Frequency Of Fractures Research Articles

Three-dimensional mapping of sternum fractures from high-energy trauma.

Sternum fractures are relatively uncommon injuries, which generally occur as a result of a high-energy mechanism and are often associated with significant concomitant injuries. These injuries may result in decreased quality of life if not properly addressed and yet are rarely operated on. The purpose of this project is to evaluate high-energy sternum fracture patterns using a previously published three-dimensional (3D) computed tomography (CT) reconstruction process to produce fracture frequency maps. Patients 18 years and older presenting to a Level I trauma center with sternum fractures due to high-energy trauma between October 2013 and January 2022 were included. A 3D reconstruction and reduction was performed for each sternum using medical image processing software (Materialize NV, Leuven, Belgium). The reconstructions were subsequently overlaid onto a template sternum and normalized using bony landmarks. Fracture lines for each injured sternum were transferred onto the template, creating 3D frequency maps. A total of 120 patients met inclusion criteria. The study population had a uniform age distribution and 57.5% were male. The most common mechanism of injury was motor vehicle collision (64.2%). The breakdown of sternum fractures were isolated sternal body (55.8%), isolated manubrium (31.7%), and combined sternal body and manubrium fractures (12.5%). No xiphoid fractures were observed. Sternal body fractures were a near even mix of transverse (31.7%), oblique (32.9%), and comminuted (35.4%), while 75.5% of manubrium fractures were oblique. The most common associated injuries included rib fractures (80.8%) and traumatic brain injury (61.7%). This study presents the fractures from sternum injuries in 3D, and provides insight into reproducible sternum injury patterns that have not previously been analyzed in this format. This fracture mapping technique presents numerous injury patterns simultaneously, such that more frequent morphologies can be appreciated for different patient groups. Diagnostic Tests or Criteria; Level V.

Experimental Investigation on Ignition of Hyperburner Based on Gliding Arc Plasma Igniter Driven by Pressure Difference

The hyperburner is a key component of a TBCC engine, and its reliable ignition and stable operation are critical. The gliding arc plasma igniter driven by differential pressure has the technical advantages of low energy consumption and high jet temperature. In this paper, the electrical and flow characteristics of the gliding arc plasma igniter are studied, and the basic ignition experiment in the hyperburner is carried out. Electrical characteristic experiments show that the discharge duration, the evolution of the gliding arc and the fracture frequency are affected by the pressure difference between the inlet and outlet of the igniter (Δp). With the increase in Δp, the frequency of the trapezoidal envelope in the voltage and current waveforms increases, and the frequency of the evolution and fracture of the gliding arc increases. The continuous discharge time of the gliding arc decreases when Δp = 550 Torr. The flow characteristic experiments show that the velocity of the swirl sheath is increased and the protective effect on the gliding arc is enhanced with the increase in Δp. In the range of 20–550 Torr, the jet length first increases and then decreases with the increase in Δp. The jet length reaches a maximum of 31 mm at Δp = 50 Torr. Basic ignition experiments show that proper Δp can widen the lean ignition limit and shorten the ignition delay time. In the working conditions of this paper, the ignition effect is the best when Δp = 350 Torr, which can widen the lean ignition limit by 37.5% and shorten the ignition delay time by 17%. After increasing the oil–gas ratios, the combustion is more complete and the ignition delay time can be shortened by 93.1% at most.

Evaluation of Facial Fracture Trends in Rural and Urban Populations in Maine

There is a paucity of literature comparing facial trauma in patients from urban and rural settings. To our knowledge, this is the first study analyzing the differences in facial trauma in patients from urban and rural communities in the United States. The study was conducted to compare the frequency and distribution of facial fractures in patients from urban and rural populations to better patient care in hospitals serving both settings, while highlighting injury prevention techniques and areas of continued research need.

Safety and Efficacy of Zoledronic Acid in children with Osteogenesis Imperfecta.

To evaluate the efficacy and safety of zoledronic acid in children with osteogenesis imperfecta (OI). Descriptive Study. National Institute of Child Health, Department of Endocrine and Diabetes, Karachi, Pakistan, from January 2011 to December 2020. Children, with OI registered for the treatment, were included. Zoledronic acid was given to them by intravenous infusion over 30 minutes with a dose of 0.05 mg/Kg/day for a median duration of 60 (24-96) months. To ensure safety, patients were kept for 24 hours after dose administration to monitor any short-term side effects. The patients were assessed after every 3-6 months for frequency of fracture, bone pain, and BMD. Out of 82 children [40 females (48.8%) and 42 males (51.2%)], 11 patients (13.4%) had fever and 2 patients (2.4%) had flu-like illness. No other side effects were observed. The annual fracture rate decreased overall from 2.8±1.5 to 0.2±0.5 (˂0.001) in both males (2.6±1.3 to 0.1±0.4) and females (3.1±1.7 to 0.2±0.6). Z-score on DEXA scan showed improvement in BMD overall (-3.9±2.0 to 2.2 ±1.7), in males (-3.7±1.9 to -2.1±1.7) and in females (4.1±2.1 to -2.3±1.8). There were no other long-term side effects like ocular problems, osteonecrosis of the jaw, and delayed healing of the fractures. Zoledronate use in children is associated with minimal short-term and long-term side effects with a significant improvement in BMD and decline in fracture rate. Osteogenesis imperfecta (OI), Bisphosphonates (BPs), DEXA scan, Bone mineral density (BMD).

Humeral Shaft Fractures in Children Incidence, Management and Treatment Effects.

Humeral shaft fractures are relatively rare in children, with incidence between 0.4% and 3% of all fractures in children and between 10% and 20% of all humeral fractures. The purpose of our study was to retrospectively evaluate all humeral shaft fractures treated at children's trauma center from january 2012 till december 2021. We retrospectively evaluated the group of 104 skeletally immature patients with humeral shaft fracture treated in our hospital. We have analyzed: age; sex; fracture type, management; time of bone healing; final effect and complications. The non-surgical group consisted of 73 patients (27 girls and 46 boys) with an average age of 8.03 (0.6 - 17.7), while the surgical group consisted of 31 patients (16 girls and 15 boys) with an average age of 12.47 (5,7- 17.8). The mean follow-up was 7.65 months (4-12) in non-surgical group, and 13.38 months (4-24) in surgical group. We have analyzed the results statistically, confirming increase the frequency of the above-mentioned fractures and increase the number of patients treated with surgery. We achieved good effect in all patients. 1. Humeral shaft fractures in children are relatively rare. Although in recent years, we have observed an increase of their frequency; 2. The vast majority of humeral shaft fractures are treated non-surgically with good clinical results; 3. Increase of number of patients treated surgically has been noticeable in the last decade; 4. Surgery is associated with a relatively low risk of complications and allows for cast withdrawal, which significantly improves the patients comfort.

THE INFLUENCE OF HYPODYNAMY ON THE QUALITY OF THE FEMUR BONE TISSUE IN THE EXPERIMENT

Femur fractures make up 10-12% in the total number of all traumatic injuries of the human bone system. Among the reasons of the high frequency of femur fractures, various authors point out, in addition to anatomical features, a decrease in the quality of bone tissue caused by hypodynamia. The purpose of our work was to fi nd out the changes in the quality of bone tissue that develop in diff erent areas of the proximal part of the femur on the background of forced hypodynamia.The study was performed on 10 white outbredsexually mature male rats aged 3.0-3.5 months and with weigh 180.0-200.0 g. Forced hypodynamia was modeled by immobilizing the hind limbs with a plaster cast of the coxite type (with metal wire reinforcement), with full restriction of movement in hip and knee joints. The observation period was 4 weeks. The density of bone tissue in the area of the head, neck, greater trochanter and the proximal area of the diaphysis of the femur was determined by radiovisiography.It was established that the bone tissue of the greater trochanterhas has the highest density indicators (156.8±14.87), slightly lower has the head (143.92±13.07 CGU) and the proximal part of the diaphysis of the femur (136.32±19.68 CGU) and the lowest has the neckof the femur (131.28±12.86 CGU).On the background of the absence of changes in the hip and knee joints and in the structure of the bone tissue of the femur according to radiography data, after four weeks of forced hypodynamia, the density of the bone tissue of the head of the femur and the greater trochanter decreased to 140.08+9.84 CGU and 149.97±16.18 CGU, respectively, the density of the bone tissue of the proximal part of the diaphysis of the femur increased to 143.73±17.52 CGU, and the density of the bone tissue of the neck of the femur remained at the same level as in the intact rat, amounting to 131.04±9.16 CGU.

Occurrence and associated risk factors of long bone fractures in food and pet animals in Mymensingh district of Bangladesh: A retrospective study

The aim of this study was to determine the prevalence of fracture and the risk variables connected to its occurrence in calves and cats at Veterinary Teaching Hospital, Bangladesh Agricultural University, Mymensingh. A total of 96 (calves) and 17 (cats) retrospective datasets were compiled between January 2015 and December 2019. Age, sex, breed, season, involvement of the bone, and type of fracture were considered to characterize fractures. To examine the data, simple descriptive statistics were used. At around 6 months, there were the highest rates of long bone fractures in both calves and cats (77%, n = 74; and 65%, n = 11). According to sex variation, fracture was more common in male calves (61%, n = 59) and female cats (76%, n = 13). Calves and cats from native breeds had the highest fracture rates (52%, n = 50) and (100%, n = 17), respectively. The summer season saw the highest rates of long bone fractures in both calves (41%, n = 39) and cats (53%, n = 9). The majority of the fractures in calves (42%, n = 41) were found to be in the metatarsal bone during pre-operative clinical assessment. In cats, this primarily affected the femur (41%, n = 7). Cats (59%, n = 10) and calves (55%, n = 53) had the highest rate of transverse long bone fractures. This study will help to establish the frequency of fractures, which is very important clinically in the examination and diagnosis of fractures in calves and cats.

195. A comparison of mortality following vertebral compression fractures in patients with or without vertebral augmentation

<h3>BACKGROUND CONTEXT</h3> With advancing age, there is a natural diminution of bone density. Aging is also associated with the development of other chronic medical conditions. The expected loss of bone density in aging patients brings an increased frequency of vertebral compression fractures; when combined with an increased presence of multiple comorbid conditions, these patients may be at a higher risk of mortality and morbidity following a compression fracture. One of the mechanisms of this is worsening physiological deconditioning that may be associated from the loss of mobility secondary to pain from a new fracture. Vertebral augmentation, such as balloon kyphoplasty, is performed to relieve pain in this patient cohort. With a reduction in pain, there is the expectation that patients may regain a degree of function and mobility, and thus avoid the risks associated with debility in elderly patients with various chronic medical conditions. <h3>PURPOSE</h3> The purpose of this study was thus to retrospectively evaluate patients who had sustained vertebral compression fractures, with the intent of comparing mortality rates in those with or without vertebral augmentation. <h3>STUDY DESIGN/SETTING</h3> This was a retrospective chart review of consecutive patients over a 5-year period. The study was performed at a Level I trauma center. <h3>PATIENT SAMPLE</h3> A cohort of 2,829 patients were included, this was based on diagnosis codes for vertebral compression fractures, and a subgroup of 110 patients who has received vertebral augmentation, based on procedures codes was extracted from within the initial cohort. <h3>OUTCOME MEASURES</h3> Presence of compression fracture, presence of vertebral augmentation procedure, mortality. <h3>METHODS</h3> Following approval from the local Institutional Review Board, consecutive patients who sustained vertebral compression fractures between the 5-year period between 01/01/2015 to 12/31/2019 were identified using diagnosis codes. These patients were then further stratified based on procedure codes to determine whether or not they had vertebral augmentation. A univariate analysis will be performed to examine quantitative variables using central tendency and variation. Qualitative variables will be examined by frequencies and counts. Variables collected will also be descriptively analyzed by time and measures of association will be analyzed between variable pairings. The primary outcome of mortality will be investigated between two cohorts by a Chi-square test or Fisher's Exact test. A survival analysis may be performed to analyze significant differences between cohorts. All tests will be two-sided where appropriate with an alpha of 0.05 to determine statistical significance. Results will also be presented graphically when appropriate. <h3>RESULTS</h3> The study population was composed of 1,406 (49.70%) females and 1,423 (50.30%) males. Comparing the mortality between patients that received a kyphoplasty or not, a statistically significant association was found where 21.82% of patients that received a kyphoplasty were deceased and 13.68% of patients that did not receive a kyphoplasty were deceased (p=0.0159). The mean age in years of 110 kyphoplasty patients was 71.65 (95% CI 69.40-73.89). A survival analysis was conducted to test the equality of mortality estimates between subjects that received a kyphoplasty or not. No significant differences were found between the strata of survival between both groups using a log-rank test of equality (p=0.7138) Fracture type and mortality's associations with comorbidities were examined by chi-square and Fisher's-exact statistics. Significant associations were found between mortality and diabetes (p=0.0145) and renal disease (p=0.0036). Frequencies and percentages for each association examined can be observed in the excel attachment. <h3>CONCLUSIONS</h3> One of the most striking features of this cohort was the relatively small proportions of patients having augmentation procedures. Patients with compression fractures vary, and there may be a degree of self-selection, as the amount of pain and debility varies; those who remain functional, and presumably in a better state of health despite a fracture (will frequently not even be aware of the presence of a fracture), will likely not undergo a vertebral augmentation. Also surprising was the fact that mortality was greater in the procedure group, although the intrinsic differences in the patient groups would account for this. The presence of comorbid conditions was associated with a heightened risk of mortality, specifically in patients with diabetes and renal disease. <h3>FDA DEVICE/DRUG STATUS</h3> This abstract does not discuss or include any applicable devices or drugs.

The fracture-controlled carbonate Brejões Karst System mapped with UAV, LiDAR, and electroresistivity in the Irecê Basin - Brazil

Understanding how fractures influence fluid flow in carbonate rocks is essential to understanding karst evolution, oil reservoirs, and aquifer exploitation. The present study investigates karst fracture geometry at the surface and subsurface in the Irecê Basin, a Neoproterozoic epicontinental cratonic basin in the São Francisco Craton, Brazil. We used an Unmanned Aerial Vehicle (UAV) to map both fractures in three outcrops and valley geometries, Light Detection And Ranging (LiDAR) to map 3500 m of cave conduits, and Electrical Resistivity Tomography (ERT) to identify karst zones between 90 and 110 m deep. Our results indicate that the Brejões Karst System is comprised of dissolution and collapse features such as caves, dolines, pavements, and karst valley. The quantitative analysis of subseismic fractures (<50 m long) identified 4398 fractures in Outcrop A, 2458 in Outcrop B, 4374 in Outcrop C, and 7172 in 18 cross-sections of the Brejões Cave. These fractures form a corridor with four main sets striking N–S, NNE–SSW, NW–SE, and E–W, where the fracture system is essential to cave connectivity, permeability, and development. The highest frequency of fractures coincides with the main cave axes, where the intersection of the fracture/fault are sites prone to dissolution. The ERT profiles indicated a high density of geophysical anomalies that correspond to enlarged fractures in the epikarstic zone that extend between the surface and approximately 30 m deep. The cave infill impacts the cave characterization and leads to underestimating cave dimensions. This study may contribute to an underestimation of the role played by subseismic scale fractures in karst evolution in gently deformed settings.

Correction of hyperphosphatemia in hemodialysis patients: 12-month findings from a randomized study

Abstract. The aim of our study was to compare the safety and effectiveness of the use of sevelamer with calcium acetate for hyperphosphatemia control in hemodialysis patients.&#x0D; Materials and methods. An open-label, randomized, parallel study was conducted to compare the safety and effectiveness of the use of sevelamer with calcium acetate for hyperphosphatemia control in hemodialysis patients. 198 patients treated with hemodialysis at the Kyiv City Center of Nephrology and Dialysis in the period from 2019 to 2021 were included. The duration of the study was 12 months. with a 2-week washout period before starting the study. Before the start of the study, any phosphate binders were withdrawn. After a 2-week washout period, patients were randomized to receive sevelamer or calcium acetate. The primary endpoint of the study was death from any cause, the surrogates were death from cardiovascular events, and the incidence of fractures.&#x0D; Results. At the end of the follow-up period, 86 (93%) of the 92 patients who remained alive (main group) had the target serum phosphorus level. At the end of treatment, the level of phosphorus in the main group was 1.62 (1.4, 1.67) mmol/l (p&lt;0.001). The dose of sevelamer carbonate was 4800 mg/day.&#x0D; The target serum phosphorus level was achieved in 72 (94%) of the 77 patients who remained alive after 12 months of follow-up period. At the end of the treatment, the phosphorus level in the comparison group was 1.62 (1.44, 1.66) mmol/l (p&lt;0.001). The dose of calcium acetate was 3000 (1500; 3000) mg/day.&#x0D; 24 (24%) patients in the main group and 22 (23%) in the comparison group reported at least one adverse event (AE) related to phosphate binder intake. In most cases, the established AEs had a mild degree of severity and did not require discontinuation of the drug.&#x0D; During the observation period, the overall mortality rate in the comparison group was more than 2.3 times higher than in the main group, and this difference was statistically significant (RR 0.43, 95% CI: 0.207 - 0.902). At the same time, cardiovascular mortality in the comparison group was more than 2.8 times higher than in the main group, and this difference was also statistically significant (RR 0.34, 95% CI: 0.128 - 0.916). Survival analysis showed a statistically significant difference in survival in patients of the studied groups. During the observation period (12 months), 6 cases of fractures (6%) were recorded in the main group. In the comparison group, the frequency of fractures was 7%, and the difference in frequency was not statistically significant (RR 0.82, 95% CI: 0.287 - 2.362).&#x0D; Conclusions. The obtained data showed the high efficiency and safety of sevelamer for hyperphosphatemia correction in hemodialysis patients, as well as a beneficial effect on important clinical outcomes.

Frequency and Causes of Fracture of Acrylic Resin Complete Dentures in Edentulous patients

Background: The rehabilitation of edentulous patients requires acrylic resin complete dentures to fulfil their functional and esthetic needs. Fractures of dentures are one of the commonest complaints around the world. Aim: To evaluate the frequency of acrylic complete denture fractures among edentulous patients and find out their association with certain variables. Methodology: A cross sectional observational study was carried out in Prosthodontic department of Lahore Medical and Dental College, Lahore from 26th March 2020 to 26th September 2021. A total of 58 completely edentulous patients reported with fractured acrylic dentures were selected. Patients were evaluated both intra and extra orally to find out the cause and site of fracture. Various parameters namely, denture age, fracture sites, gender were statistically evaluated to find out their relationship with denture fracture. Results: Results showed that male patients; 56.9% were presenting more with fractured dentures than female; 43.10%. In males the midline denture fractures were most commonly seen 45.5%, whereas in females’ fracture at premolar area was commonly observed 28.0% however no statistical dependance between fractured dentures sites and gender was found. Denture fractures were most prevalent in mandibular arch 50% as compared to maxillary 39.7%. Mid line fracture was the commonest site observed in both maxillary 30.4% and mandibular arches 31.0%. Insignificant association between fracture sites and dental arches was seen. Maximum denture fractures were recorded in first 2 years of denture fabrication 55.2%. The most frequent cause of denture fracture was accidental falling 34.5%. Conclusion: The frequency of complete denture fracture is more in mandible as compared to maxilla and the main reason is patients’ negligence. The study also showed midline fracture of dentures to be the most frequent site of denture fracture. Keywords: Acrylic dentures, Complete dentures, Edentulism, Edentulous, Prosthesis, Tooth loss,

Quantification of Rock Mass Condition Based on Fracture Frequency Using Unmanned Aerial Vehicle Survey for Slope Stability Assessment

Quantification of Rock Mass Condition Based on Fracture Frequency Using Unmanned Aerial Vehicle Survey for Slope Stability Assessment

Epidemiological Study of Frontal Sinus Fractures: Evaluation of 16 Years of Care at the Faculty of Dentistry of Ribeirão Preto/Brazil.

Aiming to evaluate and study the epidemiological profile of frontal sinus fractures treated in the region of Ribeirão Preto-Brazil. Sixteen years of activity in the Oral and Maxillofacial service of the Faculty of Dentistry of Ribeirão Preto/SP (FORP/USP), totaling 9,736 consultations, 4,524 with facial fractures, those diagnosed with frontal sinus fracture (113) were evaluated and selected for the study. Frontal sinus fractures accounted for 2.5% of facial fractures, the majority occurring in men (89.4%), concentrated in the age group 21-30years old, with 52.2% of cases being caused by road traffic accidents (RTA). Associations with other facial fractures are common and appeared in 75.2% of cases. Treatment was followed either surgically, by open reduction internal fixation (52.2%) or conservatively (35.4%). Analyzing only the 28 isolated frontal sinus fractures, the most common treatment was conservative (46.4%). surgical treatment dropped to 25%. The most common postoperative complications were temporal branch paralysis and supraorbital nerve paresthesia, both occurring in 30.5% of surgical cases. The frequency of frontal sinus fractures may be decreasing, but the pattern of occurrence in young men due to road traffic accidents does not seem to change, fortunately the appearance of serious complications is not common and it is usually associated with more severe trauma.

FEM Modelling of Weld Damage in Continuous Cold Rolling of MIG/MAG Butt-Welded Stainless Steel Strips

Weld line fracture of butt-welded strips in stainless steel continuous rolling has been studied by numerical simulation using ForgeNxT®. The simulation plan includes weld line geometry as well as weld metal constitutive model parameters. The damage criterion used is the non-dimensional Latham &amp; Cockroft function near the singular points of the weld line. Results are confronted to qualitative observations of fracture frequency and fracture initiation loci on the rolling line. Not surprisingly, the protrusion height of the weld line with respect to the strip top surface is found to be a major factor of risk. A second one pertains to the nature of the alloys used: due to the mushroom-like weld line cross-section geometry, damage at the top surface junction of the base metal and the weld metal becomes critical when the weld metal is harder than the base metal. Finally, on the rolling line investigated, prior to rolling properly speaking, the strip goes through a scale-breaking unit followed by acid pickling to eliminate oxides; the multiple, reverse plastic bending applied there contributes significantly to ductile damage, completing the explanation of why the fracture initiation locus is always found to be the same on the rolling line.

Comparing Clinical and Genetic Characteristics of De Novo and Inherited COL1A1/COL1A2 Variants in a Large Chinese Cohort of Osteogenesis Imperfecta.

PurposeNearly 85%-90% of osteogenesis imperfecta (OI) cases are caused by autosome dominant mutations of COL1A1 and COL1A2 genes, of which de novo mutations cover a large proportion, whereas their characteristics remain to be elucidated. This study aims to compare the differences in clinical and genetic characteristics of de novo and inherited COL1A1/COL1A2 mutations of OI, assess the average paternal and maternal age at conception in de novo mutations, and research the rate of nonpenetrance in inherited mutations.Materials and MethodsA retrospective comparison between de novo and inherited mutations was performed among 135 OI probands with COL1A1/COL1A2 mutations. Mutational analyses of all probands and their family members were completed by Sanger sequencing. A new clinical scoring system was developed to assess the clinical severity of OI quantitatively.ResultsA total of 51 probands (37.78%) with de novo mutations and 84 probands (62.22%) with inherited mutations were grouped by the results of the parental gene verification. The proportion of clinical type III (P<0.001) and clinical scores (P<0.001) were significantly higher in de novo mutations. Missense mutations covered a slightly higher proportion of de novo COL1A1 mutations (46.34%) compared with inherited COL1A1 mutations (33.33%), however, lacking a significant difference (P=0.1923). The mean BMD Z/T-score at the lumbar spine in de novo mutations was -2.3 ± 1.5, lower than inherited mutations (-1.7 ± 1.8), but lacking statistical significance (P=0.0742). There was no significant difference between the two groups in OI-related phenotypes (like fracture frequency, blue sclera, and hearing loss) and biochemical indexes. In de novo mutations, the average paternal and maternal age at conception was 29.2 (P<0.05) and 26.8 (P<0.0001), respectively, which were significantly younger than the average gestational age of the population. Additionally, 98.04% of pedigrees (50/51) with de novo mutations were spontaneous conception. The rate of nonpenetrance of parents with pathogenic variants in the inherited mutation group was 25.64% (20/78).ConclusionsOur data revealed that the proportion of clinical type III and clinical scores were significantly higher in de novo mutations than in inherited mutations, demonstrating that de novo mutations are more damaging because they have not undergone purifying selection.

Seismic reflectivity, fracturing and stress field data from the FFC-1 exploratory geothermal project in SW Skåne, Sweden

Enhanced geothermal systems (EGS) are a potential heat source in many parts of the world, even in locations where the temperature gradient is relatively low. We present here an integrated study of reflection seismic data, borehole logs and seismicity analysis performed in conjunction with a geothermal exploratory project operated by E.ON in Malmö, Sweden. In 2020, the pre-existing 2.1 km deep FFC-1 borehole through the sedimentary cover was deepened into the crystalline basement to about 3.1 km vertical depth. Combined interpretation of the reflection seismic data and geophysical wireline logs show that most of the reflectivity in the Precambrian basement is likely generated by lenses of mafic amphibolite embedded in a felsic gneissic matrix. The general structural bedding and foliation is gently dipping to sub-horizontal, similar to other locations in southwest Sweden. Fracture frequency is relatively high in the crystalline rock mass, with heavy fracturing in the uppermost part of the crystalline basement, obscuring a clear reflection from the top of the Precambrian. Highly fractured and hydraulically conductive intervals are also found between 2,562 and 2,695 m based on a temperature drop and the interpretation of the geophysical data. Open fractures, both natural and induced, have a clear N–S orientation, contrasting with the expected NW–SE direction based on the orientation of the Sorgenfrei-Tornquist Zone and earthquake fault plane solutions to the north. This difference may be partly explained by local variations in the stress field near the FFC-1 borehole and vairations in the stress field with depth. Despite this, the data from the FFC-1 well provide novel and unique information on the complex physical state of the crystalline basement on the margin of the Fennoscandian Shield, which further addresses the need for obtaining in-situ stress data to fully understand the local stress field prior to any stimulation. A temperature of 84°C measured at 3 km depth indicates that a desired EGS temperature of 120–140°C may be reached at 5–6 km depth, assuming a temperature gradient of about 20°C. If the relatively high fracture frequency and occurrence of fracture zones down to 3.1 km are also present at these target depths, then the FFC-1 location may be suitable for heat extraction if the rock mass is properly characterized before stimulation.

Evaluation of the Result of Dynamic Hip Screw Along with Postoperative Vitamin D Supplementation in Stable Trochenteric Fracture in Elderly Female

Background: Recently trochenteric fracture is one of the common cause of morbidity in the geriatric group. Its mainly affect the elderly group who risk the loss of independence. Frequency of trochenter fracture is increasing with population aging. Treatment is usually surgical of various sorts. ORIF by DHS, PFN, DCS, Arthoplasty all coming in the way. Choice of implant need to focusing on the technical details. Among them DHS is one of the oldest and common devices that used in trochenter fracture. To evaluate the effectiveness of DHS along with Vitamin D in stable trochenter fracture in geriatric group female. Materials and methods: This study was done for the period January 2019 to December 2020 among 36 elderly post menopausal lady with stable trochenter fracture admitted in different private hospital in Chittagong. Case selection was done after proper screening criteria. All patient were treated by ORIF by DHS under c-arm after preoperative evaluation. Post operatively all were treated with oral vitamin D supplement to enhance the union with implant. All the patient were followed up monthly both clinically and radiologicaly. Both the functional and clinical outcome was evaluate after 6 month of operation. Results : Total 36 elderly female with stable trocahnteric fracture with the age range (52-95years) were taken for the study. Open reduction and internal fixation done under c-arm by DHS and oral vitamin D given to all. Final assessment done after 24 weeks, out of 36 patient 50% patient had no limping, 11% regained previous walking ability, 8.3% unable to bear weight. Radiological improvement in healing showed in 91.7% case. Final outcome reveals excellent and good result in total 75% case which is very satisfactory surgical result. Where as only 3 case had a poor outcome those who not able to bear weight even after 24 weeks of operation. Conclusion: The treatment of trochanter fracture by DHS simplifies nursing care, allows early mobilization and reduces mortality and morbidity specially in geriatric group. Stable fixation along with post operative vitamin D supplementation enhance the healing. IAHS Medical Journal Vol 5(1), June 2022; 70-73

A review of proximal femur fracture patterns, etiologies and sociodemographic features

Objectives: To identify the frequency and patterns of proximal femur fractures in a tertiary center in Jordan to aid in the identification of the requirement of the orthopedic department and assist in the future planning for founding country-based preventive and treatment guidelines.Methods: This retrospective study reviewed 706 proximal femur fractures admitted from July 2018 to December 2021 at King Hussein Medical City in Amman, the capital of Jordan. Fractures were assessed concerning age, gender, mechanism of injury and variation over the years.Results: Proximal femoral fractures account for one-fifth of all orthopedic hospital admissions. Females represented most patients (60.9%) and the left side was most affected (52.1%). Intertrochanteric fractures were the most common, followed by intracapsular fractures of the femoral neck; both accounted for about 90% of all fractures. Patients with femoral neck fractures are ten years younger than the intertrochanteric group. Falling from the floor was the most common cause. Fractures of the proximal femur occur in elderly patients with a mean age of 70.81 years (±18.97). However, femoral head and hip dislocation occur in young patients. We notice an annual increase in the number of admissions.Conclusions: Proximal femur fractures are the leading cause of hospitalizations in the orthopedic department. This study provides information on proximal femur fractures in Jordan. However, multicenter studies are needed to evaluate proximal femur fractures adequately, provide guidelines for treating and preventing these injuries and determine our institute's supply needs.

Trans-fracture approach for ORIF of coronal shear fractures of the distal humerus

IntroductionOpen reduction and internal fixation (ORIF) of comminuted coronal shear fractures of the distal humerus is challenging. When a concomitant lateral condyle fracture is present, it may be used for a trans-fracture approach to facilitate exposure and fracture reduction. This study aimed to investigate the frequency of lateral condyle fractures in coronal shear fractures of the distal humerus and analyze fracture reduction, fracture union and clinical results following ORIF through a trans-fracture approach.Materials and methodsAll adult patients who underwent treatment for an acute distal humerus fracture during a three-year period in our level-one trauma center were identified. All fractures were classified according to the Orthopaedic Trauma Association (OTA/AO) fracture classification system and all B3 fractures were classified according to the Dubberley classification. B3 fractures with a concomitant radial condyle fracture were identified. The clinical and radiological results, (Mayo Elbow Performance Score = MEPS, Visual Analogue Scale = VAS, range of motion), complications and revision surgeries were analyzed.Results53 patients (mean age 52 ± 19 years) were identified. 13 fractures (24.5%) were B3 fractures. Four of them (30.8%) had a concomitant radial condyle fracture. All of these patients underwent ORIF with headless cannulated compression screws and a (postero-)lateral locking plate through a trans-fracture approach. At a minimum follow-up of 24 months, the MEPS was 88 ± 12 points, the VAS was 2 ± 1 and the range of motion was 118° ± 12°. All fractures showed anatomic reduction. One patient developed partial avascular necrosis and underwent arthrolysis at 6 months. One patient underwent partial hardware removal and lateral collateral ligament bracing at 6 months.ConclusionsLateral condyle fractures are present in about one third of coronal shear fractures of the distal humerus. This injury can be used for a trans-fracture approach to facilitate exposure and to reliably achieve anatomic fracture reduction.

Impact of keel saw blade design and thickness on the incidence of tibial plateau fracture and tibial implant-loosening in cementless medial UKR

BackgroundTibial plateau fractures and tibial implant- loosening are severe complications in cementless unicompartmental knee replacement (UKR). The tibial keel preparation is particularly demanding and different saw blades can be used. It was hypothesized that different blade designs and thickness have an influence on the frequency of tibial plateau fractures and implant-loosening in cementless medial UKR.Methods1258 patients with cementless medial UKR were included in this retrospective study between 2013 and 2020. The tibial keel cut was performed either with a double keel saw blade (DKS; 2.8 mm) and added hand guided pick or a mono reciprocating saw blade (RKB) of different thickness (2.5 mm; 2.65 mm; 2.75 mm). Tibial plateau fracture and loosening were demonstrated by standard two-plane radiographs. Tibial implant-loosening was defined as complete radiolucency and implant migration. Fracture and loosening were combined with pain and loss of function.ResultsIn 126 patients (10%) the tibial keel was prepared with DKS, in 407 patients (32.4%) with RKB 2.5 mm, in 330 patients (26.2%) with RKB 2.65 mm and in 395 patients (31.4%) with 2.75 mm. In 4 patients (3.17%) with DKS tibial plateau fracture occurred, in 4 patients (0.99%) with 2.5 mm RKB, in 3 patients (0.92%) with 2.65 mm RKB and in 1 patient (0.25%) with 2.75 mm RKB. Significantly fewer fractures occurred with a RKB design (p = 0.007). A negative correlation between fracture incidence and RKB saw blade thickness was found (Spearman-r = − 0.93). No difference for tibial implant-loosening was shown (p = 0.51).ConclusionDifferent blade designs and thickness have a significant influence on the incidence of tibial plateau fractures and aseptic tibial implant-loosening. The incidence of tibial plateau fractures in cementless medial UKR can be reduced by changing the design and thickness of the tibial keel saw blade. Greater thickness of RKB leads to significantly fewer tibial plateau fractures while the incidence of implant-loosening is not increasing.Trial registration: This study was retrospectively registered and ethical approval was waived by the local ethical committee (No. 2020–1174).