Different Types Of Fractures Research Articles

Effect of Surface Treatments Applied to 3D Printed Permanent Resins on Shear Bond Strength.

3D-printed permanent resins have recently been introduced to produce permanent restorations. The aim of this study is to evaluate the effect of surface treatment methods on the shear-bond strength (SBS) between 3D-printed permanent resins and adhesive cement. In this study, samples were produced using digital light projection (DLP) and stereolithography (SLA) 3D printers with two permanent resins (Crowntec, Saremco and Permanent Crown, Formlabs) in accordance with manufacturer guidelines. The samples were separated into three groups: sandblasting, hydrofluoric acid and no surface treatment. The surface profile (Ra, Sa) of the samples was examined with a confocal microscope (Smartproof 5, Zeiss). Then, a self-adhesive resin cement was applied to the samples in a transparent mold (2.38 mm diameter) in accordance with ISO 29022:2013. A universal testing machine was used to perform SBS test. A stereomicroscope was used to analyze the different types of fractures. A two-way analysis of variance (ANOVA) test was used to assess the data (p<0.05). The samples with sandblasting applied to the surface showed higher surface roughness values than the samples with hydrofluoric acid (p<0.001). 3D printer technology and surface treatment methods affected SBS values (p<0.001). Sandblasting groups higher SBS values were than in the hydrofluoric acid group (p<0.001). Sandblasting revealed cohesion fractures, which indicated a stronger bond, while hydrofluoric acid displayed adhesive and mix fractures. When sandblasting was applied to the surface of the samples prepared using permanent resins, higher adhesion was achieved with adhesive cement. Key words:3D printing, Shear bond strength, Sandblasting, Stereolithography.

Advancing fracture management: the role of minimally invasive osteosynthesis in orthopedic trauma care.

Minimally Invasive Osteosynthesis (MIO) developed to be a key technique in orthopedic trauma surgery, offering a less invasive alternative for managing fractures in various anatomical regions. However, standardized guidelines for its application are lacking. This study aims to establish comprehensive principles for MIO to guide surgeons in treating different types of fractures and its locations. A retrospective analysis including 57 fractures in 53 patients was conducted. All patients were treated with MIO. Study range - March 2017 to January 2022 at a Level-I trauma university hospital. The analysis covered various fracture types, focusing on surgical approaches, reduction techniques, plate insertion methods, and its outcomes. The efficacy and safety of MIO was evaluated by analyzing complications, fracture healing time, and necessary revision surgeries. MIO is a versatile and effective fracture treatment that minimized soft tissue damage and ensured stable osteosynthetic results. Articular fractures typically used a "one way up" plate insertion technique, while non-articular fractures applied an "inside-up-and-down" approach. Low complication rates confirmed the safety and efficiency of MIO. This research established generalized principles for MIO, offering a systematic approach that can be applied for various fracture types and its locations, by overall enhancing the surgical efficiency as well as patient recovery, without compromising outcomes. This study is classified as Level III evidence according to "The Oxford 2011 Levels of Evidence".

Study on the characteristics of increased mechanical stiffness according to changes in LCP shape to reinforce clavicle fractures

The clavicle has various anatomic shapes unique to each individual. Additionally, with the increase in high-energy traumas such as sports injuries and traffic accidents, the patterns of fractures become complex and complicated. Thus, there is a need for a variety of shapes of locking compression plates (LCP) to accommodate different types of fractures and facilitate quicker rehabilitation. The aim of this study is to present different types of LCP that secure fracture fragments and distribute stress evenly, in comparison to typical anatomical LCPs, for reinforcing clavicle fractures. Three models were compared in this study: the typical shape, the center hole removed shape, and the double-curved wing shape. The DICOM (Digital Imaging and Communications in Medicine) file obtained from the computed tomography scan of the patient’s clavicle was used to extract the three-dimensional (3D) clavicle structure. Finite element analysis (FEA) simulation was employed to analyze the structural changes of the LCP under external forces. A reinforced jig was used to apply the same type of external force to each LCP, and an experiment was conducted to analyze the mechanical impact of the LCP’s structural characteristics. When comparing the stress values at the fracture zone point, resulting from the FEA simulation with applied bending forces, it was calculated that the stress dispersion effect was approximately ten times greater when transitioning from a typical LCP shape to a double-curved partial wing structure. Moreover, the ultimate stress increased 3.33 times, from 241.322 to 804.057 N, as the LCP design changed under cantilever bending conditions. This double-curved wing LCP design reduces stress concentration at the fracture site and minimizes stress in the fracture area when subjected to cantilever bending forces. Consequently, this newly designed LCP has the potential to decrease complications related to the plate and accelerate rehabilitation protocols.

Clinical outcomes of conservative versus surgical treatment for patients with proximal humeral fracture before physiotherapy.

Fear of movement, pain, and loss of shoulder function are the most common problems irrespective of their approach to management after proximal humeral fracture (PHF). However, it has been unclear whether there could be differences between both treatments in early clinical outcomes. It can help physiotherapists to guide in choosing treatment approaches. This study aimed to compare kinesiophobia, pain, range of motion (ROM), shoulder function, and Quality of life (QoL) in patients treated with either conservative (CT) versus surgical (ST) after PHF. In addition, it aimed to determine correlations between fear of movement and seconder outcome measures. This cross-sectional study enrolled the patients having 5-6 weeks (being permitted active movement) after being treated either CT or ST and receiving no physical therapy. Pain, passive and active ROMs, shoulder function, fear of movement, and QoL were evaluated. 42 patients were recruited. Kinesiophobia scores were similar (p=0.55) and moderate in both groups. There was a significant difference in degrees of shoulder active flexion, active and passive abduction in favor of the CT group (p=0.05, p=0.02, p=0.04, respectively). However, there was no difference between groups regarding the remaining clinical outcomes. Furthermore, kinesiophobia showed a moderate negative correlation with energy/fatigue, social functioning, and general health. These findings showed that patients treated surgically did not have more kinesiophobia, less function, and QoL before starting physiotherapy, despite having soft tissue damage and different types of fractures. However, surgically treated patients had significantly less range of motion.

Differences in stress sensitivity of natural-artificial fracture networks in tight sandstone gas reservoirs

Abstract The stress sensitivity of fractures has a significant impact on the production characteristics of tight sandstone gas reservoirs. However, there has been a lack of attention to and research on the differences between different types of fracture and their stress sensitivity. Based on the core samples of the Keshen gas reservoir in Xinjiang, China, this paper conducts a comprehensive comparison of the flow capacity, stress sensitivity, and the production characteristics of the structural fracture, diagenetic fracture, and artificial fracture. The findings reveal that the flow capacity of a single structural fracture is higher than that of a diagenetic fracture. Additionally, both structural and diagenetic fractures contribute to increasing the flow capacity of the porous system by 63 and 88%, respectively. The stress sensitivity of fractures varies from strong to weak, structural fractures exhibit a higher sensitivity compared to diagenetic fractures, and artificial fractures demonstrate the weakest stress sensitivity. Based on the fitting formulas of stress-sensitivity curves for different fractures, a new seepage model considering different stress sensitivities was established and numerical simulations were conducted. The numerical simulation results indicate that the gas well with a diagenetic-artificial fracture network yields a higher production, the 10-year production is 35.01% higher than that with a structural-artificial fracture network. This study is of great significance for understanding the production differences of fractured tight sandstone gas reservoirs and provides valuable insights for selecting optimal well locations.

Unilateral external fixator and its biomechanical effects in treating different types of femoral fracture: A finite element study with experimental validated model

Previous works had successfully demonstrated the clinical effectiveness of unilateral external fixator in treating various types of fracture, ranging from the simple type, such as oblique and transverse fractures, to complex fractures. However, literature that investigated its biomechanical analyses to further justify its efficacy is limited. Therefore, this paper aimed to analyse the stability of unilateral external fixator for treating different types of fracture, including the simple oblique, AO32C3 comminuted, and 20 mm gap transverse fracture. These fractures were reconstructed at the distal diaphysis of the femoral bone and computationally analysed through the finite element method under the stance phase condition. Findings showed a decrease in the fixation stiffness in large gap fracture (645.2 Nmm-1 for oblique and comminuted, while 23.4 Nmm-1 for the gap fracture), which resulted in higher displacement, IFM and stress distribution at the pin bone interface. These unfavourable conditions could consequently increase the risk of delayed union, pin loosening and infection, as well as implant failure. Nevertheless, the stress observed on the fracture surfaces was relatively low and in controlled amount, indicating that bone unity is still allowable in all models. Briefly, the unilateral fixation may provide desirable results in smaller fracture gap, but its usage in larger gap fracture might be alarming. These findings could serve as a guide and insight for surgeons and researchers, especially on the biomechanical stability of fixation in different fracture types and how will it affect bone unity.

A novel dandelion-based bionic proppant and its transportation mechanism in different types of fractures

Low-permeability reservoirs are generally characterized by low porosity and low permeability. Obtaining high production using the traditional method is technologically challenging because it yields a low reservoir recovery factor. In recent years, hydraulic fracturing technology is widely applied for efficiently exploiting and developing low-permeability reservoirs using a low-viscosity fluid as a fracturing fluid. However, the transportation of the proppant is inefficient in the low-viscosity fluid, and the proppant has a low piling-up height in fracture channels. These key challenges restrict the fluid (natural gas or oil) flow in fracture channels and their functional flow areas, reducing the profits of hydrocarbon exploitation. This study aimed to explore and develop a novel dandelion-bionic proppant by modifying the surface of the proppant and the fiber. Its structure was similar to that of dandelion seeds, and it had high transport and stacking efficiency in low-viscosity liquids compared with the traditional proppant.Moreover, the transportation efficiency of this newly developed proppant was investigated experimentally using six different types of fracture models (tortuous fracture model, rough fracture model, narrow fracture model, complex fracture model, large-scale single fracture model, and small-scale single fracture model). Experimental results indicated that, compared with the traditional proppant, the transportation efficiency and the packing area of the dandelion-based bionic proppant significantly improved in tap water or low-viscosity fluid. Compared with the traditional proppant, the dandelion-based bionic proppant had 0.1–4 times longer transportation length, 0.3–5 times higher piling-up height, and 2–10 times larger placement area. The newly developed proppant also had some other extraordinary features. The tortuosity of the fracture did not influence the transportation of the novel proppant. This proppant could easily enter the branch fracture and narrow fracture with a high packing area in rough surface fractures. Based on the aforementioned characteristics, this novel proppant technique could improve the proppant transportation efficiency in the low-viscosity fracturing fluid and increase the ability of the proppant to enter the secondary fracture. This study might provide a new solution for effectively exploiting low-permeability hydrocarbon reservoirs.

Unconventional mobility, conventional trauma: a comparative analysis of e-scooter-related fractures.

The present research aimed to compare the different types of fractures to those caused by e-scooter use as well as reveal the severity of e-scooter injuries via an epidemiological analysis of fractures over the course of 6months. This retrospective study assessed medical records of patients with fractures or dislocations admitted to a Turkish level three trauma centre emergency orthopaedic department between June 2021 and January 2022. Using a two-group design, the first group encompassed all fractures and dislocations treated, while the second focused on e-scooter-related cases. Comparative analysis covered fracture patterns and factors within the e-scooter group, like demographics, injury mechanism, and timing. Surgical need and types were explored for e-scooter injuries. Among 4481 upper extremity fractures, finger fractures (27.47%) and distal radius fractures (25.37%) were common, while e-scooter-related cases exhibited radius and ulna shaft fractures (23.07%). Of 2400 lower extremity fractures, toe fractures (30.2%) and metatarsal fractures (19.66%) predominated, with e-scooter-related injuries largely featuring metatarsal fractures (30%). The surgery rate in all patients was 8.92%, whereas the surgery rate specifically for e-scooter injuries was 48.2%. Significantly greater occurrence of lower extremity fractures was evident in e-scooter-related injuries compared to upper extremities (p = 0.011). Collisions involving stationary or moving objects were linked to injuries in the lower extremities, whereas falls were primarily associated with injuries in the upper extremities. Treatment included surgery (48.2%) and conservative management (52.8%), with ORIF (35.7%) and CRIF (10.7%) utilised. E-scooter-related fractures and dislocations are typically more severe, often requiring surgery, compared to other fractures during the same period. The study emphasises the link between injury type and increased risk of lower extremity fractures or dislocations.

Neonatal upper limb fractures – a narrative overview of the literature

The aim of this paper is to review the topic of neonatal fractures of the upper limb, describing the different types of fractures focusing on the etiology, epidemiology, risk factors, clinical approach, diagnosis, treatment and prognosis of these injuries. We included all types of research studies, both experimental and observational, published in English, French, Portuguese and Spanish. The information was obtained using the keywords neonatal upper limb fracture, clavicle fracture or humerus fracture from the following resources: MEDLINE database, Embase® database and LILACS database. Other resources such as hand searches of the references of retrieved literature and authoritative texts, personal and hospital libraries searching for texts on upper limb neonatal fractures, discussions with experts in the field of upper limb neonatal fractures and personal experience, were also considered for the completion of the article.Neonatal fractures of the upper limb are consensually considered to have a good prognosis and no long-term sequelae. Conservative treatment is the option in the vast majority of the fractures and is associated with excellent results, with good healing, full range of motion, adequate remodeling without obvious deformity, neurologic impairment or functional implications.

Response characteristics of acoustic emission signal and judgment criteria for different fracture modes

Coal mining is going deeper into the ground, resulting in more intense and frequent mine dynamic disasters. To ensure the early warning of dynamic disasters, it is significant to accurately reveal the differences of acoustic emission (AE) signals generated by rock fractures. This paper focuses on studying how AEs average frequency (AF) and rise angle (RA) change in sandstone during loading, and examines the characteristics of waveform amplitude, energy, and frequency distribution of AE signals from different types of fractures. The findings reveal that the percentage of shear fracture gradually increases with increasing load, and the energy activity of the AE signal is significantly enhanced in the high stress stage. The occurrence of the main fracture was preceded by a large number of low-frequency tensile fracture AE signals, accompanied by a small decrease in RA and a small increase in AF. The spectra of different fracture signals were characterized as “low anomalous F” for shear fractures, “vertical F” for low-frequency tensile fractures, and “high anomalous F” for high-frequency tensile fractures. Their energy distribution in the frequency domain was respectively described as “peak-centered distribution”, “pillar-shaped distribution” and “peak-skewed distribution”. The outcomes of the decomposition and reconstruction from the P- and S-waves reveal that the P wave energy (Ep) dominates in the high-frequency tensile fracture AE signal, while the S wave energy (Es) is greater in the low-frequency tensile fracture and the shear fracture AE signals. The ES/EP threshold value for laboratory discrimination of tensile and shear fracture is 3, as the fracture extends and penetrates, the ES/EP value rises rapidly at the appearance of macroscopic fracture. The findings offer theoretical guidance for monitoring and early warning of coal and rock dynamic hazards as well as revealing the morphology of fracture source.

Developmental characteristics of fractures in deep tight sandstone reservoirs in the second Member of the Xujiahe Formation of Zhongjiang Gas Field

The development characteristics, scale and control factors of fractures are the core subjects of reservoir sweet spot prediction. The sandstone reservoir of the TX2 gas reservoir in the Zhongjiang Gas Field is a typical low porosity and low permeability tight reservoir with strong heterogeneity, but relatively high-quality reservoirs can be found in different well areas and well segments. In this paper, taking the second Member of the Xujiahe Formation (TX2) as an example, the control factors of fractures were systemically investigated via core observation, thin section, logging data, and fracture logging identifications. The results show that shear fractures are mainly developed in the cores, and they generally have high filling rate and poor effectiveness; microfractures can be found based on the vitrinite and cast thin section results. The intersection diagram (semi-quantitative) and the principal component and BP comprehensive identification (quantitative) methods can effectively identify different types of fractures. The combined application of principal component and BP comprehensive identification methods results in an 83.3 % fracture identification probability. Finally, we found that the development of fractures in TX2 is comprehensively affected by lithology, rock thickness, porosity, and faults.

Circulating FGF‐23 Is Associated With Increased Risk of Osteoporosis and Fractures in Hemodialysis Patients: A Prospective Observational Study

Background and Objective: It is still controversial whether circulating fibroblast growth factor 23 (FGF‐23) can be used as a biomarker for the diagnosis of osteoporosis and fractures in patients with chronic kidney disease undergoing hemodialysis. We investigated the association of circulating FGF‐23 concentrations with an increased risk of osteoporosis and fractures of hemodialysis patients in the prospective study.Methods: These data were collected in adult patients with hemodialysis in China from January 1 to December 30, 2016, and patients were followed up for 3.5 years. The association of circulating FGF‐23 with the risk of osteoporosis and fractures was analyzed by multivariate analysis.Results: The study included 1788 hemodialysis patients, with a median age of 56 years (50–64 years) and a female population of 54.5%. Of 1788 patients, 389 (21.8%) developed osteoporosis and 207 (11.6%) developed fractures. High concentrations of FGF‐23 were significantly related to osteoporosis and fractures and were significantly related to different types of fractures (vertebral fractures, nonvertebral fractures, and hip fractures). Adjusted for all potential risk factors, high concentrations of FGF‐23 were associated with the risk of osteoporosis or fractures.Conclusion: High concentrations of circulating FGF‐23 were associated with the risk of osteoporosis and fractures, including vertebral fractures and hip fractures. FGF‐23, along with bALP, CTX, and OC, may be used as a serum biomarker for predicting the risk of osteoporosis and fractures in patients with hemodialysis.

Assessing the Casual Association between Sex Hormone Levels and Fracture Risk: A Two-Sample Mendelian Randomization Study.

Prior observational studies have reported that levels of sex hormones constitute a risk factor for the fracture. The aim of this study was to ascertain whether there is a causal relationship between the levels of sex hormones and the risk of fracture through Mendelian randomization (MR). Single-nucleotide polymorphisms (SNPs) associated with two indicators of sex hormone levels, circulating sex hormone-binding globulin (SHBG) and bioavailable testosterone levels, as exposures were selected from a large genome-wide association study (GWAS) from UK Biobank. The summary statistics for 11 different types of fracture as outcomes from the FinnGen consortium. This study employed the two-sample MR approach. For the main analysis, the inverse-variance-weighted (IVW) method was utilized. To assess the heterogeneity of MR results, the IVW method and MR-Egger method were utilized. To evaluate potential pleiotropy, MR-Egger regression was conducted. Additionally, a leave-one-SNP-out test was performed to assess the robustness of MR results to the exclusion of any individual SNP. The MR analyses demonstrated a conspicuous impact of SHBG on the risk of pathological fracture with osteoporosis (OP). We found that an increase of one standard deviation (SD) in SHBG correspondingly increased the risk of pathological fracture with OP [odds ratio (OR) 2.42, 95% confidence interval (CI), 1.52-3.85; p = 1.93 × 10-4 ]. The bioavailable testosterone showed the negative casual genetic associations with fractures of foot and forearm. An increase of one SD in the genetically predetermined bioavailable testosterone was associated with a reduction of 37% in the risk of fracture of foot (OR 0.63, 95% Cl 0.49 to 0.81; p = 3.37 × 10-4 ), as well as a 39% decrease in the risk of fracture of forearm (OR 0.61, 95% Cl 0.50 to 0.76; p = 5.40 × 10-6 ). Our study confirms that individuals experiencing elevated SHBG concentrations showed a major causal effect on pathological fracture with OP. High bioavailable testosterone levels play an important role in preventing the fractures of foot and forearm. Although increasing bioavailable testosterone and decreasing SHBG levels had no casual effect on most fractures in the general population, they are likely to have the most clinically relevant effect on certain fracture risk reduction.

PREVALENCE AND IMPACT OF DENTOALVEOLAR TRAUMA IN CHILDREN AND ADOLESCENTS

The study addresses the prevalence and impact of dentoalveolar traumas in children and adolescents. These traumas rank second among the most common accidents in this age group and are gaining increasing global attention due to associated physical and psychological implications. Detailed clinical assessment, along with radiographic examinations, is crucial for accurate diagnosis and the selection of appropriate treatment. Dental traumas often affect the supporting dental tissues, with varying degrees of severity, ranging from subtle cracks in the dental enamel to more severe injuries such as luxations and avulsions, which can also involve damage to surrounding bone structures. These traumas are one of the main causes of tooth loss in children, especially the upper anterior teeth, with a wide variation in incidence. Causes range from accidental falls to sports activities and other events. For rapid and accurate diagnosis, it is important to conduct a methodical assessment of patients, considering incident details and possible associated symptoms. Proper treatment performed by dental surgeons is crucial to prevent irreversible damage. The study also discusses the classification of traumatic dental injuries, encompassing different types of fractures and displacements, both in dental tissues and supporting structures. Pulp necrosis is one of the main consequences of these traumas, which can have aesthetic, psychological, and social impacts, in addition to implying significant costs. Immediate care is important, but long-term follow-up is often necessary. In summary, the study emphasizes the importance of dentoalveolar traumas in children and adolescents, highlighting their prevalence, classification, and implications. It also underscores the need for proper diagnosis and treatment, as well as the importance of long-term follow-up to minimize the adverse effects of these injuries.

A critical review on fractographic studies of steel cord and bead wire used in tyre reinforcement

Fracture is one of the failure modes of a material or product which may occur during its manufacturing process or its usage. Fractography is the science and art of examination and analysis of the fractured surface. Texture and nature of the fractured surface provide valuable information on origin of a crack and crack propagation; thereby, it helps to understand the mechanism of fracture and facilitate to identify the likely causes of failure. This review covers an extensive study on various types of fractures of steel cord and bead wire which are primarily used in rubber composites viz tyre, conveyor belt etc. Different types of fractures studied include ductile, central burst, brittle, fatigue, torsion, corrosion, delamination and weld fractures. Fundamentals on specific characteristics of each type of fracture and their likely causes have been elaborately discussed Microscopic examination through scanning electron microscope (SEM) provides deeper insights of the fractured surface as well as microstructure of material. In addition to the fundamental aspects of fractures, examples of different types of fractured samples have been illustrated in this article. This focused review would be useful to the steel cord and bead wire manufactures as well as to tyre manufacturers for detailed failure investigation of material/product and thereby to take appropriate corrective measures.

Оценка сдвиговой прочности горных пород по трещинам на основе результатов испытаний образцов сферическими инденторами

Experimental data on the relationship of the residual shear strength of rocks in closed cracks with the functional characteristics of intact rocks – the tensile and compressive components of adhesion, the roughness of the crack surfaces, and the level of normal stresses are presented. A unified integrated approach determines the shear strength of intact and destroyed rocks, the residual shear strength of closed rough cracks has been developed. The approach provides for the selection of stress intervals corresponding to different types of fracture, for each of which a strength criterion is proposed, expressed in terms of functional characteristics of intact rock. An express method for estimating the residual shear strength of rocks by cracks with a rough surface has been developed, in which an improved method of loading samples with spherical indentors is used as a basic test method. The express method implements the transition from the data of mechanical tests of samples with spherical indentors to the shear strength indicators for cracks in the rock mass, taking into account the level of normal stresses and the roughness of the crack surfaces measured in field conditions. In this case the roughness scale developed by Barton is used. The express method is informative and available in the fieldwork.&#x0D;

A length scale insensitive phase field model based on geometric function for brittle materials

The commonly used phase field model has a broad application in static and dynamic scenarios with brittle materials. Following the assumption of irreversibility of fracture, monotonically increasing phase and tensile strain energy are applied in the commonly used phase field model. By doing so, a clear stiffness reduction, however, is observed in stress–strain curve before reaching fracture strength, which conflicts with the linear elastic behavior of brittle materials. The limitation has also been mentioned in publications when length scale is the only parameter to adjust fracture strength. To solve these problems, a generalized quadratic geometric function is proposed to build a length scale insensitive phase field model. Governing equations and one-dimensional analytical solutions (homogeneous and nonhomogeneous solutions) of this length scale insensitive phase field model are presented. By adjusting the extra parameter in the generalized quadratic geometric function and zeroing negative phase, different phase profile (ranged from exponential profile to linear profile) and fracture strength can be obtained, which could be more suitable to cover different types of fractures. Meanwhile, a narrower crack band and linear elastic behavior can be guaranteed. LS-DYNA user-defined element and user-defined material subroutines are used to implement the proposed length scale insensitive phase field model. A tensile test successfully verifies the properties of a narrower crack band and linear elastic behavior. Three representative numerical examples show the feasibility of this model to simulate fracture propagation, including a Mode Ⅰ failure of wedge splitting test, a mixed-mode failure of l-shaped panel test and a mixed-mode failure of notched beam test. From the crack band and force–displacement curve, the proposed model can handle fracture propagation better for brittle materials.

Clinical outcomes of closed, displaced phalangeal neck fractures in children with different types of kirschner wire fixation: A retrospective observational study.

Inappropriate treatment of Closed displaced phalangeal neck fractures (CDPNF) in children usually leads to poor outcomes.This study was to evaluate the clinical outcomes of closed/open reduction, age, and different types of fracture and Kirschner wire (K-wire) fixation in the treatment of CDPNF. Participants: Sixty patients (male, 46 and female,14; right-handed, 35 and left-handed, 25; mean age, 7.9-years-old [range, 1.0-14.5 years]) who had CDPNF were included. Preoperative x-rays showed that the fractures were displaced and exhibited obvious deformities. Interventions: First, reduction (four cases of open reduction and 56 cases of closed reduction) was performed followed by percutaneous K-wire fixation (cross fixation, 24 cases; longitudinal and slanting fixation, 17 cases; homolateral fixation, four cases; and single longitudinal fixation, 15 cases,) and immobilized by cast. x-ray examination following removal of the K-wires showed that the fractures were healed; the criteria for fracture healing were callus formation and the absence of fracture lines. Clinical outcome and radiographs between groups were compared. According to the visual analogue scale, the pain scores were excellent. According to the Al-Qattan Grade system(AGS),all the patients presented with closed, type II phalangeal neck fractures,the results were excellent in 36 cases (36/60, 60%), good in 15 cases (15/60, 25%), fair in 5 cases (5/60, 8.3%) and poor in 4 cases (4/60, 6.7%). There were significant differences in different fracture type groups (P = 0.013*), operation age groups (P = 0.025*) and open/closed reduction groups (P = 0.042*). There was no significant difference in K-wire fixation type groups (P > 0.05). Patients with open reduction, the more serious fracture type, the older at the operation, were more likely to have poor AGS result. Different K-wire fixation types for CDPNF in children had the same satisfactory results.

Comparison of Resistance to Fracture of Endodontically Treated Teeth Reinforced with Various Posts: An In-vitro Study

Introduction: Endodontically treated tooth reinforced with posts should restore its lost structural integrity, as well as withstand the various masticatory forces. Choosing the appropriate post, so that a durable prosthesis can be given, is often a challenge to a restorative dentist. Aim: To compare the resistance to fracture, of endodontically treated teeth restored with the various posts when subjected to compressive loads, and analyse the different types of fractures and cracks which are visible under normal eye, microscope and radiograph. Materials and Methods: An in-vitro study was conducted in the Department of Dentistry, Pondicherry Institute of Medical Sciences, Puducherry, India, from February 2019 to March 2020. Study was done with four types of posts namely cast post, stainless steel, fibre and titanium on seventy extracted teeth, which were randomly allocated into five groups with one group as control without any post. The teeth were subjected to increasing compressive loads with universal testing machine and the loads at which fracture occurred was recorded. The data was analysed statistically with one way Analysis of Variance (ANOVA) and the groups were compared with Tukey’s HSD test. The types of fractures that occurred were also analysed. Results: The loads at which the teeth reinforced with various posts fractured, showed significant difference (p-value &lt;0.0001). The mean load at which fracture occurred for teeth restored without any posts was 711.6086 N and teeth with stainless steel post was highest at 1605.955 N. Those with titanium posts were found to have minimum microcracks (14.2%) when seen under dissection microscope. Maximum number of teeth with titanium posts had favourable fracture and withstood the load (64.29%), with fracture occurring only at root tip and no fracture elsewhere. Tukey’s HSD test was done to compare the fracture resistance between the groups at 0.05 level of significance. There was no significant difference in the load at which fracture occurred between groups. Conclusion: In the present study, of all different post and core materials, stainless steel post resisted highest load and titanium posts had favourable fractures.

AVALIAÇÃO DA MENSURAÇÃO DA CIFOSE NAS FRATURAS DA COLUNA TORACOLOMBAR

ABSTRACT Objectives: Evaluate the reliability and reproducibility of the kyphosis measurement in thoracolumbar spine traumatic fractures by different assessment methods in different types of fractures. Methods: Fifteen fractures of the thoracolumbar spine, previously classified into types A, B, and C according to Magerl’s classification, were evaluated. The value of kyphosis was measured using five different methods: (1) Cobb angle; (2) Gardner’s method; (3) back wall method; (4) angle of adjacent endplates; and (5) wedge angle. The measurements were performed by five independent observers and repeated five times with a minimum interval of two weeks between each evaluation. Results: Intraobserver reliability was excellent among the five observers, evidencing good reproducibility of the methods. The five methods used also showed great intraobserver reliability in the global analysis, with methods one and four being more consistent. Conclusion: Although there is no universal agreement on measuring kyphosis in thoracolumbar fractures, our study concluded that method 1 (Cobb angle) and method 4 (adjacent endplate angle) presented the best interobserver reliabilities. Furthermore, the use of digitized radiographs and a simple computer program allowed the performance of highly reliable and reproducible measurements by all methods, given the high intraobserver reliability. Level of Evidence II; Comparative study.