)

Dating fractures and fracture movement in the Lac du Bonnet Batholith

International Nuclear Information System (INIS)

Gascoyne, M.; Brown, A.; Ejeckam, R.B.; Everitt, R.A.

1997-04-01

This report examines and summarizes all work that has been done from 1980 to the present in determining the age of rock crystallization, fracture initiation, fracture reactivation and rates of fracture movement in the Lac du Bonnet Batholith to provide information for Atomic Energy of Canada Limited's (AECL) Canadian Nuclear Fuel Waste Management Program. Geological and petrographical indicators of relative age (e.g. cross-cutting relationships, sequences of fracture infilling minerals, P-T characteristics of primary and secondary minerals) are calibrated with radiometric age determinations on minerals and whole rock samples, using 87 Rb- 87 Sr, 40 K- 39 Ar, 40 Ar- 39 Ar and fission track methods. Most fractures and fracture zones inclined at low angles are found to be ancient features, first formed in the Early Proterozoic under conditions of deuteric alteration. Following some movement on fractures in the Late Proterozoic and Early Paleozoic, reactivation of fractures during the Pleistocene is established from uranium-series dating methods and use of stable isotopic contents of fracture infilling minerals (mainly calcite). Some indication of movement on fracture zones during the Pleistocene is given by electron spin resonance dating techniques on fault gouge. The slow rate of propagation of fractures is indicated by mineral infillings, their P-T characteristics and U-series calcite ages in a fracture in sparsely fractured rock, accessible from AECL's Underground Research Laboratory. These results collectively indicate that deep fractures observed in the batholith are ancient features and the fracturing and jointing in the upper 200 m is relatively recent (< 1 Ma) and largely a result of stress release. (author)

Initialization effects via the nuclear radius on transverse in-plane flow and its disappearance

Directory of Open Access Journals (Sweden)

Bansal Rajni

2014-04-01

Full Text Available We study the dependence of collective transverse flow and its disappearance on initialization effects via the nuclear radius within the framework of the Isospin-dependent Quantum Molecular Dynamics (IQMD model. We calculate the balance energy using different parametrizations of the radius available in the literature for the reaction of 12C+12C to explain its measured balance energy. A mass-dependent analysis of the balance energy through out the periodic table is also carried out by changing the default liquid drop IQMD radius.

Initialization effects via the nuclear radius on transverse in-plane flow and its disappearance

International Nuclear Information System (INIS)

Bansal, Rajni; Gautam, Sakshi

2014-01-01

We study the dependence of collective transverse flow and its disappearance on initialization effects via the nuclear radius within the framework of the Isospin-dependent Quantum Molecular Dynamics (IQMD) model. We calculate the balance energy using different parametrizations of the radius available in the literature for the reaction of 12 C + 12 C to explain its measured balance energy. A mass-dependent analysis of the balance energy through out the periodic table is also carried out by changing the default liquid drop IQMD radius. (author)

Is the proton radius puzzle evidence of extra dimensions?

Energy Technology Data Exchange (ETDEWEB)

Dahia, F.; Lemos, A.S. [Universidade Federal da Paraiba, Department of Physics, Joao Pessoa, PB (Brazil)

2016-08-15

The proton charge radius inferred from muonic hydrogen spectroscopy is not compatible with the previous value given by CODATA-2010, which, on its turn, essentially relies on measurements of the electron-proton interaction. The proton's new size was extracted from the 2S-2P Lamb shift in the muonic hydrogen, which showed an energy excess of 0.3 meV in comparison to the theoretical prediction, evaluated with the CODATA radius. Higher-dimensional gravity is a candidate to explain this discrepancy, since the muon-proton gravitational interaction is stronger than the electron-proton interaction and, in the context of braneworld models, the gravitational potential can be hugely amplified in short distances when compared to the Newtonian potential. Motivated by these ideas, we study a muonic hydrogen confined in a thick brane. We show that the muon-proton gravitational interaction modified by extra dimensions can provide the additional separation of 0.3 meV between the 2S and 2P states. In this scenario, the gravitational energy depends on the higher-dimensional Planck mass and indirectly on the brane thickness. Studying the behavior of the gravitational energy with respect to the brane thickness in a realistic range, we find constraints for the fundamental Planck mass that solve the proton radius puzzle and are consistent with previous experimental bounds. (orig.)

Space Inside a Liquid Sphere Transforms into De Sitter Space by Hilbert Radius

Science.gov (United States)

Rabounski, Dmitri; Borissova, Larissa

2010-04-01

Consider space inside a sphere of incompressible liquid, and space surrounding a mass-point. Metrics of the spaces were deduced in 1916 by Karl Schwarzschild. 1) Our calculation shows that a liquid sphere can be in the state of gravitational collapse (g00 = 0) only if its mass and radius are close to those of the Universe (M = 8.7x10^55 g, a = 1.3x10^28 cm). However if the same mass is presented as a mass-point, the radius of collapse rg (Hilbert radius) is many orders lesser: g00 = 0 realizes in a mass-point's space by other conditions. 2) We considered a liquid sphere whose radius meets, formally, the Hilbert radius of a mass-point bearing the same mass: a = rg, however the liquid sphere is not a collapser (see above). We show that in this case the metric of the liquid sphere's internal space can be represented as de Sitter's space metric, wherein λ = 3/a^2 > 0: physical vacuum (due to the λ-term) is the same as the field of an ideal liquid where ρ0 0 (the mirror world liquid). The gravitational redshift inside the sphere is produced by the non-Newtonian force of repulsion (which is due to the λ-term, λ = 3/a^2 > 0); it is also calculated.

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

International Nuclear Information System (INIS)

Meny, Lucienne.

1979-06-01

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

Frictional coefficient depending on active friction radius with BPV ...

African Journals Online (AJOL)

Frictional coefficient depending on active friction radius with BPV and BTV in automobile disc braking system. ... International Journal of Engineering, Science and Technology. Journal Home · ABOUT ... AJOL African Journals Online. HOW TO ...

Characterizing SL2S galaxy groups using the Einstein radius

DEFF Research Database (Denmark)

Verdugo, T.; Motta, V.; Foex, G.

2014-01-01

Aims. We aim to study the reliability of RA (the distance from the arcs to the center of the lens) as a measure of the Einstein radius in galaxy groups. In addition, we want to analyze the possibility of using RA as a proxy to characterize some properties of galaxy groups, such as luminosity (L......) and richness (N). Methods. We analyzed the Einstein radius, θE, in our sample of Strong Lensing Legacy Survey (SL2S) galaxy groups, and compared it with RA, using three different approaches: 1) the velocity dispersion obtained from weak lensing assuming a singular isothermal sphere profile (θE,I); 2) a strong.......7 ± 0.2)RA, θE,II = (0.4 ± 1.5) + (1.1 ± 0.4)RA, and θE,III = (0.4 ± 1.5) + (0.9 ± 0.3)RA for each method respectively. We found weak evidence of anti-correlation between RA and z, with Log RA = (0.58 ± 0.06) − (0.04 ± 0.1)z, suggesting a possible evolution of the Einstein radius with z, as reported...

Hydroforming Process for an Ultrasmall Bending Radius Elbow

Directory of Open Access Journals (Sweden)

Shangwen Ruan

2018-01-01

Full Text Available Bent pipes are widely used in automotive, aviation, and aerospace industries for delivering fluids. Parts having small relative bending radiuses are called elbows. However, fabricating a thin-walled elbow part using the simple bending process poses many challenges. One possible way to manufacture elbows is with the stamping-welding process. The major drawbacks of this method include the decline in sealing performance and the addition in weight attributed to the lap welding process. Tube hydroforming (THF is considered as a feasible solution to these problems. However, the forming process could be quite complex, and multistep forming is necessary. This study investigates the effects of preliminary processes on elbow forming such as bending, partition forming, and heat treatment and presents a high-performance optimized process design to achieve an ultrasmall radius elbow. The effects of multistep forming on the thickness distribution and the heat treatment on the microstructure have been evaluated. The results obtained from simulations show a reasonable agreement with those from the experiments.

A three-dimensional analysis of the sigmoid notch

Directory of Open Access Journals (Sweden)

Evan D. Collins

2011-12-01

Full Text Available Fractures of the distal radius are among the most common injuries of the upper extremity, though treatment has traditionally focused on restoration of the radiocarpal joint and late sequelae may persist. X-ray imaging underestimates sigmoid notch involvement following distal radius fractures. No classification system exists for disruption patterns of the sigmoid notch of the radius associated with distal radius fractures. This study quantifies the anatomy of the sigmoid notch and identifies the landmarks of the articular surface and proximal boundaries of the distal radioulnar joint (DRUJ capsule. Computed tomography scans of freshly frozen cadaveric hands were used - followed by dissection, and three-dimensional reconstruction of the distal radius and sigmoid notch. The sigmoid notch surface was divided into two surfaces and measured. The Anterior Posterior (AP and Proximal Distal (PD widths of the articulating surface were reviewed, along with the radius of curvature, version angle and depth. The study showed that the sigmoid notch is flatter than previously believed - and only the distal 69% of its surface is covered by cartilage. On average, it has about nine degrees of retroversion, and its average inclination is almost parallel to the anatomical axis of the radius. Clinical implications exist for evaluation of the DRUJ involvement in distal radius fractures or degenerative diseases and for future development and evaluation of hemiarthroplasty replacement of the distal radius.

Nuclear charge radius of {sup 11}Li

Energy Technology Data Exchange (ETDEWEB)

Sanchez, Rodolfo, E-mail: R.Sanchez@GSI.de; Noertershaeuser, Wilfried [Gesellschaft fuer Schwerionenforschung (Germany); Dax, Andreas [CERN(Switzerland); Ewald, Guido; Goette, Stefan; Kirchner, Reinhard; Kluge, H.-Juergen; Kuehl, Thomas [Gesellschaft fuer Schwerionenforschung (Germany); Wojtaszek, Agnieszka [Swietokrzyska Academy, Institute of Physics (Poland); Bushaw, Bruce A. [Pacific Northwest National Laboratory (United States); Drake, Gordon W. F. [University of Windsor, Department of Physics (Canada); Yan Zongchao [University of New Brunswick, Department of Physics (Canada); Zimmermann, Claus [Physikalisches Institut, Eberhard Karls Universitaet Tuebingen (Germany); Albers, Daniel; Behr, John; Bricault, Pierre; Dilling, Jens; Dombsky, Marik; Lassen, Jens; Phil Levy, C. D. [Tri-University Meson Facility (Canada)

2006-07-15

We have determined the nuclear charge radius of {sup 11}Li by high-precision laser spectroscopy. The experiment was performed at the TRIUMF-ISAC facility where the {sup 7}Li-{sup 11}Li isotope shift (IS) was measured in the 2s{yields}3s electronic transition using Doppler-free two-photon spectroscopy with a relative accuracy better than 10{sup -5}. The accuracy for the IS of the other lithium isotopes was also improved. IS's are mainly caused by differences in nuclear mass, but changes in proton distribution also give small contributions. Comparing experimentally measured IS with advanced atomic calculation of purely mass-based shifts, including QED and relativistic effects, allows derivation of the nuclear charge radii. The radii are found to decrease monotonically from {sup 6}Li to {sup 9}Li, and then increase with {sup 11}Li about 11% larger than {sup 9}Li. These results are a benchmark for the open question as to whether nuclear core excitation by halo neutrons is necessary to explain the large nuclear matter radius of {sup 11}Li; thus, the results are compared with a number of nuclear structure models.

Stress Fractures

Science.gov (United States)

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

The radius of RX Eridani

International Nuclear Information System (INIS)

Woolley, R.; Dean, J.

1976-01-01

Photoelectric observations of the light curves of RX Eri obtained in B, V and I, and radial velocity determinations, are combined to determine the radius by a method originally proposed by van Hoof which avoids matching colours in the rising and falling branches of the light curve and concentrates on the falling branch. The results agree well with those from other stars determined by the normal Baade-Wesselink method, but the method is easier to apply if the colour curve is flat in the falling branch. The parameters found for the star are r 0 = 5.5 Sun, mass = 0.45 Sun, and Msub(v) = + 0sup(m).54. (author)

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

LENUS (Irish Health Repository)

Burke, Neil G

2014-01-01

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

Rehabilitation for distal radial fractures in adults.

Science.gov (United States)

Handoll, Helen H G; Elliott, Joanne

2015-09-25

Fracture of the distal radius is a common clinical problem, particularly in older people with osteoporosis. There is considerable variation in the management, including rehabilitation, of these fractures. This is an update of a Cochrane review first published in 2002 and last updated in 2006. To examine the effects of rehabilitation interventions in adults with conservatively or surgically treated distal radial fractures. We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL 2014; Issue 12), MEDLINE, EMBASE, CINAHL, AMED, PEDro, OTseeker and other databases, trial registers, conference proceedings and reference lists of articles. We did not apply any language restrictions. The date of the last search was 12 January 2015. Randomised controlled trials (RCTs) or quasi-RCTs evaluating rehabilitation as part of the management of fractures of the distal radius sustained by adults. Rehabilitation interventions such as active and passive mobilisation exercises, and training for activities of daily living, could be used on their own or in combination, and be applied in various ways by various clinicians. The review authors independently screened and selected trials, and reviewed eligible trials. We contacted study authors for additional information. We did not pool data. We included 26 trials, involving 1269 mainly female and older patients. With few exceptions, these studies did not include people with serious fracture or treatment-related complications, or older people with comorbidities and poor overall function that would have precluded trial participation or required more intensive treatment. Only four of the 23 comparisons covered by these 26 trials were evaluated by more than one trial. Participants of 15 trials were initially treated conservatively, involving plaster cast immobilisation. Initial treatment was surgery (external fixation or internal fixation) for all participants

On finite larmor radius stabilization of Z-pinches

International Nuclear Information System (INIS)

Hellsten, T.

1982-12-01

Finite Larmor radius stabilization of Z-pinches is discussed. Stability criteria can be derived for a class of equilibria having constant mass and current density. The internal modes can be stabilized provided the line density not exceed a critical value of the order of 10 18 ions/m. (Author)

Simultaneous Constraints on the Mass and Radius of Aql X–1 from Quiescence and X-Ray Burst Observations

Energy Technology Data Exchange (ETDEWEB)

Li, Zhaosheng [Department of Physics, Xiangtan University, Xiangtan, 411105 (China); Falanga, Maurizio [International Space Science Institute, Hallerstrasse 6, 3012 Bern (Switzerland); Chen, Li [Department of Astronomy, Beijing Normal University, Beijing 100875 (China); Qu, Jinlu [Laboratory for Particle Astrophysics, Institute of High Energy Physics, CAS, Beijing 100049 (China); Xu, Renxin, E-mail: lizhaosheng@xtu.edu.cn [Kavli Institute for Astronomy and Astrophysics, Peking University, Beijing 100871 (China)

2017-08-10

The measurement of neutron star mass and radius is one of the most direct ways to distinguish between various dense matter equations of state. The mass and radius of accreting neutron stars hosted in low-mass X-ray binaries can be constrained by several methods, including photospheric radius expansion from type I X-ray bursts and from quiescent spectra. In this paper, we apply for the first time these two methods simultaneously to constrain the mass and radius of Aql X–1. The quiescent spectra from Chandra and XMM-Newton , and photospheric radius expansion bursts from RXTE are used. The determination of the mass and radius of Aql X–1 is also used to verify the consistency between the two methods and to narrow down the uncertainties of the neutron star mass and radius. It is found that the distance to Aql X–1 should be in the range of 4.0–5.75 kpc, based on the overlapping confidence regions between photospheric radius expansion burst and quiescent spectra methods. In addition, we show that the mass and radius determined for the compact star in Aql X–1 are compatible with strange star equations of state and conventional neutron star models.

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

DEFF Research Database (Denmark)

Lauritzen, J B; Lund, B

1993-01-01

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

Determination of bone mineral density at distal radius measured by single photon absorptiometry

International Nuclear Information System (INIS)

Tomomitsu, Tatsushi; Yanagimoto, Shinichi; Hitomi, Go; Murakami, Akihiko; Suemori, Shinji; Yokobayashi, Tsuneo; Ishii, Koshi; Hiji, Hiroo

1988-01-01

We have discussed the index of the bone mineral density (BMD) at the distal radius measured by single photon absorptiometry. Initially, the shape at the distal radius was evaluated using an X-ray photogram of the forearm and a calculation formula of the cross-sectional area at the distal radius was performed using an X-CT photogram of the forearm. A new index for the bone mineral density (modified BMD, mBMD), bone mineral content/cross-sectional area, at the distal radius was obtained for 154 young normal subjects (20 ∼ 44 yrs.). No significant differences in the mBMD values between young normal males and females, except for the group 20 ∼ 24 year-old group, were observed. Furthermore, a significantly decreased in the mBMD values with aging was observed in females between the ages of 20 ∼ 24 and 40 ∼ 44. However, no significant changes in the mBMD values were recognized in the men. Thus, it was shown that the new BMD index, mBMD, was useful for evaluating the changes of the bone mass. (author)

Relationship between toughness and the physical fracture process on a microscopic scale

International Nuclear Information System (INIS)

Francois, D.

1975-01-01

Cleavage occurs when a local stress reaches a critical level sigma-f which is a function of temperature and metallurgical factors such as grain size. Cleavages occur ahead of the main crack tip. It is possible to establish a relationship between the cleavage stress and toughness, involving the notch root radius. At higher temperatures, fracture is ductile and occurs at a critical elongation epsilon-f, which is a function of the distribution of inclusions and the strain hardening index. It is possible to establish a relationship between toughness and this elongation at rupture. The influence of temperature, which affects several parameters, is complex. On the other hand, pressure, modifying only elongation at rupture represents an attractive means for confirming this theories. Experimental results are presented [fr

An Adaption Broadcast Radius-Based Code Dissemination Scheme for Low Energy Wireless Sensor Networks.

Science.gov (United States)

Yu, Shidi; Liu, Xiao; Liu, Anfeng; Xiong, Naixue; Cai, Zhiping; Wang, Tian

2018-05-10

Due to the Software Defined Network (SDN) technology, Wireless Sensor Networks (WSNs) are getting wider application prospects for sensor nodes that can get new functions after updating program codes. The issue of disseminating program codes to every node in the network with minimum delay and energy consumption have been formulated and investigated in the literature. The minimum-transmission broadcast (MTB) problem, which aims to reduce broadcast redundancy, has been well studied in WSNs where the broadcast radius is assumed to be fixed in the whole network. In this paper, an Adaption Broadcast Radius-based Code Dissemination (ABRCD) scheme is proposed to reduce delay and improve energy efficiency in duty cycle-based WSNs. In the ABCRD scheme, a larger broadcast radius is set in areas with more energy left, generating more optimized performance than previous schemes. Thus: (1) with a larger broadcast radius, program codes can reach the edge of network from the source in fewer hops, decreasing the number of broadcasts and at the same time, delay. (2) As the ABRCD scheme adopts a larger broadcast radius for some nodes, program codes can be transmitted to more nodes in one broadcast transmission, diminishing the number of broadcasts. (3) The larger radius in the ABRCD scheme causes more energy consumption of some transmitting nodes, but radius enlarging is only conducted in areas with an energy surplus, and energy consumption in the hot-spots can be reduced instead due to some nodes transmitting data directly to sink without forwarding by nodes in the original hot-spot, thus energy consumption can almost reach a balance and network lifetime can be prolonged. The proposed ABRCD scheme first assigns a broadcast radius, which doesn’t affect the network lifetime, to nodes having different distance to the code source, then provides an algorithm to construct a broadcast backbone. In the end, a comprehensive performance analysis and simulation result shows that the proposed

An Adaption Broadcast Radius-Based Code Dissemination Scheme for Low Energy Wireless Sensor Networks

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Shidi Yu

2018-05-01

Full Text Available Due to the Software Defined Network (SDN technology, Wireless Sensor Networks (WSNs are getting wider application prospects for sensor nodes that can get new functions after updating program codes. The issue of disseminating program codes to every node in the network with minimum delay and energy consumption have been formulated and investigated in the literature. The minimum-transmission broadcast (MTB problem, which aims to reduce broadcast redundancy, has been well studied in WSNs where the broadcast radius is assumed to be fixed in the whole network. In this paper, an Adaption Broadcast Radius-based Code Dissemination (ABRCD scheme is proposed to reduce delay and improve energy efficiency in duty cycle-based WSNs. In the ABCRD scheme, a larger broadcast radius is set in areas with more energy left, generating more optimized performance than previous schemes. Thus: (1 with a larger broadcast radius, program codes can reach the edge of network from the source in fewer hops, decreasing the number of broadcasts and at the same time, delay. (2 As the ABRCD scheme adopts a larger broadcast radius for some nodes, program codes can be transmitted to more nodes in one broadcast transmission, diminishing the number of broadcasts. (3 The larger radius in the ABRCD scheme causes more energy consumption of some transmitting nodes, but radius enlarging is only conducted in areas with an energy surplus, and energy consumption in the hot-spots can be reduced instead due to some nodes transmitting data directly to sink without forwarding by nodes in the original hot-spot, thus energy consumption can almost reach a balance and network lifetime can be prolonged. The proposed ABRCD scheme first assigns a broadcast radius, which doesn’t affect the network lifetime, to nodes having different distance to the code source, then provides an algorithm to construct a broadcast backbone. In the end, a comprehensive performance analysis and simulation result shows that

LOW-TRAUMATIC FRACTURES IN PATIENTS WITH ENDOGENOUS HYPERCORTISOLISM. PREDICTORS AND RISK FACTORS, THE IMPACT ON QUALITY OF LIFE

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Zh E Belaya

2013-12-01

Full Text Available The objective of this study was to investigate the prevalence of low traumatic fractures, the factors influencing fractures in endogenous Cushing’s syndrome (CS of various etiologies and their contributions into functional abilities and quality of life in patients with CS. Materials and methods: the retrospective data of patients, who had received treatment due to endogenous CS, (2001-2011, was evaluated. All enrolled patients underwent standard spinal radiographs in lateral positions of the vertebrae Th4-L4. Recent low traumatic non-vertebral fractures were recorded in the medical cards. Bone mineral density (BMD was measured by DXA GE Lunar Prodigy. Serum samples on octeocalcin (OC, carboxyterminal cross-linked telopeptide of type I collagen (CTx, latenight cortisol in serum were assayed by electrochemiluminescence (ECLIA. 24h urinary free cortisol (24hUFC was measured by an immunochemiluminescence assay (extraction with diethyl ether. Functional assessment was performed using «chair rising», «up and go» and «tandem» tests. Universal pain assessment tool (verbal descriptor scale, Wong-Baker facial grimace scale, activity tolerance scale, EQ-5D and ECOS-16 questionnaires were given to patients and they self-reported their conditions. Results: Among 215 patients, 178 were females and 37 males, median age 35 (Q25-Q75 27-48; 88patients (40,9% had low traumatic fractures, including vertebral fractures in 76 cases (in 60 cases multiple vertebral fractures and non-vertebral fractures in 27 cases (17 patients had rib fractures, 3 -fractures of metatarsal bones, 2 fractures of radius, 2 fractures of tibia and fibula, 1 humerus, 1 breastbone; 1 hip fracture. Patients with fractures had higher 24hUFC, late-night cortisol in serum, lower OC, Total Hip BMD, but did not differ in age, BMI, CTx or etiology of CS. After applying the logistic regression analysis (adjusted for sex, age, BMI, BMD, OC, the main predictor of fractures was late-night serum

High prevalence of simultaneous rib and vertebral fractures in patients with hip fracture.

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Lee, Bong-Gun; Sung, Yoon-Kyoung; Kim, Dam; Choi, Yun Young; Kim, Hunchul; Kim, Yeesuk

2017-02-01

The purpose was to evaluate the prevalence and location of simultaneous fracture using bone scans in patients with hip fracture and to determine the risk factors associated with simultaneous fracture. One hundred eighty two patients with hip fracture were reviewed for this study. Clinical parameters and bone mineral density (BMD) of the lumbar vertebra and femoral neck were investigated. To identify acute simultaneous fracture, a bone scan was performed at 15.4±4.1days after hip fracture. The prevalence and location of simultaneous fracture were evaluated, and multivariate logistic regression analysis was performed to determine the risk factors. Simultaneous fracture was observed in 102 of 182 patients, a prevalence of 56.0%. Rib fracture was the most common type of simultaneous fracture followed by rib with vertebral fracture. The BMD of the lumbar vertebra was significantly lower in patients with simultaneous fracture (p=0.044) and was identified as an independent risk factor (odds ratio: OR 0.05, 95% confidence interval: CI 0.01-0.57). The prevalence of simultaneous fracture was relatively high among patients with hip fracture, and BMD was significantly lower in patients with simultaneous fracture than in patients without it. Surgeons should be aware of the possibility of simultaneous fracture in patients with hip fracture. Copyright © 2016 Elsevier Ltd. All rights reserved.

External fixation of tibial pilon fractures and fracture healing.

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