Partial Fracture Research Articles

Stereomicroscopic Evaluation of Microcrack Formation in Dentin by ProTaper Next, Revo S, and WaveOne Gold File System.

Background:During the biomechanical preparation of the root canal by rotary file systems, stress is generated within the canal, which leads to dentinal microcrack formation. Such defects are evaluated only under the microscope.Aim:The present study aimed to evaluate dentinal microcrack formation after instrumentation with ProTaper Next (M-wire), Revo S (conventional NiTi), and WaveOne Gold (Gold-wire) file systems under the stereomicroscope.Materials and Methods:Forty single-rooted teeth free from any defect were selected and divided into four groups (Control, PTN, RS, and WOG). Experimental groups were instrumented with file system used in the study, and the control group were left unprepared. Samples were further decoronated and sectioned at 3 mm, 6 mm, and 9 mm from the apex perpendicular to the long axis and examined under a stereomicroscope at ×25 for different types of microcracks (no fracture, complete fracture, partial fracture, and other fracture).Statistical Analysis Used:Data analysis was done by the Chi-square test using the SPSS version 17.0 software. A two-sided (α = 2) P < 0.05 (P < 0.05) was considered statistically significant.Results:The null hypothesis was rejected. There was a statistically significant difference between the groups. All file systems created microcracks in the root dentin. WOG group showed an incidence of 66.7% for no fracture, PTN group had 40% for other fracture, and RS group had 60% for complete fracture.Conclusion:Single file system WOG with gold wire technology proves to be the best choice for canal preparation among the tested groups in terms of least dentinal crack formation.

Displaced three and four part proximal humeral fractures: prospective controlled randomized open-label two-arm study comparing intramedullary nailing and locking plate.

The aim of this study was (1) to compare clinical and radiological outcomes of 3- and 4-part proximal humeral fractures using either IMN or LP (2) and to report complications related to each technique. A prospective controlled randomized open-label two-arm study was performed. Ninety-nine consecutive adult patients with a 3- and 4-part displaced acute proximal humeral fractures were randomized to be treated with IMN (n = 49) or LP (n = 50). Constant, ASES and SST scores were recorded by the surgeon. Range of motion was evaluated. A visual analog scale (VAS) was used to assess shoulder pain. Complications and revision surgeries were reported. Eighty-five patients were analyzed, nine were lost, and five died during the follow-up period. The mean age was 73.7years (± 13.3,, and the mean follow-up was 66months (± 13.5). At last follow-up, VAS was lower in the IMN group (0.9 (± 1.1) vs. 1.9 (± 1.7), p = 0.001). The median Constant score was significantly higher in the IMN group (81.6 (± 10.9) points) vs. in the LP group (75.6 (± 19.5) points) (p = 0.043), and ASES score was also significantly higher in the IMN group (86.3 (± 9.5) vs. 75.2 (± 19.6), p = 0.001). There was no difference in the range of motion or SST scores between the two groups. Complications were seen higher in the LP group (9 (21%) vs. 22 (52%), p = 0.003). Revision surgery was higher in the LP group (37% vs. 21%). Satisfactory results were accomplished in both groups according to the reported clinical outcomes. Complication and revision rates were higher in LP group.

Assessment of efficacy of locking compression plate in distal femur fractures

Background: Distal femur fractures account for an estimated 6% of all femur fractures. Our study aims at evaluating the functional and radiological outcome in distal femur fractures treated with locking compression plate (DF-LCP).Methods: Patients undergoing LCP were assessed postoperatively both functionally and radiologically. Oxford Knee Score was used to assess the functional outcome. With a maximum score of 48, a score of more than 41 is scaled as excellent, 34 to 40 as good functional status, 27 to 33 as fair and score less than 27 as poor functional result.Results: Extra-articular fractures were the commonest (66.7%) type of fractures [simple-6.7%; metaphyseal wedge-20%; metaphyseal complex-40%] followed by complete articular fractures (26.7%) [Simple articular metaphyseal comminution-16.7%; metaphyseal and intra-articular comminution-10%] and partial articular fractures (6.7%) [Medial condyle-3.3%; coronal plane-3.3%]. Most of them had right sided femur injury (66.7%) and had history of fall (70%). Radiologically, 90% exhibited no complications and had united appropriately. Functionally the mean oxford knee score was 41.53±1.69 which ranged from a score of 38 to a maximum of 44. Highest proportion i.e., 63.3% had excellent outcome followed by good functional outcome and none showed fair or poor outcomes.Conclusions: LCP has shown very good radiological and functional outcomes with hundred percent union of the distal femur fractures. Hence it can be used successfully in distal femur fractures.

Failure analysis of articulated paddings at crossing interface between crossing cable and crossed pipeline

While subsea crossings are undesirable for many reasons, they are unavoidable due to the sheer density of subsea assets . The use of articulated paddings is a cost-effective and practical method to achieve the required vertical separation between the crossing and the crossed pipelines or cables, though, not without limitations. In this paper, the failure of articulated padding at several points along a subsea cable in operation was investigated. The articulated padding has experienced partial fractures at numerous crossing locations and in some places has fallen off the cable completely. A complete failure mode analysis was conducted where several possible modes of failure were considered in detail. In-place finite element (FE) analyses of the articulated padding components and the corresponding environment were also performed. The FE modelling concluded that the original design loads were significantly lower than the expected worst-case load scenarios. To replicate the failure mode, two abrasion tests were also conducted and the results of which were studied. It was concluded that the predominant failure mode (partial fracture to the articulated padding discs) was likely a combination of the increased dynamic loads, excessive lateral movement causing unexpected levels of fretting, unbalanced free span causing unexpected stress concentration factors and reduction in material mechanical properties. All above factors have contributed to the root cause of the system failure and instigated the predominant mode of failure “partial fracture”.

Which Fracture Types Are Associated with Widening of the Scapholunate Distance? A CT-Scan Study of Acute Intraarticular Distal Radius Fractures.

Background: Scapholunate injuries in distal radius fractures may frequently be overlooked. The aims of this study were to measure the scapholunate distance in intraarticular distal radius fractures and to find out which fracture types were associated with an increased scapholunate width. Methods: Measurements of the scapholunate distance were performed on computed tomography scans of 143 intraarticular distal radius fractures in 140 patients. The fractures were classified according to the AO classification. The morphology of AO type B fractures was further analysed according to the Bain classification. Results: In 43 AO type B fractures mean scapholunate distance measured 2.1 mm and in 100 type C fractures 1.6 mm. The difference between partial and complete intraarticular fractures was significant. A trend towards a greater scapholunate distance was found in AO type B1 and radial styloid oblique fractures. Conclusions: In this study, partial intraarticular distal radius fractures, especially with a sagittal split, had a greater scapholunate distance and may be at risk for ligamentous injury.

Deformation and Fracture Behaviors in Microscale Laser Dynamic Flexible Forming: The Case of Fabricating Micro-Channel on Copper Foil

The case of fabricating micro-channel on copper foil using micro-scale laser dynamic flexible forming (μLDFF) is investigated in this work. To study the deformation and fracture behaviors, the copper foils are subjected to increasing laser power density until the occurrence of fracture. When laser power density ranges from 0.110 GW/cm2 to 0.441 GW/cm2, smooth micro-channel features are formed on copper foils, and the depth of the micro-channel gradually increases. Melting marks are observed at the micro-die entrance of the sample with 0.441 GW/cm2 laser power density. When laser power density is 0.544 GW/cm2, partial fractures are observed. The surface of fracture region is rougher than that of micro-cracks and no micro-cracks regions, which is caused by the higher strain in fracture region. And the fracture edge is irregular, which is caused by the soft effect of material. Complete fracture occurs when laser power density is 0.691 GW/cm2.

Electromagnetic stirring control for resistance spot welding of SiCp/Al composites

Metal matrix composites (MMCs) have broad application prospects in high-end manufacturing fields. However, as typical MMCs, SiC p /Al composites have poor weldability due to the appearance of brittle phase, crack defects, and segregation phenomenon in the fusion welding process. Hence, this paper provides a magnetically assisted resistance spot welding (MA-RSW) method to achieve the reliable welding of SiC p /Al composites. The experimental results show that the MA-RSW technology can significantly extend the weld lobe by increasing the nugget diameter and decreasing the weld penetration, avoid the appearance of the acicular Al 4 C 3 , eliminate weld defects, and homogenize the distribution of the strengthening phase. This facilitates the transformation of the fracture mode from interfacial fracture (IF) to partial thickness fracture (PTF) at low welding current and to button pull (BP) at high welding current in lap-shear tests. Therefore, the weld strength, ductility, and energy absorption ability are greatly improved.

Outcomes of plate osteosynthesis for displaced 3-part and 4-part proximal humerus fractures with deltopectoral vs. deltoid split approach.

Three part and four-part fractures of the proximal humerus offer challenges in reduction and plate fixation, with considerable debate about use of Deltoid splitting (DS) and Delto-pectoral (DP) approaches, especially when they involving the greater tuberosity. We prospectively compared the results using DS approach and DP approach in these cases, with special focus on functional outcomes, complications, and ease of tuberosity reduction. 84 patients with three- and four-part proximal humerus fracture were alternately allocated the DP approach or DS approach for proximal humerus locking plate fixation. The outcome analysis was done by evaluating relative Constant score and ease of surgical reduction of greater tuberosity; radiological malunion was evaluated using Beredjiklian classification and complications were noted. At mean follow-up of 23months (19-48months), the mean 'relative Constant score was 74.27 ± 8.19 in the DP group and 73.26 ± 8.02 in the DS group and the difference was statistically insignificant (p = 0.988). There was no significant difference with respect to shoulder ROM, abductor strength, radiological malunion or complications. However, the mean surgical time was significantly less (p value = 0.042) in DS group (65 ± 5min) in comparison to DP group (92 ± 4.3min); significantly less difficulties were documented by the surgeon in reducing the greater tuberosity in DS group(p value = 0.02). Although surgical time was reduced and greater tuberosity reduction was easier in DS group, the other outcomes were similar; either surgical approach can be used based, and can be based on the experience and comfort level of the surgeon.

The cloverleaf plate and proximal humerus fractures

Background: Fractures of the proximal humerus are challenging injuries. They have a functional impairment and can be managed by non-operative or operative methods. Surgical methods can be intramedullary nails, tension-band wiring, or plates and screws. Aim of the study: This study aims to show the outcomes of managing fractures of the proximal humerus using the trefoil plate method. Methods: Eight young patients with type 2 or 3 part proximal humerus fractures were retrospectively analyzed concerning the cloverleaf plate fixation and consolidation method. Patients with 4-part fractures were excluded. Results: We obtained 100% consolidation with a mean ROM of 109 degrees for abduction, 4.4 degrees for external rotation, and good internal rotation. Conclusion: the trefoil plate osteosynthesis method can be used in young patients with 2- or 3-part fractures of the proximal humerus.

Thermal and Mechanical Assessment of PLA-SEBS and PLA-SEBS-CNT Biopolymer Blends for 3D Printing

Polylactic acid (PLA) is one of the most promising biopolymers often used as a raw material in 3D printing in many industrial areas. It has good mechanical properties, is characterized by high strength and stiffness, but unfortunately, it has some disadvantages; one is brittleness, and the other is slow crystallization. Amounts of 1–5% SEBS (styrene-ethylene-butylene-styrene) thermoplastic elastomer were blended into the PLA and the thermal and mechanical properties were investigated. DSC (Differential Scanning Calorimetry) measurements on the filaments have shown that SEBS increases the initial temperature of crystallization, thereby acting as a nucleating agent. The cooling rate of 3D printing, on the other hand, is too fast for PLA, so printed specimens behave almost amorphously. The presence of SEBS increases the impact strength, neck formation appears during the tensile test, and in the bending test, the mixture either suffers partial fracture or only bends without fracture. Samples containing 1% SEBS were selected for further analysis, mixed with 0.06 and 0.1% carbon nanotubes (CNTs), and tested for thermal and mechanical properties. As a result of CNTs, another peak appeared on the DSC curve in addition to the original single-peak crystallization, and the specimens previously completely broken in the mechanical tests suffered partial fractures, and the partially fractured pieces almost completely regained their original shape at the end of the test.

Functional Outcome and Complications in Management of Proximal Humerus Fractures Operated with Proximal Humerus Locking Plate.

Introduction:Controversies exist in treatment of proximal humerus fractures as treatment options vary greatly from conservative management, closed pinning, stacked intramedullary nails, plating and hemi-arthroplasty. The purpose of this study is to study the fracture patterns of each case and document the functional outcome and complications post-operative in the management of proximal humerus fractures operated with proximal humerus plate.Material and Methods:Thirty five patients with closed proximal humerus fractures, above 18 years old, admitted in our tertiary care hospital during the study period were enrolled. Patients underwent open reduction internal fixation with proximal humerus locking plate under general anaesthesia. Post-operative patients were assessed using Constant and DASH scores. Complications were recorded.Results:In our study the absolute Constant score of the study population increases at three months and six months and was found to be significant. Mean Constant score for 4-part fractures was 45.6 which were inferior as compared to 2-part and 3-part fractures (43.1 and 44.6, respectively). The mean Constant score at six months was 51.80 +/- 6.71. All three types of proximal humerus fractures showed significant improvement in the mean DASH score over our study period of six months and was found to be significant. Mean DASH score at six months was 27.97+/-12.84. Out of the 35 cases in the study two had complications. One had implant failure (Neer’s type 3, 60-year-old female) and one had varus collapse (Neer’s type 3, 45-year-old male).Conclusion:Due to angular stability and effective maintenance of the intraoperative fracture reduction during follow-up period, early post-operative mobilisation is possible which helps the patient to attain better shoulder range of motion and return to activity faster.

Operative vs. nonoperative treatment for Mason type 2 radial head fractures: a randomized controlled trial.

The optimal treatment of isolated displaced partial articular radial head fractures remains controversial. The aim of this randomized controlled trial was to compare the functional outcome of operative treatment with nonoperative treatment in adults with an isolated Mason type 2 radial head fractures. In this multicenter randomized controlled trial, patients from 18 years of age with an isolated partial articular fracture of the radial head were randomly assigned to operative treatment by means of open reduction and screw fixation or nonoperative treatment with a pressure bandage. The primary outcome was function assessed with the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Questionnaires and clinical follow-up was conducted at admission and at 3, 6, and 12 months. In total, 45 patients were randomized, 23 patients to open reduction and screw fixation and 22 patients to nonoperative treatment with a pressure bandage. At 3, 6, and 12 months, patients treated operatively had similar functional outcomes compared to patients treated nonoperatively (DASH score at 12 months: 0.0 [0.0-4.2] vs. 1.7 [0.0-8.5]; P = .076). Nonoperatively treated adults with an isolated Mason type 2 radial head fracture have similar functional results after 1 year compared with operatively treated patients. In addition, complication rates were low for both operative and nonoperative treatment.

An analysis of functional outcome and complications of proximal humeral interlocking system plating for displaced proximal humeral fractures a prospective study

Background: The study was conducted to assess functional outcome and complications of Proximal Humerus Inter Locking System (PHILOS). Plating in displaced proximal humeral fractures by Constant-Murley (Subjective and Objective) score.Materials and Methods: The study was conducted on 60 patients with displaced proximal humeral fractures operated with Proximal Humerus Inter Locking System. Among 60 patients 24 females, 36 males; mean age 50.64 years range (26-70yrs). All patients were put on same physiotherapy program following internal fixation with the PHILOS plate. The patients were assessed clinically and radio graphically at regular intervals of 6 weeks, 12 weeks and 6 months. Functional outcome was assessed using the Constant- Murley score. Complications during the follow-up period were recorded.Results: In our series of 30 patients 2-part fractures were more common accounting 60 % compared to 3-part (20%) and 4-part (20%). Fractures united in all patients. The most frequent complication seen was shoulder stiffness in 6 patients. Excellent functional outcome seen in 18 (30%) cases, good 24 (40%) cases, fair 12(20%) cases, poor 6(10%) casesConclusion: Fixation of proximal humerus fractures with proximal humerus locking plates is associated with satisfactory functional outcomes in 2-part and 3-part and 4 part fracture. The complications are high in four part fractures and old age. Good surgical skills and surgeon’s experience are of utmost importance for successful operative treatment.

Functional outcome of proximal humeral interlocking system plating for displaced proximal humeral fractures: A prospective study

Background: The study was conducted to assess functional outcome of Proximal Humerus InterLocking System (PHILOS) plating in displaced proximal humeral fractures by Constant-Murley (Subjective and Objective) score.Materials and Methods: The study was conducted for 30 patients with displaced proximal humeral fractures operated with Proximal Humerus InterLocking System. Among 30 patients 12 females, 18 males; mean age 50.64 years range (26-70yrs). All patients were put on same physiotherapy program following internal fixation with the PHILOS plate. The patients were assessed clinically and radiographically at regular intervals of 6 weeks, 12 weeks and 6 months. Functional outcome was assessed using the Constant-Murley score. Complications during the follow-up period were recorded.Results: In our series of 30 patients 2-part fractures were more common accounting 60 % compared to 3-part (20%) and 4-part (20%). Fractures united in all patients. The most frequent complication seen was shoulder stiffness in 6 patients. Excellent functional outcome seen in 9 (30%) cases, good 12 (40%) cases, fair 6(20%) cases, poor 3(10%) cases.Conclusion: Fixation of proximal humerus fractures with proximal humerus locking plates is associated with satisfactory functional outcomes in 2-part and 3-part and 4 part fracture. The complications are high in four part fractures and old age. Good surgical skills and surgeon’s experience are of utmost importance for successful operative treatment.

Surgical treatment of proximal humeral fractures with the transosseous suture fixation

BackgroundThe surgical treatment of displaced proximal humeral fractures is commonly affected by implant-related complications. We evaluated the functional and radiographic results of transosseous suture fixation in a series of displaced proximal humeral fractures (PHF).MethodsSixty-four patients were retrospectively classified by age, sex, and the Neer fracture classification. Two-part greater tuberosity (2pGT) displaced fractures and 3-part (varus and valgus) and 4-part valgus impacted fractures were managed with fragment reduction and transosseous suture fixation. Patients with minimum follow-up of 24 months and assessed with the Constant-Murley score (CMS) were included. Radiological and medical complications, as well as reinterventions were also recorded.ResultsForty-six patients with a mean follow-up of 58 (24–132) and a mean age of 58 years old were analyzed. Patients with 2pGT (n = 10) fractures had a CMS of 76 points (59–89); patients with 3-part fractures (n = 22) had a score of 67 points (13–91); and those with 4-part fractures (n = 14) had a score of 64 (24–76) points. The overall complication rate was 6 out of 46, and 4 patients required reintervention for different reasons. Patients presenting with 3-part varus fractures had significantly lower functional outcomes scores (p = 0.007). Humeral head osteonecrosis was present in 9 patients and significantly affected the functional outcomes (p < 0.05). However, only three out of nine patients with osteonecrosis required subsequent surgery at the indicated follow-up.ConclusionsThe fracture reduction and transosseous fixation technique represents a safe technique with low complication and reintervention rates. The presence of humeral head necrosis did not lead to subsequent surgical intervention because no hardware had protruded.Level of evidenceLevel IV, retrospective study

Mitigation of Triceps Avulsion Fracture After Proximal Ulna Plate Fixation.

Triceps avulsion fractures have become an increasingly common postoperative complication of olecranon fracture repair with proximal ulna plate (PUP) fixation. The purpose of this study is to create an efficient, reproducible mechanism to mitigate this issue. Ten matched pair cadaveric specimens underwent a complete transverse osteotomy to simulate an olecranon fracture, followed by fracture reduction with a PUP. One arm from each pair underwent an additional augmented suture repair, where the triceps tendon was sutured directly to the plate. A custom jig was used to hold the specimen in position and apply a tensile force on the triceps until mechanical failure. All control specimens (without augmented suture repair) failed through a full-thickness triceps avulsion fracture at an average force of 967.7 N. The augmented suture-repaired specimens failed at an average force of 1204.3 N through partial avulsion fractures, widening of the osteotomy site, and triceps ruptures. Our study demonstrated that an augmented suture repair of PUP fixation for olecranon fractures is a simple and effective way to significantly increase fixation strength and change the potential failure mechanism.

Analysis of the subcapital two-part humerus fracture by fluoroscopy: objective criteria for classification and decision making

BackgroundSurgical decision making in the treatment of proximal humerus fractures (PHFx) is primarily based on fracture classification using standard radiographs. Due to the lack of objective criteria, this classification process is associated with high interobserver variation. In this study, we investigate the fluoroscopic analysis of humerus fractures through the surgical neck using a semi-quantitative determination of distinct angulation patterns of the proximal humerus as they appear in the image intensifier.MethodsUsing a saw bone model, defined subcapital 2-part fracture configurations were generated and assessed radiographically. Anatomical landmarks—including the greater and lesser tuberosity as well as anatomical neck—were identified using an image converter, and the exact degree of fracture displacement with 10° up to 70° (in 10° increments) of posterior, varus or combined posterior-varus angulation was compared to nondisplaced controls. From the resultant series of radiographs, the appearance of these angulations in anteroposterior (AP) and scapular Y-views were also visualized and defined.ResultsAn angulation of 50° or more of any given 2-part fracture through the surgical neck is present when the greater tuberosity becomes the most proximal point in AP view (varus and combined posterior-varus angulation) or a bimodal form is found for the superior contour of the head with the lesser tuberosity being the most proximal point in the Y-view (posterior angulation).ConclusionThe radiological appearance of various PHFx constellations can be well visualized using the saw bone shoulder model. The presence of angulation in accordance with the Neer classification for group III fractures can be adequately determined by analyzing the relative position of the greater or lesser tuberosity to the humeral head calotte. This can assist the surgeon’s decision on whether to operate or opt for a conservative approach.Level of evidenceBasic Science, Anatomy Study, Imaging.

Hydrogen induced microstructure evolution and cracking mechanism in a metastable dual-phase high-entropy alloy

Metastable Fe50Mn30Cr10Co10 high-entropy alloys show outstanding mechanical properties, which are likely to be exposed to the hydrogen environment for many potential applications. However, the effects of hydrogen on mechanical properties and embrittlement behavior of this alloy are still unclear. In the present work, the influence of hydrogen on the microstructure evolution, mechanical properties, and embrittlement behavior of the metastable Fe50Mn30Cr10Co10 high-entropy alloy (HEA) is observed. Hydrogen-assisted cracking initiation and propagation are observed via electron backscatter diffraction analysis and electron channelling contrast imaging. A high hydrogen flux is observed in the FCC phase, indicating the diffusible hydrogen is preferred desorbed from this phase compared to the HCP phase. Fracture of the hydrogen-charged specimens is dominated by localized plastic deformation. Microstructural observations confirmed that cracks mainly initiated in austenite grain boundaries, propagated along austenite grain boundaries aided by the impingement of HCP laths and in a minor fraction propagated along FCC/HCP interfaces or inclusion interfaces. The failure mode under tensile deformation in the presence of hydrogen is a mainly intergranular and partial transgranular fracture.

Bond performance between SFCBs and grouted sleeves for precast concrete structures

A precast concrete structure reinforced by steel-fiber-reinforced polymer (FRP) composite bars (SFCBs) shows good durability and controllable post-yield stiffness, which makes this kind of structure suitable for marine infrastructure. The connection technology is one of the critical issues of a precast concrete structure with hybrid reinforcement. This paper presents an experimental study on the bond-slip testing (27 pullout specimens) of composite bars connected by a grouted deformed pipe splice (GDPS) connector with different bond lengths. The reinforcement included SFCBs and pure FRP bars. The test results showed that the failure modes could be classified into three categories: rebar pullout before or after the inner steel bar yielded, rupture of the FRP wrapped on the SFCB, and mixed failure of bar pullout with a partial fiber fracture. The average bond strength of the ordinary steel bar was approximately 146.8% that of the SFCB connector with the same anchored length. When the anchored length of the SFCB specimen was 15 d ( d: bar diameter), the specimen could be fully anchored to fracture. An explicit hardening bond-slip model considering the post-yield stiffness of the SFCB was used to predict the bond-slip behavior of the GDPS connector, and the experimental and analytical results agreed well with each other, which demonstrates that the proposed model could provided a reference for the analysis and design of connectors for SFCB-reinforced precast concrete structures.

Contrast examination of central venous access port implanted through internal jugular vein for evaluation of suspected complications.

We summarized the findings, diagnosis, and outcomes of cases for which contrast examination of central venous access ports (CV-ports) were attempted to detect complications. Fifty-seven contrast examinations were attempted for 45 patients with 46 CV-ports (median, 162days after implantation). Contrast examination was performed due to three suspicion catheter fractures or 54 CV-port dysfunctions (combinations of an absence of blood reflux on aspiration and 9 sufficient, 21 insufficient, or 24 impossible drip infusions). Contrast examination was successfully performed in 52 cases and revealed 45 normal findings, 5 pericatheter fibrin sheath formations, and 2 partial catheter fractures. In 23 of 45 cases with normal findings, the resistance to injection was initially mild or moderate but resolved after the CV-port was flushed slowly with heparinized saline solution. Subsequent contrast examination demonstrated normal findings. All fibrin sheath formations disappeared after thrombolytic therapy. Five cases could not undergo contrast examination due to high resistance. After contrast examination, nine of 46 CV-ports were removed or exchanged, while the use of the remaining 37 continued. Contrast examination of CV-port allowed the assessment of suspected complications and early treatment.