Chance Of Fracture Research Articles

Smart Materials: Smart Think

Smart Materials are the Recent Advances in Dentistry. Now a days various biomaterials play an important role in day-to-day life. These materials have their own importance towards dentist as well as patient. these materials do not harm the oral mucosa and supporting structures of the oral cavity. Smart materials have their own specialty in various fields of dental sciences. They are the materials with less chances of fracture and long duration of stability. Newer materials in dentistry change the concept of dentistry into digital sciences technology. The older materials in dentistry get replaced with these biomaterials. They are with well structural properties that make them popular in routine practices. Smart materials improved the durability of material and efficiency in the future of dentistry.

Broken rods in spinal deformity surgery: an analysis of clinical experience and a literature review

Backgrоund. Rod fractures are one of the specific complications of spinal deformity surgery. The number of publications on this topic is small, and the conclusions are often contradictory.
 Aim. The aim of this study is to analyze the current situation concerning the problem of fractures of the rods in spinal deformities of various etiologies in terms of frequency and risk factors for this complication.
 Materials and methods. The study included 3,833 patients who underwent operations between 1996 and 2018. The inclusion criteria of being over 10 years of age with no history of spinal surgery were applied.
 Results. Fractures of metal implant rods were detected in 85 patients out of a total of 3,833 (2.2%). There was a significant difference between the groups of idiopathic and congenital scoliosis patients. A rod fracture in 62 of the 85 patients was the reason for reintervention to restore integrity with a connector or a full replacement. An increase in BMI by one raised the chance of a fracture by 1.07 times (p = 0.019). Increasing the age by one year increased the possibility of a fracture by 1.03 times (p = 0.039). A statistically significant association of the ventral stage of surgical treatment (discectomy and interbody fusion with autologous bone) where no fracture was detected (p = 0.403) was revealed. Being over 15 years old a statistically significant predictor was in the group under 20 years of age (p = 0.048). For BMI, there was no statistically significant threshold for fracture probability in the group under 20 years of age. It was confirmed that a hybrid fixation system produced a significantly lower percentage of complications than a hook system.
 A systematic literature review of sources on this topic included international databases (Scopus, Medline, and Google Scholar) as well as investigating the publications contained in the reference list.
 Conclusions. Rod fractures during surgery for spinal deformities of various etiologies are one of the typical complications. Fracture frequency in large study groups is small. The risk of developing this complication rises with both increasing BMI and patient age, although there is no statistically significant threshold for BMI relative to the chances of fracture in the group up to 20 years of age. Modern reticular systems of attachment of the endocorrector to the vertebral structures can dramatically reduce the risk of rod fracture during the postoperative period.

Elastohydrodynamic Lubrication Analysis of Pure Squeeze Motion on an Elastic Coating/Elastic Substrate System

A rigid sphere approaching a lubricated flat surface with a layer of elastic coating on the elastic substrate is explored under constant load conditions. The transient pressure profiles, film shapes, elastic deformation, von Mises stress (σvon) during the pure squeeze process under various operating conditions in the elastohydrodynamic lubrication (EHL) regime are discussed. The simulation results reveal that the greater the Young's modulus of coating is, the greater the pressure distribution is, the smaller the contact area is, and the greater the maximum stress (σvon) value is. As the Young’s modulus of coating decreases, the central elastic deformation at the surface (Z = 0) increases and the deformation at the interface of coating/substrate (Z = −1) decreases. For hard coating cases, the maximum central pressure increases to an asymptotic value and minimum film thickness decreases to an asymptotic value as the coating thickness increases. For soft coating cases, this phenomenon reverses. A thicker and stiffer coating leads to a higher maximum stress. At the deformation recovery stage, the positions of the maximum stress would begin to offset downwards and closer to the coating/substrate interface. Moreover, the position of maximum stress varies from the coating to the subsurface as the Young’s modulus of coating increases. The EHL with stress analysis can prevent the chance of fracture in coating or substrate. These characteristics are important for the lubrication design of mechanical elements with coatings.

Alcohol-Induced Osteopenia Among In-Custody and Homicide Deaths from the Harris County Institute of Forensic Sciences

Four cases of in-custody or unlawful death are presented as examples of increased bone fragility with an associated increase in fracture rates due to ethanol-induced osteopenia. In addition, one of the individuals suffered fractures several weeks premortem, allowing some healing to take place. Using radiographs and physical examination, the ribs from these individuals are compared with those retained from three individuals with no history of alcoholism to illustrate diagnostic characteristics that will be notable using standard autopsy and anthropological procedures. Trabecular bone mass is notably decreased in the alcoholic group leading to a greater chance of fracture occurring during conflict, including arrest and in-custody situations. The average number of perimortem fractures among the alcoholic individuals is 15, while the control group is six. In the case of the individual with healing, the degree of bone repair on the ribs was less than is expected considering the interval between injury and death.

Experts' agreement on therapy for bone metastases

Experts' agreement on therapy for bone metastases

Fracture risk assessment in frail older people using clinical risk factors

this study aims to develop and evaluate a simple fracture risk index for use in frail older people. clinical risk factors were assessed at baseline for 2,005 older people (473 males, 1,532 females; mean age 85.7 years, SD 7.1 years) living in aged-care facilities. Fractures were ascertained for 2 years from baseline. Cox regression model was used to identify significant risk factors for fracture. Hazard ratios (HRs) from the model were assigned as weights. The risk index was calculated by multiplying the weights of all risk factors. during a mean follow-up of 1.64 years, 401 fractures occurred in 338 participants. Significant independent clinical risk factors for fracture were institution type, balance, history of previous fracture, cognitive function, number of medications, weight and lower leg length (n = 1,813). The index was capable of identifying higher-risk individuals, with almost an 8-fold increase in the risk of fracture for residents from the lowest 15% to the highest 18% of the score. Among 1-year survivors, a high score (>or=15) indicated approximately a one-in-six chance of fracture, while a low score (<8) indicated only a one-in-forty chance of fracture within a year. The area under the receiver operating characteristic (ROC) curve was 0.69 (95% CI: 0.65-0.72) and 0.68 (95% CI: 0.65-0.71) for identifying someone who would have a fracture in 1 and 2 years respectively. this risk index could identify individuals at higher fracture risk among institutionalised older people, and thus, could help to rationalise the provision of fracture prevention programs in this population.

Osteoporosis in diabetes

The diabetes is at great risk of the osteoporosis, and the bone fragility unrelated to bone density forms the pathological conditions peculiar to diabetes. The factor participating in diabetic osteoporosis has a state of insulin action deficiency, a hyperglycemic state, diabetic complications, and so on. An osteoblastic cell function is deteriorated and the number of that is decreased by the absolute and relative insulin deficiency, and sustained hyperglycemia also decreases an osteoblastic cell function still more. Furthermore, the osteoclast-related bone resorption is also promoted through sorbitol accumulation in the cell by the hyperglycemia state. The expression of transcription factors regulating osteoblastic cell differentiation is restrained, and the apoptosis of those cells is promoted. As a result, osteoplasty is obstructed. In the bone, AGEs (advanced glycation endproducts) is produced in excess, and bone fragility is promoted by the ratio of the AGEs bridging with the collagen rising. The complications of diabetes, such as visual disorder and the neuropathy, raise the risk of the fall in the diabetic osteoporosis patient, therefore, they will have more chance of fractures.

Elbow extension test to rule out elbow fracture: multicentre, prospective validation and observational study of diagnostic accuracy in adults and children

Objective To determine whether full elbow extension as assessed by the elbow extension test can be used in routine clinical practice to rule out bony injury in patients presenting with...

Finite Element Analysis on the Stress and Fracture in the Second Metatarsal

Footwear has direct impact on the stress level in the metatarsal bones of human feet. In particular, stress fractures at the neck of the second metatarsal are the most common injuries. A finite element analysis was carried out to study the load and stress level in the second metatarsal of a 50-kg female wearing flat and high-heel shoes. It found that the bending of metatarsal due to the flat-footed posture increases the chance of fracture, and the stiletto (high-heeled) posture leads to large compressive stress.

The Properties of Endocal 10 and Its Potential Impact on the Structural Integrity of the Root

The purpose of this research was to determine if the use of Endocal 10 (previously called Biocalex 6.9) is associated with root fracture and to assess its sealability. Thirty-six freshly extracted, single canal human mandibular incisors were instrumented and randomly divided into two equal groups (n = 15). Canals in group A were obturated with vertically compacted gutta-percha and Sealapex, and those in group B were filled with Endocal 10 placed with a #25 Lentulo spiral per manufacturer's instructions. Two blinded investigators evaluated the teeth for fractures using transillumination and an operating microscope at 12 x magnification. Three of the fifteen samples filled with Endocal 10 had vertically fractured in half, whereas none of the teeth filled with gutta-percha had any evident fracture lines. The remaining teeth were tested for leakage via a fluid filtration model at 1 wk and 30 days postobturation. No leakage was found among any of the samples whether filled with gutta-percha or with Endocal 10 at either time interval. Statistical analyses were completed using Fisher's exact test (p = 0.023), which showed that there was a significant increase in chance of fracture when using Endocal 10 versus gutta-percha. The results indicate that, although Endocal 10 is able to seal the tooth as well as gutta-percha and sealer, there is a significant potential risk of root fracture.

The intrauterine contraceptive device, “Multiload Cu 250”: A regulatory problem

Reports to the control agencies in Sweden and Australia of fractures of the intrauterine contraceptive device, Multiload Cu 250, led to a review of the safety of this device in these countries. The review revealed that fractures of the device had occurred in 15 other countries but in these countries only 5% of reports had been directed to the relevant national control authorities. The remainder either had been reported to the sponsor or had appeared in the published literature. An additional problem identified was one of thread rupture with the resultant difficulty in removal and the need for surgical intervention. It is apparent that the sponsor of the device was aware of the problems for some time since it made several significant changes to the device marketed in Sweden. These changes were made in 1983, without informing the Swedish agency and without its approval. There were 1622 Multiload Cu 250 devices returned to the Swedish agency for examination from 1988 to 1989. An analysis of 1516 of them found that the overall incidence of device fracture was 1:405 and of broken threads, 1:8. However, evidence suggests that the modifications conducted in 1983 and 1984 resulted in a device with very much less chance of fracture and/or ruptured threads on removal. Stress testing of 106 used devices suggested that the risk of fracture may increase with the length of time left in utero. Regulatory action in both Sweden and Australia involved changes in the information provided to physicians and patients. In Sweden, the additional step of withdrawing all earlier devices suspected of being associated with fracture and/or ruptured threads was taken. A regulatory network for the review of devices similar to that which has developed for drugs over a 20-year period should be encouraged.

Definition of a spine fracture threshold based upon prospective fracture risk

Assessment of fracture threshold (FT) could have important clinical application in determining which individuals should be treated preventively, and what level of therapy to prescribe, if suitable treatment regimens can be developed. We propose that FT be defined as the bone mineral content (BMC) at which the risk of fracture doubles, relative to premenopausal women, as determined by logistic regression analysis of spine fracture incidence in a prospective study of 408 postmenopausal women. The observed values for the FT agree well with those reported by others, based upon more arbitrary definitions. More than 90% of individuals with new nonviolent spine fractures have BMC below the fracture threshold, while fewer than 10% of younger women (age 30–45) are below this value. Although not all women with BMC below the FT have had fractures, they are at increased risk of fracture. Women with BMC equivalent to the FT have at least a 5% chance of fracture over a 10-year period, and the probability of fracture rises rapidly as BMC decreases. BMC appears to be a much stronger predictor of fracture risk than age or body size (height or weight). Thus, use of a BMC fracture threshold to categorize individual risk could provide a more objective basis for clinical decision making.

The analysis of fractures in skeletal populations with an example from the Libben site, Ottowa County, Ohio

AbstractA quantitative approach to the analysis of long‐bone fractures in skeletal populations is presented. These kinds of data are shown to be valuable in interpreting various behavioral aspects of the population. An example of application is provided for the Libben population. Data from this group show that the overall fracture rate was high (there is a 45% chance of a long‐bone fracture in any single individual) but lower than the rates observed in nonhuman primates by almost an order of magnitude when data are adjusted for years of risk. The data for Libben also suggest that traumatic child abuse was not practiced, that most fractures occur as a consequence of accident, that fracture risk was highest in the 10–25 and 45 + age categories, that care of patients was enlightened and skillful in this group, and that chance of fracture is largely determined by accumulated years of risk in the population (r = 0.97).

Correspondence

The proportion of patients X-rayed has vastly increased in the past few years, and the use of new methods of diagnosis with various opaque substances in kidney and gall-bladder disease has very much increased the cost of X-ray Departments. In addition to this increase it has been the practice in the past few years to X-ray every case of suspected bone injury, even when the chance of fracture is considered remote. It is not the price of apparatus nowadays which is the main cause of alarm in the minds of the Administrative Authorities of Hospitals, but the constantly increasing annual cost of X-ray films and their immediate accessories.