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Sample records for surface capital femoral

  1. Slipped capital femoral epiphysis: A modern treatment protocol

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    Slavković Nemanja

    2009-01-01

    Full Text Available The treatment of a patient with slipped capital femoral epiphysis begins with an early diagnosis and accurate classification. On the basis of symptom duration, clinical findings and radiographs, slipped capital femoral epiphysis is classified as pre-slip, acute, acute-on-chronic and chronic. The long-term outcome of slipped capital femoral epiphysis is directly related to severity and the presence or absence of avascular necrosis and/or chondrolysis. Therefore, the first priority in the treatment of slipped capital femoral epiphysis is to avoid complications while securing the epiphysis from further slippage. Medical treatment of patients with acute and acute-on-chronic slipped capital femoral epiphysis, as well as those presented in pre-slip stage, is the safest, although time-consuming. Manipulations, especially forced and repeated, are not recommended due to higher avascular necrosis risk. The use of intraoperative fluoroscopy to assist in the placement of internal fixation devices has markedly increased the success of surgical treatment. Controversy remains as to whether the proximal femoral epiphysis in severe, chronic slipped capital femoral epiphysis should be realigned by extracapsular osteotomies or just fixed in situ. The management protocol for slipped capital femoral epiphysis depends on the experience of the surgeon, motivation of the patient and technical facilities.

  2. Valgus Slipped Capital Femoral Epiphysis in Patient with Hypopituitarism

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    Yoshihiro Kotoura

    2017-01-01

    Full Text Available Slipped capital femoral epiphysis (SCFE is a common disease of adolescent and the epiphysis is positioned more posteromedially in relation to the femoral neck shaft with varus SCFE; however, posterolateral displacement of the capital epiphysis, valgus SCFE, occurs less frequently. We report a case of valgus SCFE in a 17-year-old boy with hypopituitarism. After falling down, he experienced difficulty in walking. The radiographs were inconclusive; however three-dimensional computed tomography images showed lateral displacement of the epiphysis on the right femoral head. Valgus SCFE was diagnosed. The patient underwent in situ pinning of both sides. In situ pinning on the left side was performed as a prophylactic pinning because of endocrine abnormalities. At the 1-year follow-up, he could walk without any difficulty and there were no signs of pain. The epiphysis is commonly positioned more posteromedially in relation to the femoral neck shaft with most SCFE, but, in this case, the epiphysis slipped laterally. Differential diagnosis included femoral neck fracture (Delbet-Colonna type 1; however, this was less likely due to the absence of other clinical signs. Therefore, we diagnosed the patient as SCFE. When children complain of leg pain and limp, valgus SCFE that may not be visualized on anteroposterior radiographs needs to be considered.

  3. Slip of the capital femoral epiphysis: Revival of a method of assessment

    International Nuclear Information System (INIS)

    Billing, L.; Ekloef, O.

    1984-01-01

    A simple and exact method for evaluation of suspected or overt slip of the femoral capital epiphysis is revived. This procedure gives an estimate of all degrees of abnormality from the early stages to those with gross deformity. In our experience slip of the femoral capital epiphysis is always posterior and in approximately 80% of cases bilateral. Therefore, bot hips should be examined whenever this condition is suspected. The method provides for examination of each hip separately. Strict adherence to the procedure also provides a precise way of assessing the femoral anteversion angle, significant in many orthopedic disorders. For the latter purpose access to a particular nomogram is mandatory. (orig.)

  4. Delay in the Diagnosis of Stable Slipped Capital Femoral Epiphysis.

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    Hosseinzadeh, Pooya; Iwinski, Henry J; Salava, Jonathon; Oeffinger, Donna

    2017-01-01

    Delays in the diagnosis of stable slipped capital femoral epiphysis (SCFE) is common due to the vague symptomatology and the lack of awareness of this entity by healthcare providers. Delays in the diagnosis of this condition can lead to poor outcomes for the patients. This study was designed to identify factors that contributed to delays in the diagnosis or the treatment of patients with SCFE seen at our institution. A retrospective chart review of patients with the diagnosis of a stable SCFE who had undergone screw stabilization between 1989 and 2010 at our hospital was performed. For each patient, demographic data, the date of initial onset of symptoms, the date of the first visit to the medical provider, the type of provider seen initially (orthopaedic surgeon or not), the date of diagnosis of SCFE, the type of physician who made the diagnosis (orthopaedic surgeon or not), and the date of surgery were recorded. For each patient, the presenting symptom was recorded as hip, thigh, or knee pain. The effect of demographic data, presenting symptoms, and the type of initial provider seen on the delay to diagnosis was studied using 2 Cox models. A total of 149 patients with 196 stable SCFE were included. The average time from the first physician visit to diagnosis was 94 days in the group seen by a nonorthopaedic provider compared with an average of 2.9 days in the group seen by an orthopaedist (Pprovider versus 97% in the group seen by orthopaedic surgeons. It took significantly longer to be diagnosed with SCFE in patients who presented with initial knee pain (P=0.0097) compared with those who presented with hip pain at the initial visit. This study shows a significant delay in the diagnosis of SCFE in the United States, particularly in patients seen by nonorthopaedic providers initially. Level III-prognostic.

  5. Brodie abscess of the femoral capital epiphysis in a 2-year-old child caused byKingella kingae.

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    Hourston, George Jm; Kankam, Hadyn Kn; Mitchell, Piers D; Latimer, Mark David

    2017-04-20

    We report the case of a Brodie abscess of the femoral capital epiphysis from which Kingella kingae was isolated. This is to the best of our knowledge the first report of a Brodie abscess of the femoral capital epiphysis from which K. kingae was isolated. 2017 BMJ Publishing Group Ltd.

  6. Outcome of pinning in patients with slipped capital femoral epiphysis: risk factors associated with avascular necrosis, chondrolysis, and femoral impingement.

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    Ulici, Alexandru; Carp, Madalina; Tevanov, Iulia; Nahoi, Catalin Alexandru; Sterian, Alin Gabriel; Cosma, Dan

    2017-01-01

    Objective This study aimed to assess the principal risk factors that could lead to the most common long-term complications of slipped capital femoral epiphysis, such as avascular necrosis, chondrolysis, and hip impingement. Methods We conducted a single-centre, retrospective study and evaluated patients (70 patients, 81 hips) who were treated for slipped capital femoral epiphysis from 2010 to 2015 and who underwent pinning. We measured the severity of displacement radiologically using the Southwick angle. Postoperative radiographs were evaluated for the most frequent long-term complications of avascular necrosis (AVN), chondrolysis, and femoral acetabular impingement (FAI). Results We found seven cases of AVN, 14 cases of chondrolysis, and 31 hips had an α angle of 60°. Sex, ambulation, and symptoms did not affect development of these complications. Patients with a normal weight were almost two times more likely to develop FAI. Patients with moderate and severe slips had a similar percentage of AVN. In severe slips, 85.7% of patients had an α angle higher than 60°. Conclusions This study shows that severe slips have a higher risk of developing AVN and hip impingement. Every patient who suffers from SCFE (even the mildest forms) should be regularly checked for FAI.

  7. A Huge Capital Drop with Compression of Femoral Vessels Associated with Hip Osteoarthritis

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    Tomoya Takasago

    2015-01-01

    Full Text Available A capital drop is a type of osteophyte at the inferomedial portion of the femoral head commonly observed in hip osteoarthritis (OA, secondary to developmental dysplasia. Capital drop itself is typically asymptomatic; however, symptoms can appear secondary to impinge against the acetabulum or to irritation of the surrounding tissues, such as nerves, vessels, and tendons. We present here a case of unilateral leg edema in a patient with hip OA, caused by a huge bone mass occurring at the inferomedial portion of the femoral head that compressed the femoral vessels. We diagnosed this bone mass as a capital drop secondary to hip OA after confirming that the mass occurred at least after the age of 63 years based on a previous X-ray. We performed early resection and total hip arthroplasty since the patient’s hip pain was due to both advanced hip OA and compression of the femoral vessels; moreover, we aimed to prevent venous thrombosis secondary to vascular compression considering the advanced age and the potent risk of thrombosis in the patient. A large capital drop should be considered as a cause of vascular compression in cases of unilateral leg edema in OA patients.

  8. Transtrochanteric rotational osteotomy for avascular necrosis of the femoral head after unstable slipped capital femoral epiphysis: 10-year clinical results.

    Science.gov (United States)

    Nakashima, Yasuharu; Yamamoto, Takuaki; Fukushi, Jun-Ichi; Motomura, Goro; Hamai, Satoshi; Kohno, Yusuke; Iwamoto, Yukihide

    2016-11-01

    Avascular necrosis of the femoral head (AVN) is the most serious complication after unstable slipped capital femoral epiphysis (SCFE), and is often unsalvageable. We report a minimum 10 years of clinical results for transtrochanteric rotational osteotomy of the femoral head (TRO) for AVN. This study included 7 patients (7 hips) with a mean age at surgery of 13.3 years, and the follow-up period was 15.8 years. All patients had prior treatment via closed reduction and pinning of the unstable SCFE, and showed severely collapsed femoral heads. The direction of rotation was anterior in 3 hips and posterior in 4. The Merle d'Aubigné-Postel score (MDPS) was used for clinical assessment, and joint degeneration was assessed with the Kellgren and Lawrence classification (KL-grade). The spherical intact area of the femoral head was moved to the weight-bearing portion, and subluxation was corrected via rotation combined with intentional varus positioning. The mean MDPS improved from 10.3 points to 15.6 points at 5 years, and it was maintained at 15.0 points by 10 years; 3 hips were excellent, 1 was good, 2 were fair, and 1 showed poor outcomes. No patient experienced re-collapse after TRO or required conversion to hip replacement or arthrodesis. After 10 years, degenerative changes became evident over time, and 2 hips progressed to KL-4 with a decreased MDPS. Although some joint degeneration is inevitable in the long-term, TRO is an effective salvage procedure for treating AVN after unstable SCFE. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  9. Is Assessment of Femoral Head Perfusion During Modified Dunn for Unstable Slipped Capital Femoral Epiphysis an Accurate Indicator of Osteonecrosis?

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    Novais, Eduardo N; Sink, Ernest L; Kestel, Lauryn A; Carry, Patrick M; Abdo, João C M; Heare, Travis C

    2016-08-01

    The modified Dunn procedure, which is an open subcapital realignment through a surgical dislocation approach, has gained popularity for the treatment of unstable slipped capital femoral epiphysis (SCFE). Intraoperative monitoring of the femoral head perfusion has been recommended as a method of predicting osteonecrosis; however, the accuracy of this assessment has not been well documented. We asked (1) whether intraoperative assessment of femoral head perfusion would help identify hips at risk of developing osteonecrosis; (2) whether one of the four methods of assessment of femoral head perfusion is more accurate (highest area under the curve) at identifying hips at risk of osteonecrosis; and (3) whether specific clinical features would be associated with osteonecrosis occurrence after a modified Dunn procedure for unstable SCFE. Between 2007 and 2014, we performed 29 modified Dunn procedures for unstable SCFE (16 boys, 11 girls; median age, 13 years; range, 8-17 years); two were lost to followup before 1 year. During this period, six patients with unstable SCFE were treated by other procedures. All patients undergoing modified Dunn underwent assessment of epiphyseal perfusion by the presence of active bleeding and/or by intracranial pressure (ICP) monitoring. In the initial five patients perfusion was recorded once, either before dissection of the retinacular flap or after fixation by one of the two methods. In the remaining 22 patients (81%), perfusion was systematically assessed before dissection of the retinacular flap and after fixation by both methods. Minimum followup was 1 year (median, 2.5 years; range, 1-8 years) because osteonecrosis typically develops within the first year after surgery. Patients were assessed for osteonecrosis by the presence of femoral head collapse at radiographs obtained every 3 months during the first year after surgery. Seven (26%) of the 27 patients developed osteonecrosis. Measures of diagnostic accuracy including sensitivity

  10. In situ fixation of slipped capital femoral epiphysis with Steinmann pins.

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    Lehmann, Trude G; Engesæter, Ingvild Ø; Laborie, Lene B; Rosendahl, Karen; Lie, Stein Atle; Engesæter, Lars B

    2011-06-01

    Slipped capital femoral epiphysis (SCFE) is often treated by surgical fixation; however, no agreement exists regarding technique. We analyzed the outcome of in situ fixation with Steinmann pins. All 67 subjects operated for slipped capital femoral epiphysis at Haukeland University Hospital during the period 1990-2007 were included. All were treated by in situ fixation with 2 or 3 parallel Steinmann pins (8 mm threads at the medial end). The follow-up evaluation consisted of clinical examination and hip radiographs. Radiographic outcome was based on measurements of slip progression, growth of the femoral neck, leg length discrepancy, and signs of avascular necrosis and chondrolysis. 67 subjects (41 males) were operated due to unilateral slips (n = 47) or bilateral slips (n = 20). Mean age at time of diagnosis was 13 (7.2-16) years. Mean age at follow-up was 19 (14-30) years, with a mean postoperative interval of 6.0 (2-16) years. The operated femoral neck was 9% longer at skeletal maturity than at surgery, indicating continued growth of the femoral neck. At skeletal maturity, 12 subjects had radiographic features suggestive of a previous asymptomatic slip of the contralateral hip. The total number of bilateral cases of SCFE was 32, i.e half of the children had bilateral SCFE. 3 subjects required additional surgery and mild avascular necrosis of the femoral head was seen in 1 patient. None had slip progression or chondrolysis. In situ pinning of SCFE with partly threaded Steinmann pins appears to be a feasible and safe method, with few complications. The technique allows further growth of the femoral neck.

  11. Early micromovement of the Articular Surface Replacement (ASR) femoral component

    DEFF Research Database (Denmark)

    Penny, J O; Ding, M; Varmarken, J E

    2012-01-01

    Radiostereometric analysis (RSA) can detect early micromovement in unstable implant designs which are likely subsequently to have a high failure rate. In 2010, the Articular Surface Replacement (ASR) was withdrawn because of a high failure rate. In 19 ASR femoral components, the mean micromovement...

  12. Evaluation of femoral head vascularization in slipped capital femoral epiphysis before and after cannulated screw fixation with use of contrast-enhanced MRI: initial results

    International Nuclear Information System (INIS)

    Staatz, G.; Honnef, D.; Hohl, C.; Schmidt, T.; Guenther, R.W.; Kochs, A.; Roehrig, H.

    2007-01-01

    In this study we used contrast-enhanced magnetic resonance imaging (MRI) to evaluate the vascularization of the femoral head in children with slipped capital femoral epiphysis (SCFE) before and after cannulated screw fixation. Eleven consecutive children with SCFE, seven boys and four girls, aged 10-15 years were included in the study. There were no preslips; four children had acute, three acute-on-chronic, and four chronic SCFE. The MRI examinations were performed in a 1.5 Tesla MR scanner with use of a coronal STIR sequence, a coronal contrast-enhanced T1-weighted spin-echo sequence, and a sagittal three-dimensional gradient-echo sequence. Morphology, signal intensities, and contrast-enhancement of the femoral head were assessed by two radiologists in consensus. Morphologic distortion of the physis, bone marrow edema within the metaphysis and epiphysis, and joint effusion were the preoperative MRI findings of SCFE in each child. In nine children, the vascularization of the femoral head before and after surgery was normal. In one child, a preoperative avascular zone in the superolateral aspect of the epiphysis revascularized completely after surgery. One child with severe SCFE developed avascular necrosis of the femoral head after open reduction of the slip. We conclude that MRI allows for accurate evaluation of the femoral head vascularization before and after surgery in children with SCFE. (orig.)

  13. Evaluation of femoral head vascularization in slipped capital femoral epiphysis before and after cannulated screw fixation with use of contrast-enhanced MRI: initial results

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    Staatz, G. [Friedrich-Alexander-University Erlangen-Nuernberg, Department of Radiology, Division of Pediatric Radiology, Erlangen (Germany); University Hospital of the RWTH Aachen, Department of Diagnostic Radiology, Aachen (Germany); Honnef, D.; Hohl, C.; Schmidt, T.; Guenther, R.W. [University Hospital of the RWTH Aachen, Department of Diagnostic Radiology, Aachen (Germany); Kochs, A.; Roehrig, H. [University Hospital of the RWTH Aachen, Department of Orthopaedic Surgery, Aachen (Germany)

    2007-01-15

    In this study we used contrast-enhanced magnetic resonance imaging (MRI) to evaluate the vascularization of the femoral head in children with slipped capital femoral epiphysis (SCFE) before and after cannulated screw fixation. Eleven consecutive children with SCFE, seven boys and four girls, aged 10-15 years were included in the study. There were no preslips; four children had acute, three acute-on-chronic, and four chronic SCFE. The MRI examinations were performed in a 1.5 Tesla MR scanner with use of a coronal STIR sequence, a coronal contrast-enhanced T1-weighted spin-echo sequence, and a sagittal three-dimensional gradient-echo sequence. Morphology, signal intensities, and contrast-enhancement of the femoral head were assessed by two radiologists in consensus. Morphologic distortion of the physis, bone marrow edema within the metaphysis and epiphysis, and joint effusion were the preoperative MRI findings of SCFE in each child. In nine children, the vascularization of the femoral head before and after surgery was normal. In one child, a preoperative avascular zone in the superolateral aspect of the epiphysis revascularized completely after surgery. One child with severe SCFE developed avascular necrosis of the femoral head after open reduction of the slip. We conclude that MRI allows for accurate evaluation of the femoral head vascularization before and after surgery in children with SCFE. (orig.)

  14. Slipped Capital Femoral Epiphysis as a Complication of Growth Hormone Therapy

    Directory of Open Access Journals (Sweden)

    Shuo-Yu Wang

    2007-01-01

    Full Text Available Slipped capital femoral epiphysis (SCFE is a rare complication of growth hormone (GH therapy. Here, we report three patients who developed SCFE during GH therapy. The first two patients had hypopituitarism and had started GH therapy at the age of 15 years 6 months and 13 years 9 months, respectively. SCFE developed 4 years and 1 year after GH therapy, respectively. The third patient had Prader-Willi syndrome with obesity and hypogonadism and began GH therapy at the age of 12 years and 11 months. SCFE developed 2 months after starting GH therapy. Pain over the hip joints or over the knees is an early sign of SCFE. Despite recommendation, none of the three patients continued GH therapy. A high index of suspicion during GH therapy in patients at high risk of SCFE is important for early diagnosis and appropriate management. [J Formos Med Assoc 2007;106(2 Suppl:S46-S50

  15. Bone disease in African children with slipped capital femoral epiphysis: histomorphometry of iliac crest biopsies.

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    Schnitzler, C M; Daniels, E D; Mesquita, J M; Moodley, G P; Zachen, D; Cakic, J; Pettifor, J M

    1998-03-01

    African teenagers with slipped capital femoral epiphysis (SCFE) not infrequently also have genu valgum (knock-knee). Because we had previously demonstrated metabolic bone disease attributable to dietary calcium deficiency in black teenagers with genu valgum, we examined 29 black teenagers (15 male, 14 female) with SCFE for metabolic bone disease. Each patient had an iliac crest bone biopsy taken (after double tetracycline labeling) for routine histomorphometry, and blood and urine samples for bone biochemistry. Spinal bone mineral density was measured in 13 patients. Compared to reported data, we found our patients to be sexually more immature, older, at least as obese, and to have more severe and more frequently bilateral hip disease. Eighty percent of the children took dairy products only once or twice a week or less frequently, and 37.9% had genu valgum. Compared with race- and age-matched South Africans, bone biopsies in our patients showed lower bone volume (BV/TV, p = 0.0003), wall thickness (p = 0.0002), and trabecular thickness (Tb.Th, p = 0.0002), and a tendency to greater trabecular spacing (Tb.Sp, p = 0.053). Lower osteoid volume (OV/BV, p = 0.0001), osteoid surface (OS/BS, p = 0.0001), osteoid thickness (O.Th, p = 0.0002), double labeled surface (dLS/BS, p = 0.029), and bone formation rate (BFR/BS, p = 0.037) suggested poorer bone forming capacity in our patients. No evidence of hyperparathyroid bone disease or osteomalacia was found. BV/TV was below the reference range (14.2%) in 65.5% of cases; these patients had lower values for Tb.Th (p = 0.037) and Tb.N (p = 0.0003), greater Tb.Sp (p = 0.0002), a tendency to lower adjusted apposition rate (Aj.AR, p = 0.057), and had had less frequent intake of dairy products than those with normal BV/TV (p = 0.024). Furthermore, months since menarche correlated with histomorphometric variables BV/TV (r = 0.667, p = 0.009), Tb.Th (r = 0.745, p = 0.002), Tb.Sp (r = -0.549, p = 0.042), O.Th (r = 0.784, p = 0

  16. Magnetic resonance imaging at primary diagnosis cannot predict subsequent contralateral slip in slipped capital femoral epiphysis

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    Wensaas, Anders [Akershus University Hospital, Department of Orthopaedic Surgery, Loerenskog (Norway); Wiig, Ola; Terjesen, Terje [Oslo University Hospital, Department of Orthopaedic Surgery, Rikshospitalet (Norway); Castberg Hellund, Johan; Khoshnewiszadeh, Behzad [Oslo University Hospital, Department of Radiology and Nuclear Medicine, Ullevaal (Norway)

    2017-12-15

    Prophylactic fixation of the contralateral hip in slipped capital femoral epiphysis (SCFE) is controversial, and no reliable method has been established to predict subsequent contralateral slip. The main purpose of this study was to evaluate if magnetic resonance imaging (MRI) performed at primary diagnosis could predict future contralateral slip. Twenty-two patients with unilateral SCFE were included, all had MRI of both hips taken before operative fixation. Six different parameters were measured on the MRI: the MRI slip angle, the greatest focal widening of the physis, the global widening of the physis measured at three locations (the midpoint of the physis and 1 cm lateral and medial to the midpoint), periphyseal (epiphyseal and metaphyseal) bone marrow edema, the presence of pathological joint effusion, and the amount of joint effusion measured from the lateral edge of the greater trochanter. Mean follow-up was 33 months (range, 16-63 months). Six patients were treated for contralateral slip during the follow-up time and a comparison of the MRI parameters of the contralateral hip in these six patients and in the 16 patients that remained unilateral was done to see if subsequent contralateral slip was possible to predict at primary diagnosis. All MRI parameters were significantly altered in hips with established SCFE compared with the contralateral hips. However, none of the MRI parameters showed any significant difference between patients who had a subsequent contralateral slip and those that remained unilateral. MRI taken at primary diagnosis could not predict future contralateral slip. (orig.)

  17. The role of pre-treatment MRI in established cases of slipped capital femoral epiphysis

    International Nuclear Information System (INIS)

    Tins, Bernhard; Cassar-Pullicino, Victor; McCall, Iain

    2009-01-01

    Background: Slipped capital femoral epiphysis (SCFE) often results in functional impairment and premature osteoarthritis despite surgical treatment. Treatment decisions are commonly based on the clinical history and radiographic appearance. This study assesses the pre-treatment features of SCFE and correlates them to the clinical history to: (1) define the underlying pathological mechanisms; (2) correlate the morphological hip abnormalities with the clinical classifications; (3) identify specific magnetic resonance imaging (MRI) features that could carry prognostic implications for treatment approach and outcome. Methods: Clinical history and pre- and posttreatment radiographs and pre-treatment MRIs of 14 patients with 15 affected hips were reviewed. Alignment, impingement, fulcrum formation, remodelling, osteopenia, synovitis, joint effusion, bone marrow and soft tissue oedema and status of the physis and the periosteal sleeve were assessed and related to the clinical history, in particular history of trauma, duration of clinical symptoms and ability to bear weight. Results: Bone marrow oedema around the growth plate and joint effusion occurred in all patients. Synovitis occurred in 13/15 patients. 6 patients had a fall before presenting with SCFE. 5/6 had periarticular soft tissue oedema, complete disruption of the physis and partial periosteal sleeve disruption. 9 patients had no fall prior to presentation, physis and periost were intact in 7/9; periarticular oedema was not seen. 14/15 showed evidence of chronic remodelling. Despite an acute clinical history remodelling was present. A fulcrum-like alignment, impingement of the epiphysis on the metaphysis with a small area of physical contact, was seen in 8 patients, 6/8 had a prior fall. There was no case of avascular necrosis. Spontaneous reduction of SCFE occurred in 1 case, the only case without chronic remodelling. With MRI as gold standard radiographs underestimate the severity of SCFE. Conclusion

  18. The role of pre-treatment MRI in established cases of slipped capital femoral epiphysis

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    Tins, Bernhard [Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, Shropshire SY 10 7 AG (United Kingdom)], E-mail: Bernhard.Tins@rjah.nhs.uk; Cassar-Pullicino, Victor; McCall, Iain [Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, Shropshire SY 10 7 AG (United Kingdom)

    2009-06-15

    Background: Slipped capital femoral epiphysis (SCFE) often results in functional impairment and premature osteoarthritis despite surgical treatment. Treatment decisions are commonly based on the clinical history and radiographic appearance. This study assesses the pre-treatment features of SCFE and correlates them to the clinical history to: (1) define the underlying pathological mechanisms; (2) correlate the morphological hip abnormalities with the clinical classifications; (3) identify specific magnetic resonance imaging (MRI) features that could carry prognostic implications for treatment approach and outcome. Methods: Clinical history and pre- and posttreatment radiographs and pre-treatment MRIs of 14 patients with 15 affected hips were reviewed. Alignment, impingement, fulcrum formation, remodelling, osteopenia, synovitis, joint effusion, bone marrow and soft tissue oedema and status of the physis and the periosteal sleeve were assessed and related to the clinical history, in particular history of trauma, duration of clinical symptoms and ability to bear weight. Results: Bone marrow oedema around the growth plate and joint effusion occurred in all patients. Synovitis occurred in 13/15 patients. 6 patients had a fall before presenting with SCFE. 5/6 had periarticular soft tissue oedema, complete disruption of the physis and partial periosteal sleeve disruption. 9 patients had no fall prior to presentation, physis and periost were intact in 7/9; periarticular oedema was not seen. 14/15 showed evidence of chronic remodelling. Despite an acute clinical history remodelling was present. A fulcrum-like alignment, impingement of the epiphysis on the metaphysis with a small area of physical contact, was seen in 8 patients, 6/8 had a prior fall. There was no case of avascular necrosis. Spontaneous reduction of SCFE occurred in 1 case, the only case without chronic remodelling. With MRI as gold standard radiographs underestimate the severity of SCFE. Conclusion

  19. Surface crystalline phases and nanoindentation hardness of explanted zirconia femoral heads.

    Science.gov (United States)

    Catledge, Shane A; Cook, Monique; Vohra, Yogesh K; Santos, Erick M; McClenny, Michelle D; David Moore, K

    2003-10-01

    One new and nine explanted zirconia femoral heads were studied using glancing angle X-ray diffraction, scanning electron microscopy, and nanoindentation hardness techniques. All starting zirconia implants consisted only of tetragonal zirconia polycrystals (TZP). For comparison, one explanted alumina femoral head was also studied. Evidence for a surface tetragonal-to-monoclinic zirconia phase transformation was observed in some implants, the extent of which was varied for different in-service conditions. A strong correlation was found between increasing transformation to the monoclinic phase and decreasing surface hardness. Microscopic investigations of some of the explanted femoral heads revealed ultra high molecular weight polyethylene and metallic transfer wear debris.

  20. Histomorphometric analysis of the osseointegration of four different implant surfaces in the femoral epiphyses of rabbits.

    NARCIS (Netherlands)

    Guehennec, L. Le; Goyenvalle, E.; Lopez, M.A.; Weiss, P.; Amouriq, Y.; Layrolle, P.

    2008-01-01

    OBJECTIVES: The surface properties of titanium dental implants are key parameters for rapid and intimate bone-implant contact. The osseointegration of four implant surfaces was studied in the femoral epiphyses of rabbits. MATERIAL AND METHODS: Titanium implants were either grit-blasted with alumina

  1. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), after slipped capital femoral epiphysis

    International Nuclear Information System (INIS)

    Zilkens, Christoph; Miese, Falk; Bittersohl, Bernd; Jaeger, Marcus; Schultz, Johannes; Holstein, Arne; Kim, Young-jo; Millis, Michael B.; Mamisch, Tallal C.; Krauspe, Ruediger

    2011-01-01

    Objective: The aim of this study was to assess the glycosaminoglycan (GAG) content in hip joint cartilage in mature hips with a history of slipped capital femoral epiphysis (SCFE) using delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). Methods: 28 young-adult subjects (32 hips) with a mean age of 23.8 ± 4.0 years (range: 18.1-30.5 years) who were treated for mild or moderate SCFE in adolescence were included into the study. Hip function and clinical symptoms were evaluated with the Harris hip score (HHS) system at the time of MRI. Plain radiographic evaluation included Tonnis grading, measurement of the minimal joint space width (JSW) and alpha-angle measurement. The alpha-angle values were used to classify three sub-groups: group 1 = subjects with normal femoral head-neck offset (alpha-angle o ), group 2 = subjects with mild offset decrease (alpha-angle 50 o -60 o ), and group 3 = subjects with severe offset decrease (alpha-angle >60 o ). Results: There was statistically significant difference noted for the T1 Gd values, lateral and central, between group 1 and group 3 (p-values = 0.038 and 0.041). The T1 Gd values measured within the lateral portion were slightly lower compared with the T1 Gd values measured within the central portion that was at a statistically significance level (p-value <0.001). HHS, Tonnis grades and JSW revealed no statistically significant difference. Conclusion: By using dGEMRIC in the mid-term follow-up of SCFE we were able to reveal degenerative changes even in the absence of joint space narrowing that seem to be related to the degree of offset pathology. The dGEMRIC technique may be a potential diagnostic modality in the follow-up evaluation of SCFE.

  2. Delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC), after slipped capital femoral epiphysis

    Energy Technology Data Exchange (ETDEWEB)

    Zilkens, Christoph, E-mail: Christoph.Zilkens@med.uni-duesseldorf.de [Department of Orthopaedics, Heinrich-Heine University Medical School, Moorenstrasse 5, 40225 Duesseldorf (Germany); Miese, Falk [Department of Radiology, Heinrich-Heine University Medical School, Moorenstrasse 5, 40225 Duesseldorf (Germany); Bittersohl, Bernd; Jaeger, Marcus; Schultz, Johannes [Department of Orthopaedics, Heinrich-Heine University Medical School, Moorenstrasse 5, 40225 Duesseldorf (Germany); Holstein, Arne [Department of Radiology, Heinrich-Heine University Medical School, Moorenstrasse 5, 40225 Duesseldorf (Germany); Kim, Young-jo; Millis, Michael B. [Department of Orthopaedic Surgery, Childrens Hospital Boston, Harvard Medical, School, 300 Longwood Avenue, Boston, MA 02115 (United States); Mamisch, Tallal C. [Department of Orthopaedic Surgery, Inselspital Bern, University Hospital, Bern (Switzerland); Krauspe, Ruediger [Department of Orthopaedics, Heinrich-Heine University Medical School, Moorenstrasse 5, 40225 Duesseldorf (Germany)

    2011-09-15

    Objective: The aim of this study was to assess the glycosaminoglycan (GAG) content in hip joint cartilage in mature hips with a history of slipped capital femoral epiphysis (SCFE) using delayed gadolinium-enhanced MRI of cartilage (dGEMRIC). Methods: 28 young-adult subjects (32 hips) with a mean age of 23.8 {+-} 4.0 years (range: 18.1-30.5 years) who were treated for mild or moderate SCFE in adolescence were included into the study. Hip function and clinical symptoms were evaluated with the Harris hip score (HHS) system at the time of MRI. Plain radiographic evaluation included Tonnis grading, measurement of the minimal joint space width (JSW) and alpha-angle measurement. The alpha-angle values were used to classify three sub-groups: group 1 = subjects with normal femoral head-neck offset (alpha-angle <50{sup o}), group 2 = subjects with mild offset decrease (alpha-angle 50{sup o}-60{sup o}), and group 3 = subjects with severe offset decrease (alpha-angle >60{sup o}). Results: There was statistically significant difference noted for the T1{sub Gd} values, lateral and central, between group 1 and group 3 (p-values = 0.038 and 0.041). The T1{sub Gd} values measured within the lateral portion were slightly lower compared with the T1{sub Gd} values measured within the central portion that was at a statistically significance level (p-value <0.001). HHS, Tonnis grades and JSW revealed no statistically significant difference. Conclusion: By using dGEMRIC in the mid-term follow-up of SCFE we were able to reveal degenerative changes even in the absence of joint space narrowing that seem to be related to the degree of offset pathology. The dGEMRIC technique may be a potential diagnostic modality in the follow-up evaluation of SCFE.

  3. Slipped upper femoral epiphysis: Outcome after in situ fixation and capital realignment technique

    Directory of Open Access Journals (Sweden)

    Sanjay Arora

    2013-01-01

    Results: Clinical outcome as assessed by Merle d′ Aubigne score was excellent in 6, good in 10, fair in 6 and poor in 1. Half of the in situ fixation patients underwent osteoplasty procedure for femoroacetabular impingement and 5 more were symptomatic. The head neck offset and α angle after in situ pinning were -1.12 ± 3 mm and 66.05 ± 9.7°, respectively and this improved to 8.7 mm and 49°, respectively, after osteoplasty. One child in the pinning group had chondrolysis. Eight patients with severe slip underwent capital realignment. Mean followup was 20.15 months. The anterior head neck offset and α angle were corrected to 6.8 ± 1.72 mm and 44.6 ± 7.0° mm, respectively. Two children with unstable slip in the capital realignment group had avascular necrosis which was diagnosed at presentation by bone scan. Conclusion: High BMI, vitamin D deficiency and endocrine disorders are associated with SUFE in India and should be evaluated as some of these are amenable to prevention and treatment. Most patients treated with in situ pinning developed femoroacetabular impingement. The early results after capital realignment procedure are encouraging and help to avoid a second procedure which is needed in a majority of patients who underwent in situ pinning.

  4. Early diagnosis of slipped capital femoral epiphysis on magnetic resonance imaging: A case report with review of literature

    Directory of Open Access Journals (Sweden)

    Sanjay M Khaladkar

    2015-01-01

    Full Text Available Slipped capital femoral epiphysis (SCFE is a common hip condition occurring in adolescents, with a prevalence of 10 cases per 100,000 children. It usually affects younger age group from 10 to 17 years. The condition is usually found to be coexistent with various other conditions such as obesity, growth surges, and endocrine disorders such as hypothyroidism, growth hormone supplementation, hypogonadism, and pan-hypopituitarism. Patients present with limping and a poorly localized pain in the hip, groin, thigh, or knee. Diagnosis of the condition is often delayed due to its nonassociation with trauma and hence increases the chances of developing various complications such as avascular necrosis, chondrolysis and deformity. Majority of researches of SCFE are from Europe and North America, while studies in Asian populations are rare. Delay in diagnosis of SCFE is usually due to patients presenting with knee pain. Imaging can thus aid in early diagnosis and appropriate treatment of the disease, which in turn reduces incidence of deformity and disability in the affected children. Bilateral hip radiography - anteroposterior and frog′s-leg lateral views and magnetic resonance imaging (MRI are the radiological techniques that help in early diagnosis. MRI detects early physeal changes of both preslip and SCFE even when radiographs and computed tomography are normal. MRI should be routinely used to diagnose early SCFE in preslip stage to avoid further complications.

  5. Is the timing of surgery associated with avascular necrosis after unstable slipped capital femoral epiphysis? A multicenter study.

    Science.gov (United States)

    Kohno, Yusuke; Nakashima, Yasuharu; Kitano, Toshio; Irie, Taichi; Kita, Atsushi; Nakamura, Tomoyuki; Endo, Hirosuke; Fujii, Yosuke; Kuroda, Takayuki; Mitani, Shigeru; Kitoh, Hiroshi; Matsushita, Masaki; Hattori, Tadashi; Iwata, Koji; Iwamoto, Yukihide

    2017-01-01

    An unstable slipped capital femoral epiphysis (SCFE) is associated with a high rate of avascular necrosis (AVN). The etiology of AVN seems to be multifactorial, although it is not thoroughly known. The aims of our study were to determine the rate of AVN after an unstable SCFE and to investigate the risk factors for AVN, specifically evaluating the notion of an "unsafe window", during which medical interventions would increase the risk for AVN. This retrospective multicenter study included 60 patients with an unstable SCFE diagnosed between 1985 and 2014. Timing of surgery was evaluated for three time periods, from acute onset of symptoms to surgery: period I, 7 days. Multivariate logistic regression analysis was used to identify risk factors for AVN. Closed reduction and pinning was performed in 43 patients and in situ pinning in 17. Among these cases, 16 patients (27%) developed AVN. The rate of AVN was significantly higher in patients treated by closed reduction and pinning (15/43, 35%) than in those treated by in situ pinning (1/17, 5.9%) (p = 0.022). In patients treated by closed reduction and pinning, the incidence of AVN was 2/11 (18%) in period I, 10/13 (77%) in period II and 3/15 (20%) in period III, showing the significantly higher rate in period II (p = 0.002). The surgery provided in period II was identified as an independent risk factor for the development of AVN. Our rate of AVN was 27% using two classical treatment methods. Time-to-surgery, between 24 h and 7 days, was independently associated with AVN, supporting the possible existence of an "unsafe window" in patients with unstable SCFE treated by closed reduction and pinning. Copyright © 2016 The Japanese Orthopaedic Association. Published by Elsevier B.V. All rights reserved.

  6. Slipped Capital Femoral Epiphysis

    Science.gov (United States)

    ... SCFE? The most serious complications of SCFE are avascular necrosis (a lack of blood flow to the bone) and chondrolysis (decay of cartilage). Avascular necrosis is more common in patients who have unstable ...

  7. The effect of surface morphology on the primary fixation strength of uncemented femoral knee prosthesis: a cadaveric study

    NARCIS (Netherlands)

    Berahmani, S.; Janssen, D.W.; Wolfson, D.; Rivard, K.; Waal Malefijt, M.C. de; Verdonschot, N.J.

    2015-01-01

    We investigated the effect of surface morphology on the mechanical performance of uncemented femoral knee prosthesis. Eighteen implants were implanted on nine paired femurs and then pushed-off (left legs: a novel surface morphology; right legs: Porocoat as baseline). Bone mineral density (BMD) and

  8. Hip shape and long-term hip function: a study of patients with in-situ fixation for slipped capital femoral epiphysis.

    Science.gov (United States)

    Wall, Peter D H; Brown, Jamie S; Freshney, Sara; Parsons, Helen; Griffin, Damian R

    2013-01-01

    Slipped capital femoral epiphysis (SCFE) is a rare adolescent hip disease that leads to a hip shape abnormality. Typical treatment involves in-situ fixation. It is not known if the degree of initial hip shape abnormality associated with SCFE has a significant effect on long-term hip function. A cohort of patients aged 18-50 who had undergone in-situ fixation for SCFE from 1970 onwards in our institution provided IHOT-33 (hip function) outcome data. Frog lateral radiographs from the time of surgery were used to measure radiological hip shape using both Southwick angle and alpha angle. There were 38 patients (46 hips) SCFE patients who met the eligibility criteria. We obtained follow-up data for 32 patients (38 hips), 83% follow-up. Ten patients (20 hips) had bilateral SCFE. The mean follow-up was 12.7 years (95% CI 10.7-14.7). 32 patients matched for age and sex who had no history of SCFE provided control IHOT-33 outcome data. There was a significant difference (p0.05) correlation between long-term hip function and Southwick angle or lateral alpha angle. The initial severity of hip shape abnormality due to SCFE was not a strong predictor of long-term hip function. Other extraneous factors not related to hip shape may have an equally if not more important role to play in the subsequent long-term outcome of SCFE.

  9. How does the femoral cortex depend on bone shape? A methodology for the joint analysis of surface texture and shape.

    Science.gov (United States)

    Gee, A H; Treece, G M; Poole, K E S

    2018-04-01

    In humans, there is clear evidence of an association between hip fracture risk and femoral neck bone mineral density, and some evidence of an association between fracture risk and the shape of the proximal femur. Here, we investigate whether the femoral cortex plays a role in these associations: do particular morphologies predispose to weaker cortices? To answer this question, we used cortical bone mapping to measure the distribution of cortical mass surface density (CMSD, mg/cm 2 ) in a cohort of 125 females. Principal component analysis of the femoral surfaces identified three modes of shape variation accounting for 65% of the population variance. We then used statistical parametric mapping (SPM) to locate regions of the cortex where CMSD depends on shape, allowing for age. Our principal findings were increased CMSD with increased gracility over much of the proximal femur; and decreased CMSD at the superior femoral neck, coupled with increased CMSD at the calcar femorale, with increasing neck-shaft angle. In obtaining these results, we studied the role of spatial normalization in SPM, identifying systematic misregistration as a major impediment to the joint analysis of CMSD and shape. Through a series of experiments on synthetic data, we evaluated a number of registration methods for spatial normalization, concluding that only those predicated on an explicit set of homologous landmarks are suitable for this kind of analysis. The emergent methodology amounts to an extension of Geometric Morphometric Image Analysis to the domain of textured surfaces, alongside a protocol for labelling homologous landmarks in clinical CT scans of the human proximal femur. Copyright © 2018 The Author(s). Published by Elsevier B.V. All rights reserved.

  10. Comparison of wear of ultra-high molecular weight polyethylene acetabular cups against surface-engineered femoral heads.

    Science.gov (United States)

    Galvin, A; Brockett, C; Williams, S; Hatto, P; Burton, A; Isaac, G; Stone, M; Ingham, E; Fisher, J

    2008-10-01

    Alumina ceramic heads have been previously shown to reduce polyethylene wear in comparison to cobalt chrome (CoCr) heads in artificial hip joints. However, there are concerns about the brittle nature of ceramics. It is therefore of interest to investigate ceramic-like coatings on metallic heads. The aim of this study was to compare the friction and wear of ultra-high molecular weight polyethylene (UHMWPE) against alumina ceramic, CoCr, and surface-engineered ceramic-like coatings in a friction simulator and a hip joint simulator. All femoral heads tested were 28 mm diameter and included: Biolox Forte alumina, CoCr, arc evaporative physical vapour deposition (AEPVD) chromium nitride (CrN) coated CoCr, plasma-assisted chemical vapour deposition (PACVD) amorphous diamond-like carbon (aDLC) coated CoCr, sputter CrN coated CoCr, reactive gas controlled arc (RGCA) AEPVD titanium nitride (TiN) coated CoCr, and Graphit-iC coated CoCr. These were articulated against UHMWPE acetabular cups in a friction simulator and a hip joint simulator. Alumina and CoCr gave the lowest wear volumes whereas the sputter coated CrN gave the highest. Alumina also had the lowest friction factor. There was an association between surface parameters and wear. This study indicates that surface topography of surface-engineered femoral heads is more important than friction and wettability in controlling UHMWPE wear.

  11. Experimental survey on percutaneous injection of calcium phosphate cement in preventing the articular surface collapsing secondary to avascular necrosis of femoral head

    International Nuclear Information System (INIS)

    Hou Changlong; Lv Weifu; Zhang Xuebin; Wang Weiyu; Zhang Xingming

    2007-01-01

    Objective: To study the technical way for animal model of ANFH with TAE (transcatheter arterial embolization)and to observe the image and pathologic changes of percutaneous injection with CPC (Calcium Phosphate Cement)in preventing the articular surface collapsing secondary to ANFH (avascular necrosis of femoral head)in pigs and its feasibility and safety. Methods: Branch arteries of the pig's left femoral head were embolized with woolly threads. Twenty pigs were randomly divided into A and B groups, and after about 1 month changes were assessed by imagings. Group A(n=8)was served as control of model contrast group, with only TAE and then surveyed the avascular necrosis features of femoral head by imaging together with pathologic and histologic examinations. Group B (n=12) was designated as percutaneous injection with CPC for interventional treatment group of ANFH at the stage Ficat II. Results: The animal models of ANFH in early stage were established by embolization of feeding arteries. In Group A, bone collapse occurred in 1.5 months after TAE, with imaging features of femoral head necrosis aggravated gradually. In group B, technical success of percutaneous injection with CPC was high and technical criteria included precise injection time, vigorous percutaneous fixing of bone, suitable proportion of CPC powder to liquid. CT scan of femoral head with injection CPC showed that it diffused well. Volume of bone trabecula (TBV)and percentage of bone lacuna (PBL)at unit area under microscopy were also inspected in two groups. TBV and PBL of two groups were compared in different special times and calculated especially for group B (P<0.05). Conclusion: The percutaneous injection of CPC to femoral head is a quite safe and effective palliative therapy for ANFH in early stage. (authors)

  12. Subchondral bone density distribution in the human femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Wright, David A.; Meguid, Michael; Lubovsky, Omri; Whyne, Cari M. [Sunnybrook Research Institute, Orthopaedic Biomechanics Laboratory, Toronto, Ontario (Canada)

    2012-06-15

    This study aims to quantitatively characterize the distribution of subchondral bone density across the human femoral head using a computed tomography derived measurement of bone density and a common reference coordinate system. Femoral head surfaces were created bilaterally for 30 patients (14 males, 16 females, mean age 67.2 years) through semi-automatic segmentation of reconstructed CT data and used to map bone density, by shrinking them into the subchondral bone and averaging the greyscale values (linearly related to bone density) within 5 mm of the articular surface. Density maps were then oriented with the center of the head at the origin, the femoral mechanical axis (FMA) aligned with the vertical, and the posterior condylar axis (PCA) aligned with the horizontal. Twelve regions were created by dividing the density maps into three concentric rings at increments of 30 from the horizontal, then splitting into four quadrants along the anterior-posterior and medial-lateral axes. Mean values for each region were compared using repeated measures ANOVA and a Bonferroni post hoc test, and side-to-side correlations were analyzed using a Pearson's correlation. The regions representing the medial side of the femoral head's superior portion were found to have significantly higher densities compared to other regions (p < 0.05). Significant side-to-side correlations were found for all regions (r {sup 2} = 0.81 to r {sup 2} = 0.16), with strong correlations for the highest density regions. Side-to-side differences in measured bone density were seen for two regions in the anterio-lateral portion of the femoral head (p < 0.05). The high correlation found between the left and right sides indicates that this tool may be useful for understanding 'normal' density patterns in hips affected by unilateral pathologies such as avascular necrosis, fracture, developmental dysplasia of the hip, Perthes disease, and slipped capital femoral head epiphysis. (orig.)

  13. Surface Roughness of CoCr and ZrO2 Femoral Heads with Metal Transfer: A Retrieval and Wear Simulator Study

    Directory of Open Access Journals (Sweden)

    Alan W. Eberhardt

    2009-01-01

    Full Text Available Metal transfer to femoral heads may result from impingement against the metallic acetabular shell following subluxation/dislocation, or when metallic debris enters the articulation zone. Such transfers roughen the head surface, increasing polyethylene wear in total hip replacements. Presently, we examined the surface roughness of retrieved femoral heads with metallic transfer. Profilometry revealed roughness averages in regions of metal transfer averaging 0.380 m for CoCr and 0.294 m for ZrO2 which were one order of magnitude higher than those from non-implanted controls. Scanning electron microscopy (SEM revealed adherent transfers on these retrievals, with titanium presence confirmed by electron dispersive spectroscopy. Due to the concern for increased wear, metal transfer was induced on non-implanted heads, which were then articulated against flat polyethylene discs in multidirectional sliding wear tests. Increased polyethylene wear was associated with these specimens as compared to unaltered controls. SEM imaging provided visual evidence that the transfers remained adherent following the wear tests. Pre- and post-test roughness averages exceeded 1 m for both the CoCr and ZrO2 heads. Overall, these results suggest that metal transfer increases the surface roughness of CoCr and ZrO2 femoral heads and that the transfers may remain adherent following articulation against polyethylene, leading to increased polyethylene wear.

  14. Radiographic femoral varus measurement is affected unpredictably by femoral rotation

    DEFF Research Database (Denmark)

    Miles, James Edward

    and externally by 5° and 10° using plastic wedges. Accuracy of rotation was within +1°. Digital radiographs were obtained at each position. Varus angles were measured using ImageJ, employing two definitions of PFLA. Mean varus angles increased with 10° of either internal or external rotation with both PFLA...... rotation angles. The effect of rotation on varus angle measurements in these femoral specimens contradicts a previous report using CT. The most probable explanation is the difference in femoral positioning: the CT study used a slightly elevated position compared to that in this study, resulting in better...... visualisation of the condylar articular surfaces. Zero elevation frequently results in the articular surfaces being obscured by the trochlear ridges, even when positioned perfectly. Varus measurements vary unpredictably as a result of femoral rotation and this effect is likely further influenced by femoral...

  15. Transient elastohydrodynamic lubrication analysis of a novel metal-on-metal hip prosthesis with a non-spherical femoral bearing surface.

    Science.gov (United States)

    Meng, Q E; Liu, F; Fisher, J; Jin, Z M

    2011-01-01

    Effective lubrication performance of metal-on-metal hip implants only requires optimum conformity within the main loaded area, while it is advantageous to increase the clearance in the equatorial region. Such a varying clearance can be achieved by using non-spherical bearing surfaces for either acetabular or femoral components. An elastohydrodynamic lubrication model of a novel metal-on-metal hip prosthesis using a non-spherical femoral bearing surface against a spherical cup was solved under loading and motion conditions specified by ISO standard. A full numerical methodology of considering the geometric variation in the rotating non-spherical head in elastohydrodynamic lubrication solution was presented, which is applicable to all non-spherical head designs. The lubrication performance of a hip prosthesis using a specific non-spherical femoral head, Alpharabola, was analysed and compared with those of spherical bearing surfaces and a non-spherical Alpharabola cup investigated in previous studies. The sensitivity of the lubrication performance to the anteversion angle of the Alpharabola head was also investigated. Results showed that the non-spherical head introduced a large squeeze-film action and also led to a large variation in clearance within the loaded area. With the same equatorial clearance, the lubrication performance of the metal-on-metal hip prosthesis using an Alpharabola head was better than that of the conventional spherical bearings but worse than that of the metal-on-metal hip prosthesis using an Alpharabola cup. The reduction in the lubrication performance caused by the initial anteversion angle of the non-spherical head was small, compared with the improvement resulted from the non-spherical geometry.

  16. Can a semi-automated surface matching and principal axis-based algorithm accurately quantify femoral shaft fracture alignment in six degrees of freedom?

    Science.gov (United States)

    Crookshank, Meghan C; Beek, Maarten; Singh, Devin; Schemitsch, Emil H; Whyne, Cari M

    2013-07-01

    Accurate alignment of femoral shaft fractures treated with intramedullary nailing remains a challenge for orthopaedic surgeons. The aim of this study is to develop and validate a cone-beam CT-based, semi-automated algorithm to quantify the malalignment in six degrees of freedom (6DOF) using a surface matching and principal axes-based approach. Complex comminuted diaphyseal fractures were created in nine cadaveric femora and cone-beam CT images were acquired (27 cases total). Scans were cropped and segmented using intensity-based thresholding, producing superior, inferior and comminution volumes. Cylinders were fit to estimate the long axes of the superior and inferior fragments. The angle and distance between the two cylindrical axes were calculated to determine flexion/extension and varus/valgus angulation and medial/lateral and anterior/posterior translations, respectively. Both surfaces were unwrapped about the cylindrical axes. Three methods of matching the unwrapped surface for determination of periaxial rotation were compared based on minimizing the distance between features. The calculated corrections were compared to the input malalignment conditions. All 6DOF were calculated to within current clinical tolerances for all but two cases. This algorithm yielded accurate quantification of malalignment of femoral shaft fractures for fracture gaps up to 60 mm, based on a single CBCT image of the fractured limb. Copyright © 2012 IPEM. Published by Elsevier Ltd. All rights reserved.

  17. Transfer of metallic debris from the metal surface of an acetabular cup to artificial femoral heads by scraping: comparison between alumina and cobalt-chrome heads.

    Science.gov (United States)

    Chang, Chong Bum; Yoo, Jeong Joon; Song, Won Seok; Kim, Deug Joong; Koo, Kyung-Hoi; Kim, Hee Joong

    2008-04-01

    We aimed to investigate the transfer of metal to both ceramic (alumina) and metal (cobalt-chrome) heads that were scraped by a titanium alloy surface under different load conditions. The ceramic and metal heads for total hip arthroplasties were scraped by an acetabular metal shell under various loads using a creep tester. Microstructural changes in the scraped area were visualized with a scanning electron microscope, and chemical element changes were assessed using an energy dispersive X-ray spectrometry. Changes in the roughness of the scraped surface were evaluated by a three-dimensional surface profiling system. Metal transfer to the ceramic and metal heads began to be detectable at a 10 kg load, which could be exerted by one-handed force. The surface roughness values significantly increased with increasing test loads in both heads. When the contact force increased, scratching of the head surface occurred in addition to the transfer of metal. The results documented that metallic debris was transferred from the titanium alloy acetabular shell to both ceramic and metal heads by minor scraping. This study suggests that the greatest possible effort should be made to protect femoral heads, regardless of material, from contact with metallic surfaces during total hip arthroplasty.

  18. Evolução do escorregamento epifisário proximal do fêrmur após tratamento não cirúrgico Evolution of slipped capital femoral epiphysis after nonsurgical treatment

    Directory of Open Access Journals (Sweden)

    Cláudio Santili

    2010-01-01

    Full Text Available OBJETIVO: Avaliar a eficácia do tratamento conservador em pacientes com epifisiólise proximal do fêmur (EEPF e as complicações devidas à evolução da doença. MÉTODOS: Foram analisados, retrospectivamente, 18 pacientes (26 quadris consecutivamente atendidos no período entre dezembro de 1996 e agosto de 2006 no Serviço de Ortopedia da Santa Casa de Misericórdia de São Paulo, encaminhados por outros serviços com diagnóstico de EEPF e tratados de forma não cirúrgica. RESULTADOS: A progressão do escorregamento aconteceu em 19 quadris (73%, sendo que, dos quadris com escorregamento leve, oito permaneceram leves, quatro progrediram para moderados e um tornou-se grave pela classificação Southwick. Dos seis quadris classificados como moderados, quatro evoluíram para grave e os dois graves acentuaram-se um pouco mais. Conclusões: Apesar de a indicação cirúrgica ser hoje consenso no tratamento do EEEP para evitar a progressão do escorregamento, há ainda pacientes com diagnóstico confirmado que são tratados de forma conservadora, e isto representa um grande erro, pois implica no aumento da morbidade da doença.OBJECTIVE: To evaluate the efficacy of conservative treatment of slipped capital femoral epiphysis (SCFE and the complications due to the progression of the slip. METHODS: 18 patients (26 hips seen consecutively from December 1996 to August 2006 at the Orthopedics Service of Santa Casa de Misericórdia de São Paulo, referred from other services with a SCFE diagnosis and treated without surgery were retrospectively analyzed. RESULTS: Slip progression was observed in 19 hips (73%. Among the mild cases, 8 remained mild, four turned moderate and one became severe according to Southwick classification. Four out of the six originally moderate cases became severe and the two already severe cases worsened. Conclusion: Despite there being a consensus regarding the use of surgical treatment to prevent SCFE progression, some cases

  19. MR evaluation of femoral neck version and tibial torsion

    International Nuclear Information System (INIS)

    Koenig, James Karl; Dwek, Jerry R.; Pring, Maya E.

    2012-01-01

    Abnormalities of femoral neck version have been associated with a number of hip abnormalities in children, including slipped capital femoral epiphysis, proximal femoral focal deficiency, coxa vara, a deep acetabulum and, rarely, developmental dysplasia of the hip. Orthopedic surgeons also are interested in quantifying the femoral neck anteversion or retroversion in children especially to plan derotational osteotomies. Historically, the angle of femoral version and tibial torsion has been measured with the use of radiography and later by CT. Both methods carry with them the risks associated with ionizing radiation. Techniques that utilize MR are used less often because of the associated lengthy imaging times. This article describes a technique using MRI to determine femoral neck version and tibial torsion with total scan times of approximately 10 min. (orig.)

  20. Age Predicts Disruption of the Articular Surface of the Femoral Condyles in Knee OCD: Can We Reduce Usage of Arthroscopy and MRI?

    Science.gov (United States)

    Siegall, Evan; Faust, John R; Herzog, Mackenzie M; Marshall, Kelley W; Willimon, S Clifton; Busch, Michael T

    2018-03-01

    The purpose of this study was to determine if patient age could accurately identify disrupted articular cartilage overlying an osteochondritis dissecans (OCD) lesion of the femoral condyle in adolescents. This could have important implications for imaging and treatment decisions. All patients from 2001 to 2014 who were arthroscopically treated for a femoral condyle OCD were included in this Institutional Review Board-approved study. Exclusion criteria were trochlear and patellar OCD lesions, idiopathic arthritis, and traumatic osteochondral injuries. Arthroscopy was performed to visualize and probe the articular surface. Arthroscopic and magnetic resonance imaging (MRI) findings were recorded as "intact" or "disrupted" cartilage. Extra-articular drilling was performed when the articular cartilage was intact. There were 119 patients (81 male, 68%) with 139 OCD lesions in 136 knees. The mean age at time of surgery was 13.0 years (range, 7.2 to 19.3 y). At arthroscopy, 115 knees had intact cartilage and 24 had disrupted cartilage. There was a significant difference in age between patients with intact versus disrupted cartilage at arthroscopy (12.5 vs. 15.3 y; POCD lesions had MRIs preoperatively, showing 69 as intact and 19 (24%) disrupted. MRI reading for cartilage status had 94% sensitivity and 97% specificity. Multivariable regression analysis revealed that age (P<0.01) and MRI status (P<0.0001) were strong predictors of cartilage status. Sixteen years was the critical age in which both sensitivity was maximized and false positive probability was minimized. Over the age of 17 years, 7 of 7 (100%) had disrupted cartilage. Age alone was 100% sensitive for children below the age of 10, and 96% sensitive below the age of 13. Age was a good predictor of cartilage status in both younger (<13 y) and older (≥17 y) patients in this study. For patients in the mid-range group (13 through 16 y), age alone is not an adequate predictor of cartilage status, but adding MRI

  1. Femoral bowing plane adaptation to femoral anteversion.

    Science.gov (United States)

    Akman, Alp; Demirkan, Fahir; Sabir, Nuran; Oto, Murat; Yorukoglu, Cagdas; Kiter, Esat

    2017-01-01

    Femoral bowing plane (FBP) is the unattended subject in the literature. More over the femoral shaft with its bowing is neglected in established anteversion determination methods. There is limited information about the relationship between FBP and anteversion. Thus we focused on this subject and hypothesized that there could be an adaptation of FBP to anteversion. FBP is determined on three-dimensional solid models derived from the left femoral computerized tomography data of 47 patients which were taken before for another reason and comparatively evaluated with anteversion. There were 20 women and 27 men. The mean age of patients was 56 years (range 21-84 years). The anteversion values were found as the angle between a distal condylar axis (DCA) and femoral neck anteversion axis (FNAA) along an imaginary longitudinal femoral axis (LFA) in the true cranio-caudal view. The FBP was determined as a plane that passes through the centre-points of three pre-determinated sections on the femoral shaft. The angles between DCA, FNAA and FBP were comparatively evaluated. The independent samples t -test was used for statistical analysis. At the end, it was found that FBP lies nearly perpendicular to the anteversion axis for the mean of our sample which is around 89° in females and 93° in males (range 78-102°). On the other hand, FBP does not lie close to the sagittal femoral plane (SFP); instead, there is an average 12.5° external rotation relative to the SFP. FBP is correlated well with anteversion in terms of FBP inclination from SFP and femoral torsion (i.e., angle between FBP and femoral neck anteversion axis ( P < 0.001; r = 0.680 and r = -0.682, respectively). Combined correlation is perfect ( R 2 = 1) as the FBP, SFP, and posterior femoral plane forms a triangle in the cranio-caudal view. We found that FBP adapts to anteversion. As FBP lies close to perpendicularity for the mean, femoral component positioning perpendicular to the FBP can be an alternate way in the

  2. Femoral bowing plane adaptation to femoral anteversion

    Directory of Open Access Journals (Sweden)

    Alp Akman

    2017-01-01

    Full Text Available Background: Femoral bowing plane (FBP is the unattended subject in the literature. More over the femoral shaft with its bowing is neglected in established anteversion determination methods. There is limited information about the relationship between FBP and anteversion. Thus we focused on this subject and hypothesized that there could be an adaptation of FBP to anteversion. Materials and Methods: FBP is determined on three-dimensional solid models derived from the left femoral computerized tomography data of 47 patients which were taken before for another reason and comparatively evaluated with anteversion. There were 20 women and 27 men. The mean age of patients was 56 years (range 21-84 years. Results: The anteversion values were found as the angle between a distal condylar axis (DCA and femoral neck anteversion axis (FNAA along an imaginary longitudinal femoral axis (LFA in the true cranio-caudal view. The FBP was determined as a plane that passes through the centre-points of three pre-determinated sections on the femoral shaft. The angles between DCA, FNAA and FBP were comparatively evaluated. The independent samples t-test was used for statistical analysis. At the end, it was found that FBP lies nearly perpendicular to the anteversion axis for the mean of our sample which is around 89° in females and 93° in males (range 78-102°. On the other hand, FBP does not lie close to the sagittal femoral plane (SFP; instead, there is an average 12.5° external rotation relative to the SFP. FBP is correlated well with anteversion in terms of FBP inclination from SFP and femoral torsion (i.e., angle between FBP and femoral neck anteversion axis (P0 < 0.001; r = 0.680 and r = −0.682, respectively. Combined correlation is perfect (R[2] = 1 as the FBP, SFP, and posterior femoral plane forms a triangle in the cranio-caudal view. Conclusions: We found that FBP adapts to anteversion. As FBP lies close to perpendicularity for the mean, femoral component

  3. Subchondral insufficiency fractures of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Davies, M.; Cassar-Pullicino, V.N. [Department of Radiology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, SY10 7AG, Shropshire (United Kingdom); Darby, A.J. [Department of Pathology, Robert Jones and Agnes Hunt Orthopaedic and District Hospital, Oswestry, SY10 7AG, Shropshire (United Kingdom)

    2004-02-01

    The aim of this study was to increase awareness of, and to show the variable clinical and radiological features of, subchondral insufficiency fractures of the femoral head. The clinical and radiological findings in 7 patients with subchondral insufficiency fractures of the femoral head were reviewed retrospectively. The diagnosis was confirmed histologically in 4 patients. Radiographs were performed in all patients, MRI in 5 and scintigraphy in 4 patients. Radiographs showed varying degrees of femoral head collapse in 4 patients. In the remaining 3 patients radiographs showed a normal femoral head, regional osteoporosis and focal sclerosis, respectively. Magnetic resonance imaging showed a low-signal band on T1- and T2-weighted images in the subchondral bone adjacent or parallel to the articular surface associated with bone marrow oedema. Scintigraphy showed increased uptake in the femoral head. Insufficiency fractures of the femoral head are easily overlooked or confused with avascular necrosis and, when there is significant joint destruction, osteoarthritis. Unsuspected insufficiency fracture of the femoral head can lead to significant and rapid loss of bone stock in osteoporotic patients waiting for arthroplasty for osteoarthritis. Increased awareness of this condition will hopefully lead to earlier diagnosis and a successful outcome of conservative treatment. (orig.)

  4. Social capital

    OpenAIRE

    2015-01-01

    This paper surveys research on social capital. We explore the concepts that motivate the social capital literature, efforts to formally model social capital using economic theory, the econometrics of social capital, and empirical studies of the role of social capital in various socioeconomic outcomes. While our focus is primarily on the place of social capital in economics, we do consider its broader social science context. We argue that while the social capital literature has produced many i...

  5. Wear, creep, and frictional heating of femoral implant articulating surfaces and the effect on long-term performance--Part II, Friction, heating, and torque.

    Science.gov (United States)

    Davidson, J A; Schwartz, G; Lynch, G; Gir, S

    1988-04-01

    In Part I, (J.A. Davidson and G. Schwartz, "Wear, creep, and frictional heating of femoral implant articulating surfaces and the effect on long-term performance--Part I, A review," J. Biomed. Mater. Res., 21, 000-000 (1987) it was shown that lubrication of the artificial hip joint was complex and that long-term performance is governed by the combined wear, creep, and to a lesser extent, oxidation degradation of the articulating materials. Importantly, it was shown that a tendency for heating exists during articulation in the hip joint and that elevated temperatures can increase the wear, creep, and oxidation degradation rate of UHMWPE. The present study was performed to examine closely the propensity to generate heat during articulation in a hip joint simulator. The systems investigated were polished Co-Cr-Mo alloy articulating against UHMWPE, polished alumina ceramic against UHMWPE, and polished alumina against itself. Frictional torque was also evaluated for each system at various levels of applied loads. A walking load history was used in both the frictional heating and torque tests. The majority of tests were performed with 5 mL of water lubricant. However, the effect of various concentrations of hyaluronic acid was also evaluated. Results showed frictional heating to occur in all three systems, reaching an equilibrium after roughly 30 min articulation time. Ceramic systems showed reduced levels of heating compared to the cobalt alloy-UHMWPE system. The level of frictional torque for each system ranked similar to their respective tendencies to generate heat. Hyaluronic acid had little effect, while dry conditions and the presence of small quantities of bone cement powder in water lubricant significantly increased frictional torque.

  6. Intellectual Capital.

    Science.gov (United States)

    Snyder, Herbert W.; Pierce, Jennifer Burek

    2002-01-01

    This review focuses on intellectual capital and its relationship to information professionals. Discusses asset recognition; national practices and the acceptance of intellectual capital; definitions of intellectual capital; measuring intellectual capital, including multiple and single variable measures; managing intellectual capital; and knowledge…

  7. Atherosclerotic femoral artery aneurysms

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Schroeder, T V

    1996-01-01

    Based on a clinical suspicion of an increase in the proportion of deep femoral aneurysms, we reviewed the case records of patients who underwent reconstructive procedures for femoral aneurysms to investigate if this could be confirmed and explained by selection of patient or modality of diagnosis...

  8. Vasculature deprivation – induced osteonecrosis of the rat femoral head as a model for therapeutic trials

    Science.gov (United States)

    Bejar, Jacob; Peled, Eli; Boss, Jochanan H

    2005-01-01

    Experimental Osteonecrosis The authors' experience with experimentally produced femoral capital osteonecrosis in rats is reviewed: incising the periosteum at the base of the neck of the femur and cutting the ligamentum teres leads to coagulation necrosis of the epiphysis. The necrotic debris is substituted by fibrous tissue concomitantly with resorption of the dead soft and hard tissues by macrophages and osteoclasts, respectively. Progressively, the formerly necrotic epiphysis is repopulated by hematopoietic-fatty tissue, and replaced by architecturally abnormal and biomechanically weak bone. The femoral heads lose their smooth-surfaced hemispherical shape in the wake of the load transfer through the hip joint such that, together with regressive changes of the joint cartilage and inflammatory-hyperplastic changes of the articular membrane, an osteoarthritis-like disorder ensues. Therapeutic Choices Diverse therapeutic options are studied to satisfy the different opinions concerning the significance of diverse etiological and pathogenic mechanisms: 1. Exposure to hyperbaric oxygen. 2. Exposure to hyperbaric oxygen and non-weight bearing on the operated hip. 3. Medication with enoxaparin. 4. Reduction of intraosseous hypertension, putting to use a procedure aimed at core decompression, namely drilling a channel through the femoral head. 5. Medication with vascular endothelial growth factor with a view to accelerating revascularization. 6. Medication with zoledronic acid to decrease osteoclastic productivity such that the remodeling of the femoral head is slowed. Glucocorticoid-related osteonecrosis appears to be apoptosis-related, thus differing from the vessel-deprivation-induced tissue coagulation found in idiopathic osteonecrosis. The quantities of TNF-α, RANK-ligand and osteoprotegerin are raised in glucocorticoid-treated osteoblasts so that the differentiation of osteoclasts is blocked. Moreover, the osteoblasts and osteocytes of the femoral cortex mostly

  9. Osteonecrosis of the femoral head extending into the femoral neck.

    Science.gov (United States)

    Sakamoto, Yuma; Yamamoto, Takuaki; Motomura, Goro; Sakamoto, Akio; Yamaguchi, Ryosuke; Iwasaki, Kenyu; Zhao, Garida; Karasuyama, Kazuyuki; Iwamoto, Yukihide

    2013-03-01

    Osteonecrosis of the femoral head (ONFH) is an ischemic disorder that can lead to femoral head collapse and secondary osteoarthritis. Although the condition is usually limited to the femoral head, we report a rare case of biopsy-proven ONFH extending into the femoral neck, which required hip replacement surgery. We emphasize the imaging features of this condition and briefly discuss its potential relevance.

  10. Femoral head avascular necrosis

    International Nuclear Information System (INIS)

    Chrysikopoulos, H.; Sartoris, D.J.; Resnick, D.L.; Ashburn, W.; Pretorius, T.

    1988-01-01

    MR imaging has been shown to be more sensitive and specific than planar scintigraphy for avascular necrosis (AVN) of the femoral head. However, experience with single photon emission CT (SPECT) is limited. The authors retrospectively compared 1.5-T MR imaging with SPECT in 14 patients with suspected femoral head AVN. Agreement between MR imaging and SPECT was present in 24 femurs, 14 normal and ten with AVN. MR imaging showed changes of AVN in the remaining four femoral heads. Of these, one was normal and the other three inconclusive for AVN by SPECT. The authors conclude that MR imaging is superior to SPECT for the evaluation of AVN of the hip

  11. Capital A to Z

    NARCIS (Netherlands)

    Breen, J.; Stelingwerff, M.

    2008-01-01

    Throughout the history of architecture, the Capital the intermediate between a column and the beam or surface it supports has been a recurring feature in architectural composition and articulation. In this paper we describe results and findings from the Capital A to Z exercise within the Ornamatics

  12. Intellectual Capital

    DEFF Research Database (Denmark)

    Mouritsen, Jan; Bukh, Per Nikolaj

    2015-01-01

    Intellectual capital (IC) consists of human capital, organizational capital, and relational capital, and their relationships. It has been said to be important to explain the difference between market value and book value of a firm, but measurement of IC is more likely to be important because...

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

    Directory of Open Access Journals (Sweden)

    Sampat S Dumbre Patil

    2016-01-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  15. Femoral shaft fractures

    International Nuclear Information System (INIS)

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

    1985-01-01

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

  16. [Trochanteric femoral fractures].

    Science.gov (United States)

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

    2013-01-01

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

  17. Goodwill Capitalism

    OpenAIRE

    Goda, Vish

    2007-01-01

    Markets have been treating money as another commodity, trading it, speculating on its value and finding innovative ways to multiply its supply. In it's current form, it has lost it's power to regulate anything at all in the markets, including demand and supply. Combined with profit motives, it encourages short term strategies at the expense of depleting natural resources and discouraging long term investments in social and human capital. Goodwill Capitalism monetizes social capital and in...

  18. Iodixanol in femoral arteriography

    International Nuclear Information System (INIS)

    Thorstensen, Oe.; Albrechtsson, U.; Calissendorff, B.; Larusdottir, H.; Norgren, L.; Tengvar, M.; Bolstad, B.; Aspelin, P.

    1994-01-01

    Two contrast media, iodixanol (Visipaque, Nycomed) 270 mg I/ml and iohexol (Omnipaque, Nycomed) 300 mg I/ml, were compared in femoral arteriography, in 147 patients. Both contrast media were diagnostically effective for use in femoral arteriography, without any significant difference. Pain was reported in connection with injection of iohexol by 36% of the patients, after injection of iodixanol none reported pain. Seventy-two percent of the patients in the iodixanol group reported a sensation of warmth in connection with contrast injection versus 90% in the iohexol group. The average intensity of the warmth was greater with iohexol than with iodixanol. Fourteen percent of patients in the iodixanol group and 1% in the iohexol group reported one or more subjective adverse events. (orig.)

  19. Proximal femoral fractures

    DEFF Research Database (Denmark)

    Palm, Henrik; Teixidor, Jordi

    2015-01-01

    BACKGROUND: In hip fracture surgery, the exact choice of implant often remains somewhat unclear for the individual surgeon, but the growing literature consensus has enabled publication of evidence-based surgical treatment pathways. The aim of this article was to review author pathways and national...... guidelines for hip fracture surgery and discuss a method for future pathway/guideline implementation and evaluation. METHODS: By a PubMed search in March 2015 six studies of surgical treatment pathways covering all types of proximal femoral fractures with publication after 1995 were identified. Also we......-displaced femoral neck fractures and prosthesis for displaced among the elderly; and sliding hip screw for stabile- and intramedullary nails for unstable- and sub-trochanteric fractures) but they are based on a variety of criteria and definitions - and often leave wide space for the individual surgeons' subjective...

  20. Capital gains

    International Nuclear Information System (INIS)

    Blishen, C.

    1997-01-01

    This article examines African and Middle East oil and natural gas project financing. Capital markets financing, Ras Laffan's project bonds, capital market issues in Saudi Arabia, the movement toward gas and away from oil, and Islamic opportunities are discussed, African and Middle East oil and gas projects are listed. (UK)

  1. Celebration Capitalism

    OpenAIRE

    Boykoff, Jules

    2014-01-01

    Capitalism is a nimble shapeshifter. In this talk Jules Boykoff draws from the history of the Olympic Games to offer a theory of “celebration capitalism,” a form of modern-day economics that complements Naomi Klein’s “disaster capitalism” marked by neoliberalism: privatization, deregulation, and free-market rhetoric.

  2. Femoral Hernia At Mulago Hospital, Uganda

    African Journals Online (AJOL)

    user

    2004-12-02

    Dec 2, 2004 ... the peritoneal sac of the femoral hernia may expand into an acquired defect of fascia transversalis in the femoral sheath to eventually herniate outside the canal. Therefore, femoral hernias can be classified into 5 groups as follows: 1. Femoral canal hernia: This is the commonest variety of femoral hernia. It.

  3. Femoral Hernia At Mulago Hospital, Uganda

    African Journals Online (AJOL)

    user

    2004-12-02

    Dec 2, 2004 ... Therefore, femoral hernias can be classified into 5 groups as follows: 1. Femoral canal hernia: This is the commonest variety of femoral hernia. It enters the thigh via the most medial compartment of the femoral sheath, the femoral canal. 2. Prevascular hernia (Narath's hernia) - The hernial sac emerges from ...

  4. CAPITAL STRUCTURE AND VENTURE CAPITAL

    Directory of Open Access Journals (Sweden)

    Becsky-Nagy Patricia

    2015-07-01

    Full Text Available Venture capital significantly changes the capital structure of the portfolio company at the time of the investment. Venture capitalists contribute to the company’s success through their active involvement in the management and their added value appears in the increase of the value of the equity. At the same time with taking active role in the management, agency problem occurs, that complicates the cooperation and the success of exit. In this article we search the answer for the question whether the preferred equity, that are commonly used in the US for bridging the agency problem, are used and able to help Hungarian venture capitalists to manage agency problems. On the other hand we examined how the venture capital affect capital structure, how the venture capitalists value added appear in the capital structure. During the evaluation of the three case studies, we came to the conclusion, that the venture capital investments have positive effect on the liabilities of the enterprises, as the capital structure indexes show. However, the investors need the ownership, which help them to step up resolutely, when things change for the worse, and companies need the expertise, which the investors bring with their personal assistance. The investor’s new attitude also has positive effect on a mature company, which has an experienced leader, because he can show another aspect, as a person who come from outside. During the examination of the capital structure, we cannot disregard the events of the company’s environment, which have effects on the firm. The investor’s decisions also appear different ways. Because of this, every venture capital investment is different, just as the capital structure of the firms, in which they invest.

  5. Femoral Neck Fracture

    Directory of Open Access Journals (Sweden)

    Jonathan Lee

    2016-09-01

    Full Text Available History of present illness: A 74-year-old male presented to the emergency department with left hip pain after falling off his bicycle. Pain is 3/10 in severity and exacerbated by movement. Patient denied head trauma. Exam showed left hip tenderness, 3/5 left lower extremity strength secondary to pain, and 5/5 right lower extremity strength. Sensation and pulses were intact in bilateral lower extremities. Left hip X-ray and pelvic CT revealed comminuted, impacted transcervical and subcapital fracture of the left femoral neck. Significant findings: In the anteroposterior view bilateral hip x-ray, there is an evident loss of Shenton’s line on the left (red line when compared to the normal right (white line, indicative of a fracture in the left femoral neck. This correlates with findings seen on pelvic CT, which reveals both a subcapital fracture (blue arrow and transcervical fracture (yellow arrow. The neck of the femur is displaced superiorly relative to the head of the femur while the head of the femur remains in its anatomical position within the acetabulum. Discussion: Femoral neck fractures are one of the most common types of hip fractures, accounting for 49.4% of all hip fractures.1 Diagnosing a femoral neck fracture can be made with plain x-ray, CT, or MRI. Plain film radiographs have been found to be at least 90% sensitive for hip fractures CT’s have been found to be 87%-100% sensitive and 100% specific for occult hip fractures in which plain radiographs were read as negative, but the patient still complained of hip pain Although MRI is currently the gold standard for detecting occult hip fractures (sensitivity and specificity = 100%, given MRI’s limited accessibility in the ED as well as the high sensitivity and specificity of CT scans for occult hip fractures, it is generally recommended to obtain CT scans for patients with suspected occult hip fractures as a first-line investigation

  6. Understanding Capitalism

    DEFF Research Database (Denmark)

    du Gay, Paul; Morgan, Glenn

    2013-01-01

    This chapter places The New Spirit of Capitalism in the context of the development of capitalism over the last twenty years, up to and including the 200-7-8 financial crisis and the ongoing economic crisis which has developed out of this and is now focused on the relationship between state...... expenditures, political legitimacy and financial markets. Boltanski and Chiapello's analysis of the projective city and connexionist logic captures important elements of capitalism in the era of neo-liberalism. However, as their analysis shows, any such logics require ‘spirit’, legitimacy and justification...... if they are to be sustained. Such logics are stabilized to the degree that they can pass the tests which they set themselves. The chapter shows how the projective city has increasingly failed these tests. It has instead created a privileged group of ‘mobile citizens’ working with mobile, global capital in ways...

  7. Venture Capital

    National Research Council Canada - National Science Library

    Lister, M. J; Andreassen, A; Bales, Shanda; Biddle, J. G; Chang, M. M; McCormick, R; Packard, W. J; Sun, T

    2006-01-01

    Leveraging venture capital to the advantage of the Naval Services should be viewed as part of the larger project of reforming the acquisition system to permit rapid introduction of new technologies...

  8. Femoral pseudoaneurysms in drug addicts

    DEFF Research Database (Denmark)

    Levi-Mazloum, Niels Donald; Rørdam, Peter; Jensen, L P

    1997-01-01

    OBJECTIVE: To evaluate the outcome of treatment of femoral pseudoaneurysms in drug addicts. METHODS: The records of eight patients undergoing vascular surgery for femoral pseudoaneurysms from substance abuse identified from a vascular database were reviewed. RESULTS: Were good in four out of five...

  9. Focal femoral condyle resurfacing.

    LENUS (Irish Health Repository)

    Brennan, S A

    2013-03-01

    Focal femoral inlay resurfacing has been developed for the treatment of full-thickness chondral defects of the knee. This technique involves implanting a defect-sized metallic or ceramic cap that is anchored to the subchondral bone through a screw or pin. The use of these experimental caps has been advocated in middle-aged patients who have failed non-operative methods or biological repair techniques and are deemed unsuitable for conventional arthroplasty because of their age. This paper outlines the implant design, surgical technique and biomechanical principles underlying their use. Outcomes following implantation in both animal and human studies are also reviewed. Cite this article: Bone Joint J 2013;95-B:301-4.

  10. Radiographic femoral varus measurement is affected unpredictably by femoral rotation

    DEFF Research Database (Denmark)

    Miles, James Edward

    Radiographic measurements of femoral varus are used to determine if intervention to correct femoral deformity is required, and to calculate the required correction. The varus angle is defined as the angle between the proximal femoral long axis (PFLA) and an axis tangential to the distal femoral...... condyles. Ideal positioning of the femur in terms of zero elevation relative to the radiographic plane or zero rotation along the long axis of the femur may be difficult to obtain in practice. The clinician may thus be tempted to determine varus values from less than ideal radiographs. Fourteen isolated...... and externally by 5° and 10° using plastic wedges. Accuracy of rotation was within +1°. Digital radiographs were obtained at each position. Varus angles were measured using ImageJ, employing two definitions of PFLA. Mean varus angles increased with 10° of either internal or external rotation with both PFLA...

  11. [Prediction of femoral remodeling after implantation of artifical femoral head].

    Science.gov (United States)

    Gao, Zhongli; Zhao, Changfu; Yu, Qingwei; Wu, Dankai; Yu, Jingwei

    2003-06-01

    By integrating bone-remodeling theory with finite element (FEM) models, the behavior of femoral remodeling after implantation of artificial femoral head was simulated and the stress shield effect of artificial femoral head on the femur was analyzed quantitatively. Bone was calculated with finite element code of the FEM model. The normal loading condition of femur was used as Model One, and the stress condition that bone was fixed by the bone-cement of the artificial head with collar was used as Model Two. It has been shown that bone was stress-shielded by the artificial femoral head and femur resorbed. Bone resorption near the proximal artificial stem was very severe. Its cross-section resorbed the greatest. The ratio of cross-sectional resorption was psi = 31.3% and the ratio of loss of the anti-bend cross-sectional modulus was zeta = 54.58%.

  12. Dream capitalism

    OpenAIRE

    Pierson, Christopher

    2015-01-01

    John Tomasi’s Free Market Fairness represents an heroic attempt to bridge the gap between Rawlsian ‘high liberals’ and the advocates of classical liberalism/contemporary libertarianism. I argue that Tomasi’s project fails, above all because it cannot give a compelling account of contemporary (American) capitalism or of its capacity to deliver free market fairness.

  13. Lateral Intercondylar Ridge: Is it a reliable landmark for femoral ACL insertion?: An anatomical study.

    Science.gov (United States)

    Bhattacharyya, Rahul; Ker, Andrew; Fogg, Quentin; Spencer, Simon J; Joseph, Jibu

    2018-02-01

    Incorrect femoral tunnel placement is the most common cause of graft failure during Anterior Cruciate Ligament (ACL) Reconstruction. A reliable landmark can minimize errors. To identify whether the Lateral Intercondylar Ridge (LIR) is a consistent anatomical structure and define its relationship with the femoral ACL insertion. Phase 1: we studied 23 femoral dry bone specimens macroscopically. Using a digital microscribe, the medial surface of the lateral femoral condyle was reconstructed (3D) to evaluate whether there was an identifiable bony ridge. Phase 2: 7 cadaveric specimens with intact soft tissues were dissected to identify the femoral ACL insertion. A 3D reconstruction of the femoral ACL insertion and the surface allowed us to define the relationship between the LIR and the ACL insertion. All specimens had a defined LIR on the medial surface of the lateral femoral condyle. The ridge was consistently located just anterior to the femoral ACL insertion. The ACL footprint was present in the depression between the ridge and the Inferior Articular Cartilage Margin (IACM). The mean distance from the midpoint of the IACM to the LIR was 10.1 mm. This is the first study to use the microscribe to digitally reconstruct the medial surface of the lateral femoral condyle. It shows that the LIR is a consistent anatomical structure that defines the anterior margin of the femoral ACL insertion, which guides femoral tunnel placement. Our findings support the ruler technique, which is a commonly used method for anatomic single bundle ACL reconstruction. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  14. Trinidadian capitalism

    Directory of Open Access Journals (Sweden)

    Kevin A. Yelvington

    1999-07-01

    Full Text Available [First paragraph] Capitalism: An Ethnographic Approach. DANIEL MILLER. Oxford: Berg, 1997. x + 357 pp. (Cloth £39.00, Paper £17.99 Women, Labour and Politics in Trinidad and Tobago: A History. RHODA E. REDDOCK. London: Zed, 1994. vi + 346 pp. (Cloth £39.95, Paper £15.95 Despite the underdeveloped state of the scholarship on its admittedly short sugar plantation slavery period, we now have a corpus of studies on various aspects of capitalism in Trinidad - from its historical advent (Sebastien 1978 to its twentieth-century manifestation in the petroleum sector (Seers 1964; Sandoval 1983, and from the ethnic structure of labor markets (Camejo 1971; Harewood 1971 and the role of capitalism in racial/ethnic inequality (Henry 1993; Coppin & Olsen 1998 to the way ethnicity affects business, big (Button 1981; Parris 1985; Centre for Ethnic Studies 1993 and small (Ryan & Barclay 1992; Griffith 1997, and the way ethnicity and gender are used in class recruitment (Yelvington 1995. There are also a number of fine working-class histories (e.g., Rennie 1973; Ramdin 1982; Basdeo 1983 and important works on the labor riots and strikes and the nature of the colonial state during the crises of the 1930s (e.g., Thomas 1987; Singh 1994. The two books under review here complement the works mentioned above, and they complement each other as well: Reddock's deals with the way capitalism up to the mid-century was buttressed by colonial politics, and explores how this formation engendered certain kinds of political responses, while Miller approaches capitalism through the assumption that fundamental changes in the post-Oil Boom period (ca. 1973-80 brought about considerable autonomy between production and consumption that can and should now be read through an analysis of the cultural circulation of images and commodities in the society. These books are both noteworthy because they engage in explicit theorizing on what capitalism was and is, and what it did and

  15. Correlation between baseline femoral neck marrow status and the development of femoral head osteonecrosis in corticosteroid-treated patients: A longitudinal study by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Vande Berg, Bruno C. [Radiology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium)]. E-mail: vandeberg@rdgn.ucl.ac.be; Gilon, Raphael [Radiology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium); Malghem, Jacques [Radiology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium); Lecouvet, Frederic [Radiology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium); Depresseux, Genevieve [Rheumatology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium); Houssiau, Frederic A. [Rheumatology Department, Universite Catholique de Louvain, Cliniques Universitaires Saint-Luc, Avenue Hippocrate 10, 1200 Brussels (Belgium)

    2006-06-15

    Objective: To test the hypothesis that the development of corticosteroid (CS)-associated femoral head osteonecrosis (ON) is influenced by baseline femoral neck marrow status. Patients and methods: The population consisted of 20 untreated patients with a newly diagnosed rheumatic disease in whom a standardized CS regimen was planned. Before CS treatment, baseline femoral neck marrow status was determined by magnetic resonance (MR) imaging on T1-weighted images (proportion of surface area of femoral neck and intertrochanteric area occupied by fatty marrow; index of marrow conversion [IMC]) and on a quantitative MR sequence (bulk T1 values of femoral head and neck). The presence of ON was assessed by coronal T1-weighted MR images of the hips at 6 and 12 months. Results: None of the patients suffered from ON at baseline. Four patients (20%) developed bilateral femoral head ON at 6 months. The mean percentage of fat marrow in the femoral neck before treatment was significantly higher in ON-positive than in ON-negative patients (p = 0.0025). The mean baseline femoral neck IMC value, which parallels the degree of red to yellow marrow conversion, was higher in ON-positive than in ON-negative patients (p = 0.089). The mean baseline bulk T1 value of the femoral neck (but not of the femoral head), which inversely correlates with the amount of fat marrow, was significantly shorter in ON-positive than in ON-negative patients (p = 0.0298). Conclusion: The development of CS-associated femoral head ON is correlated with a high fat content in the proximal femur before CS therapy.

  16. Correlation between baseline femoral neck marrow status and the development of femoral head osteonecrosis in corticosteroid-treated patients: A longitudinal study by MR imaging

    International Nuclear Information System (INIS)

    Vande Berg, Bruno C.; Gilon, Raphael; Malghem, Jacques; Lecouvet, Frederic; Depresseux, Genevieve; Houssiau, Frederic A.

    2006-01-01

    Objective: To test the hypothesis that the development of corticosteroid (CS)-associated femoral head osteonecrosis (ON) is influenced by baseline femoral neck marrow status. Patients and methods: The population consisted of 20 untreated patients with a newly diagnosed rheumatic disease in whom a standardized CS regimen was planned. Before CS treatment, baseline femoral neck marrow status was determined by magnetic resonance (MR) imaging on T1-weighted images (proportion of surface area of femoral neck and intertrochanteric area occupied by fatty marrow; index of marrow conversion [IMC]) and on a quantitative MR sequence (bulk T1 values of femoral head and neck). The presence of ON was assessed by coronal T1-weighted MR images of the hips at 6 and 12 months. Results: None of the patients suffered from ON at baseline. Four patients (20%) developed bilateral femoral head ON at 6 months. The mean percentage of fat marrow in the femoral neck before treatment was significantly higher in ON-positive than in ON-negative patients (p = 0.0025). The mean baseline femoral neck IMC value, which parallels the degree of red to yellow marrow conversion, was higher in ON-positive than in ON-negative patients (p = 0.089). The mean baseline bulk T1 value of the femoral neck (but not of the femoral head), which inversely correlates with the amount of fat marrow, was significantly shorter in ON-positive than in ON-negative patients (p = 0.0298). Conclusion: The development of CS-associated femoral head ON is correlated with a high fat content in the proximal femur before CS therapy

  17. Systemic effects of zoledronic acid in children with traumatic femoral head avascular necrosis and Legg-Calve-Perthes disease

    DEFF Research Database (Denmark)

    Johannesen, Jesper; Briody, Julie; McQuade, Mary

    2009-01-01

    Background: Intravenous bisphosphonate therapy is associated with preservation of femoral head sphericity and congruence in 77% of children with traumatic avascular necrosis. The aim was to describe the systemic effects of intravenous zoledronic acid (ZA) on bone and mineral metabolism in otherwise...... normal children and adolescents with femoral head AVN. Material and methods: 37 children (age 10.8+/-2.76 years) diagnosed with avascular necrosis AVN (Slipped Capital Femoral Epiphysis (SCFE), N=20 or Legg-Calve-Perthes disease (LCPD), N=17) were treated with at least 12 months of ZA. Bone mineral...

  18. Femoral head necrosis; Hueftkopfnekrose

    Energy Technology Data Exchange (ETDEWEB)

    Kramer, J.; Scheurecker, G.; Scheurecker, A.; Stoeger, A.; Huber, A. [Roentgeninstitut am Schillerpark, Linz (Austria); Hofmann, S. [Orthopaedisches Landeskrankenhaus Stolzalpe (Austria)

    2009-05-15

    The epidemiology and pathohistogenesis of avascular femoral head necrosis has still not been clarified in detail. Because the course of the disease runs in stages and over a long time period nearly always culminates in the necessity for a total hip prosthesis, an exact radiological evaluation is of paramount importance for the treatment. There is a need for a common staging system to enable comparison of different therapy concepts and especially their long-term results. In this article the ARCO staging system is described in full detail, which includes all radiological modalities as well as histopathological alterations. (orig.) [German] Bei der avaskulaeren Femurkopfnekrose handelt es sich um ein Krankheitsbild, dessen Ursachen noch immer nicht vollstaendig geklaert sind. Da die Erkrankung stadienhaft verlaeuft und ueber einen laengeren Zeitraum betrachtet nahezu immer in einem prothetischen Hueftersatz muendet, ist eine genaue radiologische Abklaerung fuer die Behandlung von enormer Bedeutung. Um Langzeiterfolge verschiedener Therapiekonzepte vergleichen zu koennen, sind eine exakte Beschreibung und darauf basierend die Verwendung einer einheitlichen Stadieneinteilung wuenschenswert. In der vorliegenden Arbeit wird die ARCO-Stadieneinteilung im Detail beschrieben, die alle bildgebenden Methoden beruecksichtigt und histopathologische Veraenderungen mit einbezieht. (orig.)

  19. Capital Unchained

    DEFF Research Database (Denmark)

    Bryan, Dick; Rafferty, Michael; Wigan, Duncan

    2017-01-01

    The rise of intangible assets such as brand names, research and development, patents and other forms of abstract capital such as digital platforms and data flows has confounded extant measures and concepts of capital and accumulation. What used to be a residual asset category known as ‘goodwill......’ has now overtaken so-called fixed or tangible assets in the profitability and valuation of many leading corporations. Yet these intangible assets lead a double life as both spatial and temporal in some dimensions, yet fluid and spatio-temporally elusive in others. Using a framework focused...... the global double life of internationalised and financialised intangible assets and wealth flows, and parallel reorganisations of state forms in response to those transformations....

  20. Instrumental Capital

    Directory of Open Access Journals (Sweden)

    Gabriel Valerio

    2007-07-01

    Full Text Available During the history of human kind, since our first ancestors, tools have represented a mean to reach objectives which might otherwise seemed impossibles. In the called New Economy, where tangibles assets appear to be losing the role as the core element to produce value versus knowledge, tools have kept aside man in his dairy work. In this article, the author's objective is to describe, in a simple manner, the importance of managing the organization's group of tools or instruments (Instrumental Capital. The characteristic conditions of this New Economy, the way Knowledge Management deals with these new conditions and the sub-processes that provide support to the management of Instrumental Capital are described.

  1. Posterior Femoral Single Limb Osteotomy for the Removal of Well-Fixed Modular Femoral Neck Components

    Directory of Open Access Journals (Sweden)

    Keith A Fehring

    2017-07-01

    Full Text Available Modular neck femoral components were introduced to optimize femoral neck anteversion, leg length, offset, and stability in total hip arthroplasty. However, concerns have been raised in recent years regarding early failure of these implants due to corrosion, pseudotumor, as well as fracture of the modular neck. Removing modular neck femoral implants is challenging as removal of the modular femoral neck leaves a proximally coated femoral stem level with the proximal bone of the femoral neck. We describe a posterior femoral single limb osteotomy  (posterior cut of an extended trochanteric osteotomy for the removal of a modular neck femoral component.

  2. Intellectual capital

    OpenAIRE

    Fondo, Clint B.; Wright, Darren B.

    2004-01-01

    MBA Professional Report Approved for public release; distribution in unlimited. The purpose of this MBA Project was to investigate and provide a comprehensive overview of the historical and current efforts directed at valuing intellectual capital (IC). This project was conducted with the sponsorship and assistance of the Office of Military Base Retention and Reuse (OMBRR), of the California Business, Transportation and Housing Agency. The goal of this project was to identify and documen...

  3. partial capitalness

    Directory of Open Access Journals (Sweden)

    Elena Grigoryeva

    2017-06-01

    A world away, in the Cape Winelands, architects of Stellenbosch struggle for the identity of the city, the capital of the unique cultural landscape. Here the traditional African culture is mixed with three century-long tradition of winegrowing and winemaking. This wonderful mixture was placed on the UNESCO Tentative List of World Heritage Sites. The authors of the project use cultural heritage protection laws to protect their city from chaotic development.

  4. Contagious Capitalism

    OpenAIRE

    Peter T. Leeson; Russell S. Sobel

    2006-01-01

    Is capitalism contagious? Since WWI, global foreign policy has treated economic freedom/repression like a virus that spreads between countries. Most recently, the ?domino theory? of freedom has played prominently in U.S. foreign policy toward Asia, Latin America, and the Caribbean during the Cold War, and the Middle East during the War on Terror. This paper investigates the spread of economic freedom between nations. Our analysis considers two potential channels of this spread: geography and ...

  5. Subchondral insufficiency fracture of the femoral head and medial femoral condyle

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Takuaki [Department of Orthopaedic Surgery, Faculty of Medicine, Kyushu University, Fukuoka (Japan); Bullough, P.G. [Department of Laboratory Medicine, Hospital for Special Surgery, New York, NY (United States)

    2000-01-01

    This case report documents the clinical, radiographic, and histologic findings in a 69-year-old obese man, who had subchondral insufficiency fracture both in the femoral head and medial femoral condyle. On plain radiographs, both lesions underwent subchondral collapse. Magnetic resonance images of the left hip showed a bone marrow edema pattern with associated low-intensity band on T1-weighted images, which was convex to the articular surface. The histopathologic findings in the hip and knee were characterized by the presence of a subchondral fracture with associated callus and granulation tissue along both sides of a fracture line. There was no evidence of antecedent osteonecrosis. To our knowledge, this is the first case report to describe the multiple occurrence of collapsed subchondral insufficiency fracture. (orig.)

  6. Deslizamientos epifisarios femorales proximales >30º. Procedimiento de Dunn modificado. Evaluación anatómica y funcional en una cohorte retrospectiva. [Slipped capital femoral epiphysis >30º. Modified Dunn procedure. Anatomical and functional evaluation in a retrospective cohort

    OpenAIRE

    Francisco Praglia; Daniel Visona Dallapozza; Jorge Sueiro; Eduardo Stefano

    2013-01-01

    Introducción La deformidad residual resultante de un deslizamiento epifisario femoral proximal moderado o grave conduce a osteoartritis prematura debida al choque femoroacetabular. Los objetivos del trabajo fueron evaluar la mejoría de la anatomía del fémur proximal y evaluar la función de la cadera en pacientes con deslizamiento epifisario femoral proximal >30 grados tratados con el procedimiento de Dunn modificado, a corto plazo. Material y Métodos Cohorte retrospectiva de ...

  7. The impact of urbanization during half a century on surface meteorology based on WRF model simulations over National Capital Region, India

    Science.gov (United States)

    Sati, Ankur Prabhat; Mohan, Manju

    2017-10-01

    An estimated 50% of the global population lives in the urban areas, and this percentage is projected to reach around 69% by the year 2050 (World Urbanization Prospects 2009). There is a considerable growth of urban and built-up area during the recent decades over National Capital Region (NCR) of India (17-fold increase in the urban extent). The proposed study estimates the land use land cover changes particularly changes to urban class from other land use types such as croplands, shrubland, open areas, and water bodies and quantify these changes for a span of about five decades. Further, the impact of these land use/land cover changes is examined on spatial and temporal variations of meteorological parameters using the Weather Research and Forecast (WRF) Model. The urbanized areas appear to be one of the regions with highest changes in the values of the fluxes and temperatures where during daytime, the surface sensible heat flux values show a noticeable increase of 60-70 W m-2 which commensurate with increase in urbanization. Similarly, the nighttime LST and T2m show an increase of 3-5 and 2-3 K, respectively. The diurnal temperature range (DTR) of LST and surface temperature also shows a decrease of about 5 and 2-3 K, respectively, with increasing urbanization. Significant decrease in the magnitude of surface winds and relative humidity is also observed over the areas converted to urban form over a period of half a century. The impacts shown here have serious implications on human health, energy consumption, ventilation, and atmospheric pollution.

  8. Femoral revision with impaction allografting and an uncemented femoral component

    DEFF Research Database (Denmark)

    Nickelsen, T N; Erenbjerg, M; Retpen, J B

    2008-01-01

    A technique for uncemented revision of the femoral component which combines impaction allografting and the use of a long-stemmed proximally coated titanium prostheses (Bimetric, Biomet Inc.) is described. The results after a mean follow-up of 112 months are reported. From 1991 to 1995 femoral...... implants 88% had no pain, 10% had slight pain and only 2% had severe pain. Thirty-eight patients had radiographic signs of remodelling of the graft and/or cortical repair. In cases with a successful outcome, the results have been encouraging in relation to clinical performance, regeneration of bone...

  9. Trombo flutuante em veia femoral

    Directory of Open Access Journals (Sweden)

    Matheus Bertanha

    2017-12-01

    Full Text Available Resumo O trombo venoso flutuante em veia femoral é um tipo de trombo com alto potencial de embolização pulmonar. Entretanto, ainda é controversa a conduta mais apropriada nesses casos. Tratamentos clínicos com anticoagulantes ou fibrinolíticos e trombectomias abertas ou por meio de dispositivos endovasculares vêm sendo empregados ainda sem um critério de indicação bem definido. Apresentamos três casos clínicos de trombos flutuantes em veia femoral, de etiologias distintas, cujos tratamentos e respectivas evoluções serão discutidos.

  10. Femoral varus: what's the angle

    DEFF Research Database (Denmark)

    Miles, James Edward; Svalastoga, Eiliv Lars; Eriksen, Thomas

    Agreement and reliability of femoral varus measurements: a comparison of four techniques Three different techniques have been described for measuring femoral varus radiographically in the dog, but how the measurements from these techniques compare is unknown. Further, measurement reliability has...... only been assessed for one technique. Seven grossly normal right femora were radiographed with the diaphysis positioned horizontally and inclined at both 12.5° and 25° to the horizontal. Radiographs were blinded, randomised and read twice by one observer using ImageJ. Using coordinate data, varus...... on varus measurement was assessed using a mixed model ANOVA. Two of the reported techniques varied significantly (P

  11. Flexible Capitalism

    DEFF Research Database (Denmark)

    Approaching “work” as at heart a practice of exchange, this volume explores sociality in work environments marked by the kind of structural changes that have come to define contemporary “flexible” capitalism. It introduces anthropological exchange theory to a wider readership, and shows how...... the perspective offers new ways to enquire about the flexible capitalism’s social dimensions. The essays contribute to a trans-disciplinary scholarship on contemporary economic practice and change by documenting how, across diverse settings, “gift-like” socialities proliferate, and even sustain the intensified...... flexible commoditization that more commonly is touted as tearing social relations apart. By interrogating a keenly debated contemporary work regime through an approach to sociality rooted in a rich and distinct anthropological legacy, the volume also makes a novel contribution to the anthropological...

  12. Femoral Reconstruction Using External Fixation

    Directory of Open Access Journals (Sweden)

    Yevgeniy Palatnik

    2011-01-01

    Full Text Available Background. The use of an external fixator for the purpose of distraction osteogenesis has been applied to a wide range of orthopedic problems caused by such diverse etiologies as congenital disease, metabolic conditions, infections, traumatic injuries, and congenital short stature. The purpose of this study was to analyze our experience of utilizing this method in patients undergoing a variety of orthopedic procedures of the femur. Methods. We retrospectively reviewed our experience of using external fixation for femoral reconstruction. Three subgroups were defined based on the primary reconstruction goal lengthening, deformity correction, and repair of nonunion/bone defect. Factors such as leg length discrepancy (LLD, limb alignment, and external fixation time and complications were evaluated for the entire group and the 3 subgroups. Results. There was substantial improvement in the overall LLD, femoral length discrepancy, and limb alignment as measured by mechanical axis deviation (MAD and lateral distal femoral angle (LDFA for the entire group as well as the subgroups. Conclusions. The Ilizarov external fixator allows for decreased surgical exposure and preservation of blood supply to bone, avoidance of bone grafting and internal fixation, and simultaneous lengthening and deformity correction, making it a very useful technique for femoral reconstruction.

  13. 78 FR 62417 - Regulatory Capital Rules: Regulatory Capital, Implementation of Basel III, Capital Adequacy...

    Science.gov (United States)

    2013-10-22

    ... Capital, Implementation of Basel III, Capital Adequacy, Transition Provisions, Prompt Corrective Action..., 2013 (78 FR 55340), regarding Regulatory Capital Rules: Regulatory Capital, Implementation of Basel III...

  14. Cemented femoral stems in patients with DDH.

    Science.gov (United States)

    Garcia-Cimbrelo, E

    2007-01-01

    Total hip arthroplasty is the procedure of choice for most adult patients with symptomatic arthrosis secondary to developmental dysplasia (DDH), but it requires complex reconstructive techniques, is usually performed in young patients, and has an increased risk of complications. THA is indicated in presence of severe pain and when osteotomy is contraindicated. The complexity of surgery is related to the degree of dysplasia. Anatomic abnormalities in the acetabulum and femur are the cause of the complexity and complications of this procedure. Acetabular bone deficiency requires reconstructive techniques before implanting the cup at the anatomic acetabular location, such as bone autograft augmentation, implanting the cup at higher level of the hip center and cup medialization. Femoral shortening and special cemented or uncemented stems are currently used to avoid intraoperative complications. While a cemented stem needs metaphyseal femoral shortening, subtrochanteric shortening requires a cementless stem. Because of these patients' age, alternative bearing surfaces, such as alumina-on-alumina couples are recommended when possible. Although the long-term results of total hip arthroplasty in DDH are inferior to those in a general population, the results show a high level of pain relief and functional improvement.

  15. Rotational stability of femoral osteosynthesis in femoral fractures - navigated measurements.

    Science.gov (United States)

    Citak, Mustafa; Kendoff, Daniel; Gardner, Michael J; Oszwald, Markus; O'Loughlin, Padhraig F; Olivier, Lucien C; Krettek, Christian; Hüfner, Tobias; Citak, Musa

    2009-01-01

    Rotational malalignment after intramedullary nailing of femoral fractures is common, and symptoms occur when malrotation reaches 15 degrees . Intraoperative measurement of rotation remains difficult, and multiple techniques have been described to address this. Regardless of the method used, rotational toggling may occur between the interlocking screws and the screw holes. We hypothesized that a clinically significant amount of rotation may occur with standard statically locked intramedullary nails. Mid-shaft diaphyseal fractures were created in 24 cadaveric femurs. Specimens were divided into 4 groups, and were stabilized with a statically locked intramedullary nail, a dynamically locked intramedullary nail, a compression plate, and a locking plate. Six additional femurs were kept intact as a control group. Specimens were mounted in a custom holding jig, which stabilized the constructs proximally and allowed free rotation distally. A computer navigation system was applied, and the femoral anteversion was measured. 4 N-m of internal and external torque was applied, and the change in version was measured. The statically locked nails rotated 14.2 degrees , and the dynamically locked group rotated 15.7 degrees . Both intramedullary nail groups showed significantly greater rotation than the plated groups. The compression plate specimens rotated 6.5 degrees on average, and the locked plate group rotated 3.8 degrees . Intramedullary femoral nailing with static or dynamic interlocking allows 15 degrees of rotation of the femur around the nail under physiologic load. This may exacerbate intraoperative errors in determining and setting rotation. Angular stable plates or nails may minimize this problem.

  16. Coupling failure between stem and femoral component in a constrained revision total knee arthroplasty.

    LENUS (Irish Health Repository)

    Butt, Ahsan Javed

    2013-02-01

    Knee revision using constrained implants is associated with greater stresses on the implant and interface surfaces. The present report describes a case of failure of the screw coupling between the stem and the femoral component. The cause of the failure is surmised with outline of the treatment in this case with extensive femoral bone loss. Revision implant stability was augmented with the use of a cemented femoral stem, screw fixation and the metaphyseal sleeve of an S-ROM modular hip system (DePuy international Ltd).

  17. Coupling failure between stem and femoral component in a constrained revision total knee arthroplasty

    International Nuclear Information System (INIS)

    Butt, A.J.; Shaikh, A.H.; Cameron, H.U.

    2013-01-01

    Knee revision using constrained implants is associated with greater stresses on the implant and interface surfaces. The present report describes a case of failure of the screw coupling between the stem and the femoral component. The cause of the failure is surmised with outline of the treatment in this case with extensive femoral bone loss. Revision implant stability was augmented with the use of a cemented femoral stem, screw fixation and the metaphyseal sleeve of an S-ROM modular hip system (DePuy international Ltd). (author)

  18. [Femoral nail osteosynthesis. Mechanical factors influencing the femoral antetorsion].

    Science.gov (United States)

    Citak, M; Kendoff, D; Citak, M; Gardner, M J; Oszwald, M; Krettek, C; Hüfner, T

    2008-04-01

    Antegrade or retrograde intramedullary nailing is a common and well established procedure for the treatment of femoral shaft fractures. One drawback of this technique is the high incidence of clinically relevant malalignment. Despite intra-operative and radiological improvements this problem has not yet been solved efficiently. The aim of this study was the evaluation of the mechanical influence on the antetorsion angle of intramedullary nails during and after interlocking in femoral shaft fractures. A mechanical instrument was developed allowing a defined torque to be administered to the distal femur fragment. As an optical measurement system for the assessment of the antetorsion angle, a navigation system was applied. Initially the influence of the interlocking mechanism of the nail on the antetorsion deviation was investigated. The distal interlocking hole was fixed free handed or by using a navigation system. The multidirectional movement of the distal femur fragment was documented. Furthermore, the influence of the rotational stability on the antetorsion angle after mechanical stress of 4 NM was investigated by measuring the remaining rotational capacity of the distal femur fragment. The average remaining rotational capacity of the distal femur fragment was 5.8 degrees after locking the nail by hand. The navigated locking resulted in a deviation of only 2 degrees , a significant difference compared to the free-hand procedure. The rotational stability under stress showed an average of 15.4 degrees deviation of the distal fragment. Even after complete interlocking of the intramedullary nail a 14.2 degrees rotational deviation was observed. It could be shown that mechanical stability as well as the interlocking itself of femoral nails have a relevant impact on the antetorsional angle of the femur. Potential sources of error of the femoral antetorsion angle can be caused by the interlocking process as well as by forced rotation of the femur after interlocking

  19. [Femoral shaft fractures in children].

    Science.gov (United States)

    Dietz, H-G; Schlickewei, W

    2011-05-01

    Femoral shaft fractures in children represent 1.5% of all fractures in childhood. Up to the age of 4 years, conservative treatment in a hip spica or short-term overhead traction is the therapy of choice. Femoral shaft fractures between the age of 5 and 16 years should be treated surgically. In over 90% of these cases elastic stable intramedullary nailing (ESIN) is the premier treatment option. Additional end caps can be used for unstable fractures and in length discrepancy. The external fixator and the locking plate are reserved for fractures with severe soft tissue injuries, vascular problems and some specific situations mentioned later on. By adhering to these standards good results can be achieved with a low complication rate.

  20. Management of femoral shaft fractures.

    Science.gov (United States)

    Neumann, M V; Südkamp, N P; Strohm, P C

    2015-01-01

    Femoral shaft fractures are severe injuries and are often associated with a high impact trauma mechanism, frequently seen in multiple injured patients. In contrast an indirect trauma mechanism can lead to a complex femoral shaft fracture especially in elderly patients with minor bone stock quality. Hence management of femoral shaft fractures is often directed by co-morbidities, additional injuries and the medical condition of the patient. Timing of fracture stabilization is depended on the overall medical condition of the patient, but definite fracture fixation can often be implemented in the early total care concept in management of multiple injured patients. The treatment of choice is intramedullary fracture fixation. Further development of existing intramedullary nailing systems now offer comfortable handling and different locking options. Ipsilateral fractures of the neck and shaft are therefore facilitated in management. Then again increasing numbers of obese patient are representing a new patient group with challenging co-factors in fracture management. Sufficient preoperative planning is helpful to choose the most adequate fixation device. Correct reduction of the fracture and perioperative control of the axis and rotation is mandatory to avoid postoperative malrotation, which still represents the most frequent complication.

  1. Is Capitalism Ethical?

    OpenAIRE

    Suciu T.

    2009-01-01

    The author of this paper have set off from the question: is the present capitalism ethical? We started with the delimitation and correlation of the concepts of ethics, morals, morality. Further on, we analysed the evolution of capitalism in connection with morals. Based on this research, we came to the conclusion that the capitalist system has undergone through three stages: moral capitalism, amoral capitalism, and immoral capitalism. We concluded by implying that the corporate capitalist soc...

  2. Collateral and Capital Structure

    OpenAIRE

    S. Viswanathan; Adriano Rampini

    2009-01-01

    This paper develops a dynamic model of the capital structure based on the need to collateralize loans with tangible assets. The model provides a unified theory of optimal firm financing in terms of the optimal capital structure, investment, leasing, and risk management policy. Tangible assets are a key determinant of the cross section and dynamic behavior of the capital structure. Firms with low tangible capital are constrained longer, lease more of their physical capital, and borrow less. Le...

  3. Risk of femoral hernia after inguinal herniorrhaphy

    DEFF Research Database (Denmark)

    Mikkelsen, T; Bay-Nielsen, M; Kehlet, H

    2002-01-01

    BACKGROUND: Small case series have suggested an increased risk of femoral hernia after previous inguinal herniorrhaphy, but no large-scale data with complete follow-up are available. METHODS: Data were extracted from the Danish Hernia Database covering the interval from 1 January 1998 to 1 July...... 2001, and included 34 849 groin hernia repairs. RESULTS: Of 1297 femoral hernia repairs, 71 patients had previously had an operation for inguinal hernia within the observation period. These 71 femoral hernias represented 7.9 per cent of all reoperations for groin hernia recorded in the database....... The median time to reoperation for a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 7 months, compared with 10 months for inguinal recurrences. The risk of developing a 'recurrent' femoral hernia after previous inguinal herniorrhaphy was 15 times higher than the rate of femoral hernia...

  4. Superselective intra-arterial DSA in patients with femoral head necrosis and femoral neck fracture

    International Nuclear Information System (INIS)

    Langer, R.; Scholz, A.; Langer, M.; Astinet, F.; Ferstl, F.; Felix, R.; Schwetlick, G.

    1991-01-01

    The prospective study includes 25 patients without pathology of the femoral head for the evaluation of the normal femoral head perfusion. In addition 34 patients with femoral head necrosis underwent i.a. DSA preoperatively before pedicled pelvic bone grafting. 15 patients after pelvic bone graft operation and 7 patients with medial femoral head fracture were also examined via superselective DSA. In cases with femoral head necrosis a rarefaction or interruption of the rami nutricii proximales, or an occlusion of the medial circumflex femoral artery were observed. Patients with medial femoral neck fracture showed an interruption of the rami nutricii proximales of the femoral head. Postoperative DSA - after pedicled pelvic bone graft - revealed a regular arterial graft perfusion in 82%. (orig.) [de

  5. Evaluation of perfusion of the femoral head after femoral neck fracture using bone scintigraphy

    Energy Technology Data Exchange (ETDEWEB)

    Yamaguchi, Satoshi; Ishido, Yasuhiro [Saiseikai Sendai Hospital, Kagoshima (Japan); Okano, Toshihiro [Ibusuki National Hospital, Kagoshima (Japan); Komiya, Setsuro [Kagoshima Univ. (Japan). Faculty of Medicine

    2002-09-01

    We treated 13 patients for femoral neck fracture. They consisted of 2 males and 11 females, and were classified according to Garden stage classification; Stage I, 3 cases; Stage II, 2 cases; Stage III, 2 cases; Stage IV, 4 cases. Two trochanteric fracture cases were used by control. We evaluated perfusion of the femoral head after femoral neck fracture using bone scintigraphy, which is considered useful for evaluation of perfusion of the femoral neck before operation. (author)

  6. Evaluation of perfusion of the femoral head after femoral neck fracture using bone scintigraphy

    International Nuclear Information System (INIS)

    Yamaguchi, Satoshi; Ishido, Yasuhiro; Okano, Toshihiro; Komiya, Setsuro

    2002-01-01

    We treated 13 patients for femoral neck fracture. They consisted of 2 males and 11 females, and were classified according to Garden stage classification; Stage I, 3 cases; Stage II, 2 cases; Stage III, 2 cases; Stage IV, 4 cases. Two trochanteric fracture cases were used by control. We evaluated perfusion of the femoral head after femoral neck fracture using bone scintigraphy, which is considered useful for evaluation of perfusion of the femoral neck before operation. (author)

  7. Osteonecrosis of Femoral Head Occurred after Stent Placement of Femoral Artery

    Directory of Open Access Journals (Sweden)

    Akiyoshi Shimatani

    2014-01-01

    Full Text Available We present a case of osteonecrosis of femoral head (ONFH that occurred after stent angiography of femoral artery for the treatment of arteriosclerosis obliterans (ASO of left inferior limb in a 76-year-old woman. No case of late collapse of femoral head as a complication of endovascular procedure such as stent placement has been previously documented. We considered that ONFH occurred after detaining stent at a junction of left deep femoral artery for the treatment of the ischemia of left lateral and medial femoral circumflex artery.

  8. Deslizamientos epifisarios femorales proximales >30º. Procedimiento de Dunn modificado. Evaluación anatómica y funcional en una cohorte retrospectiva. [Slipped capital femoral epiphysis >30º. Modified Dunn procedure. Anatomical and functional evaluation in a retrospective cohort

    Directory of Open Access Journals (Sweden)

    Francisco Praglia

    2013-12-01

    Full Text Available Introducción La deformidad residual resultante de un deslizamiento epifisario femoral proximal moderado o grave conduce a osteoartritis prematura debida al choque femoroacetabular. Los objetivos del trabajo fueron evaluar la mejoría de la anatomía del fémur proximal y evaluar la función de la cadera en pacientes con deslizamiento epifisario femoral proximal >30 grados tratados con el procedimiento de Dunn modificado, a corto plazo. Material y Métodos Cohorte retrospectiva de pacientes con deslizamiento epifisario femoral proximal >30 grados, tratados con luxación controlada de cadera y el procedimiento de Dunn modificado. Se evaluaron mediciones clínicas y radiológicas preoperatorias y posoperatorias, hallazgos intraoperatorios y funcionalidad con los puntajes de Harris y de D’aubigne-Postel. Resultados Trece casos, mediana de edad 12 años y mediana de seguimiento 14 meses. El ángulo de deslizamiento de Southwick preoperatorio (75 grados, ri 67-85 y posoperatorio (10 grados, ri 5-17 mostró una disminución estadísticamente significativa (p <0,001. El offset radio cabeza-cuello preoperatorio (-0,13 versus el posoperatorio (0,12 obtuvo una mejoría significativa (p 0,002. El 69,2% de los pacientes presentó daño de alguna estructura intraarticular. Los puntajes promedio de funcionalidad fueron 14,6 (muy buena mejoría y 83,4 (bueno. Complicaciones: necrosis avascular 15,3% y condrólisis 15,3%. Conclusion Esta técnica restaura la anatomía del fémur proximal y la funcionalidad de la cadera a corto plazo. aunque no disponemos de resultados a largo plazo, al menos en teoría, serían buenos. Sin embargo, la luxación controlada con Dunn modificado no está exenta de complicaciones y el riesgo de necrosis avascular y condrólisis persiste.

  9. Is there a role for femoral offset restoration during total hip arthroplasty? A systematic review.

    Science.gov (United States)

    De Fine, M; Romagnoli, M; Toscano, A; Bondi, A; Nanni, M; Zaffagnini, S

    2017-05-01

    Benefits of femoral offset restoration during total hip arthroplasty should be the reduction of bearing surfaces wear, implant loosening and dislocation rates. Modular neck stems ensure offset customization but fretting corrosion and catastrophic failures are well-documented complications. Since clinical evidences are needed to substantiate the effectiveness of femoral offset restoration and promote modular neck choice, we systematically reviewed the literature to ascertain whether femoral offset itself has a proven clinical influence: (1) on bearing surfaces wear, (2) implant loosening, (3) and dislocation rates. A systematic literature screening was conducted to find papers dealing with the influence of femoral offset on wear, dislocation and loosening, including articles with conventional radiographic femoral offset assessment and with comparative design. Observational studies, case reports, instructional course lectures, cadaveric and animal studies as well as biomechanical studies, letters to the editor, surgical techniques or technical notes were all excluded. No limits about publication date were supplied but only papers in English were taken into account. Data were extracted into an anonymous spreadsheet. Offset values, dislocation rates, wear rates, follow-up and surgical approaches were all detailed. Ten manuscripts were finally selected. A statistically significant correlation between femoral offset restoration and the reduction of conventional ultrahigh-molecular-weight polyethylene wear was found in two out of three papers investigating this issue, but no correlations were found between femoral offset and dislocation rates or implant loosening. Femoral offset modification influences ultrahigh-molecular-weight polyethylene liners wear, but no correlation was found with dislocation rates or implant loosening. Advantages on wear can be counterbalanced by the use of hard bearing surfaces or highly cross-linked polyethylene liners, besides the availability

  10. Retrieved Magnesia-Stabilized Zirconia Femoral Heads Exhibit Minimal Roughening and Abrasive Potential.

    Science.gov (United States)

    Roy, Marie E; Whiteside, Leo A; Sebastian, Arun M

    2017-12-01

    The degradation of ceramic femoral heads made of yttria-stabilized zirconia (Y-TZP) because of tetragonal-to-monoclinic phase transformation in vivo is well-described, whereas magnesia-stabilized zirconia (Mg-PSZ) ceramics resist phase transformation in a warm aqueous environment. The purpose of this study was to evaluate phase transformation, changes in surface topography, and roughness parameters, including changes in surface polarity and abrasiveness, among retrieved zirconia femoral heads. A total of 69 Y-TZP and 86 Mg-PSZ-retrieved femoral heads were examined, with 5 never-implanted heads of each type as controls. Selected heads were scanned by x-ray diffraction, to measure % monoclinic phase. All heads were scanned by optical profilometry to find visual evidence of degradation and to measure surface roughness, surface polarity, and the functional roughness parameters. Monoclinic phase % and roughness data were plotted vs time in vivo. Visual evidence of phase transformation was observed among Y-TZP femoral heads, and some exhibited pitting. Y-TZP femoral heads roughened and become more abrasive in vivo, although those made by CeramTec exhibited less degradation than those by Morgan and Saint Gobain. In contrast, Mg-PSZ heads did not exhibit pitting, undergo phase transformation, or roughen in vivo, and retained a negative surface polarity. All Y-TZP femoral heads exhibited increased phase transformation with time in vivo, although not all Y-TZP heads exhibited catastrophic roughening. No phase transformation was observed on Mg-PSZ femoral heads after up to 19.2 years in vivo. The lack of degradation among Mg-PSZ retrievals suggests a lower wear potential in joint replacement. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Triads of capital

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase

    Within current research on social capital, a gap exists between political history analyses at the macro level and classical, sociological analyses at the meso and micro levels. Following up on  earlier work, the main purpose of this paper is to mediate between the two conflicting stances...... represented by Putnam and Portes. The paper raises the following question: Is it possible to detect the historical driving forces behind the building of both beneficial and harmful social capital? Driving forces are defined as structural determinants, which change human organization at all levels....... The hypothesis is that three forms of capital have the potential to act as driving forces: social capital, cultural capital and physical capital, the latter operationaliz­ed as buildings. A new concept, triad of capital, is introduced to analyze the interrelationship between these three forms of capital. A triad...

  12. State Capitalism in Eurasia

    NARCIS (Netherlands)

    C. Spechler, Martin; Ahrens, Joachim; Hoen, Herman W.

    2017-01-01

    The book specifies the type of economic system that has arisen in Central Asian. It presents three types of state-capitalism established in the former Soviet Union states in Eurasia - crony, dual sector, and predatory capitalism.

  13. Capitalism and justification

    Directory of Open Access Journals (Sweden)

    Birešev Ana

    2009-01-01

    Full Text Available Weber's thesis that the spirit of capitalism was preexistent to the rise of capitalism itself inspired many sociologist to search for the cultural background of contemporary forms of capitalism. In this paper, the author focuses on and makes comparisons of three approaches of such kind. The one approach draws from Luc Boltanski and Ève Chiapello who examine the development of 'new spirit of capitalism' by focusing on the interrelation of two macroactors - capitalism and critique; the other one is of Nigel Thrift who relates the rise of 'soft capitalism' to the strengthening of 'cultural circuit of capital'; and finally, Richard Sennett's approach analyzes the culture of 'new capitalism' and work ethic of the 'mp3 organizations'.

  14. CONTROLS ON CAPITAL MOVEMENTS

    Directory of Open Access Journals (Sweden)

    Petris Sorina

    2012-12-01

    Full Text Available Until recently, capital mobility was encouraged across national borders, because it was considered that such capital can seek the highest rate of return. However, recent global financial developments have shown that, due to contagion, the mobility of capital flows can cause severe financial imbalances. In the context of globalization, liberalization or maintaining controls on capital flows is a current topic, more debated by economists. This topic is very important, due to the impact of liberalization decision or maintaining controls on capital flows has on the overall macroeconomic framework. The paper analyzes the relationship between capital flows’ control and the income per capita, the degree of central bank independence, democracy country, the foreign exchange regime. Also, it analyzes the effectiveness in time of capital controls, taking account of financial system development and potential risks of instability. Over time, it was observed that a period in which they have imposed restrictions on capital movements was followed by a removal of such restrictions, and vice versa. Cyclic change of capital movements regime corresponds to the cyclic evolution of the global economy. Full capital account liberalization led to the emergence of currency and financial crises, so that the idea of maintaining controls on capital is not rejected by economists. After a full liberalization of capital flows, there is a change in the mentality of an increasing number of economists, who support the maintenance of controls, in a gradual liberalization.

  15. Capital Equipment Replacement Decisions

    OpenAIRE

    Batterham, Robert L.; Fraser, K.I.

    1995-01-01

    This paper reviews the literature on the optimal replacement of capital equipment, especially farm machinery. It also considers the influence of taxation and capital rationing on replacement decisions. It concludes that special taxation provisions such as accelerated depreciation and investment allowances are unlikely to greatly influence farmers' capital equipment replacement decisions in Australia.

  16. Is Capitalism Ethical?

    Directory of Open Access Journals (Sweden)

    Suciu T.

    2009-12-01

    Full Text Available The author of this paper have set off from the question: is the present capitalism ethical? We started with the delimitation and correlation of the concepts of ethics, morals, morality. Further on, we analysed the evolution of capitalism in connection with morals. Based on this research, we came to the conclusion that the capitalist system has undergone through three stages: moral capitalism, amoral capitalism, and immoral capitalism. We concluded by implying that the corporate capitalist society is immoral, that it cannot regulate itself and that the government’s assistance is needed to inoculate the ethics.

  17. Femoral neck fracture following hardware removal.

    Science.gov (United States)

    Shaer, James A; Hileman, Barbara M; Newcomer, Jill E; Hanes, Marina C

    2012-01-16

    It is uncommon for femoral neck fractures to occur after proximal femoral hardware removal because age, osteoporosis, and technical error are often noted as the causes for this type of fracture. However, excessive alcohol consumption and failure to comply with protected weight bearing for 6 weeks increases the risk of femoral neck fractures.This article describes a case of a 57-year-old man with a high-energy ipsilateral inter-trochanteric hip fracture, comminuted distal third femoral shaft fracture, and displaced lateral tibial plateau fracture. Cephalomedullary fixation was used to fix the ipsilateral femur fractures after medical stabilization and evaluation of the patient. The patient healed clinically and radiographically at 6 months. Despite conservative treatment for painful proximal hardware, elective hip screw removal was performed 22.5 months after injury. Seven weeks later, he sustained a nontraumatic femoral neck fracture.In this case, it is unlikely that the femoral neck fracture occurred as a result of hardware removal. We assumed that, in addition to the patient's alcohol abuse and tobacco use, stress fractures may have attributed to the femoral neck fracture. We recommend using a shorter hip screw to minimize hardware prominence or possibly off-label use of an injectable bone filler, such as calcium phosphate cement. Copyright 2012, SLACK Incorporated.

  18. Ideal femoral head size in total hip arthroplasty balances stability and volumetric wear.

    Science.gov (United States)

    Cross, Michael B; Nam, Denis; Mayman, David J

    2012-10-01

    Over the last several years, a trend towards increasing femoral head size in total hip arthroplasty to improve stability and impingement free range of motion has been observed. The specific questions we sought to answer in our review were: (1) What are the potential advantages and disadvantages of metal-on-metal, ceramic-on-ceramic, and metal-on-polyethylene bearings? (2) What is effect that femoral head size has on joint kinematics? (3) What is the effect that large femoral heads have on bearing surface wear? A PubMed search and a review of 2012 Orthopaedic Research Society abstracts was performed and articles were chosen that directly answered components of the specific aims and that reported outcomes with contemporary implant designs or materials. A review of the literature suggests that increasing femoral head size decreases the risk of postoperative dislocation and improves impingement free range of motion; however, volumetric wear increases with large femoral heads on polyethylene and increases corrosion of the stem in large metal-on-metal modular total hip arthroplasty (THA); however, the risk of potentially developing osteolysis or adverse reactions to metal debris respectively is still unknown. Further, the effect of large femoral heads with ceramic-on-ceramic THA is unclear, due to limited availability and published data. Surgeons must balance the benefits of larger head size with the increased risk of volumetric wear when determining the appropriate head size for a given patient.

  19. Frequency of ipsilateral femoral neck fractures in patients with ...

    African Journals Online (AJOL)

    Background: Ipsilateral associated femoral neck and shaft fractures are reported to occur in 2.5-6% of all femoral shaft fractures. Objective: To establish the frequency of ipsilateral femoral neck fractures amongst all patients presenting with femoral shaft fractures in Mulago Hospital. Methodology: This was a descriptive ...

  20. Arteriosclerotic femoral artery aneurysms. A short review

    DEFF Research Database (Denmark)

    Levi, N; Schroeder, T V

    1997-01-01

    classified by Cutler and Darling in 1973 as type 1 and type 2 according to their relationship to the common femoral bifurcation. Case reports of isolated superficial and profunda femoral artery aneurysms have been published, but these are exceedingly rare although isolated aneurysms of the profunda femoris...... occurs in 0-26% of cases. Acute thrombosis occurs in around 15% of cases. Rupture is uncommon and varies between 10% and 14%. Aneurysmal dilatation of the profunda femoris artery is uncommon and occurs in only 1% to 2.6% of all femoral artery aneurysms. Individualized operative approaches are based...

  1. Limited femoral navigation versus conventional intramedullary femoral jig based instrumentation for achieving optimal restoration of mechanical axis post total knee arthroplasty: a prospective comparative study of 200 knees.

    Science.gov (United States)

    Shah, Nilen A; Patil, Hitendra G; Dhawale, Amol S; Khedkar, Bipin M

    2015-04-01

    A prospective comparative study was conducted to compare the mechanical axis post total knee arthroplasty (TKA) between two groups: In the first group of 100 knees (ASM group) Articular Surface Mounted navigation system was used to guide the distal femoral cut. In the second group of 100 knees (JIG group) conventional intramedullary femoral jig was used. The postoperative mechanical axis of the leg was within 3° of neutral alignment in 90% of the TKA in the ASM group (mean 178.12°) as compared to 74% in the JIG group (mean 177.02°). This difference was statistically significant (Pjigs. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. THE EFFECT OF HUMAN CAPITAL ON SOCIAL CAPITAL AMONG ENTREPRENEURS

    OpenAIRE

    HANNES OTTÓSSON; KIM KLYVER

    2010-01-01

    Using data collected from 714 entrepreneurs in a random sample of 10,000 Danes, this study provides an investigation of the effect of human capital on social capital among entrepreneurs. Previous entrepreneurship research has extensively investigated the separated effect of human capital and social capital on different entrepreneurial outputs. The study takes a step back and investigates how these two capital concepts are related — specifically how human capital influences social capital. In ...

  3. A biomechanical comparison of proximal femoral nails and locking proximal anatomic femoral plates in femoral fracture fixation

    Science.gov (United States)

    Ozkan, Korhan; Türkmen, İsmail; Sahin, Adem; Yildiz, Yavuz; Erturk, Selim; Soylemez, Mehmet Salih

    2015-01-01

    Background: The incidence of fractures in the trochanteric area has risen with the increasing numbers of elderly people with osteoporosis. Although dynamic hip screw fixation is the gold standard for the treatment of stable intertrochanteric femur fractures, treatment of unstable intertrochanteric femur fractures still remains controversial. Intramedullary devices such as Gamma nail or proximal femoral nail and proximal anatomic femur plates are in use for the treatment of intertrochanteric femur fractures. There are still many investigations to find the optimal implant to treat these fractures with minimum complications. For this reason, we aimed to perform a biomechanical comparison of the proximal femoral nail and the locking proximal anatomic femoral plate in the treatment of unstable intertrochanteric fractures. Materials and Methods: Twenty synthetic, third generation human femur models, obtained for this purpose, were divided into two groups of 10 bones each. Femurs were provided as a standard representation of AO/Orthopedic Trauma Associationtype 31-A2 unstable fractures. Two types of implantations were inserted: the proximal femoral intramedullary nail in the first group and the locking anatomic femoral plate in the second group. Axial load was applied to the fracture models through the femoral head using a material testing machine, and the biomechanical properties of the implant types were compared. Result: Nail and plate models were locked distally at the same level. Axial steady load with a 5 mm/m velocity was applied through the mechanical axis of femur bone models. Axial loading in the proximal femoral intramedullary nail group was 1.78-fold greater compared to the plate group. All bones that had the plate applied were fractured in the portion containing the distal locking screw. Conclusion: The proximal femoral intramedullary nail provides more stability and allows for earlier weight bearing than the locking plate when used for the treatment of

  4. Subtrochanteric femoral fracture during trochanteric nailing for the treatment of femoral shaft fracture.

    Science.gov (United States)

    Yun, Ho Hyun; Oh, Chi Hun; Yi, Ju Won

    2013-09-01

    We report on three cases of subtrochanteric femoral fractures during trochanteric intramedullary nailing for the treatment of femoral shaft fractures. Trochanteric intramedullary nails, which have a proximal lateral bend, are specifically designed for trochanteric insertion. When combined with the modified insertion technique, trochanteric intramedullary nails reduce iatrogenic fracture comminution and varus malalignment. We herein describe technical aspects of trochanteric intramedullary nailing for femoral shaft fractures to improve its application and prevent implant-derived complications.

  5. Hygroma following endovascular femoral aneurysm exclusion

    DEFF Research Database (Denmark)

    Wad, Morten; Pedersen, Brian Lindegaard; Lönn, Lars

    2013-01-01

    Endovascular treatment of aneurysms in the superficial femoral artery (SFA) and popliteal segments is a suggested alternative to open surgical repair. Careful selection of patients for endovascular treatment of SFA aneurysms is mandatory.......Endovascular treatment of aneurysms in the superficial femoral artery (SFA) and popliteal segments is a suggested alternative to open surgical repair. Careful selection of patients for endovascular treatment of SFA aneurysms is mandatory....

  6. Modern Human Capital Management

    OpenAIRE

    Feldberger, Madita

    2008-01-01

    Title: Modern Human Capital Management Seminar date: 30th of May 2008 Course: Master thesis in Business Administration, 15 ECTS Authors: Madita Feldberger Supervisor: Lars Svensson Keywords: Human capital, SWOT Analysis, Strategic Map, Balanced Scorecard Research Problem: Despite of the success of Human Capital Management (HCM) in research it did not arrive yet in the HR departments of many companies. Numerous firms even have problems to set their strategic goals with focus on HR. The HR Bala...

  7. Handbook of Social Capital

    DEFF Research Database (Denmark)

    The Handbook of Social Capital balances the ‘troika' of sociology, political science and economics by offering important contributions to the study of bonding and bridging social capital networks. This inter-disciplinary Handbook intends to serve as a bridge for students and scholars within all...... the social sciences. The contributors explore the different scientific approaches that are all needed if international research is to embrace both the bright and the more shadowy aspects of social capital....

  8. Piketty’s Capital

    DEFF Research Database (Denmark)

    Larsen, Øjvind

    2016-01-01

    Piketty’s Capital in Twenty-First Century has posed a totally new platform for the discussion of the economy and capitalism. Piketty has reinvented the classical political economy founded by Adam Smith in his 1776 Wealth of Nations. Piketty has shown via massive historical research how growth...... and inequality have developed since 1793. Piketty’s conclusion is that the French Revolution did not change the existing inequality either in the medium or in the long term. Piketty’s prediction is that a new form of global capitalism will arise, patrimonial capitalism, in which inequality will develop further...

  9. Human Capital Overview

    National Research Council Canada - National Science Library

    McCarthy, Ellen E

    2007-01-01

    ...: To provide an agile, adaptive, integrated, and innovative defense intelligence workforce through a deliberate process identifying, implementing, and directing human capital organizational, doctrinal...

  10. Electronic Capitalization Asset Form -

    Data.gov (United States)

    Department of Transportation — National Automated Capitalization Authorization Form used by ATO Engineering Services, Logistics, Accounting for the purpose of identifying and capturing FAA project...

  11. Social Capital Database

    DEFF Research Database (Denmark)

    Paldam, Martin; Svendsen, Gert Tinggaard

    2005-01-01

      This report has two purposes: The first purpose is to present our 4-page question­naire, which measures social capital. It is close to the main definitions of social capital and contains the most successful measures from the literature. Also it is easy to apply as discussed. The second purpose ...... is to present the social capital database we have collected for 21 countries using the question­naire. We do this by comparing the level of social capital in the countries covered. That is, the report compares the marginals from the 21 surveys....

  12. Bilateral femoral neck fractures following pelvic irradiation

    International Nuclear Information System (INIS)

    Mitsuda, Kenji; Nishi, Hosei; Oba, Hiroshi

    1977-01-01

    Over 300 cases of femoral neck fractures following radiotherapy for intrapelvic malignant tumor have been reported in various countries since Baensch reported this disease in 1927. In Japan, 40 cases or so have been reported, and cases of bilateral femoral neck fractures have not reached to ten cases. The authors experienced a case of 75 year-old female who received radiotherapy for cancer of the uterus, and suffered from right femoral neck fracture 3 months after and left femoral neck fracture one year and half after. As clinical symptoms, she had not previous history of trauma in bilateral femurs, but she complained of a pain in a hip joint and of gait disturbance. The pain in left femoral neck continued for about one month before fracture was recognized with roentgenogram. As histopathological findings, increase of fat marrow, decrease of bone trabeculae, and its marked degeneration were recognized. Proliferation of some blood vessels was found out, but thickness of the internal membrane and thrombogenesis were not recognized. Treatment should be performed according to degree of displacement of fractures. In this case, artificial joint replacement surgery was performed to the side of fracture of this time, because this case was bilateral femoral neck fractures and the patient had received artificial head replacement surgery in the other side of fracture formerly. (Tsunoda, M.)

  13. Femoral head wedge resection for the treatment of avascular necrosis of the femoral head after pediatric femoral neck fracture: a case report.

    Science.gov (United States)

    Kim, Ha Yong; Cha, Yong Han; Choy, Won Sik; Jeung, Sang Wook; Min, Yeon Seung

    2018-05-01

    This research focuses on femoral head wedge resection for the treatment of avascular necrosis (AVN) of the femoral head. A 9-year-old girl presented to the emergency room complaining of right hip pain that occurred after a pedestrian car accident. After 8 months of internal fixation using cannulated screws for Delbet-type 2 fracture of the femoral neck, AVN of the femoral head developed in the patient. Even though valgus-derotation-extension intertrochanteric osteotomy was performed for the treatment of AVN, it progressed further and femoral head wedge resection was performed to recover the femoral head sphericity. After 3 years of follow-up, radiograph results showed appropriate and satisfactory congruency and containment. This research shows that the treatment of AVN of the femoral head using femoral head wedge resection is an effective method that can yield excellent results.

  14. Normal radiological unossified hip joint space and femoral head size development during growth in 675 children and adolescents.

    Science.gov (United States)

    Wegener, Veronika; Jorysz, Gabriele; Arnoldi, Andreas; Utzschneider, Sandra; Wegener, Bernd; Jansson, Volkmar; Heimkes, Bernhard

    2017-03-01

    Evaluation of hip joint space width during child growth is important to aid in the early diagnosis of hip pathology in children. We established reference values for hip joint space and femoral head size for each age. Hip joint space development during growth was retrospectively investigated medial and cranial in 1350 hip joints of children using standard anteroposterior supine plain pelvic radiographs. Maximum capital femoral epiphysis diameter and femoral radii were further more investigated. Hip joint space values show a slow decline during growth. Joint space was statistically significantly (p < 0.006) larger in boys than girls. Our hip joint space measurements on supine subjects seem slightly larger than those reported by Hughes on standing subjects. Evaluation of the femoral head diameter and the radii showed a size curve quite parallel to the known body growth charts. Radii medial and perpendicular to the physis are not statistically significantly different. We recommend to compare measurements of hip joint space at two locations to age dependent charts using the same imaging technique. During growth, a divergence in femoral head size from the expected values or loss of the spherical shape should raise the question of hip disorder. Clin. Anat. 30:267-275, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  15. Subtrochanteric Femoral Fracture during Trochanteric Nailing for the Treatment of Femoral Shaft Fracture

    OpenAIRE

    Yun, Ho Hyun; Oh, Chi Hun; Yi, Ju Won

    2013-01-01

    We report on three cases of subtrochanteric femoral fractures during trochanteric intramedullary nailing for the treatment of femoral shaft fractures. Trochanteric intramedullary nails, which have a proximal lateral bend, are specifically designed for trochanteric insertion. When combined with the modified insertion technique, trochanteric intramedullary nails reduce iatrogenic fracture comminution and varus malalignment. We herein describe technical aspects of trochanteric intramedullary nai...

  16. Femoral neck shortening after internal fixation of a femoral neck fracture

    NARCIS (Netherlands)

    Zielinski, Stephanie M.; Keijsers, Noël L.; Praet, Stephan F. E.; Heetveld, Martin J.; Bhandari, Mohit; Wilssens, Jean Pierre; Patka, Peter; van Lieshout, Esther M. M.; Devereaux, Philip J.; Guyatt, Gordon; Jeray, Kyle; Liew, Susan; Richardson, Martin J.; Schemitsch, Emil H.; Swiontkowski, Marc; Tornetta, Paul; Walter, Stephen; Sprague, Sheila; Simunovic, Helena Viveiros Nicole; Heels-Ansdell, Diane; Buckingham, Lisa; Duraikannan, Aravin; Swiontkowski, Marc F.; Agel, Julie; Goslings, J. Carel; Haverlag, Robert; Ponsen, Kees Jan; Bronkhorst, Maarten W. G. A.; Guicherit, O. R.; Eversdijk, Martin G.; Peters, Rolf; den Hartog, Dennis; van Waes, Oscar J. F.; Oprel, Pim; de Rijcke, Piet A. R.; Koppert, C. L.; Buijk, Steven E.; Groenendijk, Richard P. R.; Dawson, I.; Tetteroo, G. W. M.; Bruijninckx, Milko M. M.; Doornebosch, Pascal G.; de Graaf, E. J. R.; Gasthuis, Kennemer; Visser, Gijs A.; Stockmann, Heyn; Silvis, Rob; Snellen, J. P.; Rijbroek, A.; Scheepers, Joris J. G.; Vermeulen, Erik G. J.; Siroen, M. P. C.; Vuylsteke, Ronald; Brom, H. L. F.; Ryna, H.; Roukema, Gert R.; Josaputra, H.; Keller, Paul; de Rooij, P. D.; Kuiken, Hans; Boxma, Han; Cleffken, Barry I.; Liem, Ronald; Rhemrev, Steven J.; Bosman, C. H. R.; van Otterloo, Alexander de Mol; Hoogendoorn, Jochem; de Vries, Alexander C.; Meylaerts, Sven A. G.; Poolman, Rudolf W.; Simons, Maarten P.; van der Heijden, Frank H. W. M.; Willems, W. J.; de Meulemeester, Frank R. A. J.; van der Hart, Cor P.; Turckan, Kahn; Festen, Sebastiaan; de Nies, F.; Out, Nico J. M.; Bosma, J.; van der Elst, Maarten; van der Pol, Carmen C.; van 't Riet, Martijne; Karsten, T. M.; de Vries, M. R.; Stassen, Laurents P. S.; Schep, Niels W. L.; Schmidt, G. B.; Hoffman, W. H.; Segers, Michiel J. M.; Zijl, Jacco A. C.; Verhoeven, Bart; Smits, Anke B.; de Vries, J. P. P. M.; Fioole, Bram; van der Hoeven, H.; Theunissen, Evert B. M.; de Vries Reilingh, Tammo S.; Govaert, Lonneke; Wittich, Philippe; de Brauw, Maurits; Wille, Jan; Go, Peter M. N. Y. M.; Ritchie, Ewan D.; Wessel, R. N.; Hammacher, Eric R.; Verhofstad, Michiel H. J.; Meijer, Joost; van Egmond, Teun; van der Brand, Igor; van der Vis, Harm M.; Campo, Martin; Verhagen, Ronald; Albers, G. H. R.; Zurcher, A.; van Kampen, A.; Biert, Jan; van Vugt, Arie B.; Edwards, Michael J. R.; Blokhuis, Taco J.; Frölke, Jan Paul M.; Geeraedts, L. M. G.; Gardeniers, J. W. M.; Tan, Edward T. C. H.; Poelhekke, L. M. S. J.; de Waal Malefijt, M. C.; Schreurs, Bart; Simmermacher, Rogier K. J.; van Mulken, Jeroen; van Wessem, Karlijn; van Gaalen, Steven M.; Leenen, Luke P. H.; Frihagen, Frede; Nordsletten, Lars; Stoen, Ragnhild Oydna; Brekke, Kine; Tetsworth, Kevin; Weinrauch, Patrick; Pincus, Paul; Donald, Geoff; yang, Steven; Halliday, Brett; Gervais, Trevor; Holt, Michael; Flynn, Annette; Pirpiris, Marinis; Love, David; Bucknill, Andrew; Farrugia, Richard J.; Dowrick, Adam; Donohue, Craig; Bedi, Harvinder; Li, Doug; Edwards, Elton; Csongvay, Steven; Miller, Russell; Wang, Otis; Chia, Andrew; Jain, Arvind; Mammen, Mathan; Murdoch, Zoe; Sage, Claire; Kumar, Anil; Pankaj, Amite; Singh, Ajay Pal; Pesantez, Rodrigo; Martinez, Adriana; Novoa, Catherine; Buckley, Richard E.; Duffy, Paul; Korley, Robert; Johnston, Kelly; Puloski, Shannon; Carcary, Kimberly; Avram, Victoria; Bicknell, Ryan; Yach, Jeff; Bardana, Davide; Lambert, Sue; Sanders, David W.; Howard, Jamie; Macleod, Mark; Bartly, C. T.; Tieszer, Christina; Peterson, Devin; Zalzal, Paul; Maumetz, Victor; Brien, Heather; Weening, Brad; Wai, Eugene K.; Roffey, Darren; McCormack, Robert; Stone, Trevor; Perey, Bertrand; Viskontas, Darius; Boyer, Dory; Perey, Bert; Zomar, Mauri; Moon, Karyn; Oatt, Amber; McKee, Michael; Hall, Jeremy; Ahn, Henry; Vicente, Milena R.; Wild, Lisa M.; Kreder, Hans J.; Stephen, David J. G.; Nousianinen, Markku; Cagaanan, Ria; Kunz, Monica; Syed, Khalid; Azad, Tania; Coles, Chad; Leighton, Ross; Johnstone, David; Glazebrook, Mark; Alexander, David; Trask, Kelly; Dobbin, Gwendolyn; Oliver, Todd M.; Jones, Vicky; Ronan, James; Brown, Desmond T.; Carlilse, Hope; Shaughnessy, Lisa; Schwappach, John; Davis, Craig A.; Weingarten, Peter; Weinerman, Stewart; Newman, Heike; Baker, Janell; Browner, Kieran; Hurley, Meghan; Zura, Robert; Manson, Maria J.; Goetz, David; Broderick, Scott J.; Porter, Scott; Pace, Thomas; Tanner, Stephanie L.; Snider, Becky; Schmidt, Andrew H.; Haas, Jonathan; Templeman, David; Westberg, Jerald R.; Mullis, Brian; Ertl, J. P.; Shively, Karl; Frizzel, Valda; Marcantonio, Andrew J.; Iorio, Richard; Lobo, Margaret; Kain, Michael; Specht, Lawrence; Garfi, John; Prayson, Michael J.; Davis, Craig; Laughlin, Richard; Rubino, Joe; Lawless, Mathew; DiPaola, Matt; Gaydon, Chris; Dulaney, Liz; Vallier, Heather A.; Wilber, John; Sontich, John; Patterson, Brendan; Dolenc, Andrea; Robinson, Chalitha; Wilber, Roger; DePaolo, Charles J.; Alosky, Rachel; Shell, Leslie E.; Keeve, Jonathan P.; Anderson, Chris; McDonald, Michael; Hoffman, Jodi; Baele, Joseph; Weber, Tim; Edison, Matt; Musapatika, Dana; Jones, Clifford; Ringler, James; Endres, Terrance; Gelbke, Martin; Jabara, Michael; Sietsema, Debra L.; Engerman, Susan M.; Switzer, Julie A.; Li, Mangnai; Marston, Scott; Cole, Peter; Vang, Sandy X.; Foley, Amy; McBeth, Jessica; Comstock, Curt; Ziran, Navid; Shaer, James; Hileman, Barbara; Karges, David; Cannada, Lisa; Kuldjanov, Djoldas; Watson, John Tracy; Mills, Emily; Simon, Tiffany; Abdelgawad, Amr; Shunia, Juan; Jenkins, Mark; Zumwalt, Mimi; Romero, Amanda West; Lowe, Jason; Goldstein, Jessica; Zamorano, David P.; Lawson, Deanna; Archdeacon, Michael; Wyrick, John; Hampton, Shelley; Lewis, Courtland G.; Ademi, Arben; Sullivan, Raymond; Caminiti, Stephanie; Graves, Matthew; Smith, Lori; Della Rocca, Gregory J.; Crist, Brett D.; Murtha, Yvonne; Anderson, Linda K.; Kliewer, Toni K.; McPherson, Melinda K.; Sullivan, Kelly M.; Sagebien, Carlos; Seuffert, Patricia; Mehta, Samir; Esterhai, John; Ahn, Jaimo; Tjoumakaris, Fotios; Horan, Annamarie D.; Kaminski, Christine; Tarkin, Ivan; Siska, Peter; Luther, Arlene; Irrgang, James; Farrell, Dana; Gorczyca, John T.; Gross, Jonathan M.; Kates, Stephen Lloyd; Colosi, Jen; Hibsch, Nancy; Noble, Krista; Agarwal, Animesh; Wright, Rebecca; Hsu, Joseph R.; Ficke, James R.; Napierala, Matthew A.; Charlton, Michael T.; Fan, Mary K.; Obremskey, William T.; Richards, Justin E.; Robinson, Kenya; Carroll, Eben; Kulp, Brenda

    2013-01-01

    This study assesses femoral neck shortening and its effect on gait pattern and muscle strength in patients with femoral neck fractures treated with internal fixation. Seventy-six patients from a multicenter randomized controlled trial participated. Patient characteristics and Short Form 12 and

  17. The Genesis of Capitalism

    DEFF Research Database (Denmark)

    Li, Xing

    2004-01-01

    perspectives on the birth and expansion of capitalism and instead emphasizes the role of political power in its development and present-day stage. Politics to a great extent is undertakings of coercion, rationalization, legitimization and imposition which are the essence of market capitalism itself, i...

  18. World wide spatial capital.

    Science.gov (United States)

    Sen, Rijurekha; Quercia, Daniele

    2018-01-01

    In its most basic form, the spatial capital of a neighborhood entails that most aspects of daily life are located close at hand. Urban planning researchers have widely recognized its importance, not least because it can be transformed in other forms of capital such as economical capital (e.g., house prices, retail sales) and social capital (e.g., neighborhood cohesion). Researchers have already studied spatial capital from official city data. Their work led to important planning decisions, yet it also relied on data that is costly to create and update, and produced metrics that are difficult to compare across cities. By contrast, we propose to measure spatial capital in cheap and standardized ways around the world. Hence the name of our project "World Wide Spatial Capital". Our measures are cheap as they rely on the most basic information about a city that is currently available on the Web (i.e., which amenities are available and where). They are also standardized because they can be applied in any city in the five continents (as opposed to previous metrics that were mainly applied in USA and UK). We show that, upon these metrics, one could produce insights at the core of the urban planning discipline: which areas would benefit the most from urban interventions; how to inform planning depending on whether a city's activity is mono- or poly-centric; how different cities fare against each other; and how spatial capital correlates with other urban characteristics such as mobility patterns and road network structure.

  19. Measuring Social Capital

    DEFF Research Database (Denmark)

    Svendsen, Gert Tinggaard; Bjørnskov, Christian

    2007-01-01

    How to construct a robust measure of social capital? This paper contains two contributions. The first is an attempt to establish a broad social capital measure based on four indicators, the Freedom House Index, an index of perceived corruption from Transparency International, and scores on civic...

  20. La escritura capital cursiva

    OpenAIRE

    Carbonell Boria, María José

    1989-01-01

    Estado de la cuestión de los trabajos sobre la Capital Cursiva. Análisis de la misma y muestras de su existencia y uso en la cultura occidental, incluida España. The matter of the study of Italic Capital letters. Its analysis, samples, and use in Western cultur, including Spain.

  1. Venture capital and internationalization

    NARCIS (Netherlands)

    Schertler, A.G.; Tykvova, T.

    Cross-border investments represent a substantial share of venture capital activities. We use a comprehensive dataset on investments worldwide to analyze the internationalization of venture capital financing. We postulate that cross-border activity is shaped by macroeconomic factors in the venture

  2. Productivity and Capital Goods.

    Science.gov (United States)

    Zicht, Barbara, Ed.; And Others

    1981-01-01

    Providing teacher background on the concepts of productivity and capital goods, this document presents 3 teaching units about these ideas for different grade levels. The grade K-2 unit, "How Do They Do It?," is designed to provide students with an understanding of how physical capital goods add to productivity. Activities include a field trip to…

  3. Evaluation of a pig femoral head osteonecrosis model

    Science.gov (United States)

    2010-01-01

    Background A major cause of osteonecrosis of the femoral head is interruption of a blood supply to the proximal femur. In order to evaluate blood circulation and pathogenetic alterations, a pig femoral head osteonecrosis model was examined to address whether ligature of the femoral neck (vasculature deprivation) induces a reduction of blood circulation in the femoral head, and whether transphyseal vessels exist for communications between the epiphysis and the metaphysis. We also tested the hypothesis that the vessels surrounding the femoral neck and the ligamentum teres represent the primary source of blood flow to the femoral head. Methods Avascular osteonecrosis of the femoral head was induced in Yorkshire pigs by transecting the ligamentum teres and placing two ligatures around the femoral neck. After heparinized saline infusion and microfil perfusion via the abdominal aorta, blood circulation in the femoral head was evaluated by optical and CT imaging. Results An angiogram of the microfil casted sample allowed identification of the major blood vessels to the proximal femur including the iliac, common femoral, superficial femoral, deep femoral and circumflex arteries. Optical imaging in the femoral neck showed that a microfil stained vessel network was visible in control sections but less noticeable in necrotic sections. CT images showed a lack of microfil staining in the epiphysis. Furthermore, no transphyseal vessels were observed to link the epiphysis to the metaphysis. Conclusion Optical and CT imaging analyses revealed that in this present pig model the ligatures around the femoral neck were the primary cause of induction of avascular osteonecrosis. Since the vessels surrounding the femoral neck are comprised of the branches of the medial and the lateral femoral circumflex vessels, together with the extracapsular arterial ring and the lateral epiphyseal arteries, augmentation of blood circulation in those arteries will improve pathogenetic alterations in

  4. Evaluation of a pig femoral head osteonecrosis model

    Directory of Open Access Journals (Sweden)

    Kim Harry

    2010-03-01

    Full Text Available Abstract Background A major cause of osteonecrosis of the femoral head is interruption of a blood supply to the proximal femur. In order to evaluate blood circulation and pathogenetic alterations, a pig femoral head osteonecrosis model was examined to address whether ligature of the femoral neck (vasculature deprivation induces a reduction of blood circulation in the femoral head, and whether transphyseal vessels exist for communications between the epiphysis and the metaphysis. We also tested the hypothesis that the vessels surrounding the femoral neck and the ligamentum teres represent the primary source of blood flow to the femoral head. Methods Avascular osteonecrosis of the femoral head was induced in Yorkshire pigs by transecting the ligamentum teres and placing two ligatures around the femoral neck. After heparinized saline infusion and microfil perfusion via the abdominal aorta, blood circulation in the femoral head was evaluated by optical and CT imaging. Results An angiogram of the microfil casted sample allowed identification of the major blood vessels to the proximal femur including the iliac, common femoral, superficial femoral, deep femoral and circumflex arteries. Optical imaging in the femoral neck showed that a microfil stained vessel network was visible in control sections but less noticeable in necrotic sections. CT images showed a lack of microfil staining in the epiphysis. Furthermore, no transphyseal vessels were observed to link the epiphysis to the metaphysis. Conclusion Optical and CT imaging analyses revealed that in this present pig model the ligatures around the femoral neck were the primary cause of induction of avascular osteonecrosis. Since the vessels surrounding the femoral neck are comprised of the branches of the medial and the lateral femoral circumflex vessels, together with the extracapsular arterial ring and the lateral epiphyseal arteries, augmentation of blood circulation in those arteries will improve

  5. Femoral rotation unpredictably affects radiographic anatomical lateral distal femoral angle measurements

    DEFF Research Database (Denmark)

    Miles, James Edward

    2016-01-01

    Objective: To describe the effects of internal and external femoral rotation on radiographic measurements of the anatomical lateral distal femoral angle (a-LDFA) using two methods for defining the anatomical proximal femoral axis (a-PFA). Methods: Digital radiographs were obtained of 14 right...... femora at five degree intervals from 10° external rotation to 10° internal rotation. Using freely available software, a-LDFA measurements were made using two different a-PFA by a single observer on one occasion. Results: Mean a-LDFA was significantly greater at 10° external rotation than at any other...... rotation. The response of individual femora to rotation was unpredictable, although fairly stable within ±5° of zero rotation. Mean a-LDFA for the two a-PFA methods differed by 1.5°, but were otherwise similarly affected by femoral rotation. Clinical significance: If zero femoral elevation can be achieved...

  6. Updating cultural capital theory

    DEFF Research Database (Denmark)

    Prieur, Annick; Savage, Mike

    2011-01-01

    than absolute terms, and that a field analytic perspective provides the means of understanding cultural capital as such a relative entity. Second, the move from the empirical observation of oppositions to the conceptualisation of cultural capital also demands that the functioning of features......This paper considers how the analysis of cultural engagement can be elaborated through a reworking of the concept of cultural capital, as originally derived from Bourdieu’s (1984) Distinction. Drawing on detailed studies of the UK and Aalborg, Denmark, we show that despite the weakening......, and art); and (c) an international and a local or national orientation stand out as the most important. We discuss whether these oppositions can usefully be conceptualised as cultural capital. We argue that such a conceptualisation demands, first, that cultural capital is understood in relative rather...

  7. Social Capital in Asia

    DEFF Research Database (Denmark)

    Li, Peter Ping; Redding, Gordon

    2014-01-01

    This article provides an overview of social capital in Asia. Social capital is trust and appears in two main forms: relational, based on societal norms, and systemic, based on societal institutions. The relational encourages personalistic transactions; and systemic trust, supports more formal......, and usually larger, transactions backed by law. For economic development, the systemic form becomes crucial but needs to be compatible with relational norms. The dimensions of social capital are often dual in nature. This article employs a theory that accepts this and analyses the phenomena as yin......–yang balancing, seeing trust as a culturally determined enabler of social cooperation. The evolutions of trustworthiness in Japan, China, and the Philippines are analysed. This article contributes to the literature on varieties of capitalism and business systems as well as that on social capital. It raises...

  8. Cultural Capital Today

    DEFF Research Database (Denmark)

    Prieur, Annick; Skjøtt-Larsen, Jakob; Rosenlund, Lennart

    2008-01-01

    Based on Danish survey data subjected to correspondence analysis, this article aims at carrying out a critical assessment of Pierre Bourdieu's theory of social differentiation in advanced societies as a multi-dimensional phenomenon. As his theory goes, capital volume (economic + cultural capital......) and capital composition (the relative weight of the two) are the main dimensions of social differentiation, which structure the space of social positions as well as the space of lifestyles. The central discussion of the article concerns the character of cultural capital, and the role it plays in the formation...... of distinction? Cultural capital in a contemporary Danish context appears to be less related to traditional highbrow cultural consumption than in Bourdieu's studies in France some decades ago. Third, is there a rise in the omnivorousness and tolerant taste within the cultural elite? This study answers negatively...

  9. 75 FR 4635 - Risk-Based Capital Guidelines; Capital Adequacy Guidelines; Capital Maintenance: Regulatory...

    Science.gov (United States)

    2010-01-28

    ... would have on regulatory capital, the appropriateness of adjusting the risk-based capital treatment of... agencies' risk-based capital and leverage rules would increase regulatory capital requirements for banking... measure risk and allay the agencies' concerns regarding regulatory capital arbitrage (that is, the...

  10. Significance of Lateral Pillar in Osteonecrosis of Femoral Head: A Finite Element Analysis

    Science.gov (United States)

    Wen, Peng-Fei; Guo, Wan-Shou; Zhang, Qi-Dong; Gao, Fu-Qiang; Yue, Ju-An; Liu, Zhao-Hui; Cheng, Li-Ming; Li, Zi-Rong

    2017-01-01

    Background: The lateral pillar of the femoral head is an important site for disease development such as osteonecrosis of the femoral head. The femoral head consists of medial, central, and lateral pillars. This study aimed to determine the biomechanical effects of early osteonecrosis in pillars of the femoral head via a finite element (FE) analysis. Methods: A three-dimensional FE model of the intact hip joint was constructed from the image data of a healthy control. Further, a set of six early osteonecrosis models was developed based on the three-pillar classification. The von Mises stress and surface displacements were calculated for all models. Results: The peak values of von Mises stress in the cortical and cancellous bones of normal model were 6.41 MPa and 0.49 MPa, respectively. In models with necrotic lesions in the cortical and cancellous bones, the von Mises stress and displacement of lateral pillar showed significant variability: the stress of cortical bone decreased from 6.41 MPa to 1.51 MPa (76.0% reduction), while cancellous bone showed an increase from 0.49 MPa to 1.28 MPa (159.0% increase); surface displacements of cortical and cancellous bones increased from 52.4 μm and 52.1 μm to 67.9 μm (29.5%) and 61.9 μm (18.8%), respectively. In addition, osteonecrosis affected not only pillars but also adjacent structures in terms of the von Mises stress and surface displacement levels. Conclusions: This study suggested that the early-stage necrosis in the femoral head could increase the risk of collapse, especially in lateral pillar. On the other hand, the cortical part of lateral pillar was found to be the main biomechanical support of femoral head. PMID:29067956

  11. Correlation of ultrasound appearance, gross anatomy, and histology of the femoral nerve at the femoral triangle.

    Science.gov (United States)

    Lonchena, Tiffany K; McFadden, Kathryn; Orebaugh, Steven L

    2016-01-01

    Correlation between ultrasound appearance, gross anatomic characteristics, and histologic structure of the femoral nerve (FN) is lacking. Utilizing cadavers, we sought to characterize the anatomy of the FN, and provide a quantitative measure of its branching. We hypothesize that at the femoral crease, the FN exists as a group of nerve branches, rather than a single nerve structure, and secondarily, that this transition into many branches is apparent on ultrasonography. Nineteen preserved cadavers were investigated. Ultrasonography was sufficient to evaluate the femoral nerve in nine specimens; gross dissection was utilized in all 19. Anatomic characteristics were recorded, including distances from the inguinal ligament to femoral crease, first nerve branch, and complete arborization of the nerve. The nerves from nine specimens were excised for histologic analysis. On ultrasound, the nerve became more flattened, widened, and less discrete as it coursed distally. Branching of the nerve was apparent in 12 of 18 images, with mean distance from inguinal ligament of 3.9 (1.0) cm. However, upon dissection, major branching of the femoral nerve occurred at 3.1 (1.0) cm distal to the inguinal ligament, well proximal to the femoral crease. Histologic analysis was consistent with findings at dissection. The femoral nerve arborizes into multiple branches between the inguinal ligament and the femoral crease. Initial branching is often high in the femoral triangle. As hypothesized, the FN exists as a closely associated group of nerve branches at the level of the femoral crease; however, the termination of the nerve into multiple branches is not consistently apparent on ultrasonography.

  12. Comparison of femoral morphology and bone mineral density between femoral neck fractures and trochanteric fractures.

    Science.gov (United States)

    Maeda, Yuki; Sugano, Nobuhiko; Saito, Masanobu; Yonenobu, Kazuo

    2011-03-01

    Many studies that analyzed bone mineral density (BMD) and skeletal factors of hip fractures were based on uncalibrated radiographs or dual-energy xray absorptiometry (DXA). Spatial accuracy in measuring BMD and morphologic features of the femur with DXA is limited. This study investigated differences in BMD and morphologic features of the femur between two types of hip fractures using quantitative computed tomography (QCT). Forty patients with hip fractures with normal contralateral hips were selected for this study between 2003 and 2007 (trochanteric fracture, n=18; femoral neck fracture, n=22). Each patient underwent QCT of the bilateral femora using a calibration phantom. Using images of the intact contralateral femur, BMD measurements were made at the point of minimum femoral-neck cross-sectional area, middle of the intertrochanteric region, and center of the femoral head. QCT images also were used to measure morphologic features of the hip, including hip axis length, femoral neck axis length, neck-shaft angle, neck width, head offset, anteversion of the femoral neck, and cortical index at the femoral isthmus. No significant differences were found in trabecular BMD between groups in those three regions. Patients with trochanteric fractures showed a smaller neck shaft angle and smaller cortical index at the femoral canal isthmus compared with patients with femoral neck fractures. We conclude that severe osteoporosis with thinner cortical bone of the femoral diaphysis is seen more often in patients with trochanteric fracture than in patients with femoral neck fracture. Level IV, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

  13. "Minsky's Analysis of Financial Capitalism"

    OpenAIRE

    Dimitri B. Papadimitriou; L. Randall Wray

    1999-01-01

    In this paper, the authors discuss Minsky's analysis of the evolution of one variety of capitalism--financial capitalism--which developed at the end of the nineteenth century and was the dominant form of capitalism in the developed countries after World War II. Minsky's approach, like those of Schumpeter and Veblen, emphasized the importance of market power in this stage of capitalism. According to Minsky, modern capitalism requires expensive and long-lived capital assets, which, in turn, nec...

  14. Cementing the femoral component in total knee arthroplasty: which technique is the best?

    Science.gov (United States)

    Vaninbroukx, Michaël; Labey, Luc; Innocenti, Bernardo; Bellemans, Johan

    2009-08-01

    Although several techniques exist for cementing the femoral component in TKA, no data are available on which is the best one to use. We therefore compared four cementing techniques in an anatomical open pore sawbone model (n=20), in order to investigate the influence of cementation technique on overall cement penetration as well as length of the cement mantle over the different cuts. The technique which included cement application onto the anterior and distal bone surfaces, as well as the posterior flanges of the prosthesis, was statistically superior to the other techniques. We therefore advocate this technique as the standard for cementing the femoral component.

  15. Pseudoarthrosis in atypical femoral fracture: case report.

    Science.gov (United States)

    Giannotti, S; Bottai, V; Dell'Osso, G; De Paola, G; Ghilardi, M; Guido, G

    2013-11-01

    Atypical femoral fractures can be subsequent to a long-term biphosphonates treatment; they have a high frequency of delayed healing. The authors describe a femoral pseudoarthrosis of an atypical fracture treated with intramedullary nailing in a female after prolonged alendronate therapy. Atypical femoral fractures can be subsequent to a long-term biphosphonates treatment even if, in the literature, there is no clarity on the exact pathogenetic mechanism. The Task Force of the American Society for Bone and Mineral Research described the major and minor features to define atypical fractures and recommends that all the five major features must be present while minor features are not necessary. Another controversial aspect regarding the atypical femoral fractures is the higher frequency of the delayed healing that can be probably related to a suppressed bone turnover caused by a prolonged period of bisphosphonates treatment. This concept could be corroborated by the Spet Tc exam. In the case of a pseudoarthrosis, there is not a standardization of the treatment. In this report, the authors describe a femoral pseudoarthrosis of an atypical fracture treated with intramedullary nailing in a female after prolonged alendronate therapy; the patient was studied with clinical, bioumoral end SPECT-Tc exam of both femurs. Many studies show the relationship between bisphosphonates and the presence of atypical fractures. These fractures should be monitored more closely due to the risk of nonunion and they require considering an initial treatment with pharmacological augmentation to reduce the complications for the patient and the health care costs.

  16. Femoral head vitality after intracapsular hip fracture

    International Nuclear Information System (INIS)

    Stroemqvist, B.

    1983-01-01

    Femoral head vitality before, during and at various intervals from the operation was determined by tetracycline labeling and/or 99 sp (m)Tc-MDP scintimetry. In a three-year follow-up, healing prognosis could be determined by scintimetry 3 weeks from operation; deficient femoral head vitality predicting healing complications and retained vitality predicting uncomplicated healing. A comparison between pre- and postoperative scintimetry indicated that further impairment of the femoral head vitality could be caused by the operative procedure, and as tetracycline labeling prior to and after fracture reduction in 370 fractures proved equivalent, it was concluded that the procedure of osteosynthesis probably was responsible for capsular vessel injury, using a four-flanged nail. The four-flanged nail was compared with a low-traumatic method of osteosynthesis, two hook-pins, in a prospective randomized 14 month study, and the postoperative femoral head vitality was significantly better in the hook-pin group. This was also clearly demonstrated in a one-year follow-up for the fractures included in the study. Parallel to these investigations, the reliability of the methods of vitality determination was found satisfactory in methodologic studies. For clinical purpose, primary atraumatic osteosynthesis, postoperative prognostic scintimetry and early secondary arthroplasty when indicated, was concluded to be the appropriate approach to femoral neck fracture treatment. (Author)

  17. Avascular necrosis of the femoral head

    International Nuclear Information System (INIS)

    Kokubo, Takeshi; Takatori, Yoshio; Kamogawa, Morihide; Nakamura, Toshitaka; Ninomiya, Setsuo; Yoshikawa, Kohki; Itai, Yuji; Iio, Masahiro; Mitamura, Tadayuki

    1990-01-01

    T1-weighted MR images of thirty-six hips in 25 patients with avascular necrosis of the femoral head were obtained two to five times during the course of 2 to 26 months. We investigated these MR images in the light of the chronological change and compared them with plain radiographs. MR images changes in 16 femoral head; in general, the abnormal low intensity area in the femoral head reduced in extent and the internal high intensity area became smaller of disappeared. Thirteen femoral heads among them became more flattened on plain radiographs in the same period. It is noted that four different zones are defined in the femoral head after bone necrosis takes place: the dead bone marrow, the dead marrow which still contains fat, the reactive interface and the hyperemic bone marrow. In T1-weighted MR images, the dead bone marrow, the reactive interface and the hyperemic bone marrow are demonstrated as low intensity area, while the dead marrow containing fat may remain high in intensity. On the basis of this knowledge of histopathology and MR images of this disease, we suggest that reduction of the abnormal low intensity area and disappearance of the internal high intensity area on MR images can be regarded as diminution of hyperemia in the living bone marrow and loss of fat in the dead bone marrow, respectively. (author)

  18. Ensayo sobre el Capital Social

    OpenAIRE

    Ramón Frediani

    2011-01-01

    En la teoría económica existen distintas definiciones de capital: capital físico, el capital en recursos naturales, el capital financiero, el capital en infraestructura económica, el capital en infraestructura social y el capital humano. Todos ellos son condiciones necesarias para que un país alcance el desarrollo económico y social y un alto estándar y calidad de vida de sus habitantes, pero no suficientes puesto que hace falta una categoría adicional de capital. En los últimos años ha surgi...

  19. 99mTc-MDP scintigraphy of femoral head necrosis following femoral neck fracture

    International Nuclear Information System (INIS)

    Lee, Soon Jin; Lee, Jun Hyung; Kim, Eun Kyung; Lee, Sun Wha; Kim, Soon Yong

    1985-01-01

    Secondary ischemic necrosis of femoral head due to loss of blood supply following to femoral neck fracture is well known. The regional distribution of bone-seeking radiopharmaceuricals in the skeleton can depend on a number of factors, but bone blood flow is a major physiological determinant of regional skeletal uptake of Tc-99m polyphosphate and bone imaging may thus be used for the evaluation of vascularity of the femoral head. The authors made a comparative study of scintigraphic findings and operative findings of 28 cases of femoral neck fracture treated at Kyung Hee University Hospital from April 1980 to May 1984. The results were as follows: 1. In 16 cases of proven avascular necorsis of femoral head, scintigraphy showed absent or decreased activity in 14 cases (87.5%), while radiography showed increased density in 10 cases (62.5%). 2. In 12 cases of proven vital femoral head, scintigraphy showed increased activity in 9 cases (75%) and radiography showed decreased density in 9 cases (75%). 3. 99mTc-MDP scintigraphy was an excellent and useful method for assessing bone vitality of femoral head

  20. Pathology of osteonecrosis of the femoral head

    International Nuclear Information System (INIS)

    Sissons, H.A.; Nuovo, M.A.; Steiner, G.C.

    1992-01-01

    Pathological examination of the resected femoral heads from approximately 2000 total hip replacement operations carried out at the Hospital for Joint Diseases from 1984 to 1989 identified the presence of osteonecrosis in 345 patients (377 femoral heads). In 232 patients the osteonecrosis, referred to as 'idiopathic,' had occurred in the absence of a subcapital fracture. The present paper describes the pathology of the necrotic lesions in these 232 patients. The use of undecalcified sections and microradiography provides evidence of bone marrow calcification which, at the margin of the lesion, is sufficient to influence the radiographic features of the lesion significantly. Although a subchondral fracture is an almost constant feature of osteonecrosis when it occurs in a femoral head with a normal articular cartilage, no such fracture was found in cases in which osteonecrosis had occurred in an osteoarthritic joint. (orig.)

  1. Cost comparison of femoral head banking versus bone substitutes.

    Science.gov (United States)

    Leung, Hon-Bong; Fok, Margaret Woon-Man; Chow, Lorraine Chi-Yan; Yen, Chi-Hung

    2010-04-01

    To compare the costs of femoral head banking versus bone substitutes. Records of femoral head banking from 1998 to 2008 were reviewed. The cost of allogenic cancellous bone graft was calculated by estimating the direct expenditure of femoral head procurement, screening tests, and storage, and then divided by the amount of bone harvested. 326 females and 141 males (mean age, 80.3 years) donated 470 femoral heads. Each transplantable femoral head costs US$978. Each gram of transplantable allogenic bone graft costs US$86, compared with US$9 to 26 per gram for commercially available bone substitutes. Compared with bone substitutes, femoral head banking in Hong Kong was less economical. Unless allografts yield superior outcomes, harvesting femoral heads for general usage (such as filling bone voids for fresh fractures) is not justified from a financial perspective, especially in banks dedicated to procuring bone from femoral heads only.

  2. Femoral component loosening after hip resurfacing arthroplasty

    International Nuclear Information System (INIS)

    Zustin, Jozef; Sauter, Guido; Hahn, Michael; Morlock, Michael M.; Ruether, Wolfgang; Amling, Michael

    2010-01-01

    Before the re-introduction of the current generation of total hip resurfacing arthroplasty, component loosening and osteolysis were of great concern to the orthopaedic community. Early, mid- and long-term clinical results are encouraging, but component loosening still exists. Macroscopic, contact radiographic and histopathological analyses after undecalcified preparation of bone tissue specimens were performed. To investigate the frequency and morphological patterns of the loosening of the femoral component, we analysed a series of 190 retrieved femoral remnants that were revised for aseptic failures. Thirty-five (18.4%) hips were revised for clinical and/or radiographic loosening of the femoral component. Pseudoarthrosis (n = 17; median in situ time: 16 weeks, interquartile range [IQR]: 9 to 34), collapsed osteonecrosis (n = 5; median in situ time: 79 weeks, IQR: 63 to 97), cement-socket debonding (n = 3; median in situ time: 89 weeks, IQR: 54 to 97) and at later follow-up bone-cement loosening (n = 10; median in situ time: 175 weeks; IQR 112 to 198; p =0.005) were distinct patterns of the femoral remnant-implant loosening. Fibrocartilaginous metaplasia of interface bone trabeculae (n = 38; median in situ time: 61 weeks, IQR: 32 to 138) was strongly associated with femoral component loosening (p = 0.009). Both the trabecular hyperosteoidosis (n = 32; median in situ time: 71 weeks, IQR 50 to 129) and excessive intraosseous lymphocyte infiltration (n = 12; median in situ time: 75 weeks, IQR 51 to 98) at the bone-cement interface correlated strongly with fibrocartilaginous metaplasia (p = 0.001 and p = 0.016 respectively) and all three lesions were associated with the female gender (p = 0.021, p = 0.009, and p = 0.051). Femoral component loosening at early follow-up was mostly caused by pathological changes of the femoral remnant bone tissue: pseudoarthrosis and collapsed osteonecrosis. Fibrocartilaginous metaplasia was frequently observed in hips with femoral

  3. Management of femoral head osteonecrosis: Current concepts

    Science.gov (United States)

    Tripathy, Sujit Kumar; Goyal, Tarun; Sen, Ramesh Kumar

    2015-01-01

    Osteonecrosis of femoral head (ONFH) is a disabling condition of young individuals with ill-defined etiology and pathogenesis. Remains untreated, about 70-80% of the patients progress to secondary hip arthritis. Both operative and nonoperative treatments have been described with variable success rate. Early diagnosis and treatment is the key for success in preserving the hip joint. Once femoral head collapses (>2 mm) or if there is secondary degeneration, hip conservation procedures become ineffective and arthroplasty remains the only better option. We reviewed 157 studies that evaluate different treatment modalities of ONFH and then a final consensus on treatment was made. PMID:25593355

  4. The use of femoral stems with exchangeable necks in primary total hip arthroplasty increases the rate of revision.

    Science.gov (United States)

    Graves, S E; de Steiger, R; Davidson, D; Donnelly, W; Rainbird, S; Lorimer, M F; Cashman, K S; Vial, R J

    2017-06-01

    Femoral stems with exchangeable (modular) necks were introduced to offer surgeons an increased choice when determining the version, offset and length of the femoral neck during total hip arthroplasty (THA). It was hoped that this would improve outcomes and reduce complications, particularly dislocation. In 2010, the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR) first reported an increased rate of revision after primary THA using femoral stems with an exchangeable neck. The aim of this study was to provide a more comprehensive up-to-date analysis of primary THA using femoral stems with exchangeable and fixed necks. The data included all primary THA procedures performed for osteoarthritis (OA), reported to the AOANJRR between 01 September 1999 and 31 December 2014. There were 9289 femoral stems with an exchangeable neck and 253 165 femoral stems with a fixed neck. The characteristics of the patients and prostheses including the bearing surface and stem/neck metal combinations were examined using Cox proportional hazard ratios (HRs) and Kaplan-Meier estimates of survivorship. It was found that prostheses with an exchangeable neck had a higher rate of revision and this was evident regardless of the bearing surface or the size of the femoral head. Exchangeable neck prostheses with a titanium stem and a cobalt-chromium neck had a significantly higher rate of revision compared with titanium stem/titanium neck combinations (HR 1.83, 95% confidence interval 1.49 to 2.23, p Revisions were higher for these combinations compared with femoral stems with a fixed neck. There appears to be little evidence to support the continued use of prostheses with an exchangeable neck in primary THA undertaken for OA. Cite this article: Bone Joint J 2017;99-B:766-73. ©2017 The British Editorial Society of Bone & Joint Surgery.

  5. Cytotherapy of osteonecrosis of the femoral head: a mini review

    OpenAIRE

    Gao, You-Shui; Zhang, Chang-Qing

    2010-01-01

    The pathogenesis and aetiology of nontraumatic osteonecrosis of the femoral head has not been revealed completely. However, with advances in stem cell research and regenerative medicine, it is believed that the onset of osteonecrosis of the femoral head probably has a cellular origin, and the possible therapy of osteonecrosis of the femoral head based on cytotherapy has great potential. In this review, the aetiology of osteonecrosis of the femoral head, animal experiments and clinical applica...

  6. Capital Projects Application (CPA)

    Data.gov (United States)

    General Services Administration — Capital Projects application (CPA) provides users with the ability to maintain project related financial data for Budget Activity (BA) 51, 55, 64, 01, 02, 03, 04....

  7. capital. A discussion paper

    Directory of Open Access Journals (Sweden)

    Ewa Chojnacka

    2015-04-01

    Full Text Available The purpose of this study is to confront certain propositions presented in Lesław Niemczyk’s publication Rachunkowość finansowa aktywów kompetencyjnych i kapitału intelektualnego. Nowy dział rachunkowości(Accounting for Competence Assets and Intellectual Capital. A New Area in Accounting with ideas published in other studies. The authors discuss issues concerning firm value, selected definitions of intellectual capital, as well as certain methods of intellectual capital measurement and valuation. Other problems analysed include accounting for and reporting of intellectual capital and similarities and differences between the way those issues are presented in Polish and in international studies as well as in existing legal regulations and standards.

  8. Unsustainable growth, unsustainable capitalism

    DEFF Research Database (Denmark)

    Næss, Petter

    2006-01-01

    problems, but serve to further highlight the difficulties of changing capitalism towards sustainability. In a profit-oriented economy, capital accumulation is a prime driving force, and non-growth for the economy at large tends to result in serious economic and social crises. On the other hand, a de...... according to which the powers and mechanisms of the natural world are considered totally controllable by humans as if they were mere epiphenomena of the human world. On the other hand, the assumptions of certain ecological economists about the possibility of steady-state capitalism disregard the relation...... between capital and surplus value, which constitutes a strong mechanism driving the capitalist economy toward limitless growth....

  9. HUMAN CAPITAL INVESTMENT

    Directory of Open Access Journals (Sweden)

    Ph. D. Student Ioana - Julieta Josan

    2012-05-01

    Full Text Available Once with the development of the human capital theory, the education received an economic value. Leading theorists and specialists in the field have shown that the remarkable economic effects of the investments in education influence the chances of acquiring a job and earnings, demonstrating how the theory justifies such an investment. At the hand, the allocation of resources in human capital brings performance and benefits to companies investing in their employees. Also, the investment in human capital is strategic for any country that seeks to create a knowledge economy. Considering the above arguments, the aim of this paper is to highlight the characteristics of investment in human capital, the types of investment, the factors of education investment and the entities interested in investing and their benefits.

  10. Prioritization of Capital Projects

    National Research Council Canada - National Science Library

    LaVielle, Michael

    2002-01-01

    Public works capital projects in the U,S, naval forces are not prioritized and funded in a way that best uses limited operations resources and maintenance dollars, This thesis develops a linear model...

  11. Intellectual Capital Evaluation Models

    OpenAIRE

    Agoston Simona; Puia Ramona Stefania; Orzea Ivona

    2010-01-01

    The evaluation and measurement of intellectual capital is an issue of increasing importance for companies because of the staleness of the traditional accounting systems which do not provide relevant information regarding the value of a company. Thus, specialists are working to identify a model for assessing intellectual capital that can be easily implemented and used. The large number of proposed models but also the major differences between them emphasizes the fact that the specialists are s...

  12. Capital Structure Puzzle

    OpenAIRE

    Stewart C. Myers

    1984-01-01

    This paper contrasts the "static tradeoff" and "pecking order" theories of capital structure choice by corporations. In the static tradeoff theory, optimal capital structure is reached when the tax advantage to borrowing is balanced, at the margin, by costs of financial distress. In the pecking order theory, firms preferinternal to external funds, and debt to equity if external funds are needed. Thus the debt ratio reflects the cumulative requirement for external financing. Pecking order beha...

  13. World wide spatial capital.

    Directory of Open Access Journals (Sweden)

    Rijurekha Sen

    Full Text Available In its most basic form, the spatial capital of a neighborhood entails that most aspects of daily life are located close at hand. Urban planning researchers have widely recognized its importance, not least because it can be transformed in other forms of capital such as economical capital (e.g., house prices, retail sales and social capital (e.g., neighborhood cohesion. Researchers have already studied spatial capital from official city data. Their work led to important planning decisions, yet it also relied on data that is costly to create and update, and produced metrics that are difficult to compare across cities. By contrast, we propose to measure spatial capital in cheap and standardized ways around the world. Hence the name of our project "World Wide Spatial Capital". Our measures are cheap as they rely on the most basic information about a city that is currently available on the Web (i.e., which amenities are available and where. They are also standardized because they can be applied in any city in the five continents (as opposed to previous metrics that were mainly applied in USA and UK. We show that, upon these metrics, one could produce insights at the core of the urban planning discipline: which areas would benefit the most from urban interventions; how to inform planning depending on whether a city's activity is mono- or poly-centric; how different cities fare against each other; and how spatial capital correlates with other urban characteristics such as mobility patterns and road network structure.

  14. Religion, Science and Capitalisms

    OpenAIRE

    Rehbein, Boike

    2014-01-01

    This paper enquires into the relation between capitalism, religion and the philosophy of science. We would tend to suppose that there are only superficial and accidental links between them. A closer analysis reveals, however, that the epistemology of contemporary science is still based on a certain interpretation of Christianity and linked to a particular type of capitalism. Science developed after Galileo and Descartes aims at universal truth but was founded on the notion of the Christian ...

  15. Capital mobility, tax competition, and lobbying for redistributive capital taxation

    OpenAIRE

    Lorz, Jens Oliver

    1996-01-01

    This paper analyzes the impact of international capital mobility on redistributive capital taxation and on lobbying activities by interest groups. It employs a model where different capital endowments lead to a conflict between households concerning their most preferred capital tax rate. Three main results are derived: First, redistributive source based capital taxes or subsidies decline as international tax competition intensifies. Second, lobbying activities of certain interest groups may e...

  16. Influence of fossil-fuel power plant emissions on the surface fine particulate matter in the Seoul Capital Area, South Korea.

    Science.gov (United States)

    Kim, Byeong-Uk; Kim, Okgil; Kim, Hyun Cheol; Kim, Soontae

    2016-09-01

    The South Korean government plans to reduce region-wide annual PM2.5 (particulate matter with an aerodynamic diameter ≤2.5 μm) concentrations in the Seoul Capital Area (SCA) from 2010 levels of 27 µg/m(3) to 20 µg/m(3) by 2024. At the same time, it is inevitable that emissions from fossil-fuel power plants will continue to increase if electricity generation expands and the generation portfolio remains the same in the future. To estimate incremental PM2.5 contributions due to projected electricity generation growth in South Korea, we utilized an ensemble forecasting member of the Integrated Multidimensional Air Quality System for Korea based on the Community Multi-scale Air Quality model. We performed sensitivity runs with across-the-board emission reductions for all fossil-fuel power plants in South Korea to estimate the contribution of PM2.5 from domestic fossil-fuel power plants. We estimated that fossil-fuel power plants are responsible for 2.4% of the annual PM2.5 national ambient air quality standard in the SCA as of 2010. Based on the electricity generation and the annual contribution of fossil-fuel power plants in 2010, we estimated that annual PM2.5 concentrations may increase by 0.2 µg/m(3) per 100 TWhr due to additional electricity generation. With currently available information on future electricity demands, we estimated that the total future contribution of fossil-fuel power plants would be 0.87 µg/m(3), which is 12.4% of the target reduction amount of the annual PM2.5 concentration by 2024. We also approximated that the number of premature deaths caused by existing fossil-fuel power plants would be 736 in 2024. Since the proximity of power plants to the SCA and the types of fuel used significantly impact this estimation, further studies are warranted on the impact of physical parameters of plants, such as location and stack height, on PM2.5 concentrations in the SCA due to each precursor. Improving air quality by reducing fine particle

  17. Relationship between mechanical axis-derived and anatomic landmark-derived femoral rotation in TKA: a three-dimensional CT study.

    Science.gov (United States)

    Seo, Jai Gon; Choi, Sang-Hee; Shin, Sulkyoung; Lee, Byung Hoon; Chang, Moon Jong

    2014-12-01

    We sought to determine the relationship between the mechanical axis-derived and the anatomic landmark-derived femoral rotational axes using three dimensional computed tomographic images of 20 lower extremities. The mechanical axis-derived femoral rotational axis was created on the distal articular surface of the femur using coronal mechanical limb axis and the reconstructed images of the femur. Then, we measured the angular difference between mechanical axis-derived and anatomic landmark-derived femoral rotational axes. The mechanical axis-derived femoral rotational axis was externally rotated with a mean of 2.2° (range, 0 to 4.7°; SD, 1.0) compared with the surgical epicondylar axis. Our findings should be considered to obtain a proper femoral rotational axis in total knee arthroplasty. Copyright © 2014 Elsevier Inc. All rights reserved.

  18. Private Equity and Regulatory Capital

    NARCIS (Netherlands)

    Bongaerts, D.; Charlier, E.

    2008-01-01

    Regulatory Capital requirements for European banks have been put forward in the Basel II Capital Framework and subsequently in the Capital Requirements Directive (CRD) of the EU. We provide a detailed discussion of the capital requirements for private equity investments under the simple risk weight

  19. Comparing return to sport activities after short metaphyseal femoral arthroplasty with resurfacing and big femoral head arthroplasties.

    Science.gov (United States)

    Karampinas, Panagiotis K; Papadelis, Eustratios G; Vlamis, John A; Basiliadis, Hlias; Pneumaticos, Spiros G

    2017-07-01

    Young patients feel that maintaining sport activities after total hip arthroplasty constitutes an important part of their quality of life. The majority of hip surgeons allow patients to return to low-impact activities, but significant caution is advised to taking part in high-impact activities. The purpose of this study is to compare and evaluate the post-operative return to daily living habits and sport activities following short-metaphyseal hip and high functional total hip arthroplasties (resurfacing and big femoral head arthroplasties). In a study design, 48 patients (55 hips) were enrolled in three different comparative groups, one with the short-metaphyseal arthroplasties, a second with high functional resurfacing arthroplasties and a third of big femoral head arthroplasties. Each patient experienced a clinical examination and evaluated with Harris Hip Score, WOMAC, Sf-36, UCLA activity score, satisfaction VAS, anteroposterior and lateral X-rays of the hip and were followed in an outpatient setting for 2 years. Statistical analysis revealed no notable differences between the three groups regarding their demographic data however significant differences have been found between preoperative and postoperative clinical scores of each group. Also, we fail to reveal any significant differences when comparing data of all three groups at the final 2 years postoperative control regarding their clinical scores. The overall outcome of all three groups was similar, all the patients were satisfied and returned to previous level of sport activities. Short metaphyseal hip arthroplasties in young patients intending to return to previous and even high impact sport activities, similar to high functional resurfacing, big femoral head arthroplasties. Short stems with hard on hard bearing surfaces might become an alternative to standard stems and hip resurfacing.

  20. Angiographic analysis of avascular necrosis of a femoral head -selective angiography of medial femoral circumflex artery-

    International Nuclear Information System (INIS)

    Ryu, Kyung Nam; Yoon, Yup; Lee, Sun Wha; Lim, Jae Hoon

    1991-01-01

    The degree of anatomical revascularization of a necrotic femoral head and traumatic hip would provide information about treatment and prognosis. The authors analyzed the vascular changes of femoral head among unilateral avascular necrosis, bilateral avascular necrosis, and traumatic hips. Forty - four patients with avascular necrosis and 19 patients with traumatic hips were examined by selective angiography of the medial femoral circumflex artery. In the traumatic hip cases, 12 (63%) showed occlusion, 2 (11%) hypertrophy of the capsular branches, and 5 ( 26 % ) were normal . In the avascular necrosis cases, 15 (25%) showed occlusion, 39 (67%) had hypertrophy of the capsular branches, and 4 (7%) had normal findings. Hypertrophy of the superior capsular branch of the medial femoral circumflex artery is more frequently observed in avascular necrosis than in traumatic hip. Bilateral avascular necrosis reveals more frequent incidences than unilateral cases. Selective angiography could help in the therapy plan and also provide information about the contralateral side

  1. Transvenous liver biopsy via the femoral vein

    International Nuclear Information System (INIS)

    Khosa, F.; McNulty, J.G.; Hickey, N.; O'Brien, P.; Tobin, A.; Noonan, N.; Ryan, B.; Keeling, P.W.N.; Kelleher, D.P.; McDonald, G.S.A.

    2003-01-01

    AIM: To study the safety, effectiveness and diagnostic value of transvenous forceps biopsy of the liver in 54 patients with coagulopathy, gross ascites or morbid obesity and suspected liver disease in whom percutaneous liver biopsy was contraindicated. MATERIAL AND METHODS: Forceps biopsy of the liver via the femoral vein was attempted in 54 adult patients with advanced liver disease of unknown aetiology who had coagulation disorders (41 cases), gross ascites (11 cases) or morbid obesity (two cases). In each patient two to six biopsies (average four) were taken using a radial jaw forceps inserted via the right or left femoral vein. RESULTS: The procedure was successful in 53 cases. Hepatic vein catheterization failed in one patient. Adequate liver tissue for diagnosis was obtained in 84% of cases. One patient developed delayed haemorrhage at 12 h from a capsular leak that was undetected during the biopsy procedure. This patient required blood transfusions and laparotomy to control bleeding. There were no deaths in the 53 patients studied. Transient minor chest and shoulder pain was encountered during sheath insertion into a hepatic vein in 23 patients. Three patients developed a femoral vein haematoma, which resolved with conservative treatment. CONCLUSION: Transvenous liver biopsy via the femoral vein is another safe, effective, simple alternative technique of biopsy when the percutaneous route is contraindicated

  2. EPIDEMIOLOGICAL STUDY OF CHILDREN DIAPHYSEAL FEMORAL FRACTURES.

    Science.gov (United States)

    Hoffmann, Cassiano Ricardo; Traldi, Eduardo Franceschini; Posser, Alexandre

    2012-01-01

    To evaluate the personal, fracture, treatment and complication characteristics among patients with pediatric femoral shaft fractures attended at the pediatric orthopedic service of the Joana de Gusmão Children's Hospital. This was a retrospective cross-sectional study on a population consisting of patients with femoral shaft fractures, aged between birth and 14 years and 11 months, who were divided into four age groups. Information was obtained from medical records and was transferred to a survey questionnaire to present personal, fracture, treatment and complication variables. The study population consisted of 96 patients. Their mean age was 6.8 years. The cases were predominantly among males, comprising closed fractures on the right side, in the middle third with a single line. Regarding fracture etiology, traffic accidents predominated overall in the sample. Most of the patients (74 to 77.1%) presented femoral fractures as their only injury. Conservative treatment predominated in the group younger than six years of age, and surgical treatment in the group aged 6 to 14 years and 11 months. The complications observed until bone union were: discrepancy, infection and movement limitation. The mean time taken for consolidation was 9.6 ± 2.4 weeks, varying with age. The features of these fractures were similar to those described in the literature and the treatment used showed good results. The Joana de Gusmão Children's Hospital has used the treatment proposed in the literature for pediatric femoral shaft fractures.

  3. Aseptic necrosis of femoral head complicating thalassemia

    International Nuclear Information System (INIS)

    Orzincolo, C.; Castaldi, G.; Scutellary, P.N.; Bariani, L.; Pinca, A.

    1986-01-01

    Aseptic necrosis of the femoral head is described in 4 patients, selected from 280 patients with homozygous β-thalassemia (Cooley anemia). The incidence of the complication appears to be very high (14.5per mille) in thalassemia, compared to the general population. The possible mechanism are discussed. (orig.)

  4. Proximal femoral derotation osteotomy for idiopathic excessive femoral anteversion and intoeing gait

    Directory of Open Access Journals (Sweden)

    Naqvi Gohar

    2017-01-01

    Full Text Available Aim: The purpose of this study is to assess the symptoms caused by excessive femoral anteversion and the outcomes of femoral derotation osteotomy. Methods: We reviewed data on patients who underwent proximal femoral derotation osteotomy for symptomatic intoeing gait caused by femoral anteversion. Only symptomatic patients were considered for corrective derotation osteotomy. Degree of femoral anteversion was confirmed on computed tomography (CT scan. Results: Thirty-five extremities were operated in 21 patients with an average age of 13.3 (8–18 years. Mean follow-up was 16 months (6–36 months. Mean femoral anteversion angle was 40.8° (28°–53°. External rotation of extended hips improved significantly, from 30° to 51.8° (p < 0.0001. Mean foot progressing angle improved from 15.2° internally rotated preoperatively to 7.7° externally rotated. Intoeing completely resolved in all except two patients. Thirteen out of 21 children complained about tripping and frequent falling while running and playing sports, eight patients had hip pain while 13 children had knee pain preoperatively. Tripping, falling and hip pain resolved in all patients postoperatively, while three patients whose primary complaint was knee pain failed to improve postsurgery. Eighteen of the 21 parents were satisfied with the decision to perform surgical correction. Conclusion: Excessive femoral anteversion can present with unexplained hip or knee pain refractory to conservative treatments. Careful assessment of lower limb malalignment is a valuable tool in such circumstances and derotation proximal femoral osteotomy can certainly be a procedure of choice in carefully selected cases.

  5. Trade Barriers on Capital Goods

    OpenAIRE

    Vural, Gülfer

    2015-01-01

    Capital goods play a major role in international trade. World production of capital goods and R&D activity are highly concentrated in some developed countries. Most of the countries, especially developing countries import the most of their capital equipment from some leading capital goods exporter countries. Therefore technological advances can be transmitted across borders through trade in capital goods. In international trade countries face trade costs. Trade costs can be in the for...

  6. Preoperative virtual reduction reduces femoral malrotation in the treatment of bilateral femoral shaft fractures.

    Science.gov (United States)

    Omar, Mohamed; Suero, Eduardo M; Hawi, Nael; Decker, Sebastian; Krettek, Christian; Citak, Musa

    2015-10-01

    In bilateral femoral shaft fractures, significant malrotation (>15°) occurs in about 40 % of cases after intramedullary nailing. Most of the methods that provide rotational control during surgery are based on a comparison to the intact femur and, thus, not applicable for bilateral fractures. In this study, we evaluated if preoperative virtual reduction can help improving rotational alignment in patients with bilateral femoral shaft fractures. Seven patients with bilateral femoral shaft fractures were initially treated with external fixation of both femurs. After obtaining a CT scan of both legs, the fractures were reduced virtually using the software program VoXim®, and the amount and direction of rotational correction were calculated. Subsequently, the patients were treated by antegrade femoral nailing and rotation was corrected to the preoperatively calculated amount. After external fixation, the mean rotational difference between both legs was 15.0° ± 10.2°. Four out of seven patients had a significant malrotation over 15°. Following virtual reduction, the mean rotational difference between both legs was 2.1° ± 1.2°. After intramedullary nailing, no case of malrotation occurred and the mean rotational difference was 6.1° ± 2.8°. Preoperative virtual reduction allows determining the pretraumatic femoral antetorsion and provided useful information for the definitive treatment of bilateral femoral shaft fractures. We believe that this procedure is worth being implemented in the clinical workflow to avoid malrotation after intramedullary nailing.

  7. Rotational position of femoral and tibial components in TKA using the femoral transepicondylar axis.

    Science.gov (United States)

    Aglietti, Paolo; Sensi, Lorenzo; Cuomo, Pierluigi; Ciardullo, Antonio

    2008-11-01

    Proper femoral and tibial component rotational positioning in TKA is critical for outcomes. Several rotational landmarks are frequently used with different advantages and limitations. We wondered whether coronal axes in the tibia and femur based on the transepicondylar axis in the femur would correlate with anteroposterior deformity. We obtained computed tomography scans of 100 patients with arthritis before they underwent TKA. We measured the posterior condylar angle on the femoral side and the angle between Akagi's line and perpendicular to the projection of the femoral transepicondylar axis on the tibial side. On the femoral side, we found a linear relationship between the posterior condylar angle and coronal deformity with valgus knees having a larger angle than varus knees, ie, gradual external rotation increased with increased coronal deformity from varus to valgus. On the tibial side, the angle between Akagi's line and the perpendicular line to the femoral transepicondylar axis was on average approximately 0 degrees , but we observed substantial interindividual variability without any relationship to gender or deformity. A preoperative computed tomography scan was a useful, simple, and relatively inexpensive tool to identify relevant anatomy and to adjust rotational positioning. We do not, however, recommend routine use because on the femoral side, we found a relationship between rotational landmarks and coronal deformity.

  8. Femoral neck fracture following groin irradiation

    International Nuclear Information System (INIS)

    Grigsby, Perry W.; Roberts, Heidi L.; Perez, Carlos A.

    1995-01-01

    Purpose: The incidence and risk factors are evaluated for femoral neck fracture following groin irradiation for gynecologic malignancies. Methods and Materials: The radiation therapy records of 1313 patients with advanced and recurrent cancer of the vagina, vulva, cervix, and endometrium, treated at the Mallinckrodt Institute of Radiology from 1954 to 1992, were reviewed. Median follow-up was 12.7 years. From this group, 207 patients were identified who received irradiation to the pelvis and groins with anterposterior-posterior anterior (AP-PA), 18 MV photons. Data were reviewed regarding irradiation dose to the femoral neck and other presumed risk factors including age, primary site, stage, groin node status, menopausal status, estrogen use, cigarette use, alcohol consumption, and osteoporosis. Results: The per-patient incidence of femoral neck fracture was 4.8% (10 out of 207). Four patients developed bilateral fractures. However, the cumulative actuarial incidence of fracture was 11% at 5 years and 15% at 10 years. Cox multivariate analysis of age, weight, and irradiation dose showed that only irradiation dose may be important to developing fracture. Step-wise logistic regression of presumed prognostic factors revealed that only cigarette use and x-ray evidence of osteoporosis prior to irradiation treatment were predictive of fracture. Conclusion: Femoral head fracture is a common complication of groin irradiation for gynecologic malignancies. Fracture in our database appears to be related to irradiation dose, cigarette use, and x-ray evidence of osteoporosis. Special attention should be given in treatment planning (i.e., shielding of femoral head/neck and use of appropriate electron beam energies for a portion of treatment) to reduce the incidence of this complication

  9. Pobreza, capital humano, capital social e familiar

    OpenAIRE

    Petrini, Giancarlo; Fonseca, Ricardo; Porreca, Wladimir

    2010-01-01

    O presente estudo investiga a pobreza partindo de uma análise dos recursos que os pobres dispõem em sua realidade, analisando os temas do capital humano, social e familiar, procurando estabelecer conexões e elucidar fatores da realidade pouco considerados em estudos e  projetos de combate à pobreza e à exclusão social. O presente artigo, em seu conjunto, procura compreender porque, em condições semelhantes de pobreza, algumas pessoas conseguem elaborar um projeto de vida enquanto outras se es...

  10. Capital Expert System

    Science.gov (United States)

    Dowell, Laurie; Gary, Jack; Illingworth, Bill; Sargent, Tom

    1987-05-01

    Gathering information, necessary forms, and financial calculations needed to generate a "capital investment proposal" is an extremely complex and difficult process. The intent of the capital investment proposal is to ensure management that the proposed investment has been thoroughly investigated and will have a positive impact on corporate goals. Meeting this requirement typically takes four or five experts a total of 12 hours to generate a "Capital Package." A Capital Expert System was therefore developed using "Personal Consultant." The completed system is hybrid and as such does not depend solely on rules but incorporates several different software packages that communicate through variables and functions passed from one to another. This paper describes the use of expert system techniques, methodology in building the knowledge base, contexts, LISP functions, data base, and special challenges that had to be overcome to create this system. The Capital Expert System is the successful result of a unique integration of artificial intelligence with business accounting, financial forms generation, and investment proposal expertise.

  11. CT study of avascular necrosis of femoral head in adults

    International Nuclear Information System (INIS)

    Liu Jihua; Du Yuqing; Xu Aide

    2000-01-01

    Objective: To study the early and new CT signs of avascular necrosis of femoral head in adults. Methods: The CT scans of 127 cases with this condition were analyzed. Results: There were 90 hip joints with femoral head normal in shape, including 67 femoral heads with only high-density sclerosis and 23 ones with high-density and low-density areas. In 111 hip joints, the femoral head was depressed and manifested purely high-density sclerosis in 25 and mixed-density areas in 86. Air-filled cysts appeared in 43 femoral heads. In follow-up cases, the changes in shape and density of femoral head followed some rules. Conclusion: Purely high-density sclerosis is an early sign and is of great diagnostic value combined with its special shape. Air in femoral heads is also a sign of the disease

  12. On the capitalization and cultivation of social capital

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase; Waldstrøm, Christian

    2008-01-01

    a dual focus on social capital as both immediately and potentially productive resources, i.e. assets that can be immediately capitalized by individuals as well as ‘cultivated' for future use. We argue that to further operationalize this concept we must distinguish between actual/potential social capital......Bourdieu's (1986) seminal definition of social capital as "the aggregate of the actual or potential resources" is reflected in older definitions, as well as in many current within sociology (e.g. Portes, 2000) and organization (Adler & Kwon, 2002). The definition is interesting, because it directs......, within a neo-capital framework that unifies the existing ‘plethora' of capitals....

  13. Organizational networks and social capital

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase; Waldstrøm, Christian

    2013-01-01

    This chapter presents a framework for understanding organizational networks and social capital through the lens of “social capital ownership” as well as the private and collective goods provided through this ownership. More specifically, it argues that ownership of social capital in organizations...... is closely connected to four types of social capital – two belonging to the bridging social capital type, and two belonging to the bonding social capital type. The chapter first reviews literature on organizational social capital and then directly focuses on ownership of social capital in organizations......, as well as the derived benefits, or losses. Next, the chapter presents an empirical case apt to illustrate the theoretical findings in part one, namely the nineteenth-century Danish Cooperative Dairy Movement (Svendsen and Svendsen 2004). It is demonstrated how social capital among Danish peasants...

  14. Five models of capitalism

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Bresser-Pereira

    2012-03-01

    Full Text Available Besides analyzing capitalist societies historically and thinking of them in terms of phases or stages, we may compare different models or varieties of capitalism. In this paper I survey the literature on this subject, and distinguish the classification that has a production or business approach from those that use a mainly political criterion. I identify five forms of capitalism: among the rich countries, the liberal democratic or Anglo-Saxon model, the social or European model, and the endogenous social integration or Japanese model; among developing countries, I distinguish the Asian developmental model from the liberal-dependent model that characterizes most other developing countries, including Brazil.

  15. Culture as Capital

    DEFF Research Database (Denmark)

    Kacunko, Slavko

    A collection of essays 2011-2014 By following, and reproducing, the cultural turn, the rhetoric of cultural mix and hybridism is disseminated today primarily in its crossing of trade barriers. Cultures reduced to their exchange value function as capital - an accumulative, speculative and, ultimat......A collection of essays 2011-2014 By following, and reproducing, the cultural turn, the rhetoric of cultural mix and hybridism is disseminated today primarily in its crossing of trade barriers. Cultures reduced to their exchange value function as capital - an accumulative, speculative and...

  16. Loosening of the femoral component of total hip replacement after plugging the femoral canal.

    Science.gov (United States)

    Harris, W H; McCarthy, J C; O'Neill, D A

    1982-01-01

    A roentgen follow-up study was done of 171 total hip replacements at an average of 3.3 years (range 2 to 5 years) after insertion to assess the loosening rate in older adult patients (average age 60 years) in whom the medullary canal was plugged. The cement (Simplex P) was introduced using a cement gun. The femoral components used were CAD and HD-2 in design, made of chrome cobalt alloy. Evaluation was made according to three categories of loosening: definite (requiring evidence of migration of the component or the cement), probable (requiring a continuous radiolucent zone around the cement mantle in one or more radiographic views), or possible (requiring a radiolucent zone that occupied 50% or more of the cement-bone interface in one or more views but was not continuous). One hip was revised for a loose femoral component. Another patient has asymptomatic subsidence of the femoral component. Thus the total incidence of definitely loose femoral components was 1.1%. No hip was classified as probably loose. Seven hips (4%) were rated as possibly loose. Compared to four other reported series of similar groups of patients followed for like duration, this incidence of definitely loose components is statistically significantly less than in nonplugged canals. The other differences among the series compared, such as stem design, type of cement introduction, modulus of elasticity of the metal used, presence or absence of a collar, and dates during which the surgery was done, are also discussed. Plugging the femoral canal; introducing the cement with a cement gun; using a femoral stem that largely fills the medullary canal, has a collar, and has a rounded rectangular cross section with no medial stress risers made of a superalloy with a modulus of elasticity of about 200 GPa--all these factors were associated with a low (1.1%) incidence of femoral component loosening at 3 years.

  17. Capital Requirements and Banks' Leniency

    DEFF Research Database (Denmark)

    Dietrich, J. Kimball; Wihlborg, Clas

    2003-01-01

    We investigate the effect of changes in capital regulation on the strictness(leniency) of loan terms using a simple model of bank capital requirements andasset quality examinations. Banks offer different levels of `leniency' in the senseof willingness to offer automatic extensions of loans...... rates. As capital requirements increase thedifference between initial capital levels and between interest rates of strict andlenient banks decrease. Thus, higher capital requirements in recessions tend toreduce the interest rate premium paid for leniency. If a recession is interpreted asan increase...... in the required return, the interest rate premium paid for leniency isincreased in recession at a given level of required capital....

  18. Ribbon like appearance of the midsubstance fibres of the anterior cruciate ligament close to its femoral insertion site: a cadaveric study including 111 knees.

    Science.gov (United States)

    Śmigielski, Robert; Zdanowicz, Urszula; Drwięga, Michał; Ciszek, Bogdan; Ciszkowska-Łysoń, Beata; Siebold, Rainer

    2015-11-01

    Recently, the configuration of the anterior cruciate ligament (ACL) from its direct femoral insertion to midsubstance was found to be flat. This might have an important impact for anatomical ACL reconstruction. The purpose of this anatomical study was to evaluate the macroscopic appearance of the ACL from femoral to midsubstance. The ACL was dissected in 111 human fresh frozen cadaver knees from its femoral insertion to midsubstance, and the shape was described. The anatomical findings were documented on digital photographs and on video. Thirty knees were sent for computed tomography (CT), magnetic resonance imaging (MRI) and histology of the femoral ACL insertion. Two millimetres from its direct femoral insertion, the ACL fibres formed a flat ribbon in all dissected knees without a clear separation between AM and PL bundles. The ribbon was in exact continuity of the posterior femoral cortex. The width of the ribbon was between 11.43 and 16.18 mm and the thickness of the ACL was only 2.54-3.38 mm. 3D CT, MRI and the histological examination confirmed above findings. This is a detailed anatomical study describing the ribbon-like structure of the ACL from its femoral insertion to midsubstance. A key point was to carefully remove the surface fibrous membrane of the ACL. A total of 2-3 mm from its bony femoral insertion, the ACL formed a flat ribbon without a clear separation between AM and PL bundles. The ribbon was in exact continuity of the posterior femoral cortex. The findings of a flat ligament may change the future approach to femoral ACL footprint and midsubstance ACL reconstruction and to graft selection.

  19. Evaluation of femoral tunnel positioning using 3-dimensional computed tomography and radiographs after single bundle anterior cruciate ligament reconstruction with modified transtibial technique.

    Science.gov (United States)

    Lee, Sung Rak; Jang, Hyoung Won; Lee, Dhong Won; Nam, Sang Wook; Ha, Jeong Ku; Kim, Jin Goo

    2013-09-01

    The purpose of this study is to report a modified transtibial technique to approach the center of anatomical femoral footprint in anterior cruciate ligament (ACL) reconstruction and to investigate the accurate femoral tunnel position with 3-dimensional computed tomography (3D-CT) and radiography after reconstruction. From December 2010 to October 2011, we evaluated 98 patients who underwent primary ACL reconstruction using a modified transtibial technique to approach the center of anatomical femoral footprint in single bundle ACL reconstruction with hamstring autograft. Their femoral tunnel positions were investigated with 3D-CT and radiography postoperatively. Femoral tunnel angle was measured on the postoperative anteroposterior (AP) radiograph and the center of the femoral tunnel aperture on the lateral femoral condyle was assessed with 3D-CT according to the quadrant method by two orthopedic surgeons. According to the quadrant method with 3D-CT, the femoral tunnel was measured at a mean of 32.94% ± 5.16% from the proximal condylar surface (parallel to the Blumensaat line) and 41.89% ± 5.58% from the notch roof (perpendicular to the Blumensaat line) with good interobserver (intraclass correlation coefficients [ICC], 0.766 and 0.793, respectively) and intraobserver reliability (ICC, 0.875 and 0.893, respectively). According to the radiographic measurement on the AP view, the femoral tunnel angles averaged 50.43° ± 7.04° (ICC, 0.783 and 0.911, respectively). Our modified transtibial technique is anticipated to provide more anatomical placement of the femoral tunnel during ACL reconstruction than the former traditional transtibial techniques.

  20. A semi-automated method for measuring femoral shape to derive version and its comparison with existing methods.

    Science.gov (United States)

    Berryman, F; Pynsent, P; McBryde, C

    2014-11-01

    The measurement of femoral version is important in surgical planning of derotational osteotomies particularly for patients with proximal femoral deformity. It is, however, difficult to measure version accurately and differences of 10° to 15° have been found between repeated measurements. The aim of this work was first to develop a method of measuring femoral version angle where the definition of the neck axis is based on the three-dimensional point cloud making up the neck, second to automate many of the processes involved thus reducing the influence of human error and third to ensure the method could run on freely available software suitable for most computer platforms. A CT scan was performed on 44 cadaveric femurs to generate point clouds of the femoral surfaces. The point clouds were then analysed semi-automatically to determine femoral version angle between a neck axis defined by the bone surface points belonging only to the neck and a femoral condylar axis. The results from the neck fitting method were compared against three other methods typically used in the clinic (Murphy, Reikeras and Lee methods). Version angle measured by the new method gave 19.1° ± 7.3° (mean ± standard deviation) for the set of cadaveric femurs, 3.5° lower than the Murphy method and 6.8° and 11.0° higher than the Reikeras and Lee 2D methods respectively. The results demonstrate a method of measuring femoral version angle incorporating a high level of automation running on free software. Copyright © 2014 John Wiley & Sons, Ltd.

  1. Green Capital: Student Capital student-led evaluation

    OpenAIRE

    Runkle, Q.; Haines, T.; Piper, K.; Leach, S.

    2016-01-01

    To assess and evaluate the impact of the Green Capital: Student Capital project, the partnership (the University of the West of England, the University of Bristol, the Students’ Union at UWE, and Bristol Students’ Union) worked with NUS to train a team of students from both universities to lead an evaluation process. There were two key aims for the evaluation: \\ud \\ud • To verify the quantitative outputs of the Green Capital: Student Capital project; \\ud • And to make a qualitative assessment...

  2. From political capitalism to clientelist capitalism? The case of Croatia

    OpenAIRE

    Vladimir Cvijanovic; Denis Redzepagic

    2011-01-01

    The paper analyses the typology of capitalism in Croatia. The Croatian form of capitalism is specific, in form and origin, with links between the pre-independence and post-independence periods, implying that capitalism has gradually evolved – from the political during the eighties towards current clientelistic capitalism. The manufacturing focus aims to facilitate the analysis of institutional, political and economic changes over the past forty years, emphasising the implications of instituti...

  3. Femoral neck fractures: a changing paradigm.

    Science.gov (United States)

    Su, E P; Su, S L

    2014-11-01

    Surgical interventions consisting of internal fixation (IF) or total hip replacement (THR) are required to restore patient mobility after hip fractures. Conventionally, this decision was based solely upon the degree of fracture displacement. However, in the last ten years, there has been a move to incorporate patient characteristics into the decision making process. Research demonstrating that joint replacement renders superior functional results when compared with IF, in the treatment of displaced femoral neck fractures, has swayed the pendulum in favour of THR. However, a high risk of dislocation has always been the concern. Fortunately, there are newer technologies and alternative surgical approaches that can help reduce the risk of dislocation. The authors propose an algorithm for the treatment of femoral neck fractures: if minimally displaced, in the absence of hip joint arthritis, IF should be performed; if arthritis is present, or the fracture is displaced, then THR is preferred. ©2014 The British Editorial Society of Bone & Joint Surgery.

  4. Intracorporeal knotting of a femoral nerve catheter

    Directory of Open Access Journals (Sweden)

    Ghanem, Mohamed

    2015-01-01

    Full Text Available Peripheral nerve catheters are effective and well-established tools to provide postoperative analgesia to patients undergoing orthopedic surgery. The performance of these techniques is usually considered safe. However, placement of nerve catheters may be associated with a considerable number of side effects and major complications have repeatedly been published. In this work, we report on a patient who underwent total knee replacement with spinal anesthesia and preoperative insertion of femoral and sciatic nerve catheters for postoperative analgesia. During insertion of the femoral catheter, significant resistance was encountered upon retracting the catheter. This occurred due to knotting of the catheter. The catheter had to be removed by operative intervention which has to be considered a major complication. The postoperative course was uneventful. The principles for removal of entrapped peripheral catheters are not well established, may differ from those for neuroaxial catheters, and range from cautious manipulation up to surgical intervention.

  5. Spontaneous stress fractures of the femoral neck

    International Nuclear Information System (INIS)

    Dorne, H.L.; Lander, P.H.

    1985-01-01

    The diagnosis of spontaneous stress fractures of the femoral neck, a form of insufficiency stress fracture, can be missed easily. Patients present with unremitting hip pain without a history of significant trauma or unusual increase in daily activity. The initial radiographic features include osteoporosis, minor alterations of trabecular alignment, minimal extracortical or endosteal reaction, and lucent fracture lines. Initial scintigraphic examinations performed in three of four patients showed focal increased radionuclide uptake in two and no focal abnormality in one. Emphasis is placed on the paucity of early findings. Evaluation of patients with persistent hip pain requires a high degree of clinical suspicion and close follow-up; the sequelae of undetected spontaneous fractures are subcapital fracture with displacement, angular deformity, and a vascular necrosis of the femoral head

  6. Radionuclide evaluation of spontaneous femoral osteonecrosis

    International Nuclear Information System (INIS)

    Greyson, N.D.; Lotem, M.M.; Gross, A.E.; Houpt, J.B.

    1982-01-01

    Spontaneous osteonecrosis of the femoral condyle in 40 knees was followed by sequential radiographs and three-phase bone scans using 99 /sup m/Tc-methylene diphosphonate. The characteristic bone scan appearance of focal increased uptake by the medial femoral condyle in blood flow, blood pool, and delayed images helped to make the specific diagnosis in 11 knees that had no characteristic radiographic findings at the time of presentation. The three phases of the bone scan demonstrated a pattern that was useful in determining the activity of the process. There was a gradual loss of hyperemia as healing progressed. Late bone scans were normal or showed nonspecific findings. Radionuclide bone scans were able to confirm or exclude this disease and were superior to radiographs in demonstrating the disease in the acute phase

  7. Thin Capitalization Rules and Multinational Firm Capital Structure

    NARCIS (Netherlands)

    Blouin, J.; Huizinga, H.P.; Laeven, L.; Nicodeme, G.

    2014-01-01

    Abstract: This paper examines the impact of thin capitalization rules that limit the tax deductibility of interest on the capital structure of the foreign affiliates of US multinationals. We construct a new data set on thin capitalization rules in 54 countries for the period 1982-2004. Using

  8. Human Capital and Optimal Positive Taxation of Capital Income

    NARCIS (Netherlands)

    B. Jacobs (Bas); A.L. Bovenberg (Lans)

    2005-01-01

    textabstractThis paper analyzes optimal linear taxes on capital and labor incomes in a life-cycle model of human capital investment, financial savings, and labor supply with heteroge- nous individuals. A dual income tax with a positive marginal tax rate on not only labor income but also capital

  9. On the capitalization and cultivation of social capital

    DEFF Research Database (Denmark)

    Waldstrøm, Christian; Svendsen, Gunnar Lind Haase

    2008-01-01

    a dual focus on social capital as both immediately and potentially productive resources, i.e. assets that can be immediately capitalized by individuals as well as ‘cultivated' for future use. We argue that to further operationalize this concept we must distinguish between actual/potential social capital...

  10. Zirconia femoral head fractures: a clinical and retrieval analysis.

    Science.gov (United States)

    Masonis, John L; Bourne, Robert B; Ries, Michael D; McCalden, Richard W; Salehi, Abraham; Kelman, David C

    2004-10-01

    Zirconia femoral heads provide increased fracture strength, but 343 zirconia head failures have been documented since 2000. Retrieval analysis of 6 fractured heads, 4 suspect heads, 4 control zirconia heads, and 2 failed alumina heads was performed. Zirconia failures have been isolated to heads sintered in a "tunnel" furnace introduced in 1998. The monoclinic composition at the taper surface of fractured and nonfractured heads was significantly elevated (21% to 68%) compared to that of control zirconia heads (less than 5%). Electron microscopy identified circular fracture footprints unique to the zirconia heads produced in the tunnel furnace. Cobalt chrome heads were used in the urgent revision setting due to Morse taper damage. Partial capsulectomy was performed in an effort to reduce future third body wear. Monoclinic phase transformation following implantation remains a potential mechanism of ceramic head failure. We recommend that patients with recalled zirconia heads be advised of a potential fracture risk.

  11. Osteonecrosis of the femoral head: An update in year 2012

    Science.gov (United States)

    Kaushik, Anjan P; Das, Anusuya; Cui, Quanjun

    2012-01-01

    Osteonecrosis is a phenomenon involving disruption to the vascular supply to the femoral head, resulting in articular surface collapse and eventual osteoarthritis. Although alcoholism, steroid use, and hip trauma remain the most common causes, several other etiologies for osteonecrosis have been identified. Basic science research utilizing animal models and stem cell applications continue to further elucidate the pathophysiology of osteonecrosis and promise novel treatment options in the future. Clinical studies evaluating modern joint-sparing procedures have demonstrated significant improvements in outcomes, but hip arthroplasty is still the most common procedure performed in these affected younger adults. Further advances in joint-preserving procedures are required and will be widely studied in the coming decade. PMID:22655222

  12. Culture as Capital

    DEFF Research Database (Denmark)

    Kacunko, Slavko

    A collection of essays 2011-2014 By following, and reproducing, the cultural turn, the rhetoric of cultural mix and hybridism is disseminated today primarily in its crossing of trade barriers. Cultures reduced to their exchange value function as capital - an accumulative, speculative and...

  13. Microfoundations of Social Capital

    DEFF Research Database (Denmark)

    Thöni, Christian; Tyran, Jean-Robert; Wengström, Erik Roland

    We show that the standard trust question routinely used in social capital research is importantly related to cooperation behavior and we provide a microfoundation for this relation. We run a large-scale public goods experiment over the internet in Denmark and find that the trust question is a proxy...

  14. Sabotage in Capital Budgeting

    DEFF Research Database (Denmark)

    Brunner, Markus; Ostermaier, Andreas

    2018-01-01

    This study investigates the sabotage of investments in response to hurdle contracts as a means of formal control in capital budgeting. We conduct a laboratory experiment to examine factors that drive or inhibit sabotage. Sabotage occurs when the manager provides false information to prevent...

  15. Reporting on intellectual capital

    NARCIS (Netherlands)

    Meer-Kooistra, Jeltje van der; Zijlstra, Siebren M.

    2001-01-01

    In today’s knowledge-based economy intellectual capital (IC) is becoming a major part of companies’ value. Being able to manage and control IC requires that companies can identify, measure and report internally on IC. As financial accounting rules ban full disclosure of IC in the annual report the

  16. Capital projects coordination

    Directory of Open Access Journals (Sweden)

    Zubović Jovan

    2004-01-01

    Full Text Available This paper looks at the difficulties of managing modem capital projects and endeavors to reduce the complexities to simpler and more understandable terms. It examines the project environment, defines project management and discusses points of difference from traditional management. In the second part of the paper are presented fundamentals for project success for different types of projects.

  17. Risk capital allocation

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Smilgins, Aleksandrs

    Risk capital allocation problems have been widely discussed in the academic literature. We consider a company with multiple subunits having individual portfolios. Hence, when portfolios of subunits are merged, a diversification benefit arises: the risk of the company as a whole is smaller than th...... of new axioms related directly to the problem of risk capital allocation and show that the Lorenz set satisfies these new axioms in contrast to other well-known coherent methods. Finally, we discuss how to deal with non-uniqueness of the Lorenz set.......Risk capital allocation problems have been widely discussed in the academic literature. We consider a company with multiple subunits having individual portfolios. Hence, when portfolios of subunits are merged, a diversification benefit arises: the risk of the company as a whole is smaller than...... the sum of the risks of the individual sub-units. The question is how to allocate the risk capital of the company among the subunits in a fair way. In this paper we propose to use the Lorenz set as an allocation method. We show that the Lorenz set is operational and coherent. Moreover, we propose a set...

  18. Knight Capital Americas LLC

    DEFF Research Database (Denmark)

    Austin, Robert D.; Meister, Darren

    2015-01-01

    It took 19 years to build Knight Capital Americas LLC into the largest market maker on the New York Stock Exchange, but on August 1, 2012, it took only 45 minutes for the firm to be wiped out by an information technology (IT) problem: a change in the company's software caused it to lose more than...

  19. Towards Transnational Academic Capitalism

    Science.gov (United States)

    Kauppinen, Ilkka

    2012-01-01

    This paper contributes to current debates on the relationship between globalisation and higher education. The main argument of the paper is that we are currently witnessing transnationalisation of academic capitalism. This argument is illustrated by examining the collaboration between transnational corporations and research universities, and how…

  20. Microfoundations of Social Capital

    DEFF Research Database (Denmark)

    Thöni, Christian; Tyran, Jean-Robert Karl; Wengström, Erik Roland

    2012-01-01

    Research on social capital routinely relies on survey measures of trust which can be collected in large and heterogeneous samples at low cost. We validate such survey measures in an incentivized public good experiment and show that they are importantly related to cooperation behavior in a large...

  1. Reggio Social Capital

    Science.gov (United States)

    Stejzygier, Aneta

    2009-01-01

    The paper presents the social capital as the essential element of success of the Reggio Emilia preschools known for their unique approach to the early childhood education. The collaborative effort is introduced through examples of the currently ongoing "Reggio Narrates" project of Reggio preschools, the "Dialogue with the…

  2. Capital Structure and Assets

    DEFF Research Database (Denmark)

    Flor, Christian Riis

    2008-01-01

    This paper analyzes a firm's capital structure choice when assets have outside value. Valuable assets implicitly provide a collateral and increase tax shield exploitation. The key feature in this paper is asset value uncertainty, implying that it is unknown ex ante whether the equity holders ex...

  3. Managing soil natural capital

    DEFF Research Database (Denmark)

    Cong, Ronggang; Termansen, Mette; Brady, Mark

    2017-01-01

    return but replenishes SOC. We find that managing soil natural capital can, not only improve farm profit while reducing the risk, but also reduce the downside risk. Prudent adaptation to future risks should therefore consider the impact of current agricultural management practices on the stock of soil...

  4. Manage "Human Capital" Strategically

    Science.gov (United States)

    Odden, Allan

    2011-01-01

    To strategically manage human capital in education means restructuring the entire human resource system so that schools not only recruit and retain smart and capable individuals, but also manage them in ways that support the strategic directions of the organization. These management practices must be aligned with a district's education improvement…

  5. Corruption and Social Capital

    DEFF Research Database (Denmark)

    Bjørnskov, Christian

    2003-01-01

    I examine the causal relation between social capiatl and corruption. A simple model illustrates potential mechanisms and yields testable implications, which I estimate in a sample of European countries. The estimated effect of social capital on corruption is found to be robust to the inclusion...... redistribution, which in turn reduces corruption....

  6. Cultural Capital in Context:

    DEFF Research Database (Denmark)

    Andersen, Ida Gran; Jæger, Mads Meier

    to be higher in low-achieving schooling environments than in high-achieving ones. These results support the cultural mobility explanation and are in line with previous research suggesting that children from low-SES families benefit more from cultural capital than children from high-SES families....

  7. Cooperative social capital

    Directory of Open Access Journals (Sweden)

    Oscar Acera Manero

    2005-12-01

    Full Text Available Social capital consists of the contributions of members and associates, both mandatory and voluntary. From an accounting point of view, it is a liability figure that expresses the value of a portion of the equity of the cooperative. Its inclusion in the liability is not the fact that it is a debt but by its nature unenforceable.

  8. Radiofrequency ablation of two femoral head chondroblastomas

    Energy Technology Data Exchange (ETDEWEB)

    Petsas, Theodore [Department of Radiology, University of Patras (Greece); Megas, Panagiotis [Department of Orthopaedic Surgery, University of Patras (Greece)]. E-mail: panmegas@med.upatras.gr; Papathanassiou, Zafiria [Department of Radiology, University of Patras (Greece)

    2007-07-15

    Chondroblastoma is a rare benign cartilaginous bone tumor. Surgical resection is the treatment of choice for pain relief and prevention of further growth. Open surgical techniques are associated with complications, particularly when the tumors are located in deep anatomical sites. The authors performed RF ablation in two cases of subarticular femoral head chondroblastomas and emphasize its positive impact. The clinical course, the radiological findings and the post treatment results are discussed.

  9. Ipsilateral femoral neck and trochanter fracture

    Directory of Open Access Journals (Sweden)

    Devdatta S Neogi

    2011-01-01

    Full Text Available Ipsilateral fractures in the neck and trochanteric region of the femur are very rare and seen in elderly osteoporotic patients. We present a case of a young man who presented with ipsilateral fracture of the femoral neck and a reverse oblique fracture in the trochanteric region following a motor vehicle accident. A possible mechanism, diagnostic challenge, and awareness required for identifying this injury are discussed.

  10. [Avascular necrosis of the femoral head].

    Science.gov (United States)

    Porubský, Peter; Trč, Tomáš; Havlas, Vojtěch; Smetana, Pavel

    Avascular necrosis of the femoral head in adults is not common, but not too rare diseases. In orthopedic practice, it is one of the diseases that are causing implantation of hip replacement at a relatively early age. In the early detection and initiation of therapy can delay the implantation of prosthesis for several years, which is certainly more convenient for the patient and beneficial. This article is intended to acquaint the reader with the basic diagnostic procedures and therapy.

  11. Proximal focal femoral deficiency: A case report

    Directory of Open Access Journals (Sweden)

    Shashank Sharma

    2015-01-01

    Full Text Available Proximal focal femoral deficiency (PFFD is a rare congenital anomaly resulting in limb shortening and disability in young. The exact cause of the disease is not known and it may present as varying grades of affection involving the proximal femur and the acetabulum. Recognition of this rare abnormality on radiographs can help manage these cases better since early institution of therapy may help in achieving adequate growth of the femur.

  12. Tribological changes in the articular cartilage of a human femoral head with avascular necrosis.

    Science.gov (United States)

    Seo, Eun-Min; Shrestha, Suman K; Duong, Cong-Truyen; Sharma, Ashish Ranjan; Kim, Tae-Woo; Vijayachandra, Ayyappan; Thompson, Mark S; Cho, Myung Guk; Park, Sungchan; Kim, Kwanghoon; Park, Seonghun; Lee, Sang-Soo

    2015-06-29

    The present study evaluated the tribological properties of the articular cartilage surface of the human femoral head with postcollapse stage avascular necrosis (AVN) using atomic force microscopy. The cartilage surface in the postcollapse stage AVN of the femoral head was reported to resemble those of disuse conditions, which suggests that the damage could be reversible and offers the possibilities of success of head-sparing surgeries. By comparing the tribological properties of articular cartilage in AVN with that of osteoarthritis, the authors intended to understand the cartilage degeneration mechanism and reversibility of AVN. Human femoral heads with AVN were explanted from the hip replacement surgery of four patients (60-83 years old). Nine cylindrical cartilage samples (diameter, 5 mm and height, 0.5 mm) were sectioned from the weight-bearing areas of the femoral head with AVN, and the cartilage surface was classified according to the Outerbridge Classification System (AVN0, normal; AVN1, softening and swelling; and AVN2, partial thickness defect and fissuring). Tribological properties including surface roughness and frictional coefficients and histochemistry including Safranin O and lubricin staining were compared among the three groups. The mean surface roughness Rq values of AVN cartilage increased significantly with increasing Outerbridge stages: Rq = 137 ± 26 nm in AVN0, Rq = 274 ± 49 nm in AVN1, and Rq = 452 ± 77 nm in AVN2. Significant differences in Rq were observed among different Outerbridge stages in all cases (p tribological properties, the cartilage degeneration mechanism in AVN was similar to that of osteoarthritis without reversibility.

  13. Administrative Freezing of Capital Construction

    Directory of Open Access Journals (Sweden)

    Kropacheva A. V.

    2015-07-01

    Full Text Available The author estimates administrative freezing of capital construction as a type of punishment for violating laws in this sphere. The article provides the mechanism of freezing of capital construction as a serious alternative for fine sanctions

  14. [Pregnancy-associated femoral nerve affection].

    Science.gov (United States)

    Pildner von Steinburg, S; Kühler, A; Herrmann, N; Fischer, T; Schneider, K T

    2004-10-01

    Common neuropathies during pregnancy are carpal tunnel syndrome or peripheral facial paralysis. However, there is little information about femoral nerve affection during pregnancy. We report on a female at 30 weeks of gestation, complaining of pain in hips and thighs and gait difficulty. Pregnancy was normally developed. Neurological examination showed a bilateral weakness in both quadriceps and iliopsoas muscles combined with soreness in hips and thighs, without deficits of sensibility. Laboratory findings and results of a lumbar punction were normal. Pelvic ultrasound and an MRI scan of the spine and pelvis showed no mass or disc prolaps. Neuromyographic evaluation bilaterally revealed acute signs of denervation of the muscles innervated by femoral nerve. Caesarean section was performed at 32 gestational weeks, as pain was unbearable and refractory to treatment with even opiates. Post partum, pain relieved immediately, and after weeks of physiotherapy, complete remission was achieved. This unusual manifestation of a neuropathy in pregnancy could be due to pressure on the femoral nerve. The patients' anxiety can be eliminated, as the described cases in literature show an excellent prognosis. However, the severity of symptoms can lead us to necessity of premature delivery.

  15. How venture capital works.

    Science.gov (United States)

    Zider, B

    1998-01-01

    The popular mythology surrounding the U.S. venture-capital industry derives from a previous era. Venture capitalists who nurtured the computer industry in its infancy were legendary both for their risk taking and for their hands-on operating experience. But today things are different, and separating the myths from the realities is crucial to understanding this important piece of the U.S. economy. Today's venture capitalists are more like conservative bankers than the risk takers of days past. They have carved out a specialized niche in the capital markets, filling a void that other institutions cannot serve. They are the linch-pins in an efficient system for meeting the needs of institutional investors looking for high returns, of entrepreneurs seeking funding, and of investment bankers looking for companies to sell. Venture capitalists must earn a consistently superior return on investments in inherently risky businesses. The myth is that they do so by investing in good ideas and good plans. In reality, they invest in good industries--that is, industries that are more competitively forgiving than the market as a whole. And they structure their deals in a way that minimizes their risk and maximizes their returns. Although many entrepreneurs expect venture capitalists to provide them with sage guidance as well as capital, that expectation is unrealistic. Given a typical portfolio of ten companies and a 2,000-hour work year, a venture capital partner spends on average less than two hours per week on any given company. In addition to analyzing the current venture-capital system, the author offers practical advice to entrepreneurs thinking about venture funding.

  16. Capitalism: A System of Conspiracy

    OpenAIRE

    Das, Subhendu

    2010-01-01

    There are some myths about American capitalism. Some of them are (1) Capitalism made America the richest nation, (2) Capitalism is based on self interest, and (3) America has democracy. We show that the survival of capitalism is based on several powerful conspiracy theories. We briefly describe these conspiracies. Our analysis is based on the following principles: (a) Laws of conservation, (b) System theoretic concepts, and (c) The global space time (GST) environment. Using these princip...

  17. Auditing and bank capital regulation

    OpenAIRE

    Edward Simpson Prescott

    2004-01-01

    Auditing is introduced into a model of bank capital regulation. Deterministic and stochastic auditing strategies are studied. Contrary to intuition, auditing of bank risk should be focused on the safest banks because they hold the least amount of capital. Risky banks, which hold more capital, need to be audited less. The importance of auditing by regulators and penalties for non-compliance are discussed in light of the Basel II capital regulation proposals. Emphasis is placed on the importanc...

  18. Umbrella-shaped, memory alloy femoral head support device for treatment of avascular osteonecrosis of the femoral head.

    Science.gov (United States)

    Yu, Xiaowei; Jiang, Wenxiong; Pan, Qi; Wu, Tianyi; Zhang, Yan; Zhou, Zubin; Du, Dongpeng

    2013-07-01

    Avascular necrosis (AVN) of the femoral head is a common orthopaedic disease that is difficult to treat. The purpose of this study was to explore the preliminary efficacy of a self-designed umbrella-shaped memory alloy femoral head support device in the treatment of adult patients with avascular osteonecrosis of the femoral head. The minimally-invasive approach involved curettage of the necrotic tissue of the femoral head, and a self-designed umbrella-shaped, memory alloy femoral head support device was implanted into the collapsed necrotic area to support the collapsed femoral head. Autologous iliac bone and artificial bone were implanted into the support device for the treatment of adult patients with avascular osteonecrosis of the femoral head. The clinical device was used in ten patients and 18 hip joints. The support device failed in one hip joint, which subsequently underwent joint replacement surgery, and the remaining 17 implanted devices were followed up for four to 19 months. The 17 postoperative hip joints were evaluated using the percent-efficacy evaluation method for avascular osteonecrosis of the femoral head in adult patients, and the efficacy rate was 82.35 %. The umbrella-shaped femoral head support device can be used in Ficat stage I, stage II, and stage III adult patients with avascular osteonecrosis of the femoral head.

  19. Endovascular repair of posttraumatic multiple femoral-femoral and popliteal-popliteal arteriovenous fistula with Viabahn and excluder stent graft

    Directory of Open Access Journals (Sweden)

    Šarac Momir

    2011-01-01

    Full Text Available Background. Traumatic arteriovenous (AV fistula is considered to be a pathologic communication between the arterial and venous systems following injury caused mostly by firearms, sharp objects or blasting agents. Almost 50% of all traumatic AV fistulas are localized in the extremities. In making diagnosis, besides injury anamnesis data, clinical image is dominated by palpable thrill and auscultator continual sounds at the site of fistula, extremities edemas, ischemia distally of fistula, pronounced varicose syndrome, and any signs of the right heart load in high-flow fistulas. Case report. We presented a male 32-year-old patient self-injured the region of the right lower and upper leg by shotgun during hunting in 2005. The same day the patient was operated on in a tertiary traumatology health care institution under the diagnosis of vulnus sclopetarium femoris et cruris dex; AV fistula reg popliteae dex; fractura cruris dex. The performed surgery was ligatura AV fistulae; reconstructio a. popliteae cum T-T anastomosis; fasciotomia cruris dex. Postoperatively, in the patient developed a multiple AV fistula of the femoral and popliteal artery and neighboring veins. The patient was two more times operated on for closing the fistula but with no success. Three years later the patient was referred to the Clinic for Vascular Surgery, Military Medical Academy, Belgrade, Serbia. A physical examination on admission showed the right upper leg edema, pronounced varicosities and high thrill, signs of the skin induration and initial ischemia with ulceration in the right lower leg, as well as numerous scars in the inner side of the leg from the previously performed operations. Due to the right heart load there were also present easy getting tired, tachypnoea and tachycardia. CT and contrast angiography verified the presence of multiple traumatic AV fistulas in the surface femoral and popliteal artery and neighboring veins of the highest diameter being 1 cm

  20. Evaluation of the hemodynamics of the femoral head compared with the ilium, femoral neck and femoral intertrochanteric region in healthy adults. Measurement with positron emission tomography (PET)

    International Nuclear Information System (INIS)

    Nakamura, Fuminori; Fujioka, Mikihiro; Takahashi, Kenji A.; Ueshima, Keiichiro; Arai, Yuji; Imahori, Yoshio; Itani, Kenji; Nishimura, Tsunehiko; Kubo, Toshikazu

    2005-01-01

    Non-traumatic osteonecrosis of the femoral head (ONF) is considered to be a disease that occurs primarily due to ischemia of the femoral head, while its etiology and pathology are not fully understood. It is therefore necessary to identify the characteristics of the hemodynamics of the femoral head. In this study, the hemodynamics in the ilium and proximal regions of the femur, including the femoral head, was investigated using positron emission tomography (PET). The subjects of this study consisted of 8 hip joints of four healthy male adults and 3 hip joints on the contralateral side of a femoral neck fracture, avulsion fracture of the greater trochanter and coxarthrosis (1 case each, all females) for a total of 11 hip joints of 7 subjects. The ages of the subjects ranged from 25 to 87 years (average age: 54 years). Blood flow was measured by means of the H 2 15 O dynamic study method and blood volume was measured by means of the 15 O-labeled carbon monoxide bolus inhalation method. Blood flow was determined to be 9.1±4.8 ml/min/100 g in the ilium and among proximal regions of the femur (femoral head, neck and intertrochanteric region), 1.8±0.7 ml/min/100 g in the femoral head, 2.1±0.6 ml/min/100 g in the femoral neck, and 2.6±0.7 ml/min/100 g in the intertrochanteric region. In addition, blood volume was 4.7±1.3 ml/100 g in the ilium, and among proximal regions of the femur, 1.1±0.5 ml/100 g in the femoral head, 2.1±0.7 ml/100 g in the femoral neck, and 2.6±0.9 ml/100 g in the intertrochanteric region. The results showed that both blood flow and volume were lowest in the femoral head. Blood flow and volume were significantly lower in the proximal regions of the femur (femoral head, neck and intertrochanteric region) than in the ilium (p<0.01). The present study demonstrated that the femoral head is in a hypoemic state as compared with other osseous tissue, indicating that even the slightest exacerbation of hemodynamics in the femoral head can trigger an

  1. Thin Capitalization Rules and Entrepreneurial Capital Structure Decisions

    Directory of Open Access Journals (Sweden)

    Alexandra Maßbaum

    2009-12-01

    Full Text Available Tax planners often choose debt over equity financing. As this has led to increased corporate debt financing, many countries have introduced thin capitalization rules to secure their tax revenues. In a general capital structure model we analyze if thin capitalization rules affect dividend and financing decisions, and whether they can partially explain why corporations receive both debt and equity capital. We model the Belgian, German and Italian rules as examples. We find that the so-called Miller equilibrium and definite financing effects depend significantly on the underlying tax system. Further, our results are useful for the treasury to decide what thin capitalization type to implement.

  2. Bank capital management : International evidence

    NARCIS (Netherlands)

    De Jonghe, O.G.; Öztekin, Ö.

    We examine the dynamic behavior of bank capital using a global sample of 64 countries during the 1994-2010 period. Banks achieve deleveraging through active capital management (equity growth) rather than asset liquidation. In contrast, they achieve leveraging through passive capital management

  3. Intellectual Capital: Comparison and Contrast.

    Science.gov (United States)

    Madsen, Susan R.

    2001-01-01

    Suggests that one of the most important keys for improving individual and organizational performance is in developing and strengthening intellectual capital (IC) and explores the similarities and differences between the concepts of intellectual capital, human capital, and knowledge management. Presents four IC characteristics and addresses the…

  4. Working Paper on Social capital

    DEFF Research Database (Denmark)

    Lassen Hanan, Anne

    This paper outlines the major schools within social capital theory. Contemporary authors such as Coleman, Putnam and Bourdieu are elaborated on. The paper also presents a non-exhaustive review on studies of social capital. Furthermore, a criticial discussion on social capital is reviewed, before...

  5. Cultural Capital: A Concept Analysis.

    Science.gov (United States)

    Ohashi, Yuki; Taguchi, Atsuko; Omori, Junko; Ozaki, Akiko

    2017-07-01

    Harnessing community assets may help public health nurses address health inequalities. Cultural factor is one such asset, which is assumed to be capital in a community. Cultural capital is a key concept for understanding the causes of public health issues. This paper provided an in-depth analysis of "cultural capital" as a concept. Rodgers' evolutionary methodology was used for concept analysis. Forty-two studies published in English between 1998 and 2015 were retrieved from MEDLINE by searching for "cultural capital" in the title field. Antecedents of cultural capital included "educational environment," "belongingness in one's social group," "existing health/social inequalities," and "daily behavior." Cultural capital's identified attributes were "social cultivation," "reproductive rubric," "practical knowledge," and "autogenic ability." Cultural capital's consequences were "improving productivity," "reducing health/social inequality," and "enhancing well-being." Cultural capital is defined as capital characterized by cultivation, rubric, knowledge, and ability. These aspects of cultural capital are typically autogenic, and accumulate and reproduce through lifelong community membership. Cultural capital reduces inequality and ultimately enhances the well-being of individuals and the community through bonding, bridging, and linking economic and social capital. © 2017 Wiley Periodicals, Inc.

  6. Venture Capital and Innovation Strategies

    NARCIS (Netherlands)

    Da Rin, Marco; Penas, Maria

    2015-01-01

    Venture capital investors are specialized financial intermediaries that provides funding for technological innovation with the goal of realizing a capital gain within a few years. We are the first to examine the association of venture capital funding with a company’s choice of innovation strategies.

  7. Capital Improvements for Energy Conservation.

    Science.gov (United States)

    Green, Alan C.

    1981-01-01

    Although colleges and universities have been aggressive in making capital improvements to conserve energy, their efforts have been hampered by limited capital funds. Decisions about capital investments tend to be complex because of the interrelatedness of conservation strategies and the need to consider the cost advantage of alternatives.…

  8. Ipsilateral femoral neck and shaft fractures: An overlooked association

    International Nuclear Information System (INIS)

    Daffner, R.H.; Riemer, B.L.; Butterfield, S.L.

    1991-01-01

    A total of 304 patients with injuries to the femoral shaft and ipsilateral hip presented between 1984 and 1990. Some 253 of them suffered fractures of the femoral shaft and dislocated hips or fractures of the acetabulum, and 51 of these sustained fractures of the femoral shaft and neck or trochanteric region. All of the trochanteric injuries were demonstrated on the initial radiographs. However, in 11 of the patients with combined femoral shaft and neck fractures, the diagnosis was delayed by as much as 4 weeks. This delay related to the fact that these fractures tended not to separate in the initial evaluation period and that there was external rotation of the proximal femoral fragment due to the femoral shaft fracture. (orig./GDG)

  9. Ipsilateral femoral neck and shaft fractures: An overlooked association

    Energy Technology Data Exchange (ETDEWEB)

    Daffner, R.H. (Dept. of Diagnostic Radiology, Allegheny General Hospital, Pittsburgh, PA (USA) Medical Coll. of Pennsylvania, Pittsburgh, PA (USA)); Riemer, B.L.; Butterfield, S.L. (Dept. of Orthopedic Surgery, Allegheny General Hospital, Pittsburgh, PA (USA) Medical Coll. of Pennsylvania, Pittsburgh, PA (USA))

    1991-05-01

    A total of 304 patients with injuries to the femoral shaft and ipsilateral hip presented between 1984 and 1990. Some 253 of them suffered fractures of the femoral shaft and dislocated hips or fractures of the acetabulum, and 51 of these sustained fractures of the femoral shaft and neck or trochanteric region. All of the trochanteric injuries were demonstrated on the initial radiographs. However, in 11 of the patients with combined femoral shaft and neck fractures, the diagnosis was delayed by as much as 4 weeks. This delay related to the fact that these fractures tended not to separate in the initial evaluation period and that there was external rotation of the proximal femoral fragment due to the femoral shaft fracture. (orig./GDG).

  10. Computerized tomography in evaluation of decreased acetabular and femoral anteversion

    International Nuclear Information System (INIS)

    Toennis, D.; Skamel, H.J.

    2003-01-01

    Computerized tomography has received a new importance. It has been shown that decreased anteversion of femur and acetabulum, when both have decreased angles, are causing pain and osteoarthritis of the hip joint. Operative treatment should be performed before osteoarthritis develops. Exact measurements therefore are necessary. The investigation should be performed in prone position to have the pelvis lying in a defined and normal position. Femoral torsion is measured between the transverse axis of the knee and the femoral neck. The transverse axis for measurement of the femoral anteversion is defined by a rectangular line to the sagittal plane. For evaluation of the femoral anteversion in total the angle of the condyles has to be added to the femoral neck angle when the knee is found in internal rotation. Acetabular anteversion should be measured at the level where the femoral head is still in full contact and congruence with the anterior margin of the acetabulum. (orig.) [de

  11. Incidence of Avascular Necrosis of the Femoral Head After Intramedullary Nailing of Femoral Shaft Fractures

    Science.gov (United States)

    Kim, Ji Wan; Oh, Jong-Keon; Byun, Young-Soo; Shon, Oog-Jin; Park, Jai Hyung; Oh, Hyoung Keun; Shon, Hyun Chul; Park, Ki Chul; Kim, Jung Jae; Lim, Seung-Jae

    2016-01-01

    Abstract The goal of this study was to determine the incidence of avascular necrosis of the femoral head (AVNFH) after intramedullary nailing of femoral shaft fractures and to identify risk factors for developing AVNFH. We retrospectively reviewed all patients with femoral shaft fractures treated with antegrade intramedullary nailing at 10 institutions. Among the 703 patients enrolled, 161 patients were excluded leaving 542 patients in the study. Average age was 42.1 years with average follow-up of 26.3 months. Patient characteristics and fracture patterns as well as entry point of femoral nails were identified and the incidence of AVNFH was investigated. Patients were divided into 2 groups according to open versus closed physis, open versus closed fractures, and age (<20 versus ≥20 years). Overall incidence of AVNFH was 0.2% (1 of 542): the patient was 15-year-old boy. Of 25 patients with open physis, the incidence of AVNFH was 4%, whereas none of 517 patients with closed physis developed AVNFH (P < 0.001). The incidence of AVNFH in patients aged < 20 versus ≥20 years was 1.1% (1 of 93) and 0.0% (0 of 449), respectively (P = 0.172), which meant that the incidence of AVNFH was 0% in adult with femur shaft fracture. Of 61 patients with open fractures, the incidence of AVNFH was 0%. The number of cases with entry point at the trochanteric fossa or tip of the greater trochanter (GT) was 324 and 218, respectively, and the incidence of AVNFH was 0.3% and 0.0%, respectively (P = 0.412). In patients aged ≥20 years with isolated femoral shaft fracture, there was no case of AVNFH following antegrade intramedullary nailing regardless of the entry point. Therefore, our findings suggest that the risk of AVNFH following antegrade femoral nailing is extremely low in adult patients. PMID:26844518

  12. Delayed appearance of hypaesthesia and paralysis after femoral nerve block

    OpenAIRE

    Landgraeber, Stefan; Albrecht, Thomas; Reischuck, Ulrich; von Knoch, Marius

    2012-01-01

    We report on a female patient who underwent an arthroscopy of the right knee and was given a continuous femoral nerve block catheter. The postoperative course was initially unremarkable, but when postoperative mobilisation was commenced, 18 hours after removal of the catheter, the patient noticed paralysis and hypaesthesia. Examination confirmed the diagnosis of femoral nerve dysfunction. Colour duplex sonography of the femoral artery and computed tomography of the lumbar spine and pelvis yie...

  13. Hip geometry and femoral neck fractures: A meta-analysis.

    Science.gov (United States)

    Fajar, Jonny Karunia; Taufan, Taufan; Syarif, Muhammad; Azharuddin, Azharuddin

    2018-04-01

    Several studies have reported hip geometry to predict the femoral neck fractures. However, they showed inconsistency. To determine the association between hip geometry and femoral neck fractures. Published literature from PubMed and Embase databases (until May 25 th , 2017) was searched for eligible publications. The information related to (1) name of first author; (2) year of publication; (3) country of origin; (4) sample size of cases and controls and (5) mean and standard deviation of cases and controls were extracted. The pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between hip geometry and femoral neck fractures were assessed using random or fixed effect model. A Comprehensive Meta-analysis software, version 2.0, was used to analyse the data. A total of 11 studies were included in this study. Our results showed that increase in hip axis length (OR 95% CI = 1.53 [1.06-2.21], p  = 0.025), femoral neck angle (OR 95% CI = 1.47 [1.01-2.15], p  = 0.044) and neck width (OR 95% CI = 2.68 [1.84-3.91], p  < 0.001) was associated with the risk of femoral neck fractures, whereas we could not find the correlation between femoral neck axis length and the risk of femoral neck fractures. There is strong evidence that elevated hip axis length, femoral neck angle and neck width are the risk factor for femoral neck fractures. The Translational Potential of this Article : Determining the hip axis length, femoral neck angle and neck width that are most highly associated with femoral neck fracture may allow clinicians to more accurately predict which individuals are likely to experience femoral neck fractures in the future.

  14. Femoral neck structure and function in early hominins.

    Science.gov (United States)

    Ruff, Christopher B; Higgins, Ryan

    2013-04-01

    All early (Pliocene-Early Pleistocene) hominins exhibit some differences in proximal femoral morphology from modern humans, including a long femoral neck and a low neck-shaft angle. In addition, australopiths (Au. afarensis, Au. africanus, Au. boisei, Paranthropus boisei), but not early Homo, have an "anteroposteriorly compressed" femoral neck and a small femoral head relative to femoral shaft breadth. Superoinferior asymmetry of cortical bone in the femoral neck has been claimed to be human-like in australopiths. In this study, we measured superior and inferior cortical thicknesses at the middle and base of the femoral neck using computed tomography in six Au. africanus and two P. robustus specimens. Cortical asymmetry in the fossils is closer overall to that of modern humans than to apes, although many values are intermediate between humans and apes, or even more ape-like in the midneck. Comparisons of external femoral neck and head dimensions were carried out for a more comprehensive sample of South and East African australopiths (n = 17) and two early Homo specimens. These show that compared with modern humans, femoral neck superoinferior, but not anteroposterior breadth, is larger relative to femoral head breadth in australopiths, but not in early Homo. Both internal and external characteristics of the australopith femoral neck indicate adaptation to relatively increased superoinferior bending loads, compared with both modern humans and early Homo. These observations, and a relatively small femoral head, are consistent with a slightly altered gait pattern in australopiths, involving more lateral deviation of the body center of mass over the stance limb. Copyright © 2013 Wiley Periodicals, Inc.

  15. Magnetic resonance imaging and histopathology in the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Takatori, Yoshio; Kamogawa, Morihide; Nakamura, Toshitaka; Ninomiya, Setsuo; Kokubo, Takashi

    1989-05-01

    To correlate the magnetic resonance (MR) images with the histopathological findings in the femoral head, the histopathology of 24 femoral heads, 15 with osteonecrosis, five with osteoarthritis and four with other hip disorders were subjected to preoperative MR imaging which demonstrated low intensity areas due to long T1 relaxation time in the femoral head. The MR signal was low where fibrovascular tissue, disintegrated fibrovascular tissue, amorphous necrotic material, bone, or cartilagenous tissue occupied the medullary space. From this study, it seems possible to predict the histopathologic changes in the femoral head using MR images. (author).

  16. Human Capital and Career Success

    DEFF Research Database (Denmark)

    Frederiksen, Anders; Kato, Takao

    2016-01-01

    Using Danish registry data covering the population of Danish workers, we provide new and robust evidence with external validity on the importance of the breadth of human capital for top management appointments, and support/enrich the human capital theory of corporate leadership by Gibbons...... and Waldman and Lazear. Our analysis allows for both internal promotion and external recruitment as means to achieve top management appointments, and yields additional findings: the breath of human capital is more important in mature firms, as predicted by the theory; and the concept of firm-specific human...... capital applies to the breadth of human capital....

  17. Performance systems and social capital

    DEFF Research Database (Denmark)

    Rasmussen, Grane Mikael Gregaard; Edwards, Kasper

    2014-01-01

    Performance systems and social capital are considered mutually exclusive. Contemporary studies show that social capital is essential in generating performance improvement. This raises an important question: “How do performance systems and social capital correspond?” This study draws on findings...... from a study on implementation of a performance system in Danish construction. The results show causalities between implementing the performance system and the emergence of social capital in construction projects. Results indicate that performance systems and social capital is not mutually exclusive...

  18. Entrepreneurs’ human and social capital

    DEFF Research Database (Denmark)

    Shayegheh Ashourizadeh, Shayegheh; Rezaei, Shahamak; Schøtt, Thomas

    2014-01-01

    Abstract: It is widely acknowledged that entrepreneurs’ human capital in form of education and social capital in form of networking are mutually beneficial and also that both human and social capital benefit their performance. Here, the hypothesis is that human and social capital, in combination......, provide added value and jointly add a further boost to performance, specifically if the form of exporting. Global Entrepreneurship Monitor provides data on 52,946 entrepreneurs, who reported on exporting and networking for advice. Hierarchical linear modelling shows that human capital promotes social...

  19. 78 FR 76973 - Regulatory Capital Rules: Regulatory Capital, Implementation of Basel III, Capital Adequacy...

    Science.gov (United States)

    2013-12-20

    ... contains regulatory documents #0;having general applicability and legal effect, most of which are keyed #0...-AD 87 Regulatory Capital Rules: Regulatory Capital, Implementation of Basel III, Capital Adequacy, Transition Provisions, Prompt Corrective Action, Standardized Approach for Risk-Weighted Assets, Market...

  20. Unsustainable growth, unsustainable capitalism

    DEFF Research Database (Denmark)

    Næss, Petter

    2006-01-01

    This article argues that there is a fundamental contradiction between a profit-oriented economic system and long-term environmental sustainability. The 'solutions' that are proposed by mainstream environmental economists as well as their 'ecological economy' colleagues do not solve the central...... problems, but serve to further highlight the difficulties of changing capitalism towards sustainability. In a profit-oriented economy, capital accumulation is a prime driving force, and non-growth for the economy at large tends to result in serious economic and social crises. On the other hand, a de......-coupling of economic growth from resource depletion and environmental degradation is possible only within certain sectors or product types and within relatively short time perspectives. The assumptions of mainstream economists about infinite economic growth (and infinite dematerialisation) represent a false ontology...

  1. The unipolar ASR : Viable option in unsalvageable femoral head conditions in the young patient

    Directory of Open Access Journals (Sweden)

    Marya SKS

    2006-01-01

    Full Text Available Background: The management of unsalvageable femoral head conditions in the young patient has remained an unresolved dilemma. Articular surface replacement of the hip has recently made some headway in terms of providing near-normal hip joint mechanics and function. However, this surgery has been limited to early stages of arthritis only with reasonable maintenance of head-neck congruity and morphology. Femoral neck fractures, osteonecrosis with large segment collapse, advanced arthritis with femoral incongruity, etc are traditional contraindications to the resurfacing technique. Methods: We present here a report on our series of 20 cases of unsalvageable femoral heads in young patients (age range, 27 to 52yrs, over a twelve month period (Aug 2004 to Jul 2005, treated with the unipolar ASR prosthesis. Fifteen patients (two had bilateral hip pathology had primary or secondary arthritis (degenerative, post-traumatic, ankylosing spondylitis and post-avascular necrosis while three had old operated femoral neck fractures. All patients underwent hip replacement surgery using the Unipolar ASR prosthesis. Results: Clinical and radiological results at 6-month follow up have been very encouraging and warrant further study. At an average of 4 months post-operatively, patients were able to squat, sit on the ground and perform light sporting activities. Conclusions: The Unipolar ASR prosthesis is an extension of the articular resurfacing technique employing similar principles (large size bearings, metal-on-metal interfaces, and has incorporated the advantages of the uncemented technique. We propose that this technique be more frequently used so as to brighten the prognosis of the young active patient with unsalvageable hip conditions, especially in the Asian scenario.

  2. Ensayo sobre el Capital Social

    Directory of Open Access Journals (Sweden)

    Ramón Frediani

    2011-08-01

    Full Text Available En la teoría económica existen distintas definiciones de capital: capital físico, el capital en recursos naturales, el capital financiero, el capital en infraestructura económica, el capital en infraestructura social y el capital humano. Todos ellos son condiciones necesarias para que un país alcance el desarrollo económico y social y un alto estándar y calidad de vida de sus habitantes, pero no suficientes puesto que hace falta una categoría adicional de capital. En los últimos años ha surgido el análisis de una nueva categoría: el Capital Social. El concepto se ha convertido en uno de los temas más debatidos de las ciencias sociales y políticas. Se refiere a un elemento invisible, etéreo, menos tangible que el capital humano (conocimientos y/o habilidades de los individuos o el capital físico (bienes materiales, pero que resulta decisivo para la actividad productiva, la satisfacción de las necesidades personales y el desarrollo comunitario y de una sociedad toda.

  3. Intellectual and environmental capital

    OpenAIRE

    Claver Cortés, Enrique; López-Gamero, María D.; Molina-Azorín, José F.; Zaragoza Sáez, Patrocinio del Carmen

    2007-01-01

    Purpose – Faced with increasing environmental problems, traditional methods for transmitting information regarding corporate environmental actions are insufficient. Accordingly, the purpose of this paper is to suggest the environmental capital report, the knowledge map and the balanced scorecard as alternative instruments to provide the environmental information needed to develop internal corporate activity and meet the requirements of society. Design/methodology/approach – A practical approa...

  4. Correlation Between Residual Displacement and Osteonecrosis of the Femoral Head Following Cannulated Screw Fixation of Femoral Neck Fractures.

    Science.gov (United States)

    Wang, Chen; Xu, Gui-Jun; Han, Zhe; Jiang, Xuan; Zhang, Cheng-Bao; Dong, Qiang; Ma, Jian-Xiong; Ma, Xin-Long

    2015-11-01

    The aim of the study was to introduce a new method for measuring the residual displacement of the femoral head after internal fixation and explore the relationship between residual displacement and osteonecrosis with femoral head, and to evaluate the risk factors associated with osteonecrosis of the femoral head in patients with femoral neck fractures treated by closed reduction and percutaneous cannulated screw fixation.One hundred and fifty patients who sustained intracapsular femoral neck fractures between January 2011 and April 2013 were enrolled in the study. All were treated with closed reduction and percutaneous cannulated screw internal fixation. The residual displacement of the femoral head after surgery was measured by 3-dimensional reconstruction that evaluated the quality of the reduction. Other data that might affect prognosis were also obtained from outpatient follow-up, telephone calls, or case reviews. Multivariate logistic regression analysis was applied to assess the intrinsic relationship between the risk factors and the osteonecrosis of the femoral head.Osteonecrosis of the femoral head occurred in 27 patients (18%). Significant differences were observed regarding the residual displacement of the femoral head and the preoperative Garden classification. Moreover, we found more or less residual displacement of femoral head in all patients with high quality of reduction based on x-ray by the new technique. There was a close relationship between residual displacement and ONFH.There exists limitation to evaluate the quality of reduction by x-ray. Three-dimensional reconstruction and digital measurement, as a new method, is a more accurate method to assess the quality of reduction. Residual displacement of the femoral head and the preoperative Garden classification were risk factors for osteonecrosis of the femoral head. High-quality reduction was necessary to avoid complications.

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

    OpenAIRE

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

    2013-01-01

    Background and purpose The micro-architecture of bone has been increasingly recognized as an important determinant of bone strength. Successful operative stabilization of fractures depends on bone strength. We evaluated the osseous micro-architecture and strength of the osteoporotic human femoral head. Material and methods 6 femoral heads, obtained during arthroplasty surgery for femoral neck fracture, underwent micro-computed tomography (microCT) scanning at 30 ?m, and bone volume ratio (BV/...

  6. Sources of Regional Banks Capitalization

    Directory of Open Access Journals (Sweden)

    Olga Sergeevna Miroshnichenko

    2018-03-01

    Full Text Available Searching of sources to increase the capitalization of Russian banks is an important economic problem for both the national and regional economy. Moreover, a strong capital base allows to credit institutions to meet the demands of economic agents for banking service. The research focuses on the choice of sources of regulatory capital for the banks of Tyumen region in the context of changing supervisory requirements in the period of 2005–2016, in different phases of the business cycle. We apply econometric methods of statistical information using IBM SPSS Statistics software. We have calculated the individual correlations of regional banks’ capital with gross domestic product (GDP (excluding gross regional product (GRP and GRP (with the exception of the effect of GDP. These calculations have shown that the capital of regional banks is related only to GDP. The increase in the capital of regional banks is accompanied by a change in its structure: the share of authorized capital has halved, and the share of subordinated debt has grown. All sources of capital, other than the reserve fund, are related to GDP. Authorized capital is associated with the profit of profitable lending institutions; retained earnings in the capital of regional banks — with the aggregated amount of risks of the banking system of the Russian Federation. Subordinated debt, like capital as a whole, is negatively affected by the profitability of the banking sector. The change in the capital of regional banks is determined by the change in retained earnings, subordinated debt and reserve fund. Modelling of these relations has allowed to obtain a system of equations. This system synthesizes linear regression models of changing the capital of regional banks in the context of their sourcing. The results of this study are significant for theoretical justification and practical development of a balanced financial policy of regional banks. Our research will contribute to

  7. Persistent knee complaints after retrograde unreamed nailing of femoral shaft fractures

    NARCIS (Netherlands)

    El Moumni, Mostafa; Schraven, Pim; ten Duis, Henk Jan; Wendt, Klaus

    Retrograde nailing is an attractive method for stabilisation of femoral shaft fractures in cases of polytrauma, ipsilateral pelvic, acetabular, tibial and femoral neck fractures, bilateral femoral fractures, obese and pregnant patients. However, retrograde nailing may result in complaints about the

  8. The role of MR imaging in staging femoral head osteonecrosis

    Energy Technology Data Exchange (ETDEWEB)

    Zibis, Aristidis H. [Department of Orthopaedic Surgery, Medical School, University of Thessaly, 22 Papakyriazi Street, Larissa 41222 (Greece); Karantanas, Apostolos H. [Department of Radiology, University Hospital of Heraklion, University of Crete Medical School, Heraklion, Crete 71110 (Greece); Roidis, Nikolaos T. [Department of Orthopaedic Surgery, Medical School, University of Thessaly, 22 Papakyriazi Street, Larissa 41222 (Greece); Hantes, Michael E. [Department of Orthopaedic Surgery, Medical School, University of Thessaly, 22 Papakyriazi Street, Larissa 41222 (Greece); Argiri, Paraskevi [CT-MRI Department, Larissa General Hospital, Larissa 41221 (Greece); Moraitis, Theofanis [Department of Orthopaedic Surgery, Medical School, University of Thessaly, 22 Papakyriazi Street, Larissa 41222 (Greece); Malizos, Konstantinos N. [Department of Orthopaedic Surgery, Medical School, University of Thessaly, 22 Papakyriazi Street, Larissa 41222 (Greece)]. E-mail: kmalizos@otenet.gr

    2007-07-15

    Reliability, accuracy and prognostic value of any classification system are important in evaluation and treatment of femoral head osteonecrosis. The purpose of the present study was to correlate the plain radiographs with MRI in femoral head osteonecrosis. Between 2000 and 2005, 115 hips (72 patients) were evaluated and classified according to the ARCO classification criteria with the use of plain radiographs and additional application of MRI. Classification was performed by consensus between a musculoskeletal radiologist and an orthopaedic surgeon. Sensitivity (SEN), specificity (SP), positive (PPV) and negative (NPV) predictive value of X-rays were estimated. According to MRI, 17 hips were classified as stage I, 25 as stage II, 48 as stage III and 25 as stage IV. The SEN, SP, PPV and NPV of plain radiographs were for stage II 88%, 90.5%, 78.6% and 95%; for stage III 79.2% 82%, 80.8% and 87.2%; for stage IV 76%, 100%, 100% and 90.9%, respectively. The agreement between plain radiographs and MRI was 80.6% for staging the disease, 71.2% for recording the location of the osteonecrotic lesion, 67.1% for evaluating the size of the lesion, 79.2% for the presence of collapse of the articular surface and 56.3% for the degree of collapse. In conclusion, the ARCO classification could miss important information in stages II and III, where treatment aims at preservation of the hip joint integrity. The results of the present study suggest that MRI should be incorporated in the classification of osteonecrosis (stages II and III), to add accuracy and prognostic value.

  9. The role of MR imaging in staging femoral head osteonecrosis

    International Nuclear Information System (INIS)

    Zibis, Aristidis H.; Karantanas, Apostolos H.; Roidis, Nikolaos T.; Hantes, Michael E.; Argiri, Paraskevi; Moraitis, Theofanis; Malizos, Konstantinos N.

    2007-01-01

    Reliability, accuracy and prognostic value of any classification system are important in evaluation and treatment of femoral head osteonecrosis. The purpose of the present study was to correlate the plain radiographs with MRI in femoral head osteonecrosis. Between 2000 and 2005, 115 hips (72 patients) were evaluated and classified according to the ARCO classification criteria with the use of plain radiographs and additional application of MRI. Classification was performed by consensus between a musculoskeletal radiologist and an orthopaedic surgeon. Sensitivity (SEN), specificity (SP), positive (PPV) and negative (NPV) predictive value of X-rays were estimated. According to MRI, 17 hips were classified as stage I, 25 as stage II, 48 as stage III and 25 as stage IV. The SEN, SP, PPV and NPV of plain radiographs were for stage II 88%, 90.5%, 78.6% and 95%; for stage III 79.2% 82%, 80.8% and 87.2%; for stage IV 76%, 100%, 100% and 90.9%, respectively. The agreement between plain radiographs and MRI was 80.6% for staging the disease, 71.2% for recording the location of the osteonecrotic lesion, 67.1% for evaluating the size of the lesion, 79.2% for the presence of collapse of the articular surface and 56.3% for the degree of collapse. In conclusion, the ARCO classification could miss important information in stages II and III, where treatment aims at preservation of the hip joint integrity. The results of the present study suggest that MRI should be incorporated in the classification of osteonecrosis (stages II and III), to add accuracy and prognostic value

  10. To study the role of dynamic magnetic resonance imaging in assessing the femoral head vascularity in intracapsular femoral neck fractures

    International Nuclear Information System (INIS)

    Kaushik, Abhishek; Sankaran, Balu; Varghese, Mathew

    2010-01-01

    Intracapsular femoral neck fractures remain unsolved fractures even after improvement in techniques of diagnosis and internal fixation. Individuals who sustain displaced femoral neck fractures are at high risk of developing avascular necrosis and non-union. Although several methods for predicting the viability of femoral head have been reported, they are not effective or widely used because of unreliability, potential complications and technical difficulties. Dynamic MRI was introduced in the recent past as a simple, non-invasive technique to predict the femoral head viability after the femoral neck fractures. In this study role of dynamic MRI was studied in 30 patients with 31 intracapsular femoral neck fractures. Fractures were divided in to three types according to dynamic curve patterns on MRI evaluation and were followed up for 6 months to 2 years to observe the final outcome. Sensitivity, Specificity and the Accuracy of dynamic MRI in predicting vascularity after femoral neck fracture are 87%, 88% and 87%, respectively. Type A or Type B curve pattern is a positive factor to successful osteosynthesis with p value <0.0001 (Chi-square test). This is a statistically significant value. From this finding it can be suggested that the reliability of dynamic curves A and B in predicting maintained vascularity of femoral head is high. This investigation can be used to predict the vascularity of femoral head after intracapsular femoral neck fractures. There was a good correlation between the outcomes of fractures and dynamic MRI curves done within 48 h of injury. This signifies the role of dynamic MRI in predicting the vascularity of femoral head as early as 48 h. A treatment algorithm can be suggested on the basis of dynamic MRI curves. The fractures with Type C dynamic curve should be considered as fractures with poor vascularity of femoral head and measures to enhance the vascularity of femoral head along with rigid internal fixation should be undertaken to promote

  11. To study the role of dynamic magnetic resonance imaging in assessing the femoral head vascularity in intracapsular femoral neck fractures

    Energy Technology Data Exchange (ETDEWEB)

    Kaushik, Abhishek, E-mail: abhiortho27@gmail.co [Department of Orthopedics, 513, Thermal Colony, Sector-22, Faridabad 121005, Haryana (India); Sankaran, Balu; Varghese, Mathew [Department of Orthopedics, St Stephen' s Hospital, Tis hazari, Delhi, New Delhi 110054 (India)

    2010-09-15

    Intracapsular femoral neck fractures remain unsolved fractures even after improvement in techniques of diagnosis and internal fixation. Individuals who sustain displaced femoral neck fractures are at high risk of developing avascular necrosis and non-union. Although several methods for predicting the viability of femoral head have been reported, they are not effective or widely used because of unreliability, potential complications and technical difficulties. Dynamic MRI was introduced in the recent past as a simple, non-invasive technique to predict the femoral head viability after the femoral neck fractures. In this study role of dynamic MRI was studied in 30 patients with 31 intracapsular femoral neck fractures. Fractures were divided in to three types according to dynamic curve patterns on MRI evaluation and were followed up for 6 months to 2 years to observe the final outcome. Sensitivity, Specificity and the Accuracy of dynamic MRI in predicting vascularity after femoral neck fracture are 87%, 88% and 87%, respectively. Type A or Type B curve pattern is a positive factor to successful osteosynthesis with p value <0.0001 (Chi-square test). This is a statistically significant value. From this finding it can be suggested that the reliability of dynamic curves A and B in predicting maintained vascularity of femoral head is high. This investigation can be used to predict the vascularity of femoral head after intracapsular femoral neck fractures. There was a good correlation between the outcomes of fractures and dynamic MRI curves done within 48 h of injury. This signifies the role of dynamic MRI in predicting the vascularity of femoral head as early as 48 h. A treatment algorithm can be suggested on the basis of dynamic MRI curves. The fractures with Type C dynamic curve should be considered as fractures with poor vascularity of femoral head and measures to enhance the vascularity of femoral head along with rigid internal fixation should be undertaken to promote

  12. The Femoral Epicondylar Frame to track femoral rotation in optoelectronic gait analysis

    NARCIS (Netherlands)

    Zurcher, A.W.; Wolterbeek, N.; Valstar, E.R.; Nelissen, R.G.H.H.; Poll, R.G.; Harlaar, J.

    2011-01-01

    Relative movement of skin markers to underlying bone limits a valid interpretation of axial femorotibial rotation in noninvasive optoelectronic gait analysis. A distal femoral clamp is a practical solution for thigh marker placement, however, existing devices are still susceptible to measurement

  13. [Retrograde locking nail osteosynthesis of distal femoral fractures with the distal femoral nail (DFN)].

    Science.gov (United States)

    Grass, R; Biewener, A; Rammelt, S; Zwipp, H

    2002-04-01

    Non-operative treatment with immobilization or isometric traction has been abandoned as treatment for fractures of the distal femur at the end of the 1960ies. The technique of open reduction and internal fixation with a condylar plate as suggested by the AO has been the golden standard since the 1970ies. However, anatomic reconstruction of the condylar region with interfragmentary screw fixation and axial realignment of the femur shaft with a plate are challenging procedures especially in the presence of severely compromised soft tissues and put periosteal blood supply at risk. Soft tissue complications, axial malalignment and delayed fracture healing times led to the consideration of alternative techniques, such as intramedullary nailing which has been practiced with success since the 1940ies by Gerhard Küntscher and colleagues for femoral shaft fractures with minimal complication rates and improved results after closed reduction. The era of retrograde femoral nailing began with the systematic approach through the intercondylar notch by Green. This paper reviews the biomechanical properties, indication, technique as well as potential hazards and pitfalls of fracture management with the AO "distal femoral nail" (DFN). With appropriate application this technique is suitable for all fractures of the distal third of the femoral shaft including highly instable bicondylar fractures without damage to the soft tissues and the knee joint.

  14. Effect of a porous tantalum rod on early and intermediate stages of necrosis of the femoral head

    Energy Technology Data Exchange (ETDEWEB)

    Liu Guohui; Wang Jing; Yang Shuhua; Xu Weihua; Ye Shunan; Xia Tian, E-mail: wangjingwj098@163.co [Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022 (China)

    2010-12-15

    The aim of this study was to evaluate the effect of a porous tantalum rod implant for the treatment of early femoral head necrosis. From April 2007 to June 2009, a total of 35 femoral head necrosis patients (with 49 hips) were treated with core decompression in combination with the insertion of a porous tantalum rod. The mean age was 38.2 years (22-50 years) and the mean follow-up period was 15.2 months (12-36 months). The surgical time and blood loss were recorded. The Harris hip scores and radiological results were adopted for evaluation. The mean surgical time was 35 min, and the mean blood loss was 50 ml. The mean Harris score improved from 48.3 {+-} 3.2 preoperative to 83.7 {+-} 4.1 at the last follow-up (p < 0.05). Eight affected hips exhibited progressive pain including three hips that progressed to femoral collapse, and one revision followed by total hip arthroplasty (THA). For the patient who underwent revision and THA, the articular cartilage surface was seen to be damaged and fragmented. High-density metal particle residuals were observed on radiograph in the bone channel and femoral marrow cavity. We conclude that the selection criteria for porous tantalum implants should be early and intermediate stages of femoral head necrosis. Further study is warranted to reveal whether the metal particles released play a role in the progression of pain and failure.

  15. Effect of a porous tantalum rod on early and intermediate stages of necrosis of the femoral head

    International Nuclear Information System (INIS)

    Liu Guohui; Wang Jing; Yang Shuhua; Xu Weihua; Ye Shunan; Xia Tian

    2010-01-01

    The aim of this study was to evaluate the effect of a porous tantalum rod implant for the treatment of early femoral head necrosis. From April 2007 to June 2009, a total of 35 femoral head necrosis patients (with 49 hips) were treated with core decompression in combination with the insertion of a porous tantalum rod. The mean age was 38.2 years (22-50 years) and the mean follow-up period was 15.2 months (12-36 months). The surgical time and blood loss were recorded. The Harris hip scores and radiological results were adopted for evaluation. The mean surgical time was 35 min, and the mean blood loss was 50 ml. The mean Harris score improved from 48.3 ± 3.2 preoperative to 83.7 ± 4.1 at the last follow-up (p < 0.05). Eight affected hips exhibited progressive pain including three hips that progressed to femoral collapse, and one revision followed by total hip arthroplasty (THA). For the patient who underwent revision and THA, the articular cartilage surface was seen to be damaged and fragmented. High-density metal particle residuals were observed on radiograph in the bone channel and femoral marrow cavity. We conclude that the selection criteria for porous tantalum implants should be early and intermediate stages of femoral head necrosis. Further study is warranted to reveal whether the metal particles released play a role in the progression of pain and failure.

  16. Role of Sonography in Clinically Occult Femoral Hernias.

    Science.gov (United States)

    Brandel, David W; Girish, Gandikota; Brandon, Catherine J; Dong, Qian; Yablon, Corrie; Jamadar, David A

    2016-01-01

    The purpose of this article is to evaluate the diagnostic accuracy of sonography in clinically occult femoral hernias and to describe our sonographic technique. The clinical and imaging data for 93 outpatients referred by general surgeons, all of whom underwent sonographic evaluation and surgery, were reviewed retrospectively. Of these, 55 patients who underwent surgical exploration for groin hernias within 3 months of sonography and met all inclusion criteria were included in the study. The sonographic technique involves using the pubic tubercle as an osseous landmark to identify and appropriately visualize the femoral canal. The Valsalva maneuver is then used to differentiate the movement of normal fat (a potential pitfall) from true herniation in the femoral canal. Surgical findings were used as the reference standard by which sonographic results were judged. Two-by-two contingency tables were used to calculate the sensitivity, specificity, positive predictive value, and negative predictive value. In these 55 patients, surgery revealed 15 femoral hernias. Eight femoral hernias occurred in women, and 7 occurred in men. For diagnosing femoral hernias, sonography demonstrated sensitivity of 80%, specificity of 88%, a positive predictive value of 71%, and a negative predictive value of 92%. True-positive cases of femoral hernias have a sonographic appearance of a hypoechoic sac with speckled internal echoes. When examining during the Valsalva maneuver, a femoral hernia passes deep to the inguinal ligament, expands the femoral canal, displacing the normal canal fat, and effaces the femoral vein. Sonography can exclude femoral hernias with high confidence in light of its exceptional negative predictive value. With attention to technique and imaging criteria, the diagnostic accuracy of sonography can be enhanced.

  17. [Treatment for ipsilateral fractures of the femoral neck and shaft].

    Science.gov (United States)

    Liu, Shao-Jun; He, Wei; Zhang, De-Xing; Fan, Yue-Guang

    2008-05-01

    To investigate the curative effect of different internal fixation for ipsilateral fractures of the femoral neck and shaft. By retrospective study of 27 patients who sustained ipsilateral femoral shaft and neck fractures from June 1993 to March 2004. There were 22 male and 5 female, with an average age of 35 years (range in 14 to 65 years). The femoral neck and shaft fractures were stabilized with dynamic hip screw system (DHS) in 3 cases,with dynamic compression plate and cannulated lag screw in 12 cases, with constructive nail in 8 cases, with antegrade intramedullary locking nail and cannulated lag screw in 4 cases. There were 13 cases used of the temporary fixation of Kirschner wire before the pexia of the femoral neck fractures. All of the patients were followed up for 36 to 75 months, with an average of 44 months. The average healing period of femoral neck fracture was 4.5 months in 25 cases, nonunion of femoral neck fractures in 2. The average healing period of femoral shaft fracture was 6 months in 27 cases. In 14 cases that not using temporary fixation of femoral neck with Kirschner wire, there were nonunion of femoral neck in 2 and slight coxa vara in 3. There are a wide choice of internal fixation method for treatment of ipsilateral fracture of the femoral neck and shaft, the fixation with dynamic compression plate and cannulated lag screw is a handy method. It would be avoided to the replacement and trauma, emporary fixing the fracture with Kirschner wire before the pexia of the femoral neck fracture.

  18. Fixation strength of a polyetheretherketone femoral component in total knee arthroplasty.

    Science.gov (United States)

    de Ruiter, Lennert; Janssen, Dennis; Briscoe, Adam; Verdonschot, Nico

    2017-11-01

    Introducing polyetheretherketone (PEEK) polymer as a material for femoral components in total knee arthroplasty (TKA) could potentially lead to a reduction of the cemented fixation strength. A PEEK implant is more likely to deform under high loads, rendering geometrical locking features less effective. Fixation strength may be enhanced by adding more undercuts or specific surface treatments. The aim of this study is to measure the initial fixation strength and investigate the associated failure patterns of three different iterations of PEEK-OPTIMA ® implants compared with a Cobalt-Chromium (CoCr) component. Femoral components were cemented onto trabecular bone analogue foam blocks and preconditioned with 86,400 cycles of compressive loading (2600 N-260 N at 1 Hz). They were then extracted while the force was measured and the initial failure mechanism was recorded. Four groups were compared: CoCr, regular PEEK, PEEK with an enhanced cement-bonding surface and the latter with additional surface primer. The mean pull-off forces for the four groups were 3814 N, 688 N, 2525 N and 2552 N, respectively. The initial failure patterns for groups 1, 3 and 4 were the same; posterior condylar foam fracture and cement-bone debonding. Implants from group 2 failed at the cement-implant interface. This study has shown that a PEEK-OPTIMA ® femoral TKA component with enhanced macro- and microtexture is able to replicate the main failure mechanism of a conventional CoCr femoral implant. The fixation strength is lower than for a CoCr implant, but substantially higher than loads occurring under in-vivo conditions. Copyright © 2017 IPEM. Published by Elsevier Ltd. All rights reserved.

  19. Biogeometry of femoral neck for implant placement

    Directory of Open Access Journals (Sweden)

    Patwa J

    2006-01-01

    Full Text Available Background : Treatment of fracture neck femur with three cannulated cancellous screws in an apex proximal configuration is practised in many parts of the world. Methods : Dimensions of femoral neck at the middle of transcervical neck using CT scan (live neck and vernier caliper (dry cadeveric neck in 20 subjects respectively were measured. Results : Inferior half of the neck is narrower than superior half. Conclusion : Biogeometry of the neck of femur does not accomodate two inferior screws and thus fixation of fracture neck femur with three canulated cancellous screws in an apex distal configuration is recommended.

  20. Reliability of using DXA around RTHAs. Bone Mineral Density of the femoral neck in resurfacing hip arthroplasty

    DEFF Research Database (Denmark)

    Penny, Jeannette Østergaard; Ovesen, Ole; Brixen, Kim

    2010-01-01

      Background and purpose: Resurfacing Total Hip Arthroplasty (RTHA) may preserve the femoral neck bone-stock post-operatively. Bone Mineral Density (BMD), could theoretically be affected by the hip-position, and bias longitudinal studies. We aimed to investigate BMD precision dependency on type...... of ROI and position of hip. Method: We DXA scanned the femoral neck of 15 resurfacing patients twice with the hip in 3 different rotations; 15° internal, neutral, and 15° external. For each position BMD was analyzed with 3 different surface area models. One model measured BMD in the total femoral neck......, the second model divided the neck in two and the third model had 6 divisions. Results: When all hip positions were pooled a mean Coefficient of variation (CV) of 3.1%, 3.6% and 4.6% was found in the 1, 2 and 6-region models, respectively, The external rotated hip position was less reproducible. When the hip...

  1. A Typology of Social Capital and Associated Network Measures

    OpenAIRE

    Jackson, Matthew O.

    2017-01-01

    I provide a typology of social capital, breaking it down into seven more fundamental forms of capital: information capital, brokerage capital, coordination and leadership capital, bridging capital, favor capital, reputation capital, and community capital. I discuss how most of these forms of social capital can be identified using different network-based measures.

  2. Rethinking the economics of capital mobility and capital controls

    Directory of Open Access Journals (Sweden)

    Thomas I. Palley

    2009-09-01

    Full Text Available This paper reexamines the issue of international financial capital mobility, which is today's economic orthodoxy. Discussion is often framed in terms of the impossible trinity. That framing distorts discussion by representing capital mobility as having equal significance with sovereign monetary policy and control over exchange rates. It also distorts discussion by ignoring possibilities for coordinated monetary policy and exchange rates, and for managed capital flows. The case for capital mobility rests on neo-classical economic efficiency arguments and neo-liberal political arguments. The case against capital mobility is based on Keynesian macroeconomic inefficiency arguments, neo-Walrasian market failure arguments, and neo-Marxian arguments regarding distortion of the social structure of accumulation. Close examination shows the case for capital mobility to be extremely flimsy, pointing to the ideological dimension behind today's policy orthodoxy.

  3. Comparison of Radial Access, Guided Femoral Access, and Non-Guided Femoral Access Among Women Undergoing Percutaneous Coronary Intervention.

    Science.gov (United States)

    Koshy, Linda M; Aberle, Laura H; Krucoff, Mitchell W; Hess, Connie N; Mazzaferri, Ernest; Jolly, Sanjit S; Jacobs, Alice; Gibson, C Michael; Mehran, Roxana; Gilchrist, Ian C; Rao, Sunil V

    2018-01-01

    This study was conducted to determine the association between radial access, guided femoral access, and non-guided femoral access on postprocedural bleeding and vascular complications after percutaneous coronary intervention (PCI). Bleeding events and major vascular complications after PCI are associated with increased morbidity, mortality, and cost. While the radial approach has been shown to be superior to the femoral approach in reducing bleeding and vascular complications, whether the use of micropuncture, fluoroscopy, or ultrasound mitigates these differences is unknown. We conducted a post hoc analysis of women in the SAFE-PCI for Women trial who underwent PCI and had the access method identified (n = 643). The primary endpoint of postprocedure bleeding or vascular complications occurring within 72 hours or at discharge was adjudicated by an independent clinical events committee and was compared based on three categories of access technique: radial, guided femoral (fluoroscopy, micropuncture, ultrasound), or non-guided femoral (none of the aforementioned). Differences between the groups were determined using multivariate logistic regression using radial access as the reference. Of the PCI population, 330 underwent radial access, 228 underwent guided femoral access, and 85 underwent non-guided femoral access. There was a statistically significant lower incidence of the primary endpoint with radial access vs non-guided femoral access; however, there was no significant difference between radial approach and femoral access guided by fluoroscopy, micropuncture, or ultrasound. This post hoc analysis demonstrates that while radial access is safer than non-guided femoral access, guided femoral access appears to be associated with similar bleeding events or vascular complications as radial access.

  4. Capital Income Taxation and Tax Criteria in International Capital Markets

    OpenAIRE

    Hannu Piekkola

    1995-01-01

    The study analyses the capital income taxation of foreign-source income, where residence and source criteria are the two well-known tax criteria. The study presents a globally optimal tax rule which equalizes the shadow price of capital in the countries and which is assumed to be a weighted average of the return on savings and on investment, i.e. depending on the gross rate of return to the extent that capital contributes to the capital used, and on the net interest rate to the extent that ca...

  5. Femoral neck fractures: A prospective assessment of the pattern ...

    African Journals Online (AJOL)

    OBJECTIVE: To review the pattern of femoral neck fractures, complications and outcome following fixation with Austin-Moore endoprosthesis. METHOD: A two year prospective study in patients who had fracture of the femoral neck based on strict inclusion criteria. All the patients were treated by Austin-Moore ...

  6. Bilateral impacted femoral neck fracture in a renal disease patient ...

    African Journals Online (AJOL)

    Spontaneous bilateral femoral neck facture in a renal disease patient is not common. We report a case of 47-year-old female patient with chronic renal failure and on regular hemodialysis for the past 5 years who sustained bilateral impacted femoral neck fracture without history of trauma and injury and refused any surgical ...

  7. Femoral Shaft Fractures: Management and Outcome in Nigerian ...

    African Journals Online (AJOL)

    Infection rate was 3.2% and mal-union occurred in one (3.2%) patient who had osteogenesis imperfecta. Compression plating is a suitable option in treatment of childhood and adolescent femoral fractures. Keywords: Femoral shaft fracture, Compression plating, traditional bone setters, children and adolescents.

  8. Management of Femoral Shaft Fractures in a Tertiary Centre, South ...

    African Journals Online (AJOL)

    males (95% CI 2.1-2.4)5. Treatment of femoral shaft fractures has spanned centuries .The rich history of femoral shaft fracture management reflects the challenges of maintaining anatomic alignment while encouraging early functional rehabilitation.6 Hippocrates (460-377BC) used manual reduction while emphasizing knee.

  9. Femoral bifurcation with ipsilateral tibia hemimelia: Early outcome of ...

    African Journals Online (AJOL)

    Hereby, we present a case report of a 2-year-old boy who first presented in our orthopedic clinic as a 12-day-old neonate, with a grossly deformed right lower limb from a combination of complete tibia hemimelia and ipsilateral femoral bifurcation. Excision of femoral exostosis, knee disarticulation and prosthetic fitting gives ...

  10. Current indications for open Kuntscher nailing of femoral shaft ...

    African Journals Online (AJOL)

    Current indications for open Kuntscher nailing of femoral shaft fractures. A S Bajwa FCS(SA)ORTH. E Schnaid FCS(SA)ORTH. M E B Sweet MD PhD(rned). University of Witwatersrand, Johannesburg, South Africa. Key Words: Kuntscher nail, intramedullary nail, femoral fracture. We retrospectively reviewed 32 patients with.

  11. frequency of ipsilateral femoral neck fractures in patients with ...

    African Journals Online (AJOL)

    closed, middle or upper third; and AO classes A2, C1 and C3. The femoral neck ... associated injuries. - mechanism of injury. (iii) Femoral radiographs: - shaft fracture characteristics. - neck fracture characteristics. The following procedures were used: (i) All patients .... the lower extremity at the scene of accident and during.

  12. Proximal Focal Femoral Deficiency in Ibadan a Developing ...

    African Journals Online (AJOL)

    The cultural aversion to amputation in our environment makes it difficult to employ that option of treatment. Proximal focal femoral deficiency in Ibadan a developing country's perspective and a review of the literature. Keywords: Proximal focal femoral deficiency , congenital malformations , limb malformations , lower limb ...

  13. Treatment of femoral head osteonecrosis using bone impaction grafting.

    NARCIS (Netherlands)

    Rijnen, W.H.C.; Gardeniers, J.W.M.; Buma, P.; Yamano, K.; Slooff, T.J.J.H.; Schreurs, B.W.

    2003-01-01

    Even in extensive osteonecrosis of the femoral head in younger patients, a femoral head-preserving method is preferable. We developed a new technique using the lateral approach as used in traditional core biopsy; the osteonecrotic lesion was removed and impacted bone grafts were used to regain

  14. Sugioka's osteotomy for femoral-head necrosis in young Caucasians.

    NARCIS (Netherlands)

    Rijnen, W.H.C.; Gardeniers, J.W.M.; Westrek, B.; Buma, P.; Schreurs, B.W.

    2005-01-01

    The transtrochanteric rotational osteotomy described by Sugioka is used to preserve the femoral head and to prevent secondary osteoarthritis in young patients with osteonecrosis of the femoral head. Several Japanese studies have shown favourable results, but European and American studies were

  15. Domiciliary treatment of femoral shaft fracture in children | Ogunlade ...

    African Journals Online (AJOL)

    Domiciliary treatment of femoral shaft fracture in children. ... West African Journal of Medicine ... A total of 20 children presenting in Accident and Emergency (A&E) Department of University College Hospital, Ibadan, Nigeria with femoral shaft fracture treated with straight leg fixed traction in a domiciliary setting is presented.

  16. Femoral condyle curvature is correlated with knee walking kinematics in ungulates.

    Science.gov (United States)

    Sylvester, Adam D

    2015-12-01

    The knee has been the focus of many studies linking mammalian postcranial form with locomotor behaviors and animal ecology. A more difficult task has been linking joint morphology with joint kinematics during locomotor tasks. Joint curvature represents one opportunity to link postcranial morphology with walking kinematics because joint curvature develops in response to mechanical loading. As an initial examination of mammalian knee joint curvature, the curvature of the medial femoral condyle was measured on femora representing 11 ungulate species. The position of a region of low curvature was measured using a metric termed the "angle to low curvature". This low-curvature region is important because it provides the greatest contact area between femoral and tibial condyles. Kinematic knee angles during walking were derived from the literature and kinematic knee angles across the gait cycle were correlated with angle to low curvature values. The highest correlation between kinematic knee angle and the angle to low curvature metric occurred at 20% of the walking gait cycle. This early portion of the walking gait cycle is associated with a peak in the vertical ground reaction force for some mammals. The chondral modeling theory predicts that frequent and heavy loading of particular regions of a joint surface during ontogeny will result in these regions being flatter than the surrounding joint surface. The locations of flatter regions of the femoral condyles of ungulates, and their association with knee angles used during the early stance phase of walking provides support for the chondral modeling theory. © 2015 Wiley Periodicals, Inc.

  17. Bone-femoral component interface gap after sagittal mechanical axis alignment is filled with new bone after cementless total knee arthroplasty.

    Science.gov (United States)

    Kuriyama, Shinichi; Hyakuna, Katsufumi; Inoue, Satoshi; Kawai, Yasutsugu; Tamaki, Yasuyuki; Ito, Hiromu; Matsuda, Shuichi

    2018-05-01

    This study retrospectively evaluated the fate of mismatch between an uncemented femoral component and each femoral cut surface (i.e., wedge-shaped gap) relative to sagittal mechanical alignment in total knee arthroplasty (TKA). Primary TKA was performed on 99 consecutive knees. The femoral components were aligned to the sagittal mechanical axis with CT-based navigation. All patients were assessed with postoperative true lateral radiographs. Bone-side surfaces of the uncemented femoral component were divided into five zones: anterior flange, anterior chamfer, posterior chamfer, posterior part, and distal part, which were defined as zones 1 to 5, respectively. Bone filling of wedge-shaped gaps in each zone was evaluated after 1 year. Femoral anterior notching did not occur. However, wedge-shaped gaps were observed in at least one zone in 23 of 99 knees (23%), most frequently in zone 5 (18%). There were 9 and 7 gaps in zones 1 and 2, respectively. The femoral component showed malpositioning of approximately 3° of flexion in cases with wedge-shaped gaps in zones 2 and/or 5. After one year, 67% (6/9) of zone 1, 100% (7/7) of zone 2, and 94% (17/18) of zone 5 wedge-shaped gaps were filled in with new bone. Femoral alignment relative to sagittal mechanical axis caused wedge-shaped gaps due to unstable anterior bone cutting through hard bone, but the small gaps were not clinically significant and filled in within one year. Sagittal setting of the femoral component should aim for the anatomical axis rather than the mechanical axis. IV.

  18. Contratos de capital humano

    OpenAIRE

    Oscar Alejandro Goyes Viteri

    2005-01-01

    Este documento busca dar a conocer el tema de la inversión en capital humano a través de la celebración de contratos atípicos y utilizando la fiducia mercantil y la titularización como vehículos financieros. Por medio de estos contratos un estudiante obtiene los recursos que requiere para financiar su educación superior, a cambio de entregar un porcentaje de sus ingresos después de su graduación a quien financió la operación.

  19. Antecedents of Relational Capital

    DEFF Research Database (Denmark)

    Nowinska, Agnieszka

    This paper merges economic geography and relational capital perspective in order to analyze the proximity-based antecedents of relational assets in brokerage. It investigates empirically the role and interplay of geographical and cognitive proximity between a broker and her buyers in a quantitative...... case- study. Its contribution is threefold: first, I distinguish between the effects of cognitive and geographical proximity and explore empirically their interplay on the relational assets. Second, I contribute to the under-researched field of studying the social context of relations by accounting...

  20. Contratos de capital humano

    Directory of Open Access Journals (Sweden)

    Oscar Alejandro Goyes Viteri

    2005-01-01

    Full Text Available Este documento busca dar a conocer el tema de la inversión en capital humano a través de la celebración de contratos atípicos y utilizando la fiducia mercantil y la titularización como vehículos financieros. Por medio de estos contratos un estudiante obtiene los recursos que requiere para financiar su educación superior, a cambio de entregar un porcentaje de sus ingresos después de su graduación a quien financió la operación.

  1. Contratos de capital humano

    Directory of Open Access Journals (Sweden)

    Oscar Alejandro Goyes Viteri

    2005-12-01

    Full Text Available Este documento busca dar a conocer el tema de la inversión en capital humano a través de la celebración de contratos atípicos y utilizando la fiducia mercantil y la titularización como vehículos financieros. Por medio de estos contratos un estudiante obtiene los recursos que requiere para financiar su educación superior, a cambio de entregar un porcentaje de sus ingresos después de su graduación a quien financió la operación.

  2. The postwar capitalism

    Directory of Open Access Journals (Sweden)

    Mesec Luka

    2014-01-01

    Full Text Available In this paper, I will try to offer a very concise overview of the development of the capitalism after the World War II. Specific historical constellation in the postwar period has enabled the development of Keynesian project in response to the crisis of the Great Depression. However, due to the inherent contradictions of the capitalist system, the Keynesian project has exhausted itself by the beginning of the 1970s, which caused a new crisis. This opened the way for the return of neo-liberal theory and neo-liberal policies that dominates today.

  3. Capital social comunicativo

    Directory of Open Access Journals (Sweden)

    Darío Ángel

    2011-01-01

    Full Text Available En este artículo se buscan establecer las bases para una transformación del tradicional triángulo comunicativo emisor-mensaje-receptor, por un esquema que haga alusión a la dinámica social de la comunicación relacionada con lo público: actores-escenarios-sentidos. De esta forma, es posible conformar guías para la acción y encontrar en los actores ciudadanos de comunicación, la conformaciónde un capital social para la democracia.

  4. Determinants of capital structure.

    Science.gov (United States)

    McCue, M J; Ozcan, Y A

    1992-01-01

    This study analyzes the determinants of hospital capital structure in a new market setting that are created by the financial pressures of prospective payment and the intense price competition among hospitals. Using California data, the study found hospital system affiliation, bed size, growth rate in revenues, operating risk, and asset structure affected both short- and long-term debt borrowings. In addition, percentage of uncompensated care, profitability, and payer mix influenced short-term borrowings while market conditions and ownership affected long-term borrowings. Most significant of all is the finding that smaller hospitals tend to borrow more, possibly because they cannot generate funds internally.

  5. Social Capital in Rural Denmark

    DEFF Research Database (Denmark)

    Svendsen, G.L.; Svendsen, Gert Tinggaard

    1999-01-01

    What are the roots of social capital and how can it be measured and built? Social capital is considered as a new production factor which must be added to the conventional concepts of human and physical capital. Social capital is productive because it increases the level of trust in a society...... and allows more transactions to take place without third-party enforcement. Theory and lessons from empirical evidence lead to the general recommendation that any loss in social capital must be deducted from the economic gain following market forces. For example, the voluntary organization of small......-sized groups in the Danish Cooperative Dairy Movement was eliminated due to economies of scale. It may be so that an alternative way of production, taking social capital into account, could have increased economic growth further....

  6. Social capital and psychological distress.

    Science.gov (United States)

    Song, Lijun

    2011-12-01

    The author proposes a conceptual model to explain the diverse roles of social capital--resources embedded in social networks--in the social production of health. Using a unique national U.S. sample, the author estimated a path analysis model to examine the direct and indirect effects of social capital on psychological distress and its intervening effects on the relationships between other structural antecedents and psychological distress. The results show that social capital is inversely associated with psychological distress, and part of that effect is indirect through subjective social status. Social capital also acts as an intervening mechanism to link seven social factors (age, gender, race-ethnicity, education, occupational prestige, annual family income, and voluntary participation) with psychological distress. This study develops the theory of social capital as network resources and demonstrates the complex functions of social capital as a distinct social determinant of health.

  7. Magnetic resonance imaging of the femoral head necrosis

    International Nuclear Information System (INIS)

    Narita, Shinya; Asada, Kanji; Yoshida, Kenjiro

    1986-01-01

    Ten patients with avascular femoral head necrosis and four normal adults were examined by magnetic resonance imaging (MRI). In addition, the relationship between MRI and pathophysiology of three operated-on avascular femoral heads was evaluated. The medullary cavities of the normal femoral heads had a strong signal intensity on the saturation recovery (SR) image due to fat marrow, and the T 1 relaxation time was 160 ± 11 msec. In avascular femoral head necrosis, the necrotic area had a low signal intensity on the SR image and a prolonged T 1 relaxation time, while the reactive fibrous area had more prolonged T 1 relaxation time. For these reasons, MRI was found to show the pathological changes of avascular femoral head necrosis and can be expected to be useful for making early diagnoses and operation planning. (author)

  8. Banks’ Capital and Liquidity Creation

    OpenAIRE

    Horváth, Roman; Seidler, Jakub; Weill, Laurent

    2012-01-01

    This paper examines the relation between banks’ capital and liquidity creation. This issue is of interest to determine the potential impact of higher capital requirements for banks on their liquidity creation, which may have particular importance with new Basel III reform demanding from banks higher capital. We perform Granger-causality tests in a dynamic GMM panel estimator framework on an exhaustive dataset of Czech banks from 2000 to 2010.

  9. Legal capital: an outdated concept

    OpenAIRE

    John Armour

    2006-01-01

    This paper reviews the case for and against mandatory legal capital rules. It is argued that legal capital is no longer an appropriate means of safeguarding creditors' interests. This is most clearly the case as regards mandatory rules. Moreover, it is suggested that even an 'opt in' (or default) legal capital regime is unlikely to be a useful mechanism. However, the advent of regulatory arbitrage in European corporate law will provide a way of gathering information regarding investors' prefe...

  10. Social Capital and Smoking Behavior

    OpenAIRE

    Lorenzo Rocco; Beatrice d'Hombres

    2014-01-01

    In this paper, we explore one mechanism that may underlie the negative relationship between social capital and smoking: whether social capital strengthens the effect of anti-smoking regulations. We use data on smoking behaviors collected immediately before and after the implementation of smoking bans in public places in Germany in order to determine whether the impact of these bans on smoking prevalence and intensity is greater among individuals richer in social capital. We find that smoking ...

  11. A Theory of Capital Rationing

    OpenAIRE

    Jan Toporowski

    2010-01-01

    This paper revisits some of the issues originally put forward by the author as the theory of capital market inflation, in the book The End of Finance (Toporowski 2000). The paper makes much clearer the key assumptions and relationships between the operations of the capital market dominated by institutional investors, and the balance sheets of companies. In this way, it presents a theory of how macroeconomic dynamics may be affected by disequilibrium in the capital market.

  12. Outcomes of trochanteric femoral fractures treated with proximal femoral nail: an analysis of 100 consecutive cases

    Directory of Open Access Journals (Sweden)

    Korkmaz MF

    2014-04-01

    Full Text Available Mehmet Fatih Korkmaz,1 Mehmet Nuri Erdem,2 Zeliha Disli,3 Engin Burak Selcuk,4 Mustafa Karakaplan,1 Abdullah Gogus5 1Department of Orthopedics and Traumatology, Inonu University School of Medicine, Malatya, Turkey; 2Department of Orthopedics and Traumatology, Nisantasi University School of Medicine, Istanbul, Turkey; 3Department of Anesthesiology, Malatya Government Hospital, Malatya, Turkey; 4Department of Family Medicine, Inonu University School of Medicine, Malatya, Turkey; 5Department of Orthopedics and Traumatology, Florence Nightingale Hospital, Istanbul, Turkey Purpose: In this study, we aimed to report the results of a retrospective study carried out at our institute regarding cases of patients who had suffered proximal femoral fractures between January 2002 and February 2007, and who were treated with a proximal femoral nail. Materials and methods: One hundred consecutive cases were included in the study. A case documentation form was used to obtain intraoperative data including age, sex, mechanism of injury, type of fracture according to Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF classification and the American Society of Anesthesiologists' (ASA physical status classification (ASA grade. Clinical and radiographic examinations were performed at the time of admission and at the 6th week; subsequent visits were organized on the 3rd month, 6th month, and 12th month, and in patients with longer follow-up and annually postoperatively. The Harris score of hip function was used, and any change in the position of the implants and the progress of the fracture union, which was determined radiologically, was noted. Results: The mean age of the patients was 77.66 years (range: 37–98 years, and the sex distribution was 32 males and 68 females. Seventy-three fractures were reduced by closed means, whereas 27 needed limited open reduction. The mean follow-up time for the study group was 31.3 months (range

  13. Prospective, randomized comparison of cobalt-chrome and titanium trilock femoral stems.

    Science.gov (United States)

    Healy, William L; Tilzey, John F; Iorio, Richard; Specht, Lawrence M; Sharma, Sanjeev

    2009-09-01

    The purpose of this article was to demonstrate the efficacy of a cementless, flat, tapered wedge femoral stem and compare cobalt-chrome and titanium femoral stems with this design. Three hundred ninety femoral stems observed for a mean of 4.7 years (2.0-8.9 years) were prospectively evaluated with clinical and radiographic follow-up. Hips were stratified by Dorr classification, bone stock (femoral index), size of implant used, and material of femoral implant. Survivorship of the femoral stem at 8.9 years was 99.8% with no significant difference between cohorts. Thigh pain (4.9%) was more common with cobalt-chrome femoral stems (6.5%) than titanium femoral stems (3.1%). The flat, tapered wedge femoral stem design provides excellent femoral reconstruction in total hip arthroplasty. On the basis of this study, we use titanium femoral stems.

  14. Osteosynthesis of ununited femoral neck fracture by internal fixation combined with iliac crest bone chips and muscle pedicle bone grafting

    Directory of Open Access Journals (Sweden)

    D D Baksi

    2016-01-01

    , cannulated hip screw fixation, iliac crest bone chips and quadratus femoris MPBG. Results: The mean followup is 12.5 years (range 3-35. The union of fractures occurred in 202 (82.8%, delayed union in 18 (7.3%, and established nonunion in 24 (9.8% patients. Full weight bearing was permitted at 16-22 weeks after union of fractures. Mean Harris hip score at the longest followup was 85.5. Among the complications, superficial wound infection occurred in 20 (8.2%, deep infection in seven (2.9%, and coxa vara in 39 (16% patients. Preoperative radiodensity of femoral head disappeared mostly after the union of fracture whereas fresh radiodensity of femoral head appeared in 20 (8% patients; nine (45% of them developed segmental collapse. Conclusion: Ununited femoral neck fractureis characterized by absorption of femoral neck, posterior cortical defect, smoothening and overriding of fracture surfaces with intervening fibrous tissues associated with or without AVN of femoral head. The above method of osteosynthesis rectified the above pathology and provided satisfactory results with union of fractures in 90.1% patients at long term followup.

  15. Prospecting for intellectual capital

    Energy Technology Data Exchange (ETDEWEB)

    Watts, R.L.; Levinson, T.M.

    1988-06-01

    Many nations have become aware of the importance of new technical developments in maintaining/regaining a competitive edge in the world marketplace. There are many national, state and local programs designed to reduce the time required to move new technology from the laboratory to the marketplace. These programs tend either to emphasize research or to assist entrepreneurs. Less emphasis appears to be placed on programs that encourage the development of intellectual capital (innovative inventions) that result from applying research discoveries in materials, electronics, optics, sensors, etc., to solve energy conservation problems and improve industrial productivity. A uniquely successful US Department of Energy (DOE) program in the Office of Energy Utilization Research (located in the Office of Conservation) is exploring methods of encouraging innovative invention. This ''invention laboratory,'' called the Innovative Concepts Program, applies cost-effective methods to encourage the process by which scientifically sound ideas are turned into innovative energy-saving concepts, i.e., intellectual capital. This paper briefly describes that ''invention laboratory,'' its methods and the very encouraging results attained to date. 3 figs., 3 tabs.

  16. Integrating capital budgeting techniques.

    Science.gov (United States)

    Rogers, M M; Rothe, K

    1993-02-01

    A.J. Hogan, in "Capital Expenditure Planning: The Value of Information to Hospitals," published in 1987 in Hospital and Health Services Administration, illustrated the value of information to the expenditure process. He noted that knowing what your competitors are up to, as well as where your facility stands in the market, can enable all concerned to make better judgments. One of the likely outcomes of good judgments is the efficient use of all resources. Unfortunately, Hogan's model draws on a non-existent computerized regional planning agency with the authority to approve or deny proposals. Integrated strategic financial planning also illustrates the value of information. In this case, information is readily available. The sources are the administrators: finance, accounting, marketing, and planning experts, doctors, nurses, statisticians, and epidemiologists. Each can make a unique contribution to the process, and together they can effectively guide the organization's capital budgeting programs. We have illustrated that there does exist a planning model that can work with the plurality of viewpoints in today's hospitals to produce the "most informed" decisions with known sensitivity to the decision criteria used.

  17. THE NEW BASEL CAPITAL ACCORD - AN INTERNATIONAL CONVERGENCE OF CAPITAL MEASUREMENTS AND CAPITAL STANDARDS IN BANKING

    Directory of Open Access Journals (Sweden)

    IMOLA DRIGĂ

    2007-01-01

    Full Text Available The International Convergence of Capital Measurements and Capital Standards was finally published on June 26, 2004 by the Basel Committee on Banking Supervision. This framework is known in the market as Basel II and it replaces the current framework (Basel I for banks as to how they calculate their capital requirements. The Basel II describes a more comprehensive measure and minimum standard for capital adequacy that national supervisory authorities are implementing through domestic rule-making and adoption procedures. It seeks to improve on the existing rules by aligning regulatory capital requirements more closely to the underlying risks that banks face. In addition, the Basel II is intended to promote a more forward-looking approach to capital supervision.

  18. THE CAPITAL STRUCTURE OF VENTURE CAPITAL FIRMS IN INDONESIA

    Directory of Open Access Journals (Sweden)

    Andi Buchari

    2016-10-01

    Full Text Available Venture capital (VC is an important fund source for small and medium enterprises (SMEs and start up, particularly to deliver its main product of equity participation. Therefore, capital structure and factors that affect it are very crucial. This study aims to analyze the capital structure of VC firms in Indonesia using econometric model of panel data regression. This study utilizes secondary data of six years period (2009-2014 monthly financial statements of 27 samples out of 58 VC firms to form 1,944 observations. The study reveals that capital structure of VC firms in Indonesia is dominated by debt/loan rather than capital with DER on average is 136.95%. In addition, the research confirms that VC firms’ capital structure is affected simultaneously by financial aspects which are asset size, profitability, liquidity, asset/investment quality, and earning asset structure. The attentions to financial aspects that affect the VC firms’ capital structure as well as other initiatives related to capital increases are necessary so that the VC firms could carry out its role effectively.

  19. Human capital and optimal positive taxation of capital income

    NARCIS (Netherlands)

    B. Jacobs (Bas); A.L. Bovenberg (Lans)

    2010-01-01

    textabstractThis paper analyzes optimal linear and non-linear taxes on capital and labor incomes in a life-cycle model of human capital investment, financial savings, and labor supply with heterogenous individuals. A dual income tax with a positive marginal tax rate on not only labor income but also

  20. Femoral revision with a primary cementless stem.

    Science.gov (United States)

    Gastaud, O; Cambas, P M; Tabutin, J

    2016-04-01

    The use of a primary cementless component is a tempting option for revision total hip arthrosplasty (reTHA), however, the results of this type of revision have not been clearly determined. The goal of this retrospective study was to determine: if revision with a primary anatomical cementless femoral stem gives adequate bone fixation; the rate of secondary subsidence or recurrent loosening; the survival rate with this device. Revision with a primary anatomical cementless femoral stem results in a low rate of subsidence and recurrent loosening. This retrospective series of 43 reTHA performed between 1994 and 2012 included 43 patients, mean age 66 years old (37-90) with a minimum follow-up of 24months. There were grade 1 (n=24) or 2A (n=19) bone defects according to the Paprosky classification. The causes of revision were: aseptic loosening in 27, septic loosening in 6, malposition of the implant in 7 and periprosthetic fractures in 3. Clinical (Postel Merle d'Aubigné [PMA] and Harris scores), and radiological (subsidence) assessment was performed, as well as survival analysis (with a 95% confidence interval). All components were changed through posterolateral approach without femorotomy. In four cases de-escalation (use of a primary component for secondary revision of a prior revision component) was performed. There were no perioperative fractures or perforations. After a mean 47months (24-134), the mean PMA score increased from 10 (5-15) to 16 (11-18), and the Harris score from 58 (20-80) to 85 (66-96). Radiological assessment did not show any extensive radiolucencies or secondary subsidence. Only 3 components were placed in a varus position, with no clinical consequences. One patient had subsequent revision for recurrent dislocations. Estimated survival at 80months by Kaplan-Meier analysis was 85% (CI 95%: 64-100%). There are very few studies in the literature (7 series) on this topic, which shows the reluctance of surgeons to use this technique. Placement of a

  1. Seeding Social Capital? Urban Community Gardening and Social Capital

    DEFF Research Database (Denmark)

    Christensen, Søren

    2017-01-01

    , it is demonstrated that several studies substantiate that urban community gardens create social capital, both bonding and bridging, and exhibit indications of linking. It is moreover identified how there is much to be learned from future research, illuminating how urban community gardens can foster social capital...... focus on the structural dimensions of social capital, in addition to the cognitive dimensions, as this would yield a more nuanced depiction of social advantages of urban community gardening.......There is a continuing debate regarding urban community gardening’s benefits to local communities, and a particularly interesting branch of this debate has focused on community gardens capacity to encourage and facilitate social interaction, which may generate social capital. Social capital...

  2. Effect of morselized bones on binding of the canine hydroxyapatite-coated femoral stem.

    Science.gov (United States)

    Song, Ke-guan; Ma, De-heng; Hou, Jian-wen; Wang, Huan; Yan, Jing-long; Yu, Zhan-ge; Liang, Zhi-zhong

    2010-05-05

    the femoral bone stem surface.

  3. The influence of composition and location on the toughness of human atherosclerotic femoral plaque tissue.

    Science.gov (United States)

    Cunnane, E M; Barrett, H E; Kavanagh, E G; Mongrain, R; Walsh, M T

    2016-02-01

    The toughness of femoral atherosclerotic tissue is of pivotal importance to understanding the mechanism of luminal expansion during cutting balloon angioplasty (CBA) in the peripheral vessels. Furthermore, the ability to relate this parameter to plaque composition, pathological inclusions and location within the femoral vessels would allow for the improvement of existing CBA technology and for the stratification of patient treatment based on the predicted fracture response of the plaque tissue to CBA. Such information may lead to a reduction in clinically observed complications, an improvement in trial results and an increased adoption of the CBA technique to reduce vessel trauma and further endovascular treatment uptake. This study characterises the toughness of atherosclerotic plaque extracted from the femoral arteries of ten patients using a lubricated guillotine cutting test to determine the critical energy release rate. This information is related to the location that the plaque section was removed from within the femoral vessels and the composition of the plaque tissue, determined using Fourier Transform InfraRed spectroscopy, to establish the influence of location and composition on the toughness of the plaque tissue. Scanning electron microscopy (SEM) is employed to examine the fracture surfaces of the sections to determine the contribution of tissue morphology to toughness. Toughness results exhibit large inter and intra patient and location variance with values ranging far above and below the toughness of healthy porcine arterial tissue (Range: 1330-3035 for location and 140-4560J/m(2) for patients). No significant difference in mean toughness is observed between patients or location. However, the composition parameter representing the calcified tissue content of the plaque correlates significantly with sample toughness (r=0.949, ptough sections. Regression analysis highlights the potential of employing the calcified tissue content of the plaque as a

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

    Science.gov (United States)

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

    2015-01-01

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

  5. Outcomes of trochanteric femoral fractures treated with proximal femoral nail: an analysis of 100 consecutive cases.

    Science.gov (United States)

    Korkmaz, Mehmet Fatih; Erdem, Mehmet Nuri; Disli, Zeliha; Selcuk, Engin Burak; Karakaplan, Mustafa; Gogus, Abdullah

    2014-01-01

    In this study, we aimed to report the results of a retrospective study carried out at our institute regarding cases of patients who had suffered proximal femoral fractures between January 2002 and February 2007, and who were treated with a proximal femoral nail. One hundred consecutive cases were included in the study. A case documentation form was used to obtain intraoperative data including age, sex, mechanism of injury, type of fracture according to Association for Osteosynthesis/Association for the Study of Internal Fixation (AO/ASIF) classification and the American Society of Anesthesiologists' (ASA) physical status classification (ASA grade). Clinical and radiographic examinations were performed at the time of admission and at the 6th week; subsequent visits were organized on the 3rd month, 6th month, and 12th month, and in patients with longer follow-up and annually postoperatively. The Harris score of hip function was used, and any change in the position of the implants and the progress of the fracture union, which was determined radiologically, was noted. The mean age of the patients was 77.66 years (range: 37-98 years), and the sex distribution was 32 males and 68 females. Seventy-three fractures were reduced by closed means, whereas 27 needed limited open reduction. The mean follow-up time for the study group was 31.3 months (range: 12-75 months). Postoperative radiographs showed a near-anatomical fracture reduction in 78% of patients. The Harris hip score was negatively correlated with the ASA score and patient age. No cases of implant failure were observed. Three patients died before discharge (one due to pulmonary embolism, two due to cardiac arrest), and five patients died due to unrelated medical conditions within the first 3 months of the follow-up. Our study showed that proximal femoral nail is a reliable fixation with good fracture union, and it is not associated with major complications in any type of trochanteric femoral fracture.

  6. Avascular necrosis of the femoral head after osteosynthesis of femoral neck fracture.

    Science.gov (United States)

    Min, Byung-Woo; Kim, Sung-Jin

    2011-05-18

    The reported incidence of avascular necrosis after femoral neck fracture fixation varies widely, and there is no consensus regarding its risk factors. We evaluated the incidence of avascular necrosis of the femoral head with the use of contemporary techniques for femoral neck fracture fixation. We then sought to determine what potential risk factors influenced the development of avascular necrosis.Between 1990 and 2005, one hundred sixty-three intracapsular femoral neck fractures in 163 patients were treated with internal fixation at our level-I trauma center. All patients were monitored until conversion to total hip arthroplasty or for a minimum of 2 years postoperatively. Ten patients (10 hips) died and 7 patients (7 hips) were lost to follow-up. The remaining 146 patients (146 hips) had a mean 5.2 years of follow-up (range, 3 months to 17 years). The incidence of avascular necrosis was 25.3% (37 hips). The average time to diagnosis of avascular necrosis was 18.8 months (range, 3-47 months). Patient sex, age, interval from injury to surgery, and mechanism of injury were statistically not associated with the development of avascular necrosis. The quality of fracture reduction, adequacy of fixation, degree of displacement, and comminution of the posterior cortex were significantly associated. After we controlled for patient and radiographic characteristics, multivariate analyses indicated that the important predictors for avascular necrosis are poor reduction (odds ratio=13.889) and initial displacement of the fracture (odds ratio=4.693). Copyright 2011, SLACK Incorporated.

  7. Isolated femoral profundoplasty using endarterectomised superficial femoral artery for limb salvage in the elderly.

    Science.gov (United States)

    Witz, M; Shnacker, A; Lehmann, J M

    2000-12-01

    The deep femoral artery provides the primary blood supply to the thigh, and in addition serves as the major collateral channel for bypassing the obstructed superficial femoral artery. The purpose of isolated profundoplasty is to relieve a significant stenosis and improve perfusion of the ischaemic leg. Twenty-seven patients with critical limb ischaemia underwent isolated profundoplasty in the Vascular Unit of Meir General Hospital, using endarterectomised superficial femoral artery (ESFA) as an arterial patch. Nineteen patients were men. The average age was 72 (65-79). The presenting symptoms: rest pain: 18 (67%), ischaemic foot ulcer: 7 (28%), pedal gangrene: 2 (7%). Selection criteria for isolated profundoplasty: 1) > 50%: stenosis of arteria profunda femoris lumen. 2) Adequate profunda: popliteal collateral system. 3) Adequate arterial inflow: common femoral artery. There was no operative mortality or immediate operative failure. All 27 limbs were improved: relief of rest pain, healing of ischaemic ulcers and good healing after minor amputations (transphalangeal, transmetatarsal). Follow-up period ranged from 12 to 45 months (mean 30 months) and was based on clinical investigation + ankle/brachial Doppler measurements. All patients remained asymptomatic with improvement of limb function--either to the present or until their death. In view of our favourable experience, we feel that isolated profundoplasty still has a place in vascular surgery practice--when limb revascularization in elderly patients considered at high risk is dangerous and when there is impossible below knee vascular reconstruction. We recommend the use of ESFA as a patch for long segment profundoplasty--with all advantages of an autogenous material.

  8. Hip stability during lengthening in children with congenital femoral deficiency.

    Science.gov (United States)

    Eidelman, Mark; Jauregui, Julio J; Standard, Shawn C; Paley, Dror; Herzenberg, John E

    2016-12-01

    Congenital femoral deficiency (CFD) is one of the most challenging and complex conditions for limb lengthening. We focused on the problem of hip instability during femoral lengthening because subluxation and dislocation are potentially catastrophic for hip function. We assessed for hip stability in 69 children (91 femoral lengthenings) who had CFD Paley type 1a (43 children) and 1b (26 children). The mean age at first lengthening was 6.4 years. Hip subluxation/dislocation occurred during 14 (15 %) of 91 lengthenings. Thirty-three pelvic osteotomies were performed before lengthening in an attempt to stabilize hips. Thirteen patients (type 1a, eight; type 1b, five) had acetabular dysplasia at initiation of lengthening. One of the eight with type 1a experienced mild femoral head subluxation; four of the five with type 1b experienced three dislocations and one subluxation. Eight patients (type 1b) experienced hip instability although they had pelvic osteotomies. Proximal femoral lengthening was a significant factor for hip subluxation. Patients with hip subluxation more likely underwent monolateral fixation and the original superhip procedure. Age ±six years was not a contributing factor for hip instability. Important risk factors for hip instability during femoral lengthening are severity of CFD, residual acetabular dysplasia, and proximal femoral lengthening. We recommend routine performance of pelvic osteotomy for patients with Paley type 1b CFD and distal lengthening. Therapeutic Level IV.

  9. Femoral neck buttressing: a radiographic and histologic analysis

    International Nuclear Information System (INIS)

    Dixon, T.; Benjamin, J.; Lund, P.; Graham, A.; Krupinski, E.

    2000-01-01

    Objective. To examine the incidence, radiographic and histologic findings of medial femoral neck buttressing in a consecutive group of patients undergoing total hip arthroplasty.Design. Biomechanical parameters were evaluated on standard anteroposterior pelvic radiographs of 113 patients prior to hip replacement surgery. Demographic information on all patients was reviewed and histologic evaluation was performed on specimens obtained at the time of surgery.Results. The incidence of medial femoral neck buttressing was found to be 50% in a consecutive series of patients undergoing total hip arthroplasty. The incidence was slightly higher in women (56% vs 41%). Patients with buttressing had increased neck-shaft angles and smaller femoral neck diameters than were seen in patients without buttressing. Histologic evaluation demonstrated that the buttress resulted from deposition bone by the periosteum on the femoral neck in the absence of any evidence of femoral neck fracture.Conclusion. It would appear that femoral neck buttressing occurs in response to increased joint reactive forces seen at the hip being transmitted through the femoral neck. The increased joint reactive force can be related to the increased neck shaft angle seen in patients with buttressing. (orig.)

  10. Simultaneous avascular necrosis of both medial and lateral femoral condyles

    International Nuclear Information System (INIS)

    Mansberg, R.

    2002-01-01

    Full text: Avascular necrosis (AVN) of a femoral condyle is a common orthopaedic condition. While both medial and lateral femoral condyles may be involved either singly or sequentially the simultaneous occurrence of AVN of both femoral condyles is extremely uncommon. A 57-year-old male is presented who developed the onset of severe left sided knee pain suddenly at rest. Plain and tomographic radiography was unremarkable and a bone scan was performed. Markedly increased vascularity was demonstrated in the left knee with intense osteoblastic activity in the left medial and femoral condyles more marked in the lateral femoral condyle. A diagnosis of AVN of both femoral condyles was made and a MRI exam was performed to confirm this unusual diagnosis. The MRI showed a diffuse increase in intensity bilaterally with subtle bony change in the subarticular bone consistent with AVN more marked in the left lateral femoral condyle. The patients' symptoms resolved with supportive treatment. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  11. Postmortem Femoral Blood Concentrations of Risperidone

    DEFF Research Database (Denmark)

    Linnet, Kristian; Johansen, Sys Stybe

    2014-01-01

    Postmortem femoral blood concentrations of the antipsychotic drug risperidone and the active metabolite 9-hydroxyrisperidone were determined by an achiral LC-MS/MS method in 38 cases. The cause of death was classified as unrelated to risperidone in 30 cases, in which the sum of the concentration...... of the drug and metabolite ranged from below the limit of quantification to 0.058 mg/kg (median 0.0098 mg/kg). This concentration range, which largely corresponds to published in vivo plasmalevels under therapy, may serve as a reference for judgment of postmortem cases involving risperidone. In one case......, risperidone was judged to be a contributing factor to death, and the sum of concentrations was 0.29 mg/kg. This concentration is of the same order of magnitude as observed for plasma levels in clinical intoxication cases. For the remaining seven cases, the cause of death was unclear. The measurements observed...

  12. Spatial Differences in the Distribution of Bone Between Femoral Neck and Trochanteric Fractures.

    Science.gov (United States)

    Yu, Aihong; Carballido-Gamio, Julio; Wang, Ling; Lang, Thomas F; Su, Yongbin; Wu, Xinbao; Wang, Manyi; Wei, Jie; Yi, Chen; Cheng, Xiaoguang

    2017-08-01

    There is little knowledge about the spatial distribution differences in volumetric bone mineral density and cortical bone structure at the proximal femur between femoral neck fractures and trochanteric fractures. In this case-control study, a total of 93 women with fragility hip fractures, 72 with femoral neck fractures (mean ± SD age: 70.6 ± 12.7 years) and 21 with trochanteric fractures (75.6 ± 9.3 years), and 50 control subjects (63.7 ± 7.0 years) were included for the comparisons. Differences in the spatial distributions of volumetric bone mineral density, cortical bone thickness, cortical volumetric bone mineral density, and volumetric bone mineral density in a layer adjacent to the endosteal surface were investigated using voxel-based morphometry (VBM) and surface-based statistical parametric mapping (SPM). We compared these spatial distributions between controls and both types of fracture, and between the two types of fracture. Using VBM, we found spatially heterogeneous volumetric bone mineral density differences between control subjects and subjects with hip fracture that varied by fracture type. Interestingly, femoral neck fracture subjects, but not subjects with trochanteric fracture, showed significantly lower volumetric bone mineral density in the superior aspect of the femoral neck compared with controls. Using surface-based SPM, we found that compared with controls, both fracture types showed thinner cortices in regions in agreement with the type of fracture. Most outcomes of cortical and endocortical volumetric bone mineral density comparisons were consistent with VBM results. Our results suggest: 1) that the spatial distribution of trabecular volumetric bone mineral density might play a significant role in hip fracture; 2) that focal cortical bone thinning might be more relevant in femoral neck fractures; and 3) that areas of reduced cortical and endocortical volumetric bone mineral density might be more relevant for

  13. Influences of knee flexion angle and portal position on the location of femoral tunnel outlet in anterior cruciate ligament reconstruction with anteromedial portal technique.

    Science.gov (United States)

    Osaki, Kanji; Okazaki, Ken; Tashiro, Yasutaka; Matsubara, Hirokazu; Iwamoto, Yukihide

    2015-03-01

    To evaluate the influences of knee flexion angle and portal position on the location of femoral tunnel outlet in anterior cruciate ligament (ACL) reconstruction with the anteromedial (AM) portal technique. We recruited 6 volunteers with 12 normal knees. Each knee was flexed 120° or 135° and scanned with an open MRI. A 3D knee model was created. Virtual femoral tunnels were created on the footprint of the AM bundle and the posterolateral (PL) bundle of the ACL from three arthroscopic portals: the standard AM portal, the far medial and low portal, and the far medial and high (FMH) portal. The location of the femoral tunnel outlet was evaluated by comparing to the dissected cadaveric knee. Both increased flexion angle and lowering the drilling portal have a similar influence on the femoral tunnel outlet by moving them anterior and distally. Medialization of the portal moves them posteriorly and distally. PL tunnels created on the 120° knee model are more likely to be located under the lateral head of the gastrocnemius especially when they are drilled through the AM or FMH portals. If the femoral tunnel outlet is located under the soft tissue such as gastrocnemius attachment, suspension fixation devices may lapse into fixation failure by sitting on the soft tissue rather than the cortex bone surface. It is more desirable to drill in 135° knee flexion rather than 120°, and through a lower portal, to avoid creating the femoral tunnel outlet under soft tissues.

  14. Social Capital and Savings Behavior

    DEFF Research Database (Denmark)

    Newman, Carol; Tarp, Finn; Khai, Luu Duc

    In this paper, we analyze household savings in rural Vietnam paying particular attention to the factors that determine the proportion of savings held as formal deposits. Our aim is to explore the extent to which social capital can play a role in promoting formal savings behavior. Social capital...

  15. Schools, Social Capital and Space

    Science.gov (United States)

    Allan, Julie; Catts, Ralph

    2014-01-01

    This paper reports on the significance of social capital in relation to education, exploring its relevance to teachers and other professionals as well as among young people. It draws on aspects of five case studies undertaken by the Schools and Social Capital Network, within the Applied Educational Research Scheme in Scotland. These case studies…

  16. Operational risk economic capital allocation

    Science.gov (United States)

    Nikonov, Oleg I.; Vlasov, Vladimir E.; Medvedeva, Marina A.

    2013-10-01

    In the paper we describe a model of operational risk of economic capital estimation and allocation based on Loss Distribution Approach (LDA). Bank's total losses are modeled through Monte-Carlo simulations of its business units' losses. It allows to fairly distributing the corresponding capital between business units in order to assess and manage their risk adjusted performance.

  17. Avascular Necrosis of the Capitate

    Science.gov (United States)

    Bekele, Wosen; Escobedo, Eva; Allen, Robert

    2011-01-01

    Avascular necrosis of the capitate is a rare entity. The most common reported etiology is trauma. We report a case of avascular necrosis of the capitate in a patient with chronic wrist pain that began after a single episode of remote trauma. PMID:22470799

  18. Avascular Necrosis of the Capitate

    OpenAIRE

    Bekele, Wosen; Escobedo, Eva; Allen, Robert

    2011-01-01

    Avascular necrosis of the capitate is a rare entity. The most common reported etiology is trauma. We report a case of avascular necrosis of the capitate in a patient with chronic wrist pain that began after a single episode of remote trauma.

  19. Venture Capital and Innovation Strategies

    NARCIS (Netherlands)

    Da Rin, M.; Penas, M.F.

    2015-01-01

    Venture capital is a specialized form of financial intermediation that often provides funding for costly technological innovation. Venture capital firms need to exit portfolio companies within about five years from the investment to generate returns for institutional investors. This paper is the

  20. Universities Venture into Venture Capitalism.

    Science.gov (United States)

    Desruisseaux, Paul

    2000-01-01

    Reports that some universities are starting their own venture-capital funds to develop campus companies, or are investing endowment funds with established venture-capital firms inclined to finance potential spinoffs from campus research. Examples cited are from the University of Alabama, Vanderbilt University (Tennessee), University of…

  1. Exploring the social capital grid

    DEFF Research Database (Denmark)

    Svendsen, Gunnar Lind Haase; Patulny, Roger

    2007-01-01

    The purpose of this paper is to show that numerous studies have advanced social capital research over the past decade. Most studies have accepted the theoretical distinction between bonding and bridging social capital networks. Many, however, tend to agglomerate empirical research under the one...

  2. 76 FR 35351 - Capital Plans

    Science.gov (United States)

    2011-06-17

    ... the view that bank holding companies generally should operate with capital positions well above the... elevated risk posed to the financial system by large bank holding companies and the importance of capital... would be extended to apply to large savings and loan holding companies and nonbank financial companies...

  3. Capital intelectual no varejo brasileiro

    OpenAIRE

    Edelweiss, Danila Lorens

    2010-01-01

    Através de uma pesquisa realizada com empresas rio setor de varejo, é realizada uma análise do conjunto de indicadores de capital intelectual com o objetivo de buscar evidências que empresas que apresentam melhores indicadores de capital intelectual, também apresentam melhores resultados financeiros.

  4. San Diego's Capital Planning Process

    Science.gov (United States)

    Lytton, Michael

    2009-01-01

    This article describes San Diego's capital planning process. As part of its capital planning process, the San Diego Unified School District has developed a systematic analysis of functional quality at each of its school sites. The advantage of this approach is that it seeks to develop and apply quantifiable metrics and standards for the more…

  5. Anthropometric study of angle of femoral torsion in Maharashtrian population

    Directory of Open Access Journals (Sweden)

    Anil Kumar Dwivedi

    2016-01-01

    Full Text Available Introduction: Angle of femoral torsion is a normal torsion or twist present in femur that plays an important role in stability and function of the hip joint. The angle of femoral torsion can be defined as the angle formed by femoral condyle′s plane (bicondylar plane and a plane passing through center of neck and femoral head. Abnormal angle of femoral torsion has been implicated in the etiology of hip osteoarthrosis and developmental dysplasia of hip joint. Materials and Methods: This study was carried out on unpaired 280, adult human femora devoid of any gross pathology, 139 male (65 right and 74 left, and 141 female (71 right and 70 left from bone banks of three medical colleges of Maharashtra. The gender of each specimen was determined by the established practice. Femora were evaluated by Kingsley Olmsted method, and data were tabulated and statistically analyzed. Results: The average angle of femoral torsion 13.39° and 11.23° on the right and left side respectively in male, 16.21° and 13.23° on the right and left side, respectively, in female. Statistical analysis using Student′s "t"-test revealed significant difference (P < 0.05, greater angle of femoral torsion in female and on the right side. Conclusion: Knowledge of angle of femoral torsion is becoming significant nowadays with an increase in demand for total hip replacement, as the angle of femoral torsion is crucial to attain a normal activity of the replaced joint.

  6. Treatment of the femoral neck peudoarthrosis in childhood: Case report

    Directory of Open Access Journals (Sweden)

    Vukašinović Zoran

    2013-01-01

    Full Text Available Introduction. Femoral neck fractures in children and adolescents are rare. However, their complications are frequent - avascular necrosis, femoral neck pseudoarthrosis, premature physeal closure with consequent growth disturbance and coxa vara deformity. Case Outline. A 9.5­year­old boy was injured in a car accident, and femoral neck fracture was diagnosed. Prior to admission at our hospital he was surgically treated several times. He was admitted at our hospital eight months following the accident. On the X­ray transcervical pseudoarthrosis of the femoral neck was found, as well as coxa vara deformity and metaphyseal avascular necrosis. He was operated at our hospital; all previously placed ostefixation material was removed, valgus osteotomy of 30 degrees was done as well as additional local osteoplasty using the commercial osteoindactive agent (Osteovit®. Postoperatively, we applied skin traction, bed rest and physical therapy. At the final follow­up, the patient was recovered completely. He is now painless, the legs are of equal length, range of movements in the left hip is full, life activity is normal. The X­ray shows that the femoral neck pseudoarthrosis is fully healed. Conclusion. This case is presented in order to encourage other colleagues to challenge the problematic situation such as this one. Also, we would like to remind them what one should think about and what should be taken into consideration in the primary treatment of femoral neck fractures in children. Valgus femoral osteotomy, as a part of the primary treatment of femoral neck fracture in children (identically as in the adults can prevent the occurrence of femoral neck pseudoarthrosis.

  7. International venture capital perspective

    International Nuclear Information System (INIS)

    Carter, D.

    2004-01-01

    'Full text:' The emerging fuel cell industry is characterized by global cooperation and partnerships in commercial, technical, and financial aspects. In this talk, we would like to provide observations about international venture capital focused on fuel cells globally. The talk will refer to experiences Conduit Ventures has had with its portfolio companies and other investors in various countries. We discuss our approach to working with portfolio companies who are geographically remote from our main office in London. We also discuss the process of making investment decisions on possible investments in various countries. The talk will conclude with insights and 'lessons learned' which may be of interest to fellow members of Fuel Cells Canada. (author)

  8. Governing Global Capital

    DEFF Research Database (Denmark)

    Harrington, Brooke

    How do professions affect the configuration of political economies worldwide? This study addresses the question through interviews with members of a new transnational profession - wealth management - whose innovations are reshaping the balance of power in global finance. Wealth managers specialize...... in helping elites avoid taxes and other forms of regulation. The study documents how the means through which they achieve this objective - shifting billions in private capital wealth between Asia, Africa, India and Europe - and how this affects the balance of regional economic power. Drawing from...... and international policy-making bodies to advance the interests of the profession and its wealthy clients; and 3) by writing the fiscal legislation of some jurisdictions. Through these mechanisms, the profession has reconfigured political and economic power trans-nationally, shifting the world’s financial center...

  9. Culture as Capital

    DEFF Research Database (Denmark)

    Kacunko, Slavko

    A collection of essays 2011-2014 By following, and reproducing, the cultural turn, the rhetoric of cultural mix and hybridism is disseminated today primarily in its crossing of trade barriers. Cultures reduced to their exchange value function as capital - an accumulative, speculative and...... essays, Slavko Kacunko discusses the process art by crossing the disciplines of art history and comparative media-, visual- and -cultural studies. As a first approximation, several historiographical remarks on closed-circuit video installations underline their importance as a core category of process art....... In the second part, the problems of process art, seen as a threshold of art history, are further examined in another retroanalytical step, in which concepts and objects related to `mirror', `frame' and `immediacy' are analyzed as the triple delimitation of visual culture studies. In the third part, previously...

  10. Individual social capital and survival

    DEFF Research Database (Denmark)

    Ejlskov, Linda; Mortensen, Rikke N; Overgaard, Charlotte

    2014-01-01

    BACKGROUND: The concept of social capital has received increasing attention as a determinant of population survival, but its significance is uncertain. We examined the importance of social capital on survival in a population study while focusing on gender differences. METHODS: We used data from...... a Danish regional health survey with a five-year follow-up period, 2007-2012 (n = 9288, 53.5% men, 46.5% women). We investigated the association between social capital and all-cause mortality, performing separate analyses on a composite measure as well as four specific dimensions of social capital while...... controlling for covariates. Analyses were performed with Cox proportional hazard models by which hazard ratios and 95% confidence intervals were calculated. RESULTS: For women, higher levels of social capital were associated with lower all-cause mortality regardless of age, socioeconomic status, health...

  11. Measuring social capital: further insights.

    Science.gov (United States)

    Carrillo Álvarez, Elena; Riera Romaní, Jordi

    Social capital is defined as the resources available to individuals and groups through membership in social networks. However, multiple definitions, distinct dimensions and subtypes of social capital have been used to investigate and theorise about its relationship to health on different scales, creating a confusing picture. This heterogeneity makes it necessary to systematise social capital measures in order to build a stronger foundation in terms of how these associations between the different aspects of social capital and each specific health indicator develop. We aim to provide an overview of the measurement approaches used to measure social capital in its different dimensions and scales, as well as the mechanisms through which it is presumed to influence health. Understanding the mechanisms through which these relationships develop may help to refine the existing measures or to identify new, more appropriate ones. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  12. Ipsilateral femoral shaft and vertical patella fracture: a case report

    Science.gov (United States)

    Ozkan, Korhan; Eceviz, Engin; Sahin, Adem; Ugutmen, Ender

    2009-01-01

    Introduction A femoral shaft fracture with an ipsilateral patella fracture has been, to our knowledge, given only cursory attention in English-speaking literature. Case presentation A 15 year old male patient had hitten by a car to his motorcycle came to emergency room and he had been operated for his femoral shaft freacture and vertical patellar fracture which was iniatally missed. Conclusion To us it is vital to obtain CT scan of the patient’s knee if there is an ipsilateral femoral fracture with an ipsilateral knee effusion and a punction which reveals hematoma even in the absence of a fracture line seen in AP and lateral projections. PMID:19829933

  13. Avascular osteonecrosis of the femoral condyle after arthroscopic surgery

    International Nuclear Information System (INIS)

    Al-Kaar, M.; Garcia, J.; Fritschy, D.; Bonvin, J.C.

    1997-01-01

    Avascular osteonecrosis of the femoral condyle after arthroscopic surgery. Retrospective review of 10 patients who presented with avascular necrosis of the ipsilateral femoral condyle following arthroscopic meniscectomy (9 medial, 1 lateral). The bone lesions were evaluated by radiography and MRI, which were repeated for few patients. MRI allows earlier diagnosis of avascular necrosis of the femoral condyle and offers an evaluation of extent of the lesions whose evolution is variable: 3 patients required a knee prosthesis, the other 7 patients were treated medically. (authors)

  14. Use of Huckstep nail in the periimplant femoral shaft fracture.

    Science.gov (United States)

    Kim, Hong Kyun; Noh, Kyu Cheol; Chung, Kook Jin; Hwang, Ji Hyo

    2012-11-01

    87-year-old female underwent open reduction of distal femoral fracture and internal fixation with locking compression plate and bone graft. She was operated for ipsilateral proximal femoral fractures and stabilized by intramedullary interlocked nail 5 years ago. She developed stress fracture proximal to locked plate. We inserted Huckstep nail after removal of the previous operated proximal femoral nail without removing the remaining plate and screws. At 15 month followup the fractures have united. The Huckstep nail has multiple holes available for screw fixation at any level in such difficult situations.

  15. Late Nontraumatic Dissociation of the Femoral Head and Trunnion in a Total Hip Arthroplasty

    Directory of Open Access Journals (Sweden)

    Simon J. M. Parker

    2015-01-01

    Full Text Available Background. Modular total hip arthroplasties are increasingly popular because customisation allows optimal restoration of patient biomechanics. However, the introduction of component interfaces provides greater opportunities for failure. We present a case of late nontraumatic dissociation of the head-neck interface, more than 10 years after insertion. Case Description. A 58-year-old woman had a left metal-on-metal total hip arthroplasty in 2002 for hip dysplasia. Following an uneventful 10-year period, she presented to hospital in severe pain after standing from a seated position, and radiographs demonstrated complete dissociation of the modular femoral head from the stem, with the femoral head remaining in its cup. There was no prior trauma or infection. Mild wear and metallosis were present on the articulating surface between the femoral head and trunnion. Soft tissues were unaffected. Discussion and Conclusions. This is the latest occurrence reported to date for nontraumatic component failure in such an implant by more than 7 years. The majority of cases occur in the context of dislocation and attempted closed reduction. We analyse and discuss possible mechanisms for failure, aiming to raise awareness of this potential complication and encouraging utmost care in component handling and insertion, as well as the long term follow-up of such patients.

  16. Femoral cortical thickness influences the pattern of proximal femoral periprosthetic fractures with a cemented stem.

    Science.gov (United States)

    Stevens, Jarrad; Clement, Nicholas; Nasserallah, Michael; Millar, Michael; Joseph, Sam

    2018-02-08

    Periprosthetic fractures of the proximal femur place a significant burden on the patients who endure them, as well as the medical health system that supports them. The purpose of this study was to determine whether femoral cortical thickness, as an absolute measurement, is a predictor of periprosthetic fracture pattern. A cohort of 102 patients who had sustained a periprosthetic hip fracture were retrospectively identified. This included 58 males and 44 females with a mean age of 79.8 years. The femoral periprosthetic fracture pattern was classified based on the Vancouver classification system. Stem fixation was recorded and femoral cortical thickness measured. Patients were grouped into cemented and cementless stems. The relationship between cortical thickness and periprosthetic fracture pattern was assessed using the primary stem fixation method. Receiver operating characteristic (ROC) curve analysis was used to identify a threshold in the cortical thickness that predicted fracture pattern. Multinomial logistic regression analysis was used to adjust for confounding variables to assess the independent influence of cortical thickness on the risk of sustaining a Vancouver type A, B or C. There were 65 (63.7%) patients in the cemented group and 37 (36.3%) in the cementless group. The pattern of periprosthetic fractures around cemented stems was significantly (p pattern. In contrast, no association between femoral cortical thickness and fracture pattern assessment was demonstrated in the cementless group (p = 0.82 Chi square). Comparing the rate of type A fracture patterns between the groups illustrated a significantly decreased risk in the cemented group with a cortical thickness of > 7 mm (odds ratio 0.03, p  6.3 mm. In contrast, the ROC curve analysis did not find cortical thickness to be a predictor of fracture pattern in the cementless group. When adjusting for confounding variables, multinomial logistic regression demonstrated a cortical thickness of 6

  17. Informal tourism entrepreneurs’ capital usage and conversion

    NARCIS (Netherlands)

    Çakmak, Erdinç; Lie, Rico; Selwyn, Tom

    2018-01-01

    This article examines informal entrepreneurs’ capital usage and conversion in the Thai tourism sector. On the Bourdieusian assumption that people perpetually transform tangible and intangible forms of capital, this study seeks to answer how informal tourism entrepreneurs transform intangible capital

  18. 78 FR 62017 - Regulatory Capital Rules: Regulatory Capital, Implementation of Basel III, Capital Adequacy...

    Science.gov (United States)

    2013-10-11

    .... Multiple Credit Risk Mitigants 2. Collateralized Transactions a. Eligible Collateral b. Risk-management... Provisions, Prompt Corrective Action, Standardized Approach for Risk-weighted Assets, Market Discipline and Disclosure Requirements, Advanced Approaches Risk-Based Capital Rule, and Market Risk Capital Rule; Final...

  19. Avascular osteonecrosis of the femoral condyle after arthroscopic surgery; Osteonecrose aseptique du condyle femoral apres meniscectomie par voie arthroscopique

    Energy Technology Data Exchange (ETDEWEB)

    Al-Kaar, M.; Garcia, J. [Hopital Cantonal Geneve, Geneva (Switzerland); Fritschy, D.; Bonvin, J.C. [Policlinique de Chirurgie, Hopital Cantonal Universitaire, Geneve (Switzerland)

    1997-04-01

    Avascular osteonecrosis of the femoral condyle after arthroscopic surgery. Retrospective review of 10 patients who presented with avascular necrosis of the ipsilateral femoral condyle following arthroscopic meniscectomy (9 medial, 1 lateral). The bone lesions were evaluated by radiography and MRI, which were repeated for few patients. MRI allows earlier diagnosis of avascular necrosis of the femoral condyle and offers an evaluation of extent of the lesions whose evolution is variable: 3 patients required a knee prosthesis, the other 7 patients were treated medically. (authors). 21 refs.

  20. National Capital Planning Commission Meeting Transcripts

    Data.gov (United States)

    National Capital Planning Commission — Transcripts of the monthly (with the exception of August) National Capital Planning Commission meeting transcripts are provided for research to confirm actions taken...

  1. Sand in the Wheels of Capitalism

    DEFF Research Database (Denmark)

    Bersem, Mario; Perotti, Enrico; von Thadden, Ernst-Ludwig

    frictions do not naturally arise in a static framework, or even in a dynamic framework if capital market frictions are reversible. But if capital market frictions can be made to p ersist over time, we show that young workers favor capital market frictions as a way to smo oth income, especially if wealth......We present a positive theory of capital market frictions that raise the cost of capital for new firms and lower the cost of capital for incumbent firms. Capital market frictions arise from a political conflict across voters who differ in two dimensions: (i) a fraction of voters owns capital...

  2. Proof testing of ceramic femoral heads for hip joint implants.

    Science.gov (United States)

    Weisse, B; Affolter, C; Koller, R E; Stutz, A

    2010-01-01

    A proof test procedure for the rejection of defective ceramic hip ball heads in the production line is presented. The procedure consists of applying a load to each ceramic ball head. This load, being somewhat higher than the maximum physiological load, should not cause any damage in cases where the highly stressed areas are free of flaws. In this procedure, a polymer ring is positioned inside the ball head bore between a socket and the head of a tie bolt. Once the tie bolt is pulled downwards, the ring creates a radial pressure on the inner bore surface of the ball head. With an iterative approach based on finite element analysis, the proof test design was optimized in order to obtain a stress distribution in the ball head similar to that resulting in in vivo conditions. The calculated results were validated by strain gauge measurements performed on an assembled proof test apparatus. Several polymers were considered for the ring. Ultrahigh-molecular-weight polyethylene (UHMWPE grade RCH 1000) showed the best durability properties and lowest wear rates. The requirement to perform 1000 reruns without significant reduction of stress in the ball head was fulfilled. Although other proof test procedures for ceramic femoral heads already exist, the procedure presented in this article shows advantages concerning maintenance and operating costs.

  3. Treatment of osteonecrosis of the femoral head using autologous cultured osteoblasts: a case report

    Directory of Open Access Journals (Sweden)

    Kim Seok-Jung

    2008-02-01

    Full Text Available Abstract Introduction Osteonecrosis of the femoral head is a progressive disease that leads to femoral head collapse and osteoarthritis. Our goal in treating osteonecrosis is to preserve, not to replace, the femoral head. Case presentation We present the case of a patient with bilateral osteonecrosis of the femoral head treated with autologous cultured osteoblast injection. Conclusion Although our experience is limited to one patient, autologous cultured osteoblast transplantation appears to be effective for treating the osteonecrosis of femoral head.

  4. Cost of treatment of paediatric femoral shaft fractures: compression ...

    African Journals Online (AJOL)

    one case of osteogenesis imperfecta is on record) and indication for surgery. Results: Thirty-one patients who had ORIF and 31 matched controls were recruited from a pool of 775 children who sustained femoral fractures over the study period.

  5. Delayed appearance of hypaesthesia and paralysis after femoral nerve block

    Science.gov (United States)

    Landgraeber, Stefan; Albrecht, Thomas; Reischuck, Ulrich; von Knoch, Marius

    2012-01-01

    We report on a female patient who underwent an arthroscopy of the right knee and was given a continuous femoral nerve block catheter. The postoperative course was initially unremarkable, but when postoperative mobilisation was commenced, 18 hours after removal of the catheter, the patient noticed paralysis and hypaesthesia. Examination confirmed the diagnosis of femoral nerve dysfunction. Colour duplex sonography of the femoral artery and computed tomography of the lumbar spine and pelvis yielded no pathological findings. Overnight the neurological deficits decreased without therapy and were finally no longer detectable. We speculate that during the administration of the local anaesthetic a depot formed, localised in the medial femoral intermuscular septa, which was leaked after first mobilisation. To our knowledge no similar case has been published up to now. We conclude that patients who are treated with a nerve block should be informed and physician should be aware that delayed neurological deficits are possible. PMID:22577509

  6. Delayed appearance of hypaesthesia and paralysis after femoral nerve block

    Directory of Open Access Journals (Sweden)

    Stefan Landgraeber

    2012-03-01

    Full Text Available We report on a female patient who underwent an arthroscopy of the right knee and was given a continuous femoral nerve block catheter. The postoperative course was initially unremarkable, but when postoperative mobilisation was commenced, 18 hours after removal of the catheter, the patient noticed paralysis and hypaesthesia. Examination confirmed the diagnosis of femoral nerve dysfunction. Colour duplex sonography of the femoral artery and computed tomography of the lumbar spine and pelvis yielded no pathological findings. Overnight the neurological deficits decreased without therapy and were finally no longer detectable. We speculate that during the administration of the local anaesthetic a depot formed, localised in the medial femoral intermuscular septa, which was leaked after first mobilisation. To our knowledge no similar case has been published up to now. We conclude that patients who are treated with a nerve block should be informed and physician should be aware that delayed neurological deficits are possible.

  7. Effectiveness of plate augmentation for femoral shaft nonunion after nailing

    Directory of Open Access Journals (Sweden)

    Chin-Jung Lin

    2012-08-01

    Conclusion: Plate augmentation with retention of the nail with autologous bone grafting may be an effective and reliable alternative in treating nonunion of the femoral shaft fracture after open reduction and internal fixation with intramedullary nail.

  8. Osteonecrosis of the femoral head after renal transplantation

    International Nuclear Information System (INIS)

    Meneghello, A.; Bertoli, M.; Ruffatti, A.

    1988-01-01

    In 5 out of 16 renal transplantation patients, osteonecrosis of the femoral head developed in the presence (p < 0.01) of significant uremic neuropathy; its possible pathogenetic role is discussed. (orig.)

  9. Cell therapy for avascular osteonecrosis of femoral head

    Directory of Open Access Journals (Sweden)

    Tomoki Aoyama

    2009-04-01

    Full Text Available Avascular osteonecrosis of femoral head causes severe musculoskeletal disability. There is not standard treatment to cure avascular osteonecrosis.? Recently, cell therapy using bone marrow stromal cells has begun for this disease.

  10. Cell therapy for avascular osteonecrosis of femoral head

    OpenAIRE

    Tomoki Aoyama; Junya Toguchida

    2009-01-01

    Avascular osteonecrosis of femoral head causes severe musculoskeletal disability. There is not standard treatment to cure avascular osteonecrosis.? Recently, cell therapy using bone marrow stromal cells has begun for this disease.

  11. 'Femoral head necrosis' in metabolic and hormonal osteopathies

    International Nuclear Information System (INIS)

    Heuck, F.H.W.; Treugut, H.

    1984-01-01

    The pathogenesis of bone necrosis is discussed with special attention and with respect to metabolic, hormonal, and vascular factors. The influence of statics and dynamics of the hip joint bones for the development of aseptic necrosis are discussed. 45 patients with ''idiopathic femoral head necroses'' were observed, including 6 cases of renal osteopathy following renal transplantation and immune suppression therapy, 14 cases of long term corticoid therapy, and 11 cases of liver diseases of different genesis. The femoral head necrosis understood as complication of an osteopathy. In our patients there were 31 males and 14 females - which means higher involvement of males. Plain radiological findings and CT-findings of changes of the femoral heat structure in different stages of the disease are described. Early diagnosis of metabolic and hormonal osteopathies is demanded for a joint keeping therapy of the beginning femoral head necrosis. (orig.) [de

  12. Immigrant Capital and Entrepreneurial Opportunities

    Directory of Open Access Journals (Sweden)

    Malavika Sundararajan

    2016-01-01

    Full Text Available Objective: The main objective of this study is to define and operationalize the concept of immigrant capital, a key factor that differentiates immigrant from host country entrepreneurs in how they recognize and start new ventures. Research Design & Methods: A detailed analysis of contemporary immigrant entrepreneurship and opportunity recognition literature was carried out. Using grounded theory, we synthesized the outcomes from the analysis of eight Canadian and U.S. case studies of successful immigrant entrepreneurs with the key findings from the literature to define and develop a model of immigrant capital. Findings: Based on our grounded theory development process we show that the concept of immigrant capital as a distillate of human, cultural, economic and social capital that goes beyond expected opportunity recognition (OR drivers like prior knowledge and prior experience to differentiate and enhance the immigrant entrepreneur’s ability to recognize business opportunities compared to host country entrepreneurs. We found immigrant capital to be a consequence of being boundary spanners in host and home country networks. Implications & Recommendations: Understanding a unique resource like immigrant capital, will help immigrant as well as host country entrepreneurs further develop their opportunity recognition ability by bridging gaps and fulfilling the needs for both, immigrant and host country consumers. Contribution & Value Added: The main contribution is the theoretical development, identification and definition of the immigrant capital model and propositions that will articulate the factors that lead to the conceptualization and operationalization of immigrant capital. Furthermore, the immigrant capital model can serve host country entrepreneurs to develop cross-cultural networks and jump-start entrepreneurial activities in their home countries as well as learn how to expand their operations into global markets.

  13. A Case of Bilateral Aseptic Necrosis of the Femoral Head

    OpenAIRE

    KAMAL, DIANA; TR?ISTARU, RODICA; KAMAL, C.K.; ALEXANDRU, D.O.; MOGOANT?, L.; GRECU, D.C.

    2014-01-01

    Aseptic necrosis of the femoral head is a disease whose etiology is not completely elucidated and generally affects young adults aged between 30 and 50 years. In a significant number of patients bilateral disease occurs, which makes detection in its early stages constitute an important objective. We present the case of a male patient, aged 23 years, with the following risk factors: smoking and chronic alcohol consumption, who is diagnosed with aseptic necrosis of the left femoral head, ARCO s...

  14. Interlocked intramedullary nailing for treatment of open femoral shaft fractures.

    Science.gov (United States)

    Baixauli, F; Baixauli, E J; Sánchez-Alepuz, E; Baixauli, F

    1998-05-01

    Twenty-eight patients with open femoral shaft fractures treated by reamed intramedullary nailing were reviewed retrospectively. Nine patients had Gustilo Grade I injuries; 14, Grade II; and five, Grade IIIA. Twenty cases had static locking, two cases had dynamic locking, and six cases were not locked. Average time to union was 20 weeks. The infection and nonunion rates were 0%. The data suggest that interlocked reamed intramedullary nailing is a safe treatment option for treating open femoral shaft fractures.

  15. The Performance of Intellectual Capital

    DEFF Research Database (Denmark)

    Murthy, Vijaya; Mouritsen, Jan

    2011-01-01

    interviews. This allows the development of a nuanced account of the performance of intellectual capital. This account questions the universality of the linear model typically found in statistical studies. The model makes it possible to show how items of intellectual capital not only interact but also compete......'s budgeting processes. Research limitations/implications – The findings suggest future development of accounts of the role and performance (strength) of intellectual capital be developed around imaginative, perhaps recursive and certainly dynamic, statistical models and/or more inclusive case studies...

  16. Social capital and localised learning

    DEFF Research Database (Denmark)

    Lorenzen, Mark

    2007-01-01

      This conceptual paper analyses why social capital is important for learning and economic development, how it is created and its geography. It argues that with the rise of globalisation and learning-based competition, social capital is becoming valuable because it organises markets, lowering...... business firms' costs of co-ordinating and allowing them flexibly to connect and reconnect. The paper defines social capital as a matrix of various social relations, combined with particular normative and cognitive social institutions that facilitate co-operation and reciprocity, and suggests that social...

  17. Emerging Forms of Cultural Capital

    DEFF Research Database (Denmark)

    Prieur, Annick; Savage, Mike

    2013-01-01

    This paper takes stock of recent research on patterns of cultural engagement in various European nations, with specific reference to British and Danish research. It argues that Bourdieu's original theorisation of cultural capital in ‘Distinction’ needs to be significantly updated to register...... the decline of ‘highbrow’ culture which these studies reveal. However, we argue that this shift does not entail the erosion of cultural capital itself, or the rise of the ‘cultural omnivore’, so much as the emergence of a form of ‘cosmopolitan cultural capital’. We argue that this emerging cultural capital...

  18. Capitalism, Socialism and Public Choice

    Directory of Open Access Journals (Sweden)

    Adrián Osvaldo Ravier

    2010-10-01

    Full Text Available The essay examines Schumpeter’s understanding of the capitalist process and develops a critical analysis of his explanation of why capitalism cannot survive. Part I deals with how Schumpeter understood capitalism. Part II studies why –- from his point of view — capitalism couldn’t survive. Part III analysis why it is actually socialism, as a socio-political alternative, that is impractical and must collapse from contradictions inherent in it. Part IV presents some final reflections, presenting the public choice and the thought of James M. Buchanan, as an alternative to the pessimist Schumpeterian view.

  19. Social capital in engineering education

    Science.gov (United States)

    Brown, Shane

    A theoretical argument is presented to suggest that engineering curriculum be designed to develop social capital. Additionally, the value of social capital in the retention of students in the College of Engineering, and the development, role, and value of social capital in an electrical engineering laboratory is evaluated. Data collected includes participant observations, informal and formal student interviews, and a researcher-designed survey. Social capital consists of interaction among individuals (networks), social rules that encourage interactions such as trust and reciprocity (norms), and the value of these networks and norms to the individual and the group. A large body of evidence suggests that social capital is valuable in terms of retention and multiple measures of academic achievement. The importance of social capital in retention was verified by students that have left engineering and those that remain, in terms of interactions with peers, teaching assistants, and engineering faculty; and a lack of sense of community in freshman engineering courses. Students that have left engineering differed in their perceptions of social capital from those that remain in their frustrations with teaching methods that encourage little discussion or opportunities to ask questions about assumptions or approaches. The open-ended nature of laboratory assignments, extensive required troubleshooting, and lack of specific directions from the teaching assistants were found to encourage the development of social capital in the laboratory setting. Degree centrality, a network measure of social capital as the number of ties an individual has within a social network, was found to be positively correlated with laboratory grade. Student perceptions of the importance of interactions with other students on success in the laboratory setting has a negative model effect on academic achievement in the laboratory. In contrast, student perceptions of the quality of interactions with

  20. From political capitalism to clientelist capitalism? The case of Croatia

    Directory of Open Access Journals (Sweden)

    Denis Redžepagić

    2011-12-01

    Full Text Available The paper analyses the typology of capitalism in Croatia. The Croatian form of capitalism is specific, in form and origin, with links between the pre-independence and post-independence periods, implying that capitalism has gradually evolved – from the political during the eighties towards current clientelistic capitalism. The manufacturing focus aims to facilitate the analysis of institutional, political and economic changes over the past forty years, emphasising the implications of institutional changes which have to a great extent, apart from the war of course, influenced the evolution of capitalism. The paper finds that the transition generated a number of costs, mainly generated by the state (fall in employment, manufacturing and social capital. The claim that the manufacturing industry has inherited low competitiveness neglects the necessary discussion on the role of the state in the formation of industrial policy and market actions. It is also an ex post argument for the claim that restructuring should have been implemented prior to privatisation as this would reduce negative impacts. Institutional changes led to a drastic reduction of the role of the manufacturing sector in the economy. The main finding in this paper is that the change in the interaction between the financial and the real sectors of the economy, the educational system and industrial relations system exposed the vulnerability of the current institutional environment. Despite similarities, institutional advantages of political capitalism are lost in the new type of Croatian capitalism, due to the complexity of the double transition process and the institutional or socio-economic particularities.

  1. Destructive Capitalism, an Investigation on the Inner Logic of Capital

    OpenAIRE

    Saavedra, Roque Martin

    2008-01-01

    This research, while centered upon capital development, will concentrate its efforts on explaining the urgent contingencies behind its destructive aspects. If capitalism in order to advance must destroy the past, what are the sources and effects of this inexorable tension between creation and destruction? Moreover, what are the principles of this contradictory logic that determines destruction in order to make progress? This research will not investigate the totality of the destructive...

  2. Intellectual capital: Evidence from banking industry

    Directory of Open Access Journals (Sweden)

    Somayeh Boostani

    2014-09-01

    Full Text Available This paper investigates different components on intellectual capital including human capital, structural capital and customer capital in banking industry in city of Salmas, Iran. The study uses the questionnaire developed by Bontis (1998 [Bontis, N. (1998. Intellectual capital: an exploratory study that develops measures and models. Management Decision, 36(2, 63-76.] to measure the effects of human capital. The questionnaire consists of 42 questions and all of them are designed in Likert scale. Cronbach alphas for human capital, structural capital and relationship capital were calculated as 0.79, 0.76 and 0.72, respectively. The implementation of Kolmogorov-Smirnov test has indicated that the data were normally distributed. Using t-student test, the study determined that while management team did not pay enough attention on human capital, there were some statistically significant evidence that social and relationship capitals gained good attention.

  3. PENGARUH INTELLECTUAL CAPITAL TERHADAP KINERJA KEUANGAN PERUSAHAAN

    Directory of Open Access Journals (Sweden)

    Denny Andriana

    2014-04-01

    Full Text Available The purpose of this research is to examine the influence of intellectual capital and its components, represented by physical capital (capital employed, human capital, and structural capital,on financial performance of mining and manufacturing companies listed in Indonesia Stock Exchange (Bursa Efek Indonesia – BEI period of 2010 – 2012. Total population observed during this research shows 169 mining and manufacturing companies.The sample was determined by purposive sampling method and found a total of 70 samples as the research subjects. The analytical technique for the quantitaive data uses a statistical tool, i.e. multiple regression. Intellectual capital and its components were measured by Pulic Model, while financial performance uses Return on Equty (ROE ratio. The results show that intellectual capital and human capital have negative influence, yet insignificant, impacton companies financial performance. While physical capital (capital employed and structural capital do have positive influence but not significanton companies financial performance.

  4. Femoral Neck Shaft Angle in Men with Fragility Fractures

    Directory of Open Access Journals (Sweden)

    S. P. Tuck

    2011-01-01

    Full Text Available Introduction. Femoral neck shaft angle (NSA has been reported to be an independent predictor of hip fracture risk in men. We aimed to assess the role of NSA in UK men. Methods. The NSA was measured manually from the DXA scan printout in men with hip (62, 31 femoral neck and 31 trochanteric, symptomatic vertebral (91, and distal forearm (67 fractures and 389 age-matched control subjects. Age, height, weight, and BMD (g/cm2: lumbar spine, femoral neck, and total femur measurements were performed. Results. There was no significant difference in mean NSA between men with femoral neck and trochanteric hip fractures, so all further analyses of hip fractures utilised the combined data. There was no difference in NSA between those with hip fractures and those without (either using the combined data or analysing trochanteric and femoral neck shaft fractures separately, nor between fracture subjects as a whole and controls. Mean NSA was smaller in those with vertebral fractures (129.2° versus 131°: P=0.001, but larger in those with distal forearm fractures (129.8° versus 128.5°: P=0.01. Conclusions. The conflicting results suggest that femoral NSA is not an important determinant of hip fracture risk in UK men.

  5. OUTCOME OF INTERTROCHANTERIC FRACTURES TREATED WITH SHORT FEMORAL NAIL

    Directory of Open Access Journals (Sweden)

    Yadkikar Shriniwas V, Yadkikar Vishnu S, Patel Mayank, Dhruvilkumar Gandhi, Kunkulol Rahul

    2015-07-01

    Full Text Available Aim: To study the functional and anatomical outcome of Inter trochanteric fractures of femur treated with Short femoral nail. Method: This was retrospective study carried out in which 60 patients (50 Male & 10 Female of 5th to 8th decade of life who underwent Short femoral nail fixation for both Stable & unstable Inter Trochanteric fractures. From the records each patient data was assessed for time required for mobilization, average fracture healing time, degree and grade of hip range of movements, complications, anatomical reduction achieved using Short femoral nail fixation. Results: 55 cases achieved Anatomical reduction. Good to Excellent Hip range of Motion was in 55 (90 % cases. Fracture union was seen in all cases. No evidence of Z Effect, AVN of femoral head, Implant failure, Fracture of femoral shaft below the Nail tip was seen in any case, However Reverse Z Effect was seen in 4 & shortening of less than 2 cm was seen in 2 cases, External rotation of 10 degree was seen in1 case. Average fracture Union time was 14 weeks. Conclusion: Short femoral nail appears to be better implant for fixation of both Stable & unstable Inter Trochanteric fractures as it fulfills the biomechanical demands being minimally invasive, less blood loss , it prevents excessive varus collapse at fracture site, produces less stress riser effect below the nail tip, Short operative time, Facilitates early mobilization & functional recovery of patients. But Anatomical fracture reduction & optimal implant placement are absolutely must for better results.

  6. Use of the term "superficial femoral vein" in ultrasound.

    Science.gov (United States)

    Thiagarajah, Ramya; Venkatanarasimha, Nanda; Freeman, Simon

    2011-01-01

    To determine the frequency of use of the term "superficial femoral vein" (SFV) in the radiologic reports from a sample of sonographic investigations for suspected deep vein thrombosis and to assess the potential for clinical error in their interpretation. Retrospective review of 425 consecutive reports from medical patients attending the Imaging Department over a 6-month period for the presence of the term "superficial femoral vein" and for the presence of thrombus. A questionnaire was sent to a sample of referring clinicians to assess their understanding of the anatomy of the deep venous system of the leg and indications for anticoagulant treatment. Of the 425 sonographic investigations reviewed, 90 (21.2%) used the term "superficial femoral vein," and 12 (13.3%) were positive for SFV thrombus. Among 87 clinicians, 74.7% believed the SFV to be part of the superficial venous system and that its thrombosis did not require anticoagulant treatment, although anticoagulation is now indicated in selected cases of superficial venous thrombosis. Seventy-five percent of clinicians do not recognize the SFV as being part of the deep venous system and that its thrombosis requires anticoagulant treatment. In this study, 13% of SFV examined were positive for thrombus, and four patients (4.4%) had an isolated SFV thrombus that could have been left untreated due to this misunderstanding. Use of the term "superficial femoral vein" is prone to misinterpretation by clinicians and potentially hazardous to patients. It should be replaced by "common femoral vein" and "femoral vein" in reports.

  7. Morpho-functional study of ionizing radiation effects on the rabbits` femoral vein; Avaliacao morfofuncional do efeito da radiacao ionizante sobre a veia femoral. Estudo experimental em coelhos

    Energy Technology Data Exchange (ETDEWEB)

    Sakiyama, Mauro Yoshimitsu

    1995-12-31

    In this study we evaluate the effects of the ionizing radiation on the rabbits femoral vein. The samples of femoral vein were obtained from 56 New Zealand rabbits, male with ageing from 90 to 120 days, that were divided into 4 groups of 14 animals: one control group non-irradiated and three animal groups sacrificed 2 days, 14 days and 90 days after irradiation. In the three irradiated rabbits groups, each animal received the total dose 4000 cGy (rads) divided in 10 sessions of 400 cGy, a dose equivalent that utilized on clinical therapeutic. A morpho functional study of vein samples was carried out with: light microscopy: stained by hematoxin - eosin, Masson`s tricromic, and Verhoeff. Immunohistochemical: reactions of immunoperoxidase with monoclonal mouse anti-human endothelial cell factor CD-31 and anti-human Von Willebrand factor (factor VIII), to study the vein endothelium. Histomorphometry of elastic fiber system stained by Weigert`s resorcin-fuchsin with and without prior oxidation with oxone; for the study of mature, elaunin or pre-mature and oxytalan or young elastic fibers. Electronic microscopy: transmission and scanning. With the methodology utilized we observe changes in the femoral vein of the animals submitted to irradiation in relation to the control group, thus described: there is formation of vacuoles between the endothelium and the basal membrane, called sub endothelial vacuoles, in focal areas. The factor VIII and CD-31 endothelial antigens are preserved with no changes in their functions. Focal alterations are present in the endothelial surface with disorder in the setting and orientation of the endothelial cells. there is degeneration of the elastic fibers with significant decrease in their quantity in the stage, 2 days and 14 days after irradiation. There is increase in the quantity of elastic fibers in the late stage, 90 days after irradiation, tending to normality. In this present study, the changes described are not accompanied by venous

  8. Can martial arts techniques reduce fall severity? An in vivo study of femoral loading configurations in sideways falls.

    Science.gov (United States)

    van der Zijden, A M; Groen, B E; Tanck, E; Nienhuis, B; Verdonschot, N; Weerdesteyn, V

    2012-06-01

    Sideways falls onto the hip are a major cause of femoral fractures in the elderly. Martial arts (MA) fall techniques decrease hip impact forces in sideways falls. The femoral fracture risk, however, also depends on the femoral loading configuration (direction and point of application of the force). The purpose of this study was to determine the effect of fall techniques, landing surface and fall height on the impact force and the loading configuration in sideways falls. Twelve experienced judokas performed sideways MA and Block ('natural') falls on a force plate, both with and without a judo mat on top. Kinematic and force data were analysed to determine the hip impact force and the loading configuration. In falls from a kneeling position, the MA technique reduced the impact force by 27%, but did not change the loading configuration. The use of the mat did not change the loading configuration. Falling from a standing changed the force direction. In all conditions, the point of application was distal and posterior to the greater trochanter, but it was less distal and more posterior in falls from standing than from kneeling position. The present decrease in hip impact force with an unchanged loading configuration indicates the potential protective effect of the MA technique on the femoral fracture risk. The change in loading configuration with an increased fall height warrant further studies to examine the effect of MA techniques on fall severity under more natural fall circumstances. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Common site of subchondral insufficiency fractures of the femoral head based on three-dimensional magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Iwasaki, Kenyu; Yamamoto, Takuaki; Motomura, Goro; Karasuyama, Kazuyuki; Sonoda, Kazuhiko; Kubo, Yusuke; Iwamoto, Yukihide [Kyushu University, Department of Orthopaedic Surgery Graduate School of Medical Sciences, Higashi-ku, Fukuoka (Japan)

    2016-01-15

    The objective of this study was to investigate the common sites of subchondral insufficiency fractures of the femoral head (SIF) based on three-dimensional (3-D) reconstruction of MR images. In 33 hips of 31 consecutive patients diagnosed with SIF, 3-D reconstruction of the bone, fracture, and acetabular edge was performed using MR images. These 3-D images were used to measure the fractured areas and clarify the positional relationship between the fracture and degree of acetabular coverage. The fractured area in the anterior portion was significantly larger than in the posterior area. In 11 cases, the fractures contacted the acetabular edge and were distributed on the lateral portion. The indices of acetabular coverage (center-edge angle and acetabular head index) in these cases were less than the normal range. In the remaining 22 cases, the fractures were apart from the acetabular edge and distributed on the mediolateral centerline of the femoral head. The majority of these cases had normal acetabular coverage. The common site of SIF is the anterior portion. In addition, two types of SIF are proposed: (1) Lateral type: the contact stress between the acetabular edge and lateral portion of the femoral head causes SIF based on the insufficient acetabular coverage, and (2) Central type: the contact stress between the acetabular surface and the mediolateral center of the femoral head causes SIF independent from the insufficiency of acetabular coverage. These findings may be useful for considering the treatment and prevention of SIF. (orig.)

  10. The Impact of Capital Structure on Economic Capital and Risk Adjusted Performance

    OpenAIRE

    Porteous, Bruce; Tapadar, Pradip

    2008-01-01

    The impact that capital structure and capital asset allocation have on financial services firm economic capital and risk adjusted performance is considered. A stochastic modelling approach is used in conjunction with banking and insurance examples. It is demonstrated that gearing up Tier 1 capital with Tier 2 capital can be in the interests of bank Tier 1 capital providers, but may not always be so for insurance Tier 1 capital providers. It is also shown that, by allocating a bank or insuranc...

  11. Subcapital femoral neck fracture after fixation of an intertrochanteric fracture with a proximal femoral nail: a report of two cases.

    Science.gov (United States)

    Kaneko, Haruka; Matsuda, Keiji; Kim, Sungon; Maeda, Kouichi; Ikegami, Takashi; Kubota, Reiko; Nagayama, Masataka; Nozawa, Masahiko

    2009-12-01

    Subcapital femoral neck fractures are a rare complication after fixation of an intertrochanteric fracture with a proximal femoral nail. We report 2 such cases where the patients had severe osteoporosis, based on Singh's index and pathological findings. In one case there was a technical error leading to a tip-apex distance of more than 20 mm, but osteoporosis appeared to be a more significant cause than any technical problems.

  12. Taxes and Venture Capital Support

    DEFF Research Database (Denmark)

    Keuschnigg, Christian; Nielsen, Søren Bo

    2003-01-01

    In this paper we set up a model of start-up finance under double moral hazard.Entrepreneurs lack own resources and business experience to develop their ideas.Venture capitalists can provide start-up finance and commercial support. The effortput forth by either agent contributes to the firm......'s success, but is not verifiable. Asa result, the market equilibrium is biased towards inefficiently low venture capitalsupport. The capital gains tax becomes especially harmful, as it further impairsadvice and causes a first-order welfare loss. Once the capital gains tax is in place,limitations on loss off......-set may paradoxically contribute to higher quality of venturecapital finance and welfare. Subsidies to physical investment in VC-backed startupsare detrimental in our framework.Keywords: Venture capital, capital gains taxation, double moral hazard.JEL-Classification: D82, G24, H24, H25...

  13. Corporate governance and intellectual capital

    Directory of Open Access Journals (Sweden)

    Rahmat Alizadeh

    2014-01-01

    Full Text Available The purpose of this paper is to examine the association between corporate governance and Intellectual capital in the pharmaceutical companies accepted in Tehran Stock Exchange over the period 2004-2009 using a regression based model. The study investigates the impacts of three some independent variables of the corporate governance (i.e. the number of board members, the relative extent of nonexecutive to executive directors, the auditing committee. The results suggest that corporate governance had no special effect on intellectual capital in the pharmaceutical companies. Furthermore among corporate governance's variables, the first one (i.e. board size had negative impact on firms' intellectual capital and the second and the third variables had no effects on intellectual capital.

  14. Emerging Forms of Cultural Capital

    DEFF Research Database (Denmark)

    Prieur, Annick; Savage, Mike

    - the claims that there are forms of emotional, subcultural or national cultural capital at work - The claim about cosmopolitanism or an international orientation as a distinctive feature of the culturally privileged classes The paper responds to the first theme announced in the call for this conference......This paper reviews recent European studies to assess whether cultural capital now has the same characteristics – or may be rather the same functions - as when Distinction was written. The paper will examine empirical applications of the concept of cultural capital in leading European studies...... – and hence are highly appropriate for direct comparisons with that study. This paper will begin by raising general issues regarding the meaning of the concept, and about how one may make assessments and claims about cultural capital. Here we consider how the legitimacy of certain cultural competencies...

  15. Understanding Japan's Capital Goods Exports

    OpenAIRE

    THORBECKE, Willem

    2015-01-01

    Japan is the leading supplier of sophisticated capital goods to East Asian countries. These goods embody advanced technologies and facilitate learning and productivity growth. Capital goods also represent 30%-40% of Japan's exports. This paper investigates the determinants of these exports. Results from dynamic ordinary least squares estimation indicate that exports depend on exchange rates, income in the importing countries, and downstream countries' exports to the rest of the world. Results...

  16. Organizational Capital of the Enterprise

    Directory of Open Access Journals (Sweden)

    Vladimir Nikiforovich Belkin

    2016-09-01

    Full Text Available In the article, the main theoretical questions of the organizational capital of the enterprise are considered. The concept of «organizational capital of the enterprise» as a system consisting of three subsystems (organization of production, labour organization and management is introduced. It is shown that the organizational capital forms the labour relations system at the enterprise consisting of the cooperation, technological, economic, moral labour relations and the relations of workers’ responsibility. The model of cyclic evolution of crisis at the enterprise caused by shortcomings of the organizational capital is revealed. It is shown that the organizational capital is a basis for the realization of the human capital, which creates value added. A considerable attention is paid to the experience of the creation and functioning of the organizational capital at the enterprises of the Japanese corporation «Toyota». The Russian economic literature on crisis management quite often considers only the financial aspects of diagnostics, proposing the optimization of cash flows, elimination of excess stocks, transition to the medium-term budgeting and others. However, the deep reasons of crisis need to be found not only in financial streams, but also in the system of the work relationships. The shortcomings in the development of technological, cooperation, economic, moral labour relations and the relations of responsibility directly reflects the shortcomings in the development of the elements of the organizational capital as they «are adjusted» by these elements. In turn, organizational problems affect the product quality leading to the customer attrition and decrease in the enterprise’s financial performance. The lack of financial resources cause the need to save costs (first of all, on personnel, that was brightly shown by the economic crisis of 2009 that even more weakens the enterprise and system of labour relations. Finally, the

  17. ORGANIZATIONAL CAPITAL IN ENTERPRISE ARCHITECTURE

    Directory of Open Access Journals (Sweden)

    Kirill G. Skripkin

    2016-01-01

    Full Text Available The paper describes a new approach to the description of organizational capital in enterprise architecture. This approach is focused on internal consistency of organizational mechanisms and their fit to the requirements of technologies in use and key employees. The description rests on Henry Mintzberg organizational design theory. The value of this description is demonstrated for the case of influence of Ministry of Education and Science policy on the organizational capital of the Russian university.

  18. Reforming Capital Taxation in Italy

    OpenAIRE

    Luc Eyraud

    2014-01-01

    This paper reviews capital taxation issues in Italy based on a comprehensive definition encompassing taxes on income, transactions, and ownership. It discusses options to enhance the neutrality of the capital income tax system, followed by a detailed analysis of the property tax, the inheritance tax, and various transaction taxes. The paper also examines the case for replacing the set of existing taxes on financial and real assets with a single net wealth tax.

  19. Effect of collapse on the deformity of the femoral head-neck junction in osteonecrosis of the femoral head.

    Science.gov (United States)

    Kubo, Yusuke; Motomura, Goro; Ikemura, Satoshi; Sonoda, Kazuhiko; Yamamoto, Takuaki; Nakashima, Yasuharu

    2017-07-01

    The purpose of this study was to morphologically assess the effect of collapse on the deformity of the femoral head-neck junction in patients with nontraumatic osteonecrosis of the femoral head (ONFH). From January 2005 through March 2016, magnetic resonance (MR) imaging including the oblique view was repeatedly performed before and after collapse in 24 hips of patients with ONFH (16 men, 8 women; mean age 43 years; range 23-68 years), that were the subjects of this study. The interval of MR imaging before and after collapse was 8.0 months (range 1-32 months). In addition, 82 asymptomatic hips in patients without ONFH as identified by MR imaging taken at the same duration were used as controls. The oblique MR image was used to measure the radiological parameters of the femoral head-neck junction, including the α-angle and head-neck offset ratio (HNOR). The α-angle and HNOR after collapse (58.3° ± 10.0° and 0.138 ± 0.033, respectively) indicated significantly decreased anterior femoral head-neck offset compared with those before collapse (46.2° ± 5.7° and 0.178 ± 0.018, respectively; p femoral head collapse (p femoral head-neck offset observed in patients with ONFH was a consequence of collapse.

  20. Social capital and workplace bullying.

    Science.gov (United States)

    Pihl, Patricia; Albertsen, Karen; Hogh, Annie; Andersen, Lars Peter Sønderbo

    2017-01-01

    Workplace bullying is a serious stressor with devastating short- and long-term consequences. The concept of organizational social capital may provide insights into the interactional and communicative dynamics of the bullying process and opportunities for prevention. This study aimed to explore the association between organizational social capital and being a target or observer of workplace bullying. Based on self-reported cross-sectional data from a large representative sample of the Danish working population (n = 10.037), logistic regression analyses were conducted to explore at the individual level the associations between vertical and horizontal organizational social capital with being a target or observer of workplace bullying. In the fully adjusted models, low organizational social capital (vertical and horizontal) was associated with significantly increased odds ratios of both self-labelled (vertical: OR = 3.25; CI = 2.34-4.51; horizontal: OR = 3.17; CI = 2.41-4.18) and observed workplace bullying (vertical: OR = 2.09; CI = 1.70-2.56; horizontal: OR = 1.60; CI = 1.35-1.89), when compared with high organizational social capital. This study supports that characteristics of the psychosocial work environment are of importance in the development of workplace bullying, and provides focus on the importance of self-reported organizational social capital.

  1. Managed care contracting/capitation.

    Science.gov (United States)

    Reardon, T M

    1995-11-01

    Both the general approach for entering into a managed care contract and the subject of capitation are presented. The general approach section outlines the criteria that a physician group should apply in analyzing the feasibility of entering into a managed care contract with any insurer. The physician group's contracting process should be iterative and refined over time. The capitation section addresses issues revolving around the assessment of a capitated contract. The example assumes a typical health maintenance organization-primary care group contract. Not analyzed in this article are the exciting opportunities presented through specialty carveout capitation. Managing the transition to a more competitive environment will be the major challenge facing group practices. Survival in the tightening healthcare market will depend on sound strategic decisions regarding the physician group's mission as well as its relationship to its hospital partners and other delivery systems. To support these strategic decisions, a solid knowledge base and a thorough understanding of the terms and provisions regarding the formulation of these new relationships are necessary. The budget methodology is a relatively straightforward approach to establishing a capitation. Careful consideration will have to be given to the method of allocating the capitation among providers. A special concern is the risk-sharing arrangement with primary care physicians.

  2. Bridges in social capital: A review of the definitions and the social capital of social capital researchers

    OpenAIRE

    Akcomak, Semih

    2009-01-01

    There has been a recent surge of interest in social economics and social capital. Articles on social capital that are published in the last five years constitute more than 60 percent of all articles on social capital. Research on social capital is now massive and spans sociology, economics, management, political science and health sciences. Despite this interest there is still not a consensus on the definition and the measurement of social capital. This paper argues that this is due to lack o...

  3. RETROSPECTIVE OF FINANCIAL REPORTING ON CAPITAL MARKET

    OpenAIRE

    Diana Muresan

    2012-01-01

    The purpose of this paper is to develop a conceptual framework for the evolution offinancial reporting on capital market. Due to the worlwide changes, the role of financial reportingin capital market is constantly growing. Financial reporting analyzed through market perspective isstrongly correlated with issues like: capital allocation, financial statements, internationalaccounting standards and informational valences. Capital market research emphasizes the need forqualitative and transparent...

  4. 12 CFR 567.4 - Capital directives.

    Science.gov (United States)

    2010-01-01

    ... capital directive may be based on a savings association's noncompliance with the risk-based capital... or its rate of liability growth, or imposing restrictions on the savings association's payment of... of the capital directive and (ii) The proposed contents of the capital directive. (3) Response to...

  5. 12 CFR 725.5 - Capital stock.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 6 2010-01-01 2010-01-01 false Capital stock. 725.5 Section 725.5 Banks and... ADMINISTRATION CENTRAL LIQUIDITY FACILITY § 725.5 Capital stock. (a) The capital stock of the Facility is divided... or hypothecated except to the Facility. (b) The capital stock subscriptions provided for in §§ 725.3...

  6. Levels of Social Capital in Internationalization

    DEFF Research Database (Denmark)

    Decker, Arnim

    2016-01-01

    be attributed to individuals, affecting their relationship with the external environment. Secondly, social capital is an inherent property of networks, into which smaller firms and entrepreneurs are embedded. Thirdly, social capital exists at the macro level, where its characteristics and availability varies...... between environments and nations. This contribution attemps to fascilitate the operationalization of social capital for an improved understanding of processes of internationalization of smaller firms and entrepreneurs.......This contribution introduces the notion of social capital and discusses integration into the studies on internationalization of smaller firms and entrepreneurs. Integrating social capital into the resource based perspective, we categorize social capital at three levels: firstly, social capital can...

  7. Prevention of excessive postoperative sliding of the short femoral nail in femoral trochanteric fractures.

    Science.gov (United States)

    Ito, Juji; Takakubo, Yuya; Sasaki, Kan; Sasaki, Junya; Owashi, Kazuya; Takagi, Michiaki

    2015-05-01

    Lag screw cut-out is one of the major postoperative complications on femoral trochanteric fractures. However, precise analyses of excessive sliding and lag screw cut-out were limited. The purpose of this study was to investigate the factors that induce this unfavorable event. From April 2010 to April 2013, 226 patients were operated in our institute using a short femoral nail. Among them, 177 patients (29 males and 148 females) with a mean age of 84 years (60-97 years), who were followed up >3 months, were included in this study. The postoperative sliding distance, fracture type (AO/OTA classification), tip-apex distance (TAD), reduction pattern in the postoperative X-ray (antero-posterior and lateral views), bone quality (canal flare and cortical indices), walking ability at the time of pre-injury and final follow-up, and complications were investigated retrospectively. The mean sliding distance was 3.7 mm, and one cut-out case (0.6 %) was observed. The sliding distance of the AO/OTA 31-A2 fractures was significantly longer than that of the A1 fractures (p fractures, an accurate reduction in the lateral view at surgery is important, particularly in unstable fractures.

  8. Correlation between the distal anterior femoral cortical axis and femoral rotational alignment: an anatomic study.

    Science.gov (United States)

    Sathappan, S S; Tan, M Wp; Ginat, D; Walsh, M G; Schweitzer, M E; Di Cesare, P E

    2016-08-01

    To determine the correlation between the distal anterior femoral cortical axis (DAFCA) and the femoral rotational alignment/axis. Magnetic resonance images (MRI) of 82 knees in 34 men and 23 women aged 16 to 47 (mean, 33.4) years were reviewed by a musculoskeletal radiologist. Their diagnoses included meniscal tear (n=4), chondromalacia (n=25), anterior cruciate ligament tears (n=11), and normal (n=42). In all patients the collateral ligaments were intact. The transepicondylar axis (TEA), posterior condylar axis (PCA), Whiteside line (WL), and joint line were drawn on the images, and the condylar twist angle (CTA), TEA-WL angle, DAFCA, epicondylar cortical angle (ECA), and condylar cortical angle (CCA) were measured. The correlations among ECA, CCA, and CTA (control) were assessed. The mean distances between the joint line and the TEA, PCA, and DAFCA were 30.8, 22.1, and 62.2 mm, respectively. The angles subtended by the intersection between the standard axes (TEA, PCA, and WL) and the DAFCA were determined. There was correlation between the CTA and ECA (r=0.34, protational alignment when the standard landmarks are distorted by severe soft tissue and bone loss.

  9. STATISTICAL MODELS OF REPRESENTING INTELLECTUAL CAPITAL

    Directory of Open Access Journals (Sweden)

    Andreea Feraru

    2016-06-01

    Full Text Available This article entitled Statistical Models of Representing Intellectual Capital approaches and analyses the concept of intellectual capital, as well as the main models which can support enterprisers/managers in evaluating and quantifying the advantages of intellectual capital. Most authors examine intellectual capital from a static perspective and focus on the development of its various evaluation models. In this chapter we surveyed the classical static models: Sveiby, Edvisson, Balanced Scorecard, as well as the canonical model of intellectual capital. Among the group of static models for evaluating organisational intellectual capital the canonical model stands out. This model enables the structuring of organisational intellectual capital in: human capital, structural capital and relational capital. Although the model is widely spread, it is a static one and can thus create a series of errors in the process of evaluation, because all the three entities mentioned above are not independent from the viewpoint of their contents, as any logic of structuring complex entities requires.

  10. SOCIAL CAPITAL AND CIVIC PARTICIPATION

    Directory of Open Access Journals (Sweden)

    Melike ERDOGAN

    2010-07-01

    Full Text Available The concept of social capital has a long intellectual history in the fie ld of social sciences. In recent years, interest of scholars from sociology, po litical science, economics and public administration is rapidly increasing. The reason for this increasing interest is that it has been aware of the importance of social capital in communities’ administrative, social, economic and political development. In this sense, the concept of social ca pital is an issue to be discussed with solution of current problems of public administration, subjects of governance, civil society, and participation. Social capital has a lot of definitions which are completely different from each other. Common point of these different definitions is that social capital is a resource at both individual and community level. We will use Robert Putnam’s defi nition about social cap ital in this paper. Putnam (1993 defines social capital as “features of social organization, such as trust, norms, and networks that can improve the efficiency of society by facilitating coordinated action”. In his book; Bowling Alone: The Collapse and Revival of the American Community, Putnam describes declining social capital in America. He analyzes relationship between social capital and civic participation and assumes that there is a positive relationship between social capital and civic participation. The paper aims to reveal how there is a relationshi p between social capital and civic participation in Central Florida. We will use “The Central Florida Social Capital Community Benchmark Survey that is made by The Survey Research Labora tory in the Ins titute for Social and Behavior Sciences at the University of Central Florida among central Florida residents. We use notion of civic participation not only as voting but also as concern of politics, volunteering, attending a political meeting, participating in any demonstrations, protests or boycotts, cooperating to solve problems and

  11. Femoral Condyle Fracture during Anterior Cruciate Ligament Reconstruction

    Directory of Open Access Journals (Sweden)

    Selahattin Ozyurek

    2015-07-01

    Full Text Available Dear Editor,We have greatly enjoyed reading the case report entitled “‘Femoral Condyle Fracture during Revision of Anterior Cruciate Ligament Reconstruction: Case Report and a Review of Literature in the issue of Arch Bone Jt Surg. 2015;3(2 with great interest. We would like to commend the authors for their detailed and valuable work. Although various case reports have described postoperative distal femur fracture at a range of time intervals (1,2 intraoperative intra-articular distal femur fracture is a unique entity.However, we believe that some important additional observations seem necessary to be contributed through this study. In this article, the authors stated that, to the best of their knowledge, there is no other case report in the literature introducing a femoral condyle fracture during arthroscopic ACL reconstruction or revision reconstruction. Nevertheless, we would like to call the attention of the readers to the fact that that the literature contains one additional case report re‌porting on intraoperative distal femoral coronal plane (Hoffa fracture during primary ACL reconstruction (2. Werner BC and Miller MD presented of case report of an intraoperative distal femoral coronal plane (Hoffa fracture that occurred during independent femoral tunnel drilling and dilation in a primary ACL reconstruction. As in the their case, this type of fracture can occur with appropriately placed femoral tunnels, but the risk can increase with larger graft diameters in patients with smaller lateral femoral condyles The patient was treated with open reduction and internal fixation, without compromise of graft stability and with good recovery of function. We believe that tailoring graft size to the size of the patient is important to prevent similar adverse events.

  12. Structural and functional studies of bioobjects prepared from femoral heads

    Energy Technology Data Exchange (ETDEWEB)

    Kirilova, I. A., E-mail: IKirilova@niito.ru; Podorozhnaya, V. T., E-mail: VPodorognaya@niito.ru [Research Institute of Traumatology and Orthopedics n.a. Ya.L. Tsivyan, 17, Frunze, Novosibirsk, 630091 (Russian Federation); Sharkeev, Yu. P., E-mail: sharkeev@ispms.tsc.ru [Institute of Strength Physics and Materials Science SB RAS, 2/4, pr. Akademicheskii, Tomsk, 634021 (Russian Federation); National Research Tomsk Polytechnic University, 30, Lenin Avenue, Tomsk, 634050 (Russian Federation); Popova, K. S., E-mail: kseniya@ispms.tsc.ru; Uvarkin, P. V., E-mail: uvarkin@ispms.tsc.ru [Institute of Strength Physics and Materials Science SB RAS, 2/4, pr. Akademicheskii, Tomsk, 634021 (Russian Federation)

    2015-11-17

    Results of examination of physicomechanical characteristics of samples of medial femoral head cuts are presented. The samples of medial femoral head cuts resected in 6 patients with coxarthrosis in primary endoprosthetic replacement of a coxofemoral joint have been tested for micro- and nanohardness. Young’s modulus and elemental composition of bone tissue have been investigated. To estimate the architectonics of cancellous tissue of the femoral head, adjacent cuts of the same patient have been analyzed. The porosity of bone tissue was estimated from macroscopic images obtained using macrophotography. The total porosity is calculated as the ratio of the total length of straight line segments overlapping pores to the total length of secants. A three-point bending test of the samples has shown that their strength changed from 0.187 to 1.650 MPa and their elasticity modulus changes from 1.69 to 8.15 MPa. The microhardness of the samples changes in the range 220–265 MPa and the average microhardness of medial femoral head cuts is 240 MPa. The elemental composition of medial femoral head cuts is represented by basic Ca, P, O, Na and Mg elements as well as by Sn, S, Fe, Cr, and C in microamounts. The atomic Ca to P ratio for bone tissue is 1.55. It is revealed that pores of the upper part of the femoral head have a more regular shape and in the lower part they are more elongated along the cut and occupy a larger volume. The lower part of the femoral head has a higher porosity (39 and 33%) than the upper part (34 and 30%). The total porosity of all samples does not exceed 37%.

  13. Apoptosis in the osteonecrosis of the femoral head.

    Science.gov (United States)

    Youm, Yoon-Seok; Lee, Soo-Youn; Lee, Soo-Ho

    2010-12-01

    Osteonecrosis of the femoral head is classified into idiopathic and secondary forms. A number of etiological factors in the development of osteonecrosis have been suggested but the biological mechanisms are still unclear. Recently, some reports suggested that the apoptosis is closely related to osteonecrosis of the femoral head. Therefore, this study examined the expression of apoptosis in osteonecrosis of the femoral head. Of the patients diagnosed preoperatively with osteonecrosis and underwent total hip replacement arthroplasty between August 2004 and July 2005, 58 patients (58 hips) were available for this study. Their diagnoses were confirmed by the postoperative pathology findings. Tissue samples of the femoral head sections were terminal deoxynucleotydyl transferase mediated dUTP nick-end labeling (TUNEL) stained using an in situ cell death detection POD kit. The number of total and TUNEL-positive osteocytes, and the average ratio of TUNEL-positive cells were calculated and analyzed according to the cause. Osteonecrosis was steroid-induced in 8 cases (13.8%), alcohol-induced in 29 cases (50%), post-traumatic in 6 cases (10.3%) and idiopathic in 15 cases (25.9%). The percentage of TUNEL-positive osteocytes was high in patients with steroid- and alcohol-induced osteonecrosis of the femoral head but low in patients with post-traumatic and idiopathic osteonecrosis. The difference in the percentage of TUNEL-positive osteocytes between these groups was significant (p osteonecrosis of the femoral head induced by steroid and alcohol. These findings highlight a need for further research into the role of apoptosis in the development of osteonecrosis of the femoral head.

  14. [Femoral artery pseudoaneurysms encountered in orthopedics and traumatology].

    Science.gov (United States)

    Raherinantenaina, F; Rajaonanahary, T M A; Rakoto Ratsimba, H N

    2015-12-01

    Most published articles regarding orthopedic- and trauma-related femoral artery pseudoaneurysms (FAPs) are case reports in English. Reported cases are often associated with a literature review but actually provide little robust data. We wanted to summarize the current knowledge on diagnostic and therapeutic features of these FAPs. A new case of superficial FAP is described followed by a review of the literature. A bibliographic search was performed online (PubMed, ScinceDirect) from 1964 to 2015 using the descriptors "traumatic femoral pseudoaneurysm, orthopedic surgery, osteochondroma". A total of 64 cases of FAPs was analyzed. There were 50 men with an average age of 40.72±26.45 years old. The most common clinical presentation was painful swelling (34%). Arteriography was the commonest radiological investigation used (63%). The main etiologies were orthopedic injuries (47%), surgery of the upper thigh (30%) and femoral osteochondromas (23%). Arterial injuries included superficial femoral (47%) and profunda femoris artery (50%). The treatment was open surgery (56%) or endovascular repair (36%). Deep femoral artery and its branches were embolized (47%) or ligated (38%). Endovascular stenting was performed in 30% of posttraumatic FAPs. All FAPs relating to osteochondromas were repaired surgically. Postoperative courses were uneventful in 95% of patients. Endovascular embolization is preferred in management of postsurgical FAPs which have usually involved the deep femoral artery. Endovascular stenting graft may be proposed for posttraumatic FAPs, for which the superficial femoral trunk is the most often involved vessel. Surgical repair should be performed when endovascular stenting graft is not feasible. Surgical repair is mandatory for all FAPs secondary to traumatic exostoses. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. Radiological assessment of the femoral bowing in Japanese population

    Directory of Open Access Journals (Sweden)

    Abdelaal Ahmed Hamed Kassem

    2016-01-01

    Full Text Available Introduction: Differences in the magnitude of bowing between races are well-known characteristics of the femur. Asian races have an increased magnitude of femoral bowing but most of the orthopedic implants designed for the femur do not match this exaggerated bowing. We calculated the sagittal and coronal femoral bowing in the Japanese population at different levels of the femur and addressed its surgical significance. Material and methods: We calculated the sagittal and coronal bowing of 132 Japanese femora using CT scan of the femur. A mathematical calculation of the radius of curvature at proximal, middle, and distal regions of the femur was used to determine the degree of femoral bowing. Results: Mean sagittal bowing of the femur was 581, 188, and 161 mm for the proximal, middle, and distal thirds of the femur and mean lateral bowing was 528, 5092, and 876 mm, respectively. Mean sagittal and coronal bowing for the whole femur was 175 and 2640 mm, respectively. No correlation was found between age, gender, length of femur, and the degree of bowing. Conclusion: Our study reveals that femoral bowing in the Japanese population is 175 mm in the sagittal plane and 2640 mm in the coronal plane; these values are greater than the femoral bowing in other ethnic groups studied in the literature. This may result in varying degrees of mismatch between the western-manufactured femoral intramedullary implants and the Japanese femur. We recommend that orthopedic surgeons to accurately perform preoperative evaluation of the femoral bowing to avoid potential malalignment, rotation, and abnormal stresses between the femur and implant.

  16. Femoral shaft bowing in the coronal plane has more significant effect on the coronal alignment of TKA than proximal or distal variations of femoral shape.

    Science.gov (United States)

    Kim, Jong-Min; Hong, Soo-Heon; Kim, Jong-Min; Lee, Bum-Sik; Kim, Dong-Eun; Kim, Kyung-Ah; Bin, Seong-Il

    2015-07-01

    The aim of this study was to determine (1) variations in the shape of the proximal, middle, and distal femur in a series of Korean patients who had undergone total knee arthroplasty (TKA), (2) the preoperative relationship between these three parameters and the distal valgus cutting angle referenced off the femoral intramedullary guide, and (3) whether there was any relationship between femoral bowing and variations in the shape of the proximal or distal femur in the coronal plane. The preoperative long-standing anteroposterior radiographs of 316 consecutive osteoarthritis patients who underwent primary TKA from 2009 to 2011 were examined. The femoral neck shaft angle, the femoral shaft bowing angle, and the mechanical lateral distal femoral angle were measured to assess the shape of the proximal, middle, and distal femur, respectively. The valgus cutting angle of the femur was defined as the angle between the distal anatomical and mechanical axes of the femur. The study population showed large variations in femoral shape. The mean femoral intramedullary guide angle was 6.5° ± 1.3° (range: 4°-13°). The femoral shaft bowing angle was the factor that showed the strongest correlation with this angle (P shaft angle showed no correlation (n.s.). The femoral shaft bowing angle showed a weak correlation with the mechanical lateral distal femoral angle (P = 0.001), but was not significantly correlated with the femoral neck shaft angle (n.s.). Apparent femoral bowing (>3° of lateral or medial bowing) was found in 42 (13.3 %) of cases (37 cases of lateral bowing and five of medial bowing). Cases with lateral apparent femoral bowing >3° had a distal cutting angle of 8.6° ± 2.2° relative to the femoral intramedullary guide. The femoral intramedullary guide angle was mainly influenced by femoral shaft bowing among femoral deformities in the coronal plane. Therefore, to increase the accuracy of distal femoral cut during TKA, it is necessary to confirm femoral

  17. Migration, income redistribution, and international capital mobility

    OpenAIRE

    Meckl, Jürgen

    1994-01-01

    This paper studies income-redistribution effects from labor migration in a small open economy under alternative assumptions on the international mobility of capital. Our principal result is that induced international capital flows dampen or may even reverse redistribution effects. However, as long as the location of capital is unaffected by migration redistribntion effects may be greater if some of the capital is foreign owned, depending on whether labor and capital are friends or enemies. On...

  18. Capital, endogenous separations, and the business cycle

    OpenAIRE

    van Roye, Björn; Wesselbaum, Dennis

    2009-01-01

    We implement capital in an endogenous separations New Keynesian matching model. In contrast to the vintage capital theory, we suggest a more general approach, such that workers have unrestricted access to a proportional share of the capital stock. We find that the introduction of capital generates an important channel for the transmission of aggregate productivity shocks, using capital-labor trade-off. The model generates higher volatilities of key variables and therefore enhances the perform...

  19. Intangible Capital, Corporate Valuation and Asset Pricing

    OpenAIRE

    Danthine, Jean-Pierre; Jin, Xiangrong

    2006-01-01

    Recent studies have found unmeasured intangible capital to be large and important. In this paper we observe that by nature intangible capital is also very different from physical capital. We find it plausible to argue that the accumulation process for intangible capital differs significantly from the process by which physical capital accumulates. We study the implications of this hypothesis for rational firm valuation and asset pricing using a two-sector general equilibrium model. Our main fi...

  20. Clinical and imaging features of intra-articular osteoid osteoma in the femoral neck

    International Nuclear Information System (INIS)

    Zeng Yonghan; Cheng Xiaoguang; Gu Xian; Luan Yixin; Li Jiangtao

    2012-01-01

    Objective: To evaluate the clinical and imaging characteristics of osteoid osteoma in femoral neck and to improve diagnostic accuracy of this disease. Methods: Twenty-one patients (18 males and 3 females, age, 7-26 years, median age, 13 years) with pathologically proven osteoid osteoma of the femoral neck were retrospectively analyzed for their clinical profile and radiologic features. CT and X-ray examinations were performed in all patients, 10 of them performed post-contrast CT scan and 4 of them performed MRI examinations. Results: Nineteen patients had hip pain (pain worse at night in 11, and 8 received salicylates treatment with good response), and 2 patients only with intermittent claudication. The duration ranged from 2 months to 54 months (median duration 12 months). X-ray: Nidus was seen on plain film in 10 cases, 18 cases showed different degrees of bone sclerosis of the nidus. CT: Nidus was demonstrated in all cases. Among them, 8 were intracortical, 6 were subperiosteal, 7 were endosteal. Twenty cases showed different degrees of bone sclerosis of the nidus-extra-articular anteromedial cortical surface of the femur neck. Nineteen cases showed 'vascular groove sign'. MRI: Nidus was seen in 4 cases. Bone sclerosis was low signal on all sequences. Three cases had joint effusion, 4 cases had bone marrow edema, and 2 cases had synovial thickening. Conclusions: Although osteoid osteoma of femoral neck has non-specific clinical features, the radiographic findings are usually typical. The nidus of osteoid osteoma is often located within the joint. Bony sclerosis occurs at the area of extra-articular anteromedial cortical surface of the femur neck.CT examination remains an optimal method to identify the nidus. (authors)

  1. Investigations of Cartilage Matrix Degeneration in Patients with Early-Stage Femoral Head Necrosis

    Science.gov (United States)

    Xu, Ronghua; Wei, Bo; Li, Jiayi; Huang, Chenyu; Lin, Rongcai; Tang, Cheng; Xu, Yan; Yao, Qingqiang; Wang, Liming

    2017-01-01

    Background The purpose of this study was to explore changes in cartilage matrix in early-stage femoral head necrosis (FHN). Material/Methods Femoral head samples of patients with early FHN were collected during total hip arthroplasty (THA), high-field 7.0T MRI scans were performed in vitro, and the average T2 values were calculated. Cartilage samples were obtained from the weight-bearing area (FHN group) and non-weight-bearing area (Control group), divided into 3 equal parts and used for biochemical analysis, histopathological staining, and gene expression analysis. Results T2 mapping of the femoral head specimens showed that the density distribution of cartilage surface was not uniform, and the average T2 value increased unevenly. Histological staining demonstrated that the number of chondrocytes was significantly decreased and they were irregularly arranged, SO staining was lost, and collagen fiber arrangement was slightly more irregular on the cartilage surface in the FHN group. The biochemical results in the FHN group showed that the water content increased significantly and the DNA content decreased significantly, while no significant changes in GAG and total collagen contents were detected. Gene expression analysis in the FHN group showed that SOX9 expression was significantly down-regulated, while COL10A1 and RUNX2 expressions were significantly up-regulated. The expression of ACAN and COL2A1 were decreased and COL1A1 was increased, but there was no significant difference compared with the Control group. Conclusions Taken together, the results of this study suggest that patients with early-stage FHN tend to have cartilage matrix degeneration, which provides new ideas for studying the pathogenesis of FHN and selecting treatment strategies. PMID:29208853

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

    Directory of Open Access Journals (Sweden)

    Korhan Ozkan

    2015-01-01

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

  3. Femoral articular geometry and patellofemoral stability.

    Science.gov (United States)

    Iranpour, Farhad; Merican, Azhar M; Teo, Seow Hui; Cobb, Justin P; Amis, Andrew A

    2017-06-01

    Patellofemoral instability is a major cause of anterior knee pain. The aim of this study was to examine how the medial and lateral stability of the patellofemoral joint in the normal knee changes with knee flexion and measure its relationship to differences in femoral trochlear geometry. Twelve fresh-frozen cadaveric knees were used. Five components of the quadriceps and the iliotibial band were loaded physiologically with 175N and 30N, respectively. The force required to displace the patella 10mm laterally and medially at 0°, 20°, 30°, 60° and 90° knee flexion was measured. Patellofemoral contact points at these knee flexion angles were marked. The trochlea cartilage geometry at these flexion angles was visualized by Computed Tomography imaging of the femora in air with no overlying tissue. The sulcus, medial and lateral facet angles were measured. The facet angles were measured relative to the posterior condylar datum. The lateral facet slope decreased progressively with flexion from 23°±3° (mean±S.D.) at 0° to 17±5° at 90°. While the medial facet angle increased progressively from 8°±8° to 36°±9° between 0° and 90°. Patellar lateral stability varied from 96±22N at 0°, to 77±23N at 20°, then to 101±27N at 90° knee flexion. Medial stability varied from 74±20N at 0° to 170±21N at 90°. There were significant correlations between the sulcus angle and the medial facet angle with medial stability (r=0.78, pgeometry with knee flexion to patellofemoral stability. Copyright © 2017 Elsevier B.V. All rights reserved.

  4. PEEK-OPTIMA™ as an alternative to cobalt chrome in the femoral component of total knee replacement: A preliminary study

    Science.gov (United States)

    Cowie, Raelene M; Briscoe, Adam; Fisher, John; Jennings, Louise M

    2016-01-01

    PEEK-OPTIMA™ (Invibio Ltd, UK) has been considered as an alternative joint arthroplasty bearing material due to its favourable mechanical properties and the biocompatibility of its wear debris. In this study, the potential to use injection moulded PEEK-OPTIMA™ as an alternative to cobalt chrome in the femoral component of a total knee replacement was investigated in terms of its wear performance. Experimental wear simulation of three cobalt chrome and three PEEK-OPTIMA™ femoral components articulating against all-polyethylene tibial components was carried out under two kinematic conditions: 3 million cycles under intermediate kinematics (maximum anterior-posterior displacement of 5 mm) followed by 3 million cycles under high kinematic conditions (anterior-posterior displacement 10 mm). The wear of the GUR1020 ultra-high-molecular-weight polyethylene tibial components was assessed by gravimetric analysis; for both material combinations under each kinematic condition, the mean wear rates were low, that is, below 5 mm3/million cycles. Specifically, under intermediate kinematic conditions, the wear rate of the ultra-high-molecular-weight polyethylene tibial components was 0.96 ± 2.26 mm3/million cycles and 2.44 ± 0.78 mm3/million cycle against cobalt chrome and PEEK-OPTIMA™ implants, respectively (p = 0.06); under high kinematic conditions, the wear rates were 2.23 ± 1.85 mm3/million cycles and 4.44 ± 2.35 mm3/million cycles, respectively (p = 0.03). Following wear simulation, scratches were apparent on the surface of the PEEK-OPTIMA™ femoral components. The surface topography of the femoral components was assessed using contacting profilometry and showed a statistically significant increase in measured surface roughness of the PEEK-OPTIMA™ femoral components compared to the cobalt chrome implants. However, this did not appear to influence the wear rate, which remained linear over the duration of the study. These

  5. Bilateral femoral neck stress fractures in a fire academy student.

    Science.gov (United States)

    Wright, Russell C; Salzman, Garrett A; Yacoubian, Stephan V; Yacoubian, Shahan V

    2010-10-11

    Unilateral femoral neck stress fractures are well documented in active patients; however, the risk of a subsequent contralateral stress fracture remains unknown in patients who continue to be active. This article describes a 24-year-old male fire academy student who sustained a left femoral neck stress fracture, followed approximately 11 months later by a right femoral neck stress fracture, both of which went on to completely displace. A review of the index radiographs of each hip from outside institutions revealed femoral neck stress fractures that went undiagnosed until they displaced. The patient was referred to our institution and underwent closed reduction and internal fixation using cannulated screws in both cases. A full endocrine evaluation was performed in the following weeks and proved unremarkable. Although it is difficult to extrapolate the results from 1 patient beyond the case studied, there is cause for concern in patients who remain active following femoral neck stress fractures. Our case highlights the significance of obtaining a complete and thorough medical history on physical examination and appropriately counseling patients regarding activity level. Until further research explores this possible relationship, physicians evaluating patients with a history of a stress fracture are encouraged to be vigilant of subsequent contralateral fractures and educate patients of this potentially avoidable injury. Copyright 2010, SLACK Incorporated.

  6. Avascular necrosis of the femoral head in HIV infected patients

    Directory of Open Access Journals (Sweden)

    Marcos Almeida Matos

    Full Text Available Avascular necrosis (AVN of the femoral head is an emerging complication in HIV infected patients. It has been suggested that the increased incidence of AVN in this population may be caused by an increased prevalence of predisposing factors for osteonecrosis, including protease inhibitors, hyperlipidemia, corticosteroid use, alcohol and intravenous drug abuse. The aim of this study was to assess the risk factors for avascular necrosis developing in the femoral head of HIV infected individuals. This study consisted of meta-analysis of the secondary data extracted from current literature. The selected articles allowed two study groups to be drawn up for comparison. Group 1 comprised 324 individuals infected by the HIV virus, who did not present femoral head AVN. Group 2 comprised 32 HIV positive patients, who presented femoral head AVN. The parameters used for analysis were as follows: age, gender, sexual preference, use of intravenous drugs, time of diagnosis, CD4+ cell count, use of antiretroviral agents and duration, serum cholesterol and serum triglycerides. The present study found a statistically significant association between hypertriglyceridemia, hypercholesterolemia, sexual preference and intravenous drug abuse. The authors concluded that femoral head osteonecrosis is associated with hyperlipidemia (hypercholesterolemia and hypertriglyceridemia and intravenous drug abuse. This study supports the hypothesis that protease inhibitors play a role in the development of osteonecrosis through a tendency to cause hyperlipidemia.

  7. Osteonecrosis of the femoral head associated with pigmented villonodular synovitis.

    Science.gov (United States)

    Baba, Shoji; Motomura, Goro; Fukushi, Junichi; Ikemura, Satoshi; Sonoda, Kazuhiko; Kubo, Yusuke; Utsunomiya, Takeshi; Hatanaka, Hiroyuki; Nakashima, Yasuharu

    2017-05-01

    A 23-year-old Japanese woman with no history of corticosteroid intake or alcohol abuse presented with a 10-month history of left hip pain without any antecedent trauma. An anteroposterior radiograph performed 10 months after the onset of pain showed slight joint space narrowing and bone erosions surrounded by sclerotic lesions in both the acetabular roof and femoral neck. Magnetic resonance images of the left hip showed a feature of osteonecrosis of the femoral head and a mass with villus proliferation extending from the posterior intertrochanteric area to the anteromedial aspect of the femoral neck. In addition, the left quadratus femoris muscle, which is generally located just above the nutrient vessels of the femoral head, was not detected. Based on these findings, the patient was diagnosed with osteonecrosis of the femoral head caused by impairment of the nutrient vessels from invasion of the pigmented villonodular synovitis. She underwent radical synovectomy of the left hip 16 months after the onset of pain, and her hip pain improved after the surgery.

  8. [Treatment of femoral shaft fractures with expandable intramedullary nail].

    Science.gov (United States)

    Cilli, Feridun; Mahiroğullari, Mahir; Pehlivan, Ozcan; Keklikçi, Kenan; Kuşkucu, Mesih; Kiral, Ahmet; Avşar, Serdar

    2009-07-01

    Femoral shaft fractures are usually seen in the young population as a result of high energy traumas and are often accompanied by major organ injuries. In this paper, we aimed to assess the clinical results of expandable femoral intramedullary nails in the treatment of 20 femoral shaft fractures. The average age was 34.7. One fracture was the result of a gunshot wound, type 3A open fracture, and the other 19 fractures were closed. Under fluoroscopic control, all patients underwent elective closed reduction and internal fixation with intramedullary expandable femoral nails (Fixion, Disc-O-Tech; Israel). In case of failed or unacceptable closed reduction, open reduction was achieved with a second incision over the fracture site. Average operation time was 26.3 minutes. Full union was achieved in all patients. The shortest union time was 12 weeks and the longest 24 weeks, with an average of 15.2 weeks. Results in 15 patients (75%) were excellent, in 4 patients (20%) good and in 1 patient (5%) moderate according to Thorensen criteria. Use of expandable nails provides union without major complications and offers advantages such as less exposure to radiation as seen in distal locking of classical intramedullary nails. In conclusion, the good results of this study show that the expandable femoral intramedullary nail provides a successful option to classical intramedullary nails.

  9. Financial capital and intellectual capital in physician practice management.

    Science.gov (United States)

    Robinson, J C

    1998-01-01

    Medical groups need financial resources yet most retain no earnings and have no reserves. Physician practice management (PPM) companies have recognized the need for investment and the scarcity of indigenous capital in the physician sector and are rushing to fill the void. Resources are being contributed by venture capitalists, bond underwriters, private investors, pharmaceutical manufacturers, health plans, hospital systems, and public equity markets. The potential contribution of PPM firms is to nurture the intellectual capital of leading physician organizations and diffuse it throughout the health care system. The risk is that short-term financial imperatives will impede necessary long-term investments.

  10. Clinical use of femoral artery hemostasis sticking after interventional procedure via femoral artery access

    International Nuclear Information System (INIS)

    Zhu Zhongsheng; Chen Shaoliang; Ye Fei; Zhang Junjie; Zhou Jie; Tian Nailiang; Lin Song; Liu Zhizhong; Xiao Pingxi; Qu Hong

    2010-01-01

    Objective: To observe the clinical effect of the use of femoral artery hemostasis sticking V+PAD after the interventional procedure via femoral artery access. Methods: By using random permutation list 80 patients, who decided to receive coronary angiography and percutaneous transluminal coronary angioplasty, were randomly selected. Of the 80 patients, hemostasis sticking V + PAD was employed in 40 patients with even numbers (trial group), only manual compression was adopted to stop bleeding in another 40 patients with odd numbers (control group). All the patients were informed about this trial and had to sign a consent letter. The pressure time, the treatment method of access site after hemostasis, the posture in bed, the immobilization time, the comfort degree of patients, the complications of access site prior to discharge, etc. were observed and the results were compared between two groups. Results: There was no significant difference between two groups as respect to age, gender ratios,activated clotting time (ACT) value and blood pressure. However, significantly difference in the compression time and bed rest time existed between the two groups. The compression time in trial group and control group was (7.9 ± 0.5) min and (19.8 ± 5.1) min respectively (P<0.01), while the bed rest time in trial group and control group was (6.1 ± 5.0) hours and (23.9 ± 0.2) hours respectively (P<0.01). All patients in trial group was supine in bed with the head side of the bed raised at 30 degree immediately after the procedure, and the head side of the bed was further raised to 90 degree one hour later. The puncture site was bandaged with conventional compression and immobilization was not employed. Patients could lie in bed with free posture and the patient's comfort degree was greatly improved. During hospitalization no complications related to puncture site occurred in all patients except one obese woman in trial group who developed pseudoaneurysm. Conclusion: Femoral

  11. Intellectual Capital Management in Transport Sector

    Directory of Open Access Journals (Sweden)

    Asta Znakovaitė

    2011-03-01

    Full Text Available This article presents an analysis of intellectual capital; its management, features and processes by which intellectual capital of a company can be evaluated. The main elements of intellectual capital (human, structural and relationship capital are presented and used in research. After surveying bibliography, intellectual capital evaluation model, which applies to Lithuanian and Latvian companies operating in the transport sector, is created. The research is based on the value-added intellectual capital factor model, the relationship between indicators, multi-asset return correlation and regression analysis and generation of alternatives to intellectual capital performance-enhancing. Following an assessment of intellectual capital of Lithuanian and Latvian transport sectors, on the basis of the results, it was found that the intellectual capital is a key factor in corporation management to increase revenue. Article in Lithuanian

  12. Toxic cyanobacteria in the lakes located in R- lga (the capital of ...

    African Journals Online (AJOL)

    the capital of Latvia) were investigated between 1998 and 2004. These lakes are shallow eutrophic water bodies with a high surface to depth ratio and are widely used for recreational and fishing activities. Intense cyanobacterial blooms were ...

  13. The measurement of social capital

    Directory of Open Access Journals (Sweden)

    Ester Villalonga-Olives

    2015-01-01

    Full Text Available Social capital has been defined as the resources available to individuals and groups through membership in social networks. The definition is consistent with either an individualistic approach, i.e. resources (such as information or instrumental assistance that are accessed by individuals through their network connections; or a collective approach, e.g. the benefits accruing to members of a group – such as the ability of a community to engage in collective action – as a consequence of the existence of cohesive relationships. While research often restricts itself to a single level of analysis, the benefits (and downsides of social capital accrue to both the individual as well as to the network to which he belongs. In the Dictionary of Epidemiology both the individual and collective levels of analysis were recognized in the definition of social capital.

  14. Human capital and career success

    DEFF Research Database (Denmark)

    Frederiksen, Anders; Kato, Takao

    Denmark’s registry data provide accurate and complete career history data along with detailed personal characteristics (e.g., education, gender, work experience, tenure and others) for the population of Danish workers longitudinally. By using such data from 1992 to 2002, we provide rigorous...... formal schooling and subsequent human capital obtained informally on the job are found to be complements in the production of career success. Fourth, though there is a large body of the literature on the relationship between firm-specific human capital and wages, the relative value of firm-specific human...... evidence for the first time for the population of workers in an entire economy (as opposed to case study evidence) on the effects of the nature and scope of human capital on career success (measured by appointments to top management). First, we confirm the beneficial effect of acquiring general human...

  15. CAPITALISM IN ILLUSION AND DELUSION

    Directory of Open Access Journals (Sweden)

    DORU CÎRNU

    2011-12-01

    Full Text Available The current crisis seems to shake the foundations of contemporary society as a whole and generated increasingly more opinions that show the capitalist society has begun and continues to lose ground. This is because capitalism has changed something inside so deeply that eternal truths of capitalism – economic growth, full employment, financial stability – seem to have crashed like the New York twin towers. Beyond all the shortcomings, quite a lot in numbers, known and recognized, the world and those who analyze it agree that , at least so far, has not been invented a better mechanism to obstruct and retain tyranny and so it is possible to consider the evolution of capitalism only in and through democracy.

  16. Transnational Investments in Informational Capital

    DEFF Research Database (Denmark)

    D. Munk, Martin

    This paper analyses the acquisition of informational capital, e.g. academic capital, measured as student mobility, and understood as transnational investments in prestigious foreign educational institutions. In the 1990s, educational “zones of prestige” have especially been the United States......) are more likely than students from other social classes to pursue transnational investments, even though students from the middle and working classes have now entered the competition. This result is also recently found in an analysis of Danish academic emigrants. All in all, the studies confirm...... the hypothesis that students from upper classes are more likely than others to invest in specific informational capital in the field of education, in national environments but also in international settings....

  17. The measurement of social capital.

    Science.gov (United States)

    Villalonga-Olives, Ester; Kawachi, Ichiro

    2015-01-01

    Social capital has been defined as the resources available to individuals and groups through membership in social networks. The definition is consistent with either an individualistic approach, i.e. resources (such as information or instrumental assistance) that are accessed by individuals through their network connections; or a collective approach, e.g. the benefits accruing to members of a group - such as the ability of a community to engage in collective action - as a consequence of the existence of cohesive relationships. While research often restricts itself to a single level of analysis, the benefits (and downsides) of social capital accrue to both the individual as well as to the network to which he belongs. In the Dictionary of Epidemiology both the individual and collective levels of analysis were recognized in the definition of social capital. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  18. Avascular Necrosis of the Femoral Head: Are Any Genes Involved?

    Science.gov (United States)

    Pouya, Farzaneh; Kerachian, Mohammad Amin

    2015-01-01

    Avascular necrosis of the femoral head (ANFH) is a pathologic process that results from interruption of blood supply to the femur bone resulting in the death of bone cells and collapse of the femoral head. Nontraumatic ANFH continues to be a significant challenge to orthopedic surgeons. While the exact mechanisms remain elusive, many new insights have emerged from research in the last decade that has given us a clearer picture of the pathogenesis of nontraumatic ANFH. Progression to the end stage of ANFH appears to be related to five main mechanisms: hypercoagulable conditions, angiogenesis suppressions, hyperadipogenesis, heritable states, and switching the bone remodelling into bone resorption. Researchers have been examining the pathogenic mechanisms of ANFH but none of these theories have been firmly confirmed although some appear more plausible than the others. All of these factors can switch bone remodelling into bone resorption, which can further lead to ANFH progression ending up to femoral head collapse. PMID:26213697

  19. Avascular Necrosis of the Femoral Head: Are Any Genes Involved?

    Directory of Open Access Journals (Sweden)

    Farzaneh Pouya

    2015-07-01

    Full Text Available Avascular necrosis of the femoral head (ANFH is a pathologic process that results from interruption of blood supply to the femur bone resulting in the death of bone cells and collapse of the femoral head. Nontraumatic ANFH continuesto be a significant challenge to orthopedic surgeons. While the exact mechanisms remain elusive, many new insights have emerged from research in the last decade that has given us a clearer picture of the pathogenesis of nontraumatic ANFH. Progression to the end stage of ANFH appears to be related to five main mechanisms: hypercoagulable conditions, angiogenesis suppressions, hyperadipogenesis, heritable states, and switching the bone remodelling into bone resorption. Researchers have been examining the pathogenic mechanisms of ANFH but none of these theories have been firmly confirmed although some appear more plausible than the others. All of these factors can switch bone remodelling into bone resorption, which can further lead to ANFH progression ending up to femoral head collapse.

  20. Financing Human Capital: Families & Society

    Directory of Open Access Journals (Sweden)

    Neantro Saavedra-Rivano

    2016-10-01

    Full Text Available The Organization for Economic Cooperation and Development (OECD describes human capital as “knowledge, skills, competencies and attributes embodied in individuals that facilitate the creation of personal, social and economic wellbeing.”* It follows from this interpretation that investment in human capital includes the sum of all costs that allow a new being to reach economic autonomy. In this paper we analyze the family and social dimensions of human capital and discuss how decisions on human capital formation are taken and how its associated costs are shared. The discussion leads us to identify an important paradox underlying human capital formation, namely the fact that while families are its main contributors the benefits of such investment go primarily to society as a whole. This paradox and its consequences are central to two very important current issues. The first issue, one that is common to many developed countries, is low female fertility which is the source, in particular, of population aging. The second issue, affecting chiefly developing countries, is the inequality of opportunities, a problem lying at the root of underdevelopment. Two options are discussed to respond to this dilemma, one based on redistributive programs and another on market solutions. The paper discusses the limits inherent to redistributive programs and goes on to present at length the alternative market solution. In a nutshell this consists of securitizing the human capital of individuals so as to finance the expenses leading to their upbringing, from birth to adulthood. In addition to describing this scheme the paper analyzes its advantages as well as the difficulties associated with its implementation. It concludes by exploring possible interpretations of the scheme and feasible routes for its adoption.

  1. A STUDY OF UNSTABLE INTERTROCHANTERIC FEMORAL FRACTURES TREATED BY TROCHANTERIC FEMORAL NAIL

    Directory of Open Access Journals (Sweden)

    Sreenivasa Neikar

    2017-11-01

    Full Text Available BACKGROUND Intertrochanteric fracture is one of the most common fracture of the hip especially in the elderly. The incidence of intertrochanteric fracture is rising because of the increase in number of elderly population along with superadded osteoporosis. MATERIALS AND METHODS Study included cases of unstable intertrochanteric fractures (AO and OTA Classification 31-A2 and 31-A3 fracture patterns that were operated with the short trochanteric femoral nail, which fitted into the inclusion criteria done in medical college hospital, Vijayanagara Institute of Medical Sciences, Bellary, from February 2015 to September 2016. RESULTS The age distribution was from 40 to 80 years. The largest group of patients were from 61 to 70 years. The average age was 60.5 years. The number of male patients in our series was 20 (66.7% and female was 10 (33.3%. Right side was affected in 11 cases (36.7% and left side in 19 cases (63.3%. Good reduction was achieved in 23 patients (76.7%. Acceptable reduction was achieved in 7 (23.3% patients due to severe comminution. In our study, 25 patients (83.33% had no complications. We encountered one intraoperative complication in the form of greater trochanter splintering, while inserting the nail. In our study, we encountered following postoperative complications. We noticed one case of delayed union, one case of Z effect and 2 cases of varus malunion. CONCLUSION We conclude that short trochanteric femoral nail provides good fixation for unstable intertrochanteric fractures if proper preoperative planning, good reduction and surgical technique are followed leading to high rate of bone union and minimal soft tissue damage especially for Asian patients with relatively small femora.

  2. Biophysical stimulation in osteonecrosis of the femoral head

    Directory of Open Access Journals (Sweden)

    Massari Leo

    2009-01-01

    Full Text Available Osteonecrosis of the femoral head is the endpoint of a disease process that results from insufficient blood flow and bone-tissue necrosis, leading to joint instability, collapse of the femoral head, arthritis of the joint, and total hip replacement. Pain is the most frequent clinical symptom. Both bone tissue and cartilage suffer when osteonecrosis of the femoral head develops. Stimulation with pulsed electromagnetic fields (PEMFs has been shown to be useful for enhancing bone repair and for exerting a chondroprotective effect on articular cartilage. Two Italian studies on the treatment of avascular necrosis of the femoral head with PEMFs were presented in this review. In the first study, 68 patients suffering from avascular necrosis of the femoral head were treated with PEMFs in combination with core decompression and autologous bone grafts. The second one is a retrospective analysis of the results of treatment with PEMFs of 76 hips in 66 patients with osteonecrosis of the femoral head. In both studies clinical information and diagnostic imaging were collected at the beginning of the treatment and at the time of follow up. Statistical analysis was performed using chi-square test. Both authors hypothesize that the short-term effect of PEMF stimulation may be to protect the articular cartilage from the catabolic effect of inflammation and subchondral bone-marrow edema. The long-term effect of PEMF stimulation may be to promote osteogenic activity at the necrotic area and prevent trabecular fracture and subchondral bone collapse. PEMF stimulation represents an important therapeutic opportunity to resolve the Ficat stage-I or II disease or at least to delay the time until joint replacement becomes necessary.

  3. Image features of herniation pit of the femoral neck

    International Nuclear Information System (INIS)

    Zhang Xuezhe; Li Guangming; Wang Cunli; Wang Guimin

    2008-01-01

    Objective: To evaluate imaging appearances of herniation pit of the femoral neck. Methods: We retrospectively analyzed the X-ray, CT and MRI findings of 9 patients with herniation pit of the femoral neck. All nine patients were male with the age ranging from 21 to 73 years. They had pain in the hip from two months to two years duration. Results: The bilateral hips were affected in six patients, the right hips in the other 3 patients. Of the nine patients, X-ray plain films (2 cases), CT scanning(6 cases), and MR scanning (5 cases ) were performed. The size of the lesions ranged from 0.5 cm x 0.6 cm to 1.0 cm x 1.5 cm, located in the anterosuperior portion of the femoral neck (n=7) or anteroinferior portion (n=2). X-ray plain films showed an osteolytic lesion surrounded by a sclerotic rim. CT scanning showed the lesion just below the cortex of the femoral neck surrounded by a rim of sclerosis or associated with a small cortical break in two patients. MR scanning showed low signal intensity in five patients on T 1 WI and high signal intensity surrounded by a rim of low signal intensity (n=3) or low signal intensity (n=2) on T 2 WI, and high signal intensity on fat suppression MR image. A small joint effusion was observed in two cases on T 2 WI. Conclusion: The CT and MRI findings of herniation pit of the femoral neck are characteristic, it is useful in defining the diagnosis of the herniation pit of the femoral neck. (authors)

  4. [Antegrade femoral intramedullary nailing in a lateral position].

    Science.gov (United States)

    Friederichs, J; von Rüden, C; Hierholzer, C; Bühren, V

    2015-04-01

    Intramedullary nailing is the gold standard for the treatment of femoral shaft fractures; however, rotational malalignment remains a common complication. The patient can be positioned on the fracture table in a supine position or alternatively in the lateral decubitus position without any traction. The aim of this article is to describe an effective method to control intraoperative torsion of the femur. The surgical technique described in this article is the standard procedure for femoral shaft fractures and subtrochanteric fractures in this level 1 trauma center. The patient is positioned in a lateral position on a radiolucent table with free draping of the injured leg. Using the C-arm, reduction can be performed with this technique with precise placing of the nails and torsion can be exactly adjusted and controlled with the aid of the femoral neck axis, the distal locking holes and both parallel femoral condyles. The described technique represents an effective method for the intraoperative control of femoral torsion. With an acceptable and most probably clinically irrelevant bias, this technique is able to avoid significant rotational malalignment. It does not prolong the operative procedure and does not require additional navigation settings. It has also been shown to be helpful in the treatment of subtrochanteric fractures. The surgical technique of anterograde intramedullary nailing using the lateral decubitus position without any traction device and free draping of the injured leg represents a safe and reliable treatment concept and offers logistical advantages compared to the supine position of the patient on a fracture table. Together with other described methods of intraoperative torsional control of femoral fractures, the radiological technique described in this study is an easily applicable and safe method, which needs to be confirmed in clinical studies.

  5. Retrograde femoral nailing in elderly patients: outcome and functional results.

    Science.gov (United States)

    Neubauer, Thomas; Krawany, Manfred; Leitner, Lukas; Karlbauer, Alois; Wagner, Michael; Plecko, Michael

    2012-06-01

    Functional outcome after retrograde femoral intramedullary nailing was investigated in 35 patients older than 60 years (mean, 86 years) with 36 fractures, comprising 15 (41.7%) shaft and 21 (58.3%) distal fractures; overall, 7 (19.4%) periprosthetic fractures occured. Twenty-two (62.9%) of 35 patients were evaluated at a mean 16.5-month follow-up with the Lyshom-Gillquist score and the SF-8 questionaire. Primary union rate was 97.8%, with no significant differences in duration of surgery, bone healing, mobilization, and weight bearing among different fracture types; periprosthetic fractures revealed a significantly delayed mobilization (P=.03). Complications occured significantly more often among distal femoral fractures (P=.009), including all revision surgeries. The most frequently encountered complication was loosening of distal locking bolts (n=3). Lysholm score results were mainly influenced by age-related entities and revealed fair results in all fractures (mean in the femoral shaft fracture group, 78.1 vs mean in the distal femoral fracture group, 74.9; P=.69), except in the periprosthetic subgroup, which had good results (mean, 84.8; P=.23). This group also had increased physical parameters according to SF-8 score (P=.026). No correlation existed between SF-8 physical parameters and patient age or surgery delay, whereas a negative correlation existed between patient age and SF-8 mental parameters (P=.012). Retrograde femoral intramedullary nailing is commonly used in elderly patients due to reliable bone healing, minimal soft tissue damage, and immediate full weight bearing. It also offers a valid alternative to antegrade nailing in femoral shaft fractures. Copyright 2012, SLACK Incorporated.

  6. Stress fracture of the femoral neck in a child (stress fracture)

    International Nuclear Information System (INIS)

    Coldwell, D.; Gross, G.W.; Boal, D.K.

    1984-01-01

    Femoral neck stress fracture is extremely rare in childhood. We report a case of femoral neck stress fracture in an 11-year-old girl. Differentials diagnosis and a brief review of the literature follow. (orig.)

  7. Imaging diagnosis of the early aseptic osteonecrosis of the femoral head

    International Nuclear Information System (INIS)

    Liang Jingyin; Liu Yiqiang; Pan Zhifeng

    2006-01-01

    Objective: To study the early imaging signs of aseptic osteonecrosis of the femoral head in adults. Methods: The X-ray plain films and CT scans of 80 cases with this condition were analyzed. Results: There were 40 hip joints with the femoral head normal in shape, including 49 femoral heads with only high-density sclerosis and 26 ones with high-density and low-density areas. Air-filled cysts appeared in 12 femoral heads. In the other 40 hip joints, the femoral heads were depressed and manifested purely high-density sclerosis in 8 and mixed-density areas in 63. Air-filled cysts appeared in 22 femoral heads. Conclusions: Purely high-density sclerosis and air density in the femoral heads are the early signs of aseptic osteonecrosis of the femoral head. The special CT signs are of great diagnostic value and can provide more information for the surgeons. (authors)

  8. The treatment of nonisthmal femoral shaft nonunions with im nail exchange versus augmentation plating.

    Science.gov (United States)

    Park, Jin; Kim, Sul Gee; Yoon, Han Kook; Yang, Kyu Hyun

    2010-02-01

    The purpose of this study was to compare the results between exchange nailing (EN) and augmentation plating (AP) with a nail left in situ for nonisthmal femoral shaft nonunion after femoral nailing. : Retrospective data analysis, November 1996-March 2006. A level I trauma center. Eighteen patients with 18 nonisthmal femoral nonunions. Seven patients with 7 fractures treated for nonisthmal femoral shaft nonunions after femoral nailing with EN and 11 patients with 11 fractures treated for nonisthmal femoral shaft nonunions after nailing with AP combined with bone grafting. Union and complications. Five nonunions in the EN group failed to achieve union (72% failure rate), whereas all 11 pseudarthroses in the AP group obtained osseous union. Fisher exact test showed a higher nonunion rate of EN compared with AP for nonisthmal femoral shaft nonunion (odds ratio, 6.5; P = 0.002). AP with autogenous bone grafting may be a better option than EN for nonisthmal femoral nonunions.

  9. Reaping benefits from intellectual capital.

    Science.gov (United States)

    Weston, Marla J; Estrada, Nicolette A; Carrington, Jane

    2007-01-01

    The wealth and value of organizations are increasingly based on intellectual capital. Although acquiring talented individuals and investing in employee learning adds value to the organization, reaping the benefits of intellectual capital involves translating the wisdom of employees into reusable and sustained actions. This requires a culture that creates employee commitment, encourages learning, fosters sharing, and involves employees in decision making. An infrastructure to recognize and embed promising and best practices through social networks, evidence-based practice, customization of innovations, and use of information technology results in increased productivity, stronger financial performance, better patient outcomes, and greater employee and customer satisfaction.

  10. Capital-as-a-Service?

    OpenAIRE

    Rosa, Frederico

    2013-01-01

    The global financial crisis of 2007-2008 changed the landscape of financing a business, affecting all projects that are looking for growth based on access to capital. Non-bank finance and new forms of equity access started to emerge not only for attractive born-global start-ups but also for smaller SME´s with sound and sustainable business plans, creating a stronger link between capital and knowledge. This article aims to open a reflection on the future of the sources of financing for an entr...

  11. Capital-as-a-Service?

    OpenAIRE

    Rosa, Frederico

    2013-01-01

    The global financial crisis of 2007-2008 changed the landscape of financing a business, affecting all projects that are looking for growth based on access to capital. Non-bank finance and new forms of equity access started to emerge not only for attractive born-global start-ups but also for smaller SME´s with sound and sustainable business plans, creating a stronger link between capital and knowledge. This article aims to open a reflection on the future of the sources of financing for an ent...

  12. Navigating today's opportunities for capital.

    Science.gov (United States)

    Sandrick, Karen M

    2008-12-01

    Today's lending dynamics are leading many hospitals to revisit their strategies for accessing capital: Fixed-rate bonds will likely be a centerpiece of just about any organization's capital structure going forward. Joint partnerships with physicians may provide opportunity for specific service-line strength without heavy investment in facility and equipment. Many hospitals are evaluating the sale of noncore and core assets as well as the use of ground leases or arrangements that would permit them to repurchase the assets at a later time.

  13. Capital humano y capacidad humana Human capital and human capacity

    Directory of Open Access Journals (Sweden)

    Sen Amartya Kumar

    1998-12-01

    Full Text Available En este articulo se examinan las relaciones y diferencias entre el concepto de 'capital humano' y el concepto de 'capacidad humana'. El concepto de capital humano es mas limitado puesto que solo concibe las cualidades humanas en su relación con el crecimiento económico mientras que el concepto de capacidades da énfasis a la expansión de libertad humana para vivir el tipo de vida que la gente considera valedera. Cuando se adopta esa visión mas amplia, el proceso de desarrollo no puede verse simplemente como un incremento del PIB sino como la expansión de la capacidad humana para llevar una vida mas libre y mas digna.In this article the relationships and the differences between the concept of 'human capital' and the concept of 'human capability' are examined. The concept of human capital is more limited since it only conceives human qualities in relation to economic growth, whereas the concept of capabili ties puts emphasis on the expansion of human freedom to live the kind of life that people judge valuable. Whenthis broader vision is adopted, the process of development cannot be seen as simply an increase in the GNP, but rather as the expansion of the human capability to live a more free and worthy life.

  14. ¿Necesitamos capital social? Sí, pero socializando el capital

    Directory of Open Access Journals (Sweden)

    Silvio Salej Higgins

    2005-07-01

    Full Text Available A partir de O Capital S ocia! está na moda: aná!isepara sua reconstruido teórica (Salej: 2003, ofrecemos una sinopsis sobre la arquitectura teórica de uno de los conceptos más utilizados en las ciencias sociales durante la última década. En el nivel de la discusión sobre las transformaciones de las democracias del primer mundo (putnam: 2001, cuestionamos la tesis básica de que la merma del asociativismo cívico es el resultado de la modernización tecnológica y su concomitante cultura individualista. Por el contrario y en la misma linea de Rothstein (2001, construimos la hipótesis de que la disminución del capital social, denunciada por Putnam (1995, es correlativa al desmantelamiento de las políticas de asistencia social, con la consecuente caída en los indicadores de equidad. De modo prospectivo se presentan las preguntas- clave y las hipótesis para un programa de investigación alternativo y plausible sobre el capital social. Palabras clave: capital social, asociativismo cívico, integración social, equidad.

  15. Measuring Social Capital Accumulation in Rural Development

    DEFF Research Database (Denmark)

    Teilmann, Kasper

    2012-01-01

    Using a theoretical framework, the study proposes an index that can measure the social capital of local action group (LAG) projects. The index is founded on four indicators: number of ties, bridging social capital, recognition, and diversity, which are aggregated into one social capital index. Th...... capital, and a high level of motivation leads to increased social capital........ The index has been tested in LAG-Djursland, Denmark, and the study further investigates whether the organisational affiliation, project financing, and LAG co-financing can explain the degree of social capital accumulation. Furthermore, the author has tested if there are connections between motivation...

  16. Can femoral dialysis catheter insertion cause a life threatening complication?

    Directory of Open Access Journals (Sweden)

    Nurkay Katrancıoğlu

    2014-09-01

    Full Text Available Venous catheter (VC insertion may be necessary for the patients with renal failure facing vascular access problem. Femoral VCs are commonly used for their lower complication rates especially in emergency clinics. The incidence of bleeding associated with VC is reported 0.5-1.6%, however, life threatening hemorrhage and complications requiring surgical intervention are very rare. In this manuscript, we aimed to present a case with hemolytic uremic syndrome complicated with retroperitoneal hematoma after femoral VC insertion. J Clin Exp Invest 2014; 5 (3: 472-474

  17. Postoperative hemoglobin level in patients with femoral neck fracture

    OpenAIRE

    Nagra, Navraj; van Popta, Dmitri; Whiteside, Sigrid; Holt, Edward

    2018-01-01

    Objective: The aim of this study was to analyze the changes of hemoglobin levels in patients undergoing fixation for femoral neck fracture.Methods: Peroperative hemoglobin levels of patients who underwent either dynamic hip screw (DHS) fixation (n=74; mean age: 80 years) or hip hemiarthroplasty (n=104; mean age: 84 years) for femoral neck fracture was monitored.Results: There was a statistically and clinically significant mean drop of 31.1 g/L between the preoperative (D0) and postoperative D...

  18. Repair of femoral trochanteric osteotomy in the dog

    International Nuclear Information System (INIS)

    Whitelock, R.G.; Dyce, J.; Houlton, J.E.F.

    1997-01-01

    The records and radiographs of 24 dogs that underwent femoral trochanteric osteotomy repair were reviewed. Osteotomy repair was performed with either a pin and tension band wire or a lag screw technique. Significant clinical complications associated with the osteotomy were identified in one dog (4 per cent) six weeks after surgery, although abnormal radiographic changes were evident in 15 dogs (62 per cent). The method of repair did not influence healing and there were comparable radiographic complication rates. It is concluded that femoral trochanteric osteotomy is not associated with significant clinical problems, despite a high incidence of abnormal radiographic findings

  19. Avascular necrosis associated with nailing of femoral neck fracture

    International Nuclear Information System (INIS)

    Stroemqvist, B.; Hansson, L.I.

    1983-01-01

    Two patients with femoral neck fractures, one displaced and one undisplaced, are presented. Preoperative intravital staining with tetracycline and Tc-MDP scintimetry both showed intact femoral head circulation while Tc-MDP-scintimetry 1 week after operation showed pronounced circulatory deficiency. SR 85 -scintimetry performed at the same time was inconclusive. Segmental collapse was observed radiographically, 8 and 12 months postoperatively. The major vascular injury resulting in avascularity most probably occured during the procedure of osteosynthesis, and Tc-MDP-scintimetry was found suitable for early postoperative recognition of avascular necrosis in both fractures. (author)

  20. Identification of avascular necrosis in the dysplastic proximal femoral epiphysis

    International Nuclear Information System (INIS)

    Mandell, G.A.; Harcke, H.T.; MacKenzie, W.G.; Bassett, G.S.; Scott, C.I. Jr.; Wills, J.S.

    1989-01-01

    Bilateral radiographic irregularities and deformities of the proximal femoral epiphyses are features of both multiple epiphyseal dysplasia and bilateral idiopathic avascular necrosis. In the past these entities have been difficult to differentiate. This report documents radiographically the occurrence of avascular necrosis in 10 patients with multiple epiphyseal dysplasia by recognizing the superimposition of sclerosis and subchondral fissuring on pre-existing symmetrically irregular proximal femoral ossification centers. Scintigraphic (photopenia) or magnetic resonance (loss of signal) criteria of avascular necrosis confirm its added presence and help to establish an imaging scheme to identify avascular necrosis superimposed on multiple epiphyseal dysplasia. (orig.)

  1. [SURGICAL HIP DISLOCATION APPROACH FOR TREATMENT OF FEMORAL HEAD FRACTURE].

    Science.gov (United States)

    Tang, Yanfeng; Liu, Youwen; Zhu, Yingjie; Li, Jianming; Li, Wuyin; Li, Qiyi; Jia, Yudong

    2015-11-01

    To discuss the value of surgical hip dislocation approach in the treatment of femoral head fracture. A retrospectively analysis was made on the clinical data of 15 patients with femoral head fractures treated through surgical hip dislocation approach between January 2010 and February 2013. There were 11 men and 4 women with an average age of 30.8 years (range, 15-63 years). The causes included traffic accident injury in 9 cases, falling injury from height in 5 cases, and sports injury in 1 case. According to Pipkin typing, 2 cases were rated as type I, 7 cases as type II, 1 case as type III, and 5 cases as type IV. The interval of injury and operation was 2-10 days (mean, 4.1 days). Reduction was performed in 10 patients within 6 hours after injury, and then bone traction was given for 4-6 weeks except 5 patients who received reduction in the other hospital. Primary healing of incision was obtained in all patients after surgery without complications of dislocation and lower limbs deep venous thrombosis. The mean follow-up time was 29.9 months (range, 25-36 months). During follow-up, there was no infection, breakage of internal fixation, or nonunion of femoral greater trochanter fracture. In 3 patients having necrosis of the femoral head, 2 had no obvious symptoms [staging as IIa and IIb respectively according to Association Research Circulation Osseous (ARCO) staging system], and 1 (stage IIIb) had nonunion of the femoral neck fracture, who underwent total hip arthroplasty (THA). In 4 patients having myositis ossificans (2 cases of grade I, 1 case of grade II, and 1 case of grade III based on Brooker grading), no treatment was given in 3 cases and the focus was removed during THA in 1 case. According to the Thompson-Epstein scale at last follow-up, the results were excellent in 9 cases, good in 3 cases, fair in 1 case, and poor in 2 cases, and the excellent and good rate was 80%. Surgical hip dislocation approach can not only protect the residual vessels of the

  2. Osteochondral Fracture Lateral Femoral Condyle Treated with ORIF Using Z-Plasty: A Modification of Coonse and Adams Approach

    Directory of Open Access Journals (Sweden)

    Sanjay Agarwala

    2011-01-01

    Full Text Available Osteochondral fractures of lateral femoral condyle are common in adolescents and young adults. They are usually caused by direct trauma or twisting injuries of the knee. We present a case of large osteochondral fracture of lateral femoral condyle involving the articular surface in a fifteen-year-old male with a positive history of significant weight gain of 5 kilograms in last six months. Blood investigations reported low vitamin D and testosterone levels with elevated alkaline phosphatase. Adequate exposure was achieved by doing Z-plasty of quadriceps apparatus. The fracture was treated with open reduction and internal fixation using Herbert's screws. Medical management in the form of vitamin D and calcium along with testosterone was given. After the surgery, full weight-bearing was allowed at three months. At one year followup, patient has good quadriceps function without any weakness of the muscle.

  3. Bone mineral density of the femoral neck in resurfacing hip arthroplasty.

    Science.gov (United States)

    Penny, Jeannette Østergaard; Ovesen, Ole; Brixen, Kim; Varmarken, Jens-Erik; Overgaard, Søren

    2010-06-01

    Resurfacing total hip arthroplasty (RTHA) may preserve the femoral neck bone stock postoperatively. Bone mineral density (BMD) may be affected by the hip position, which might bias longitudinal studies. We investigated the dependency of BMD precision on type of ROI and hip position. We DXA-scanned the femoral neck of 15 resurfacing patients twice with the hip in 3 different rotations: 15 degrees internal, neutral, and 15 degrees external. For each position, BMD was analyzed with 3 surface area models. One model measured BMD in the total femoral neck, the second model divided the neck in two, and the third model had 6 divisions. When all hip positions were pooled, average coefficients of variation (CVs) of 3.1%, 3.6%, and 4.6% were found in the 1-, 2-, and 6-region models, respectively. The externally rotated hip position was less reproducible. When rotating in increments of 15 degrees or 30 degrees , the average CVs rose to 7.2%, 7.3%, and 12% in the 3 models. Rotation affected the precision most in the model that divided the neck in 6 subregions, predominantly in the lateral and distal regions. For larger-region models, some rotation could be allowed without compromising the precision. If hip rotation is strictly controlled, DXA can reliably provide detailed topographical information about the BMD changes around an RTHA. As rotation strongly affects the precision of the BMD measurements in small regions, we suggest that a less detailed model should be used for analysis in studies where the leg position has not been firmly controlled.

  4. Morpho-functional study of ionizing radiation effects on the rabbits' femoral vein

    International Nuclear Information System (INIS)

    Sakiyama, Mauro Yoshimitsu

    1995-01-01

    In this study we evaluate the effects of the ionizing radiation on the rabbits femoral vein. The samples of femoral vein were obtained from 56 New Zealand rabbits, male with ageing from 90 to 120 days, that were divided into 4 groups of 14 animals: one control group non-irradiated and three animal groups sacrificed 2 days, 14 days and 90 days after irradiation. In the three irradiated rabbits groups, each animal received the total dose 4000 cGy (rads) divided in 10 sessions of 400 cGy, a dose equivalent that utilized on clinical therapeutic. A morpho functional study of vein samples was carried out with: light microscopy: stained by hematoxin - eosin, Masson's tricromic, and Verhoeff. Immunohistochemical: reactions of immunoperoxidase with monoclonal mouse anti-human endothelial cell factor CD-31 and anti-human Von Willebrand factor (factor VIII), to study the vein endothelium. Histomorphometry of elastic fiber system stained by Weigert's resorcin-fuchsin with and without prior oxidation with oxone; for the study of mature, elaunin or pre-mature and oxytalan or young elastic fibers. Electronic microscopy: transmission and scanning. With the methodology utilized we observe changes in the femoral vein of the animals submitted to irradiation in relation to the control group, thus described: there is formation of vacuoles between the endothelium and the basal membrane, called sub endothelial vacuoles, in focal areas. The factor VIII and CD-31 endothelial antigens are preserved with no changes in their functions. Focal alterations are present in the endothelial surface with disorder in the setting and orientation of the endothelial cells. there is degeneration of the elastic fibers with significant decrease in their quantity in the stage, 2 days and 14 days after irradiation. There is increase in the quantity of elastic fibers in the late stage, 90 days after irradiation, tending to normality. In this present study, the changes described are not accompanied by venous

  5. Real Capital: Complementarity and Structural Characteristics

    Directory of Open Access Journals (Sweden)

    Miriasov Iurii О.

    2016-05-01

    Full Text Available Two opposite approaches to the concept of real capital are considered. The presupposition for studying capital within the neoclassical school, which can be characterized as “empirical realism”, is the homogeneity of capital. This allows to apply formal methods of studying and modeling industrial processes but excludes from consideration the properties and characteristics of capital as a real factor of production. The approach of the Austrian school corresponding to traditions of “critical realism” in the economy focuses on real properties of capital and its role in the process of public production. The aim of this study is to clarify the idea of real capital, its properties, structural characteristics and mechanisms of formation. According to this, the characteristic of two different approaches is given. It is shown that the heterogeneity of capital is the basis of complementarity of capital goods and their combinations in each particular case of their application. The same capital goods have different performance depending on the method of their combination as a result of the production plans of entrepreneurs. Emergent properties of capital are also the result of the combination. Differences in the use and combination of capital determine its overall structure, subsystems of which are natural objects at different levels included in the production, capital goods themselves and their various combinations, social capital. Each of these subsystems is relatively independent and forms a higher level subsystem.

  6. Combined antegrade femoral artery and retrograde popliteal artery recanalization for chronic occlusions of the superficial femoral artery.

    Science.gov (United States)

    Shi, Weihao; Yao, Ye; Wang, Wei; Yu, Bo; Wang, Song; Que, Huafa; Xiang, Huanyu; Li, Qiong; Zhao, Qiufeng; Zhang, Zhen; Xu, Jienan; Liu, Xiaodong; Shen, Liang; Xing, Jie; Wang, Yunfei; Shan, Wei; Zhou, Jie

    2014-09-01

    To evaluate the efficacy and safety of a dual femoral-popliteal approach in the supine position after failed antegrade recanalization attempts in chronic total occlusion (CTO) of the superficial femoral artery (SFA). From May 2011 to October 2012, 21 patients underwent dual femoral-popliteal recanalization for CTO of the SFA, with a mean lesion length of 87.4 mm ± 5.8. When contralateral antegrade recanalization of SFA occlusions via the common femoral artery could not be achieved, the occlusions were intrainterventionally accessed by retrograde approach via the popliteal artery, which was punctured anteriorly with gently flexed knee and crus extorsion. When the SFA had been recanalized, further angioplasty and stent placement procedures were completed via the femoral artery. A technical success rate of 100% (entailing puncture of the popliteal artery and SFA recanalization) was achieved, and no hemorrhage, hematoma, pseudoaneurysm, arteriovenous fistula, or other complications developed. During a mean follow-up of 9.8 months ± 1.5, claudication severity, rest pain, and toe ulcers improved significantly. The pulse of the distal arteries, as well as the filling of the veins, could be distinctly felt. Ankle-brachial index changed from 0.48 ± 0.17 to 0.84 ± 0.11 at 1 year after intervention (P < .001), and patency rates at 1, 6, and 12 months after interventions were 100%, 80%, and 42%, respectively. A dual femoral-popliteal approach in the supine position is an alternative backup option after failed attempts at the antegrade approach for patients with proximal barriers in CTO or lesions with major extending collateral vessels. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

  7. The stability of the femoral component of a minimal invasive total hip replacement system.

    NARCIS (Netherlands)

    Willems, M.M.M.; Kooloos, J.G.M.; Gibbons, P.; Minderhoud, N.; Weernink, T.; Verdonschot, N.J.J.

    2006-01-01

    In this study, the initial stability of the femoral component of a minimal invasive total hip replacement was biomechanically evaluated during simulated normal walking and chair rising. A 20 mm diameter canal was created in the femoral necks of five fresh frozen human cadaver bones and the femoral

  8. Increased risk of intraoperative and early postoperative periprosthetic femoral fracture with uncemented stems

    DEFF Research Database (Denmark)

    Lindberg-Larsen, Martin; Jørgensen, Christoffer C; Solgaard, Søren

    2017-01-01

    .4 per 10 years, CI: 1.2-1.6) were associated with increased risk of periprosthetic femoral fracture when analyzed using multivariable regression analysis. Interpretation - Uncemented femoral components were associated with an increased risk of early periprosthetic femoral fractures, especially...

  9. Evaluation in femoral neck fracture scintimetry: modes of region of interest selection and influence on results

    Energy Technology Data Exchange (ETDEWEB)

    Holmberg, S.; Mesko, L.; Stroemqvist, B.; Thorngren, K.G.

    1985-04-01

    Different sized ROIs within the femoral head and different modes of calculation were used in (/sup 99m/Tc)MDP scintimetry after femoral neck fracture. In preoperative scintimetry, correction for increased trochanteric uptake gave the best discrimination, whereas in postoperative scintimetry the direct ratio fractured/intact femoral head was superior. The change in ROI size had little influence.

  10. Evaluation in femoral neck fracture scintimetry: modes of region of interest selection and influence on results

    International Nuclear Information System (INIS)

    Holmberg, S.; Mesko, L.; Stroemqvist, B.; Thorngren, K.G.

    1985-01-01

    Different sized ROIs within the femoral head and different modes of calculation were used in [/sup 99m/Tc]MDP scintimetry after femoral neck fracture. In preoperative scintimetry, correction for increased trochanteric uptake gave the best discrimination, whereas in postoperative scintimetry the direct ratio fractured/intact femoral head was superior. The change in ROI size had little influence

  11. THE INTELLECTUAL CAPITAL OF UNIVERSITIES

    Directory of Open Access Journals (Sweden)

    Bratianu Constantin

    2009-05-01

    Full Text Available The purpose of this paper is to present some of our research results concerning the intellectual capital of universities. This is an important topic of the intellectual research area since universities are knowledge intensive organizations. They contain b

  12. Varieties of capitalism in crisis?

    DEFF Research Database (Denmark)

    Bruff, Ian; Horn, Laura

    2012-01-01

    In this introduction to the special issue, we provide a brief overview of the two distinct but connected meanings of the phrase ‘varieties of capitalism in crisis’: (1) the crisis of empirical political economies under conditions of capitalist diversity; and (2) the crisis of the institutionalist...

  13. Building Social Capital for Internationalization

    Directory of Open Access Journals (Sweden)

    Suzana Braga Rodrigues

    2012-01-01

    Full Text Available Social capital may be defined as social relationships that confer actual or potential benefits. It can therefore beunderstood as a particular type of resource. Recent research has drawn attention to how connections andrelationships (networking both at home and abroad can be crucially important for small and medium-sizedenterprises (SMEs seeking to export or invest abroad. However, relatively little is known about how SMEsinitiate, develop and maintain network relationships. This paper reports a study of 32 British SMEs exporting, orattempting to export, to Brazil and of domestic institutional agencies whose role was to facilitate businessconducted between British and Brazilian SMEs. The study explored both the functions of social capital for theSMEs and the process whereby it was developed. Its findings confirm the value of social capital in internationalentrepreneurship. It can provide information, interpretation, market opportunities, and some degree of protectionagainst the risks associated with foreignness, newness and smallness. The study also confirms the vitalimportance of personal trust in sustaining social capital between small firms.

  14. Capital Punishment: An International Perspective.

    Science.gov (United States)

    Kaufman, Edy

    1983-01-01

    The debate over the death penalty in the United States has implications beyond our borders. Because of the lack of universal standards governing its use, only those countries which have abolished capital punishment may, with any moral authority, denounce its exploitation as an instrument of political expediency. (IS)

  15. Social Capital, Institutions and Trust

    NARCIS (Netherlands)

    Nooteboom, B.

    2006-01-01

    This paper analyzes the relations between social capital, institutions and trust.These concepts are full of ambiguity and confusion.This paper attempts to dissolve some of the confusion, by distinguishing trust and control, and analyzing institutional and relational conditions of trust.It presents a

  16. Measurement of individual social capital

    NARCIS (Netherlands)

    Gaag, Martin Pieter Johannes van der

    2005-01-01

    The last twenty years have seen the idea of social capital blossoming as a popular and promising new look at phenomena in the social sciences. Essentially a theory that explains how and why relational networks are important for the production of outcomes at the individual and collective level,

  17. Business model and Intellectual Capital

    DEFF Research Database (Denmark)

    Lindgren, Peter; Saghaug, Kristin Margrethe

    2012-01-01

    When practicing business model (BM) innovation releasing intellectual capital (IC) strategically from SME´s BMs through the innovation process can be extremely difficult and complex to carry out especially to small and medium size enterprises (SME). There are so many opportunities and resources i...

  18. School Cheating and Social Capital

    Science.gov (United States)

    Paccagnella, Marco; Sestito, Paolo

    2014-01-01

    In this paper we investigate the relationship between social capital and cheating behaviour in standardized tests. Given the low-stakes nature of these tests, we interpret the widespread presence of cheating as a signal of low trust towards central education authorities and as lack of respect for the rule of law. We find that cheating is…

  19. Impression management as symbolic capital

    DEFF Research Database (Denmark)

    Lueg, Klarissa; Nielsen, Camilla

    2015-01-01

    Social Network Sites (SNS) play an increasingly important role in the European business world, especially with respect to cross-cultural impression management. Departing from the Bourdieusian concept of “capital,” this paper analyzes the differences in the use of two popular business SNS: XING...

  20. Natural capital must be defended

    NARCIS (Netherlands)

    Fletcher, Robert; Dressler, Wolfram H.; Anderson, Zachary R.; Büscher, Bram

    2018-01-01

    This contribution addresses the growing global trend to promote ‘natural capital accounting’ (NCA) in support of environmental conservation. NCA seeks to harness the economic value of conserved nature to incentivize local resource users to forgo the opportunity costs of extractive activities. We

  1. Real Assets and Capital Structure

    NARCIS (Netherlands)

    Campello, M.; Giambona, E.

    2013-01-01

    We characterize the relation between asset structure and capital structure by exploiting variation in the salability of corporate assets. To establish this link, we distinguish across different assets in firms’ balance sheets (machinery, land, and buildings) and use an instrumental approach that

  2. Productivity spillovers of organization capital

    NARCIS (Netherlands)

    Chen, Wen; Inklaar, Robert

    Investments in organization capital increase productivity of not just the investing firm but could also spillover to other firms-similar to investments in research and development. Recent evidence at the industry and economy level suggests such spillovers could be important. In this paper, we fail

  3. 76 FR 74631 - Capital Plans

    Science.gov (United States)

    2011-12-01

    ...)). During the years leading up to the recent financial crisis, many bank holding companies made significant... has long held the view that bank holding companies generally should operate with capital positions... company experiencing financial distress must take specific remedial actions in order to minimize the...

  4. Social capital and community heterogeneity

    NARCIS (Netherlands)

    Coffé, Hilde R.

    2009-01-01

    Abstract Recent findings indicate that more pronounced community heterogeneity is associated with lower levels of social capital. These studies, however, concentrate on specific aspects in which people differ (such as income inequality or ethnic diversity). In the present paper, we introduce the

  5. Social Capital and Community Heterogeneity

    Science.gov (United States)

    Coffe, Hilde

    2009-01-01

    Recent findings indicate that more pronounced community heterogeneity is associated with lower levels of social capital. These studies, however, concentrate on specific aspects in which people differ (such as income inequality or ethnic diversity). In the present paper, we introduce the number of parties in the local party system as a more…

  6. Solow Residuals Without Capital Stocks

    DEFF Research Database (Denmark)

    Burda, Michael C.; Severgnini, Battista

    2014-01-01

    We use synthetic data generated by a prototypical stochastic growth model to assess the accuracy of the Solow residual (Solow, 1957) as a measure of total factor productivity (TFP) growth when the capital stock in use is measured with error. We propose two alternative measurements based on current...

  7. Economic Analysis of Social Common Capital

    Science.gov (United States)

    Uzawa, Hirofumi

    2005-06-01

    Social common capital provides members of society with those services and institutional arrangements that are crucial in maintaining human and cultural life. The term æsocial common capital' is comprised of three categories: natural capital, social infrastructure, and institutional capital. Natural capital consists of all natural environment and natural resources including the earth's atmosphere. Social infrastructure consists of roads, bridges, public transportation systems, electricity, and other public utilities. Institutional capital includes hospitals, educational institutions, judicial and police systems, public administrative services, financial and monetary institutions, and cultural capital. This book attempts to modify and extend the theoretical premises of orthodox economic theory to make them broad enough to analyze the economic implications of social common capital. It further aims to find the institutional arrangements and policy measures that will bring about the optimal state of affairs.

  8. Hospital Capital Investment During the Great Recession

    Science.gov (United States)

    Choi, Sung

    2017-01-01

    Hospital capital investment is important for acquiring and maintaining technology and equipment needed to provide health care. Reduction in capital investment by a hospital has negative implications for patient outcomes. Most hospitals rely on debt and internal cash flow to fund capital investment. The great recession may have made it difficult for hospitals to borrow, thus reducing their capital investment. I investigated the impact of the great recession on capital investment made by California hospitals. Modeling how hospital capital investment may have been liquidity constrained during the recession is a novel contribution to the literature. I estimated the model with California Office of Statewide Health Planning and Development data and system generalized method of moments. Findings suggest that not-for-profit and public hospitals were liquidity constrained during the recession. Comparing the changes in hospital capital investment between 2006 and 2009 showed that hospitals used cash flow to increase capital investment by $2.45 million, other things equal. PMID:28617202

  9. National Capital Planning Commission Library contents

    Data.gov (United States)

    National Capital Planning Commission — The National Capital Planning Commission library catalog is a compilation of titles, authors, years of publication and topics of books, reports and NCPC publications.

  10. Hospital Capital Investment During the Great Recession.

    Science.gov (United States)

    Choi, Sung

    2017-01-01

    Hospital capital investment is important for acquiring and maintaining technology and equipment needed to provide health care. Reduction in capital investment by a hospital has negative implications for patient outcomes. Most hospitals rely on debt and internal cash flow to fund capital investment. The great recession may have made it difficult for hospitals to borrow, thus reducing their capital investment. I investigated the impact of the great recession on capital investment made by California hospitals. Modeling how hospital capital investment may have been liquidity constrained during the recession is a novel contribution to the literature. I estimated the model with California Office of Statewide Health Planning and Development data and system generalized method of moments. Findings suggest that not-for-profit and public hospitals were liquidity constrained during the recession. Comparing the changes in hospital capital investment between 2006 and 2009 showed that hospitals used cash flow to increase capital investment by $2.45 million, other things equal.

  11. Spare Parts Management of Aging Capital Products

    NARCIS (Netherlands)

    M. Hekimoğlu (Mustafa)

    2015-01-01

    textabstractSpare parts are critical for operations of capital products such as aircraft, refineries, trucks, etc/, which require maintenance regularly. Original Equipment Manufacturers (OEMs) bear the responsibility of undisrupted maintenance service and spare parts flow for their capital products.

  12. Staged Financing in Venture capital market.

    OpenAIRE

    Damania, Priti

    2009-01-01

    The report shows the venture capital decision making in staged financing from a real option perspective. The report also describes entrepreneur-venture capital relationship from a prisoner's dilemma approach.

  13. Real Options and Human Capital Investment

    OpenAIRE

    Bas Jacobs

    2007-01-01

    This paper extends the standard human capital model with real options. Real options influence investment behavior when risky investments in human capital are irreversible and individuals can affect the timing of the investment. Option values make individuals more reluctant to invest in human capital and, as a result, required returns on the investment increase. Real options may help to explain a larger human capital premium for higher education, smaller responsiveness of higher education inve...

  14. Capital goods trade and economic development

    OpenAIRE

    Mutreja, Piyusha; Ravikumar, B.; Sposi, Michael J.

    2014-01-01

    Almost 80 percent of capital goods production in the world is concentrated in 10 countries. Poor countries import most of their capital goods. We argue that international trade in capital goods has quantitatively important effects on economic development through two channels: (i) capital formation and (ii) aggregate TFP. We embed a multi country, multi sector Ricardian model of trade into a neoclassical growth model. Barriers to trade result in a misallocation of factors both within and acros...

  15. Sex determination from femoral head diameters in black Malawians ...

    African Journals Online (AJOL)

    Objectives: To determine the sex of black Malawians from femoral head diameters. Design: A retrospective study on patients investigated in three x-ray departments. Setting: Radiographs were collected from the archives of Queen Elizabeth Central, Chikwawa and Balaka hospitals. Subject: X-ray films of 496 pelves of adult ...

  16. Femoral nailing in adults : doctor and patient reported outcomes

    NARCIS (Netherlands)

    El Moumni, Mostafa

    2016-01-01

    The treatment of traumatic femoral shaft fractures using an unreamed nail is associated with good results. Both antegrade and retrograde unreamed nailing techniques result in high union rates and low rates of complications, such as non-union, deep infection and septic arthritis. These results are

  17. Treatment of femoral neck fracture by Moore Prosthesis in Cotonou ...

    African Journals Online (AJOL)

    Treatment of femoral neck fracture by Moore Prosthesis in Cotonou. AHM Akue, M Lawson, S Madougou, R Zannou, J Padonou. Abstract. Keywords: Benin; hip; Moore prosthesis; results. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  18. Isolated femoral hypoplasia: an intrauterine differential diagnosis to campomelia

    Energy Technology Data Exchange (ETDEWEB)

    Koerber, Friederike; Benz-Bohm, Gabriele [University of Cologne, Department of Paediatric Radiology, Cologne (Germany); Schoenau, Eckard [University of Cologne, Department of Paediatrics, Cologne (Germany); Horwitz, A.Eldad [Klinikum Krefeld, Department of Paediatric Radiology, Krefeld (Germany)

    2005-06-01

    The isolated form of femoral bowing is an important differential diagnosis of campomelia. Therefore, knowledge of isolated anomalies is fundamental for prenatal diagnosis, especially for the differential diagnosis from severe syndromes. Four cases are presented to discuss the differential diagnosis of femoral bowing including a review of the literature. We report four newborn babies with unilateral bowing and shortening of the femur. Three had no further anomaly; one child had additional abnormalities due to coumarin embryopathy. The radiological findings were shortened femora with bowing and varus deformity and cortical thickening on the concave side. All other parts showed normal bone structure. The aetiology of femoral bowing is unknown. Early damage of the cartilaginous model followed by remodelling with thickening on the concave side of the bone similar to the healing of malaligned fractures is suspected. The isolated form of femoral bowing without any other anomalies has to be differentiated from complex and more often severe congenital syndromes such as campomelia. Postpartum radiological examination should be reduced to a single exposure of the affected limb and follow-up should be done by clinical examination. (orig.)

  19. Incidental finding of hypertension and diminished femoral pulses ...

    African Journals Online (AJOL)

    2012-06-08

    Jun 8, 2012 ... Case Study: Incidental finding of hypertension and diminished femoral pulses. 168. Vol 55 No 2. S Afr Fam Pract 2013. Introduction. Coarctation of the aorta is ... Surgery of the aorta and its branches. Philadelphia: WB Saunders Company, 2000; p. 3-10. 2. Rao PS. Coarctation of the aorta. Curr Cardiol Rep.

  20. Incidental finding of hypertension and diminished femoral pulses ...

    African Journals Online (AJOL)

    Incidental finding of hypertension and diminished femoral pulses: short-segment stenosis of the aorta just distal to the origin of the left subclavian artery. ... Young patients may present within the first few weeks of life with poor feeding, tachypnea and lethargy. They usually progress to overt congestive heart failure and shock.