Fracture Site Research Articles

Use of tie-in femur osteosynthesis in free-living aracuã scamoso (ortalis squamata) with blockage of the femoral and ischiatic nerves

We report the case of an adult scaly-breasted arachnid, which arrived for treatment with a history of being on the ground in the courtyard of a house, unable to stay in a station. On clinical examination, the bird had an immobile right femur, with a probable comminuted fracture, and the decision was made to perform a surgical procedure to correct the fracture. The treatment used the tie-in technique, where a 1.2 mm intramedullary pin was placed in the femur for initial alignment of the bone fragments, while external fixation was carried out with three pins of the same thickness as the previous one, two in the cranial region and one in the region distal to the fracture site. Two months after the surgery, an X-ray was taken to check for the formation of bone callus, with a satisfactory result. The external fixator was removed the following day, and seven days after removal the bird was discharged and released. As well as the tie-in technique having a high success rate with a complete return of function, it has the advantage that its implants are removable, which is important when the animal is returned to the wild, preventing these implants from remaining in the environment if it dies.

Factors which can influence elastic stable intramedullary nailing removal in healed bone cysts in children

Elastic stable intramedullary nailing (ESIN) internal fixation is used clinically to treat pathological fractures of bone cysts in children. However, one of the most important complications was removal difficulty. In this study, we aim to analyse the factors which can influence ESIN removal in healed bone cysts in children. From April 2014 to November 2020, the clinical data of 49 children who underwent elastic stable intramedullary nail removal for pathological fractures of the bone cysts in our hospital were retrospectively analysed. The following data, including age, sex, pathological fracture site, with bone graft, number of ESINs, ESIN indwelling time, and extraosseous length of ESIN were collected, and univariate analysis and logistic regression analysis was performed. The frequency of difficulty in ESIN extraction was 44.90% (22/49). The univariate logistic regression analysis showed that age,ESIN indwelling time,with bone garft and extraosseous length of ESIN may be correlated with the difficulty in removing ESIN (P < 0.05), while sex, pathological fracture site, number of ESIN may not be correlated with the difficulty in removing ESIN (P > 0.05).The multivariate logistic regression analysis showed that the ESIN indwelling time was the independent influencing factor for difficulty in removing ESIN (P < 0.05). The factors influencing the ESIN removal in healed bone cysts in children include over 11.79 years old, the long indwelling time of the ESIN(over 10.5 months),with bone graft and short extraosseous length of ESIN(≤ 0.405 cm). These factors influencing ESIN removal in healed bone cysts in children should be considered.

Management of Atypical M-Shaped Zygomatic Arch Fractures.

M-shaped zygomatic arch fractures can usually be treated effectively through closed reduction. It consists of 2 fracture segments: the anterior zygomatic segment and the posterior temporal bone segment. In clinical practice, atypical M-shaped fractures are often encountered, in which the anterior and posterior fracture segments are discontinuous and separated. Closed reduction usually cannot achieve the desired anatomic reduction effect for this type of fracture. The preoperative design showed that the anatomic reduction of the posterior zygomatic arch fracture segment was hindered due to bone spurs in the most concave area of the anterior zygomatic bone fracture segment. Open reduction and fixation were performed to achieve anatomic reduction and restore facial symmetry. The fracture sites were exposed through a hemicoronal incision. After the bone spurs are removed, the posterior bone segment can be anatomically reduced. Absorbable plates were used for fixation. The patient's facial appearance was restored after the surgery. The postoperative computed tomography scan showed a good alignment of the fracture. The authors believe that for patients with high requirements for facial symmetry, the presence of atypical M-shaped fractures can indicate open reduction and fixation.

Unstable Distal Tibia Fracture Management By Anatomically Contoured Plate With Mipo Technique

Background: Fracture at distal tibia is a notorious fracture and difficult to manage. This fracture can be managed conservatively or operatively. Minimally invasive percutaneous osteosynthesis (MIPO) technique can be applied in distal tibia fracture and it usually provides better outcome. This technique ensures minimal soft tissue damage, preserves periosteum and hematoma of the fracture. As the fracture site is not opened, indirect fracture reduction technique is applied. This study tries to evaluate the outcome of MIPO technique application in distal tibia fracture management. Methods: The study was cross sectional study and was carried out on 20 patients during the period of January 2019 to July 2021 in orthopaedic department of Combined Military Hospital (CMH), Dhaka. During this tenure all patients who fulfilled the inclusion and exclusion criteria was included in the study. All had close fracture. Follow up interval was at 2 weeks then 06 weeks, thereafter at 3 months, 6 month and 12 months' time from the date of operation. Data were collected and evaluated in terms of bony union and postoperative complications. Results: 12 patients i.e. 60% were male and same percentage of patient had fracture at right lower limb. Mode of trauma was mostly road traffic accidents (RTA) and fall from height. 40 years was mean age of the patients. It was 07 weeks mean partial weight bearing time and 14 weeks mean full weight bearing time. Mean radiological union time was seen at 18 weeks. Non union or delayed union did not happen in any case. But ankle stiffness (3/20) was most commonly found postoperative complications. Conclusion: For distal tibia fracture MIPO technique is a better treatment option as it gives good outcome and fewer complications. Bangladesh Armed Forces Med J Vol 56 No (1) June 2023, pp 1-6

Polyene phosphatidylcholine promotes tibial fracture healing in rats by stimulating angiogenesis dominated by the VEGFA/VEGFR2 signaling pathway

One of the factors that predispose to fractures is liver damage. Interestingly, fractures are sometimes accompanied by abnormal liver function. Polyene phosphatidylcholine (PPC) is an important liver repair drug. We wondered if PPC had a role in promoting fracture healing. A rat model of tibial fracture was developed using the modified Einhorn model method. X-rays were used to detect the progression of fracture healing. Progress of ossification and angiogenesis at the fracture site were analyzed by Safranin O/fast green staining and CD31 immunohistochemistry. To investigate whether PPC has a direct angiogenesis effect, HUVECs were used. We performed MTT, wound healing, Transwell migration, and tube formation assays. Finally, RT-qPCR and Western blot analysis were used to study the underlying mechanism. The results showed that PPC significantly shortened the apparent recovery time of mobility in rats. PPC treatment significantly promoted the formation of cartilage callus, endochondral ossification, and angiogenesis at the fracture site. In vitro, PPC promoted the proliferative viability of HUVECs, their ability to heal wounds, and their ability to penetrate membranes in the Transwell apparatus and increased the tube formation of cells. The transcription of VEGFA, VEGFR2, PLCγ, RAS, ERK1/2 and MEK1/2 was significantly up regulated by PPC. Further, the protein level results demonstrated a significant increase in the expression of VEGFA, VEGFR2, MEK1/2, and ERK1/2 proteins. In conclusion, our findings suggest that PPC promotes angiogenesis by activating the VEGFA/VEGFR2 and downstream signaling pathway, thereby accelerating fracture healing.

A Facile Scalable Strategy for Constructing Novel Robust Self‐Healing Glove Utilizing Nanoreinforced Thermoreversible Carboxylated Nitrile Butadiene Rubber

AbstractRecent decades have seen an increase in using self‐healing technology in fabricating multifunctional rubber materials, which incorporate intrinsic mechanisms. However, achieving commendable self‐healing efficiency while maintaining strength in thin rubber films remains challenging. Herewith, the preparation of self‐healing carboxylated nitrile butadiene rubber thin films is presented with 0.40 ± 0.05 mm thickness, reinforced with sustainable TEMPO‐oxidized cellulose nanofibers. The thin films are fabricated using wet mixing and casting methods and translated to prototype fabrication via dipping. The study involves the effect of varying zinc stearate and filler concentrations on healing efficiency via ionic mechanisms alongside other characterization techniques, such as chemical composition, surface morphology, cross‐link density, and thermal stability. The fabricated thin films exhibited a tensile strength of 5.38 MPa and an elongation‐at‐break of 518%. After undergoing a temperature‐induced healing process at 100 °C for 1 h, the healing efficiency for both properties reached 72% and 90%, respectively. Moreover, these films demonstrates the ability to heal repeatedly at the same fracture site over multiple cycles, maintaining a healing efficiency of over 45% after the third cycle. A glove prototype is fabricated and tested using water and air leakage tests to prove the self‐healing technology's successful transfer.

Biomechanical effects of muscle loading on early healing of femoral stem fractures: a combined musculoskeletal dynamics and finite element approach

Femoral stem fractures (FST) are often accompanied by muscle injuries, however, what muscle injuries affect fracture healing and to what extent is unknown. The purpose of this study was to analyze the extent to which different muscles affect FST healing through a combined musculoskeletal dynamics and finite element approach. Modeling the lower extremity musculoskeletal system for 12 different muscle comprehensives. Muscle and joint reaction forces on the femur were calculated and these data were used as boundary conditions input to the FSTs model to predict the degree of muscle influence on fracture healing. Finally, we will investigate the extent to which muscle influences FST healing during knee flexion. Muscle and joint forces are highly dependent on joint motion and have a significant biomechanical influence on interfragmentary strain (IFS) healing. The psoas major (PM), gastrocnemius lateralis (GL) and gastrocnemius medialis (GM) muscles play a major role in standing, with GM > PM > GL, whereas the gluteus medius posterior (GMP), vastus intermedius (VI), vastus medialis (VM), vastus lateralis superior (VLS), and adductor magnus distalis (AMD) muscles play a major role in knee flexion, with VLS > VM > VI > AMD > GMP. Mechanical stimulus-controlled healing can be facilitated when the knee joint is flexed less than 20°. Different muscles exert varying degrees of influence on the healing of fractures. Therefore, comprehending the impact of particular muscles on fracture site tissue FST healing can aid orthopedic surgeons in formulating improved surgical and rehabilitation strategies.

Current Strategies for Treatment of Mandibular Fractures With Plate Osteosynthesis: A European Prospective Study.

The training and preferences of surgeons influence the type of surgical treatment for mandibular fractures. This multicentre prospective study analyzed the current treatment strategies and outcomes for mandibular fractures with open reduction and internal fixation (ORIF). This prospective study included patients aged ≥16 years who underwent ORIF for mandibular fractures in 12 European maxillofacial centers. Age, sex, pretrauma dental status, fracture cause, site and type, associated facial fractures, surgical approach, plate number and thickness (≤1.4 or ≥1.5mm), duration of postoperative maxillomandibular fixation, occlusal and infective complications at 6 weeks and 3 months, and revision surgeries were recorded. Between May 1, 2021 and April 30, 2022, 425 patients (194 single, 182 double, and 49 triple mandibular fractures) underwent ORIF for 1 or more fractures. Rigid osteosynthesis was performed for 74% of fractures and was significantly associated with displaced (P=0.01) and comminuted (P=0.03) fractures and with the number of nonsurgically treated fracture sites (P=0.002). The angle was the only site associated with nonrigid osteosynthesis (P<0.001). Malocclusions (5.6%) and infective complications (5.4%) were not associated with osteosynthesis type. Rigid osteosynthesis was the most frequently performed treatment at all fracture sites, except the mandibular angle, and was significantly associated with displaced and comminuted fractures and the number of nonsurgically treated fracture sites. No significant differences were observed regarding postoperative malocclusion or infections among osteosynthesis types.

Three-Dimensional Analysis of Bone Remodeling After Closed Treatment for Mandibular Condylar Head Fracture.

Closed treatment of mandibular condylar fractures has been used for its indications based on the fracture site, fracture status, and patient age. Posttreatment mandibular condyle size is associated with mandibular function; however, a few studies have reported bone remodeling patterns and volume changes in the condyle and glenoid fossa after mandibular condylar head fractures (CHFs). Therefore, volumetric changes in the mandibular condyle and glenoid fossa were analyzed in the present study, and bone remodeling patterns were evaluated after mandibular CHFs. The present study included 16 condyles from 12 patients who received closed treatment for CHF. After reconstruction of a 3-dimensional skull model, including the mandible, using computed tomography data taken immediately after injury and 6 months after treatment, volume changes in the mandibular condyle and glenoid fossa were analyzed. The condylar volume increased by 0.32±0.66cm3 during the 6-month healing period without statistical significance (P=0.093). Regarding the glenoid fossa, the fossa showed a statistically significant volume increase of 0.41±0.59cm3 (P=0.021), and 12 glenoid fossae (75%) showed downward bone apposition; however, no change or only mild bone resorption was observed in 4 glenoid fossae (25%). The results of this study indicated that the volume changes in the mandibular condyle after closed treatment of a mandibular CHF are not significant, and the glenoid fossa adapts to the displaced mandibular condyle through downward growth accompanied by volume increase.

The role of hematopoiesis in bone repair: an update

Purpose of review The repair of bone after injury requires the participation of many different immune cell populations, which are derived from the hematopoietic lineage. The field of osteoimmunology, or the study of the interactions between bone and the immune system, is a growing field with emerging impact on both the basic science and clinical aspects of fracture healing. Recent findings Despite previous focus on the innate immune system in fracture healing, recent studies have revealed an important role for the adaptive immune system in bone repair. The composition of adaptive and innate immune cell populations present at the fracture site is significantly altered during aging and diet-induced obesity, which may contribute to delayed healing. Recent data also suggest a complicated relationship between fracture repair and systemic inflammation, raising the possibility that immune populations from distant sites such as the gut can impact the bone repair process. Summary These findings have important implications for the treatment of fracture patients with antibiotics or anti-inflammatory drugs. Furthermore, the effects of systemic inflammation on fracture repair in the contexts of aging or obesity should be carefully interpreted, as they may not be uniformly detrimental.

Cemented vs cementless stems for revision arthroplasties due to Vancouver B2 periprosthetic hip fracture.

According to Vancouver classification, B2 type fractures are most often treated with removal of the loose stem and implantation of a long stem that bypasses the fracture site. However, there is a controversy about the stem fixation that should be used: cemented or cementless. Hence, this study aims to compare cemented and cementless stems in prosthetic revision due to Vancouver B2 (VB2) periprosthetic hip fracture. A retrospective study was done including all the patients treated with stem exchange due to VB2 periprosthetic hip fracture in a tertiary hospital between 2015 and 2022. Patients were divided into two groups according to the stem fixation used: cemented or cementless. Functional outcomes, hospital stay, surgical time, complication rate, and mortality were compared between the two groups of patients. Of the 30 included patients, 13 (43.4%) were treated with cementless stems and 17 (56.7%) with cemented stems. There were no statistically significant differences in age, gender, anesthesia risk scale (ASA) or functional capacity prior to the intervention. Patients treated with cementless stems had a higher complication and reintervention rate than those treated with cemented stems: 62 and 45% versus 34 and 6% (p = 0.035; p = 0.010), respectively. Furthermore, in the group of cementless stems a higher proportion of non-union was found (53.8% vs. 17.6%; p = 0.037). Also, the hospital stay (33 vs. 24days; p = 0.037) and the time to full weight-bearing (21days vs. 9days; p < 0.001) were longer in the cementless stem group. Cemented fixation in stem revision due to Vancouver B2 periprosthetic hip fracture could be an optimal option with faster recovery which could decrease the rate of complications and reintervention, without compromising the fracture healing and patient mortality. Thus, this option can be considered when an anatomical reduction can be obtained, especially in elderly patients with multiple comorbidities in which a less aggressive surgical option should be considered.

Finite element analysis of acromial fracture after reverse total shoulder arthroplasty

BackgroundThe prevalence of acromial fracture after reverse total shoulder arthroplasty (RSA) is reportedly 2.6–8.4%, and clinical outcomes differ among fracture sites. However, few studies have investigated the factors affecting fracture sites. This study aimed to reproduce acromial fractures after RSA by replicating the postoperative displacement of the humerus using finite element models (FEM), and to investigate the effect of humeral displacement on the fracture site. MethodsSix patients (mean age, 76.3±7.9 years; five women, one man) with acromial fractures after RSA treated at our institution were included. Among them, three had Levy Type 1 fractures, whereas the other three had Levy Type 2 fractures. Preoperative computed tomography (CT) data were used to create a three-dimensional FEM. All elements within the proximal 2 cm of the clavicle and the scapular body were completely constrained. The entire humerus was forcibly displaced following its displacement after RSA, as measured by preoperative and postoperative CT. The fracture sites, total displacement, external constraint of the humerus at the initial fracture, and bone density from the acromion to the scapular spine were investigated. Values of P < 0.05 were considered statistically significant in tests of statistical inference but were interpreted as reference values due to the small number of cases. ResultsThere were no major differences in humeral displacement between Type 1 and Type 2 fractures. Although the fracture sites in the FEM were slightly more medial than the actual fracture sites, they were similar. The total displacement and external constraint of the humerus at the initial fracture were similar in Type 1 and Type 2 fractures. The distribution of bone density from the acromion to the scapular spine differed between fracture types. ConclusionWe were able to reproduce acromial fractures after RSA by replicating humeral displacement using FEM. The extent and direction of humeral displacement may not significantly affect the acromial fracture site, whereas the bone density distribution from the acromion to the scapular spine may affect it.

A Scoping Review of the Epidemiology, Management, and Outcomes of Golf-Related Fractures.

Golf is a popular sport; however, there is a paucity of data in relation to golf-associated fractures, and the rate and timing of returning to golf. The aim of this review is to describe golf-associated fractures, including epidemiology, management, and timing of returning to golf following treatment. A literature search was performed using MEDLINE/PubMed, Embase, and Web of Science. Data were extracted and summarized in a narrative synthesis. A total of 436 articles were identified with an initial search of which 58 met the inclusion criteria. Twelve anatomical sites of golf swing-related fractures were identified, of which 10 sites were specific for stress fractures. The most common sites of golf swing-related stress fractures were the ribs followed by the hook of hamate. There was a common theme of delay to diagnosis, being initially assigned to a soft tissue injury. Most golfers with swing-related stress fractures were able to return to golf with the exception of osteoporotic associated vertebral stress fractures. Timing of returning to golf was between 4 and 12 months for most of the golfers with stress fractures following conservative management. Operative intervention was an option of hook of hamate nonunion, following a stress fracture, and tibial shaft stress fractures. Golf equipment-related fractures were not rare and were associated with major trauma and in some cases associated with significant persistent morbidity. Golf-related stress fractures commonly involve the ribs and hook of hamate; knowledge of this may aid in early diagnosis and appropriate treatment when symptomatic golfers are encountered. Although golf is a noncontact sport, fractures associated with golf equipment can be life changing, and safety training guidelines should be established.

Shots fired: evaluation of vascular injury, compartment syndrome, and transfusion rates among civilian ballistic orthopaedic fracture patients presenting to two Level I trauma centres.

This study investigates baseline patient demographics and predictors of vascular injury, blood transfusion, and compartment syndrome in patients with orthopaedic fractures secondary to GSWs at two high-volume Level I trauma centres. A retrospective chart review of all GSW-related trauma patients at two Level I trauma centres between July 2019 and September 2021 was conducted. Chi-squared and two-tailed independent t tests were used for data analysis, and logistic regression with odds ratios (OR) determined predictors of primary outcomes. Among 478 GSW patients, 94 (19.7%) sustained 130 orthopaedic fractures, most commonly at the lower extremity (77.7%). Orthopaedic fracture patients showed significantly higher rates of vascular injury (29.8 vs. 4.7%, p < 0.001), transfusion (27.7 vs. 12.8%, p = 0.006), and compartment syndrome (3.2 vs. 0.3%, p = 0.011) compared to non-orthopaedic injury patients. Univariable analysis identified ankle (OR = 47.50, p < 0.001) and hip/femur fractures (OR = 5.31, p < 0.001) as predictors of vascular injury. Multivariable logistic regression revealed lower extremity vascular injury (OR = 54.69, p = 0.006) and anatomic fracture sites of the humerus (OR = 15.17, p = 0.008), clavicle/scapula (OR = 11.30, p = 0.009), and acetabulum/pelvis (OR = 7.17, p = 0.025) as predictors of blood transfusion. Univariable analysis showed lower extremity vascular injury (OR = 30.14, p = 0.007) as a predictor of compartment syndrome. These findings underscore the importance of diagnosing and managing vascular injuries and compartment syndrome in GSW-related orthopaedic fractures, emphasizing the necessity for targeted transfusion strategies in such cases.

A STUDY OF FUNCTIONAL OUTCOME IN THREE COLUMN FIXATION OF COMPLEX TIBIAL PLATEAU FRACTURES

Introduction: The treatment of complex tibial plateau fractures (TPF), especially those caused by high-energy trauma, remains a challenge in many respects. Tibial plateau fractures are one of the commonest periarticular fractures. These fractures include 1% of all fractures and 8% of fractures in elderly. Motor vehicle accidents account for the majority of these fractures in younger individuals with good bone stock, but in elderly individuals these fractures may result from simple fall due to osteopenic bone. Conservative methods may result in malunion and articular congruity cannot be restored. Surgical treatment can regain articular congruity and restore mechanical alignment, and can allow early range of motion. Open reduction and internal fixation techniques had been associated with wound complications. Aim Of The Study: To evaluate functional outcome in patients of complex tibial plateau fractures treated by three column fixation. Materials and Methods: In our institution 20 patients with displaced tibial plateau fractures with posterior column involvement were selected for the study. This is a prospective study done from AUGUST 2023 to APRIL 2024(9 months).Patients were evaluated with X rays (AP and lateral views) and Computed Tomography (axial, coronal, sagittal with 3D reconstruction views). Fractures classified based on 3 column concept classification. Mean follow up period was 6 months .Functional and radiological outcome was assessed using functional knee score , modified rasmussen score and WOMAC score. Inclusion Criteria: 1. Patients admitted with complex tibial plateau fractures involving medial, lateral and posterior column of tibia. 2. Both sexes 3. Age 20-60 yrs. Exclusion Criteria: 1) Bad skin status of the fractured site. 2) Patients with co morbidities not fit for surgery. 3) Patients with neurovascular deficit. 4) Patients not willing for surgery. Results:In our study, 70% of the patients were in active productive age group (30-50 years). 85% of the patients were male. The fractures were left sided in 75% patients. 85% patients in study sustained injury due to road traffic accident. 80% cases in the study were type 5 schatzker type 5 fractures and all the cases included in the study were 3 column fractures. 8 cases out of 20 cases in the study required epidural analgesia instead of a repeat spinal as the duration of the surgery was longer. Conclusion: To conclude,3 column fixation in high energy displaced tibial plateau fractures with three column fractures resulted in Good clinical and radiological outcomes.

Pediatric patients with facial fractures: a retrospective study.

Epidemiology of maxillofacial injuries vary depending on geographic location, culture and socioeconomic condition. This study assessed etiology and pattern of facial fractures in children reported at Burdwan Dental College and Hospital, Burdwan, West Bengal, India. Clinical files of 206 children with facial fractures were evaluated retrospectively. Diagnosis of fractures were confirmed by radiographic examination. Study period was from July 2018 to June 2022. Data collected were age and sex of the patient, site of fracture, and etiology of trauma. Descriptive statistics were used for statistical analysis with a P-value less than 0.05. There were 127 (61.7%) males and 79 (38.3%) females with a male to female ratio of 1.6:1. Within the study sample, the majority of facial fractures (n= 146, 70.9%) belonged to 6-to-9-year age group. Overall, falls (44.2%) and motor vehicles accidents (31.5%) were the two leading causes of trauma. Mandible fracture was the most common, accounting for 72.8% of cases. 74 patients (35.9%) with facial fracture had dental injuries. Male predominance in facial fracture is seen. With age, frequency of facial fractures tends to increase. Falls are the main cause of facial fracture and mandible is the most common anatomic location.

Aseptic Diaphyseal Pseudarthrosis of the Forearm Initially Treated with Target Plate: Risk Factors and Management

Aseptic diaphyseal pseudarthrosis of the forearm is a major complication. There are patient-related and treatment-related risk factors. The aim of our work is to evaluate the functional and radiological results of aseptic diaphyseal pseudarthrosis of the forearm initially treated with a screw plate. A series of 12 patients were collected in the Orthopedic and Traumatological Surgery Department A of IBN TOFAIL Hospital, retrospectively over a 5-year period. The most frequent site of these pseudarthroses was the ulna (5 cases), followed by both bones (4 cases) and finally the radius (3 cases). 50% of pseudarthroses were atrophic (12 cases). The use of a screw-plate stabilization technique combined with bone grafting and osteo-muscular decortication yielded satisfactory results in terms of bone consolidation and clinical outcome. Smoking is a major risk factor. Solid restraint is necessary to immobilize the fracture site and protect it from forces detrimental to consolidation. De-periostealization and muscular deinsertion are iatrogenic factors that favour the occurrence of pseudarthrosis. Solid DCP plate osteosynthesis combined with autograft after decortication of the fracture site is an important therapeutic weapon with good results.

Post-traumatic Fat Embolism in Intensive Care

Fat embolism syndrome (FES) is a group of clinical, biological and radiological symptoms resulting from obstruction of the microcirculatory network by microdroplets of insoluble fat. It is a complication most often observed in the aftermath of a polytrauma involving several long bone fractures, but it can also occur outside the traumatic context. The aim of this study was to examine the epidemiological, pathogenic, clinical, paraclinical, therapeutic and evolutionary aspects of fat embolism syndrome. This was a retrospective study including all cases of post-traumatic fat embolism collected in the surgical intensive care unit of the Chu Ibn Rochd in Casablanca over a period of 5 years. 24 cases of post-traumatic fat embolism were collected. Male sex, age less than 40 years and the presence of a femur fracture were the dominant characteristics of the epidemiological profile of the trauma patient presenting with this syndrome occurring mainly within 72 hours of the trauma. The clinico-biological presentation was dominated by respiratory distress, consciousness disorders, anaemia, thrombocytopenia and hypocholesterolaemia. The management of FES was symptomatic, combining early immobilisation of fracture sites, optimal analgesia and maintenance of an effective blood volume. 41.66% of patients required mechanical ventilation and 75% underwent osteosynthesis of their fracture sites. 25% developed ARDS and the mortality rate was 26.08%.

Retrospective analysis of pattern of injuries and cause of death in unclaimed dead bodies brought to Mortuary of Private Medical Institute

Introduction: Establishment of identity is required both in living and dead bodies and in both civil and criminal cases. Unclaimed body is defined as dead person who had no next of kin or no relative or no authorized representative willing to make final disposition of the remains.Aims and objective: The aim of this study was to determine the pattern and distribution of injuries and to find out the cause of the death in unclaimed bodies.Material and methods: In this retrospective study all the autopsies of unclaimed body from September 2018 to August 2022 were included.Results: A total 75 unclaimed body were brought to mortuary for autopsy. Out of 75 cases, 65 (87%) were male and 10 (13 %) were female. Majority of unclaimed bodies in this study belonged to age group 40-50. Contusion on the body was most common type of external injury. Lower limb was most common body part for external injuries. Skull was most common site for fracture. Temporal and temporoparietal were most common cranial bone fractured. Mandible was most common facial bone fractured. Liver laceration was most common internal organ injured in unclaimed bodies. Subarachnoid haemorrhage was most common intracranial haemorrhage. Most common cause of death in the present study was haemorrhage and shock due to antemortem injury.Conclusions: Identification of unclaimed dead body need to be increased by police workforce. Bodies which are unclaimed should be brought to mortuary just after prompt investigation so that autopsy should be started before decomposition which may interfere with autopsy finding and even in identification of the unclaimed body. Colour photography, DNA sampling, finger printing and maintaining dental records should be done for every unclaimedbody.

Uniaxial compressive stress-strain model of Molybdenum tailings concrete after high-temperature exposure

To investigate the effect of high-temperature exposure on the mechanical properties of molybdenum tailings concrete, 75 cubes and 150 prisms of molybdenum tailings concrete were tested, by considering five heating temperatures (20, 200, 400, 600, and 800 ℃) and five replacement ratios (0, 25, 50, 75, 100%). The failure modes, mass loss rate, and mechanical properties of the specimens were analyzed in detail. The experimental results indicate that with an increasing heating temperature, the color of the blocks became lighter, accompanied by gradually intensifying phenomena such as skin peeling and crack propagation. At 800 ℃, many small cracks at the fracture site of the blocks after splitting failure, and obvious fracture zones in the block under axial compression failure were observed. With an increasing temperature, the mass loss rate and peak strain of the molybdenum tailings concrete show a linear growth trend, reaching the maximum amplitude at 800 ℃ (7.85% and 192.5%), whilst the molybdenum tailings concrete splitting tensile strength, peak stress, and elastic modulus showed a decreasing trend, reaching the maximum amplitude (404%, 61.7%, and 84.9%). By increasing replacement ratios, the mass loss rate of the molybdenum tailings concrete shows a linear growth trend, with a maximum increase of 1.07%. The mechanical properties of the concrete at all temperatures show a trend of first increasing and then decreasing. A 25% replacement ratio can improve the deterioration of the molybdenum tailings concrete after high-temperature exposure, with the maximum amplitude increase of the peak stress, peak strain, and elastic modulus being 24.3%, 12.4%, and 21%, respectively. Based on the test data, the prediction formulas of the mechanical properties of molybdenum tailings under different high-temperature and molybdenum tailings replacement ratios are fitted. The existing constitutive equations are modified to establish the stress-strain constitutive model of molybdenum tailings concrete after high-temperature exposure, of which results are in good agreement with the test data.