Joint Fracture Research Articles

Effect of B on microstructure and properties of joints brazed by In-situ Ag-Cu-Zn-Sn filler metal with high Sn content

The copper brazed joints were obtained by induction brazing using in situ synthetic high Sn content silver filler metals with different B contents and the effect of element B on the wettability of filler metals and microstructure and mechanical properties of the joints were studied. With the addition of element B, the spreading area of the filler metals on the copper increases. The microstructure of the joints mainly consists of silver-based solid solution and copper-based solid solution, and the distribution of silver-based solid solution in the brazing seam becomes dispersed with the addition of B. The width of the brazing seam increases significantly with the increase in B content. Meanwhile, the B element was mainly distributed in the Ag-based solid solution. The tensile strength firstly increased and then sharply decreased with B added. The maximum average tensile strength of 206.83 MPa was obtained with a 2% addition of B and the joint fracture pattern is a brittle fracture.

Comparison of multislice spiral CT and MRI in diagnosis of occult fracture of knee joint with meniscus and ligament injury

To investigate the diagnostic value of multislice spiral CT (MSCT) and MRI in occult fracture of knee joint with meniscus and ligament injury. From January 2020 to March 2021, 63 patients with knee occult fracture with meniscus and ligament injury, including 41 males and 22 females, aged from 21 to 67 years old, with an average of (44.35±8.77) years old, the course of disease ranged from 1 to 6 days, with an average of (4.64±1.75) days, the body mass index (BMI) was (19.85±2.78) kg/m2. MSCT and MRI data of 63 patients were collected and statistically analyzed to evaluage their diagnist value. The detection of MRI for occult knee fravtures with meniscus and ligament injury, joint cavity effusion, bone marrow edema, and articular surface injury were 100.00% (63/63), 95.24% (60/63), 42.86% (27/63) and 36.51% (23/63), respectively. The detection rates of MSCT were 49.21% (31/63), 41.27% (26/63), 0.00% (0/63) and 1.59% (1/63), respectively, significantly lwver than that of MRI (P<0.05). The diagnostic sensitivity, specificity and accuracy of MRI were significantly higher than those of MSCT(P<0.05). The sensitivity, specificity and accuracy of magnetic resonance imaging in the diagnosis of occult fracture of knee joint with meniscus and ligament injury are significantly better than that of MSCT. MRI has higher accuracy in the diagnosis of peripheral tissue diseases such as joint cavity, articular surface and bone marrow, and can reduce the risk of clinical misdiagnosis.

Methods for Studying Appendicular Skeletal Biology in Axolotls.

The axolotl is a great model for studying cartilage, bone and joint regeneration, fracture healing, and evolution. Stainings such as Alcian Blue/Alizarin Red have become workhorses in skeletal analyses, but additional methods complement the detection of different skeletal matrices. Here we describe protocols for studying skeletal biology in axolotls, particularly Alcian Blue/Alizarin Red staining, microcomputed tomography (μCT) scan and live staining of calcified tissue. In addition, we describe a method for decalcification of skeletal elements to ease sectioning.

The Impact of Wrist Fractures on Long-Term Basketball Performance

BackgroundWrist joint fractures may present challenging obstacles for the rehabilitating athlete upon return to play. Although current literature has examined the effects of specific injuries to the upper extremity for basketball athletes, little is known about long-term performance outcomes following wrist joint fractures. MethodsReview of all National Basketball Association players who sustained wrist joint fractures was conducted. Player characteristics, preinjury and postinjury performance, and overall efficiency were analyzed. ResultsA total of 31 players were deemed appropriate for inclusion, with an average age of 26.2 ± 4.3 years and a mean of 5.2 ± 3.6 years played before injury and 4.1 ± 3.1 years played upon return. Operative management was pursued in 48.4% of players. Players demonstrated a significant decrease in win shares before injury (mean: 24.3 ± 31.5) compared to after return from injury (mean: 9.6 ± 19.6) (p < 0.032). Multivariate regression demonstrated that increased points per game before injury (standardized β: 0.71; 95% confidence interval [CI]: 1.2–8.5, p < 0.011) and increased win shares before injury (β: 1.0; 95% CI: 1.4–9.5, p < 0.001) were both independently predictive with increased win shares after return to play. Player position, age, management type, and all other statistics were not significantly associated with any other findings upon return. ConclusionOverall efficiency following return to play in the setting of basketball-associated wrist joint fractures appears to be decreased in athletes. However, preinjury performance as captured through win share efficiency and points per game appears to be predictive of increased productivity after successful return.

Achievement of high-strength Al/Cu dissimilar joint during submerged friction stir welding and its regulation mechanism of intermetallic compounds layer

The control of intermetallic compounds (IMCs) is the key to achieve high-performance Al/Cu dissimilar joints. In the present study, the dissimilar metals of 6061-T6 Al and T2 pure Cu were joined by submerged friction stir welding (SFSW) technology. The results indicated that the peak temperature and dwelling time at high temperature were obviously reduced by applying additional water cooling in SFSW. In comparison to the joint fabricated by normal friction stir welding (FSW), the thickness of IMCs layer at the interface for the SFSW joint was much thinner and its distribution was more uniform, the formation of IMCs was effectively inhibited during the SFSW process. The Al2Cu phase was first formed at the Al/Cu interface, and then Al4Cu9 phase precipitated between Al2Cu phase and Cu. The tensile properties of the Al/Cu joints were significantly improved by the SFSW process. The maximum tensile strength of 255 MPa was obtained in the SFSW joint, which was 41.7% higher than that of the FSW joint. A higher joint efficiency of 91.1% was reached, which was due to the reduced stress concentration at the interface in SFSW caused by the thinner IMCs layer and lower welding heat input. The fracture occurs within Al2Cu phase or along the interface between Al and Al2Cu layer for the FSW joint. In contrast, the SFSW joint fractures at the HAZ on Cu side, showing favorable ductility.

Hemihamate Arthroplasty Revisited: A Retrospective Review of 11 Cases.

Proximal interphalangeal joint (PIPJ) fracture dislocations are complex injuries that can result in persistent pain, stiffness, and angulation. Hemihamate arthroplasty (HHA) can be used to reconstruct the base of the middle phalanx in cases of unstable PIPJ fracture dislocations. Despite previous case series describing good outcomes with HHA, it has not gained widespread use. The purpose of this study is to describe our straightforward, reproducible technique and to demonstrate the benefit in motion after the procedure in chronic unstable PIPJ fracture dislocations. All patients with chronic, unstable PIPJ fracture dislocations requiring joint resurfacing of greater than 40% of the base of the middle phalanx treated with HHA were retrospectively reviewed. Patient demographics, injury features, surgical technique, preoperative and postoperative PIPJ range of motion and arc of motion, time to surgery, and complications were reviewed. Any fracture amenable to fixation or cases with radiographic evidence of arthritis or injury to the head of the proximal phalanx were excluded. Eleven cases were reviewed. The mean patient age was 35 years. The mean time from injury to surgery was 6 months. The mean joint surface involved was 64%. The mean PIPJ arc of motion was 17 degrees preoperatively and 63 degrees postoperatively. The mean bone block size required was 8 × 8 × 8 mm. The mean follow-up was 26 months. Postoperative pain at the PIPJ on the visual analog scale was 0.4 (scale of 0 to 10). Complications included 2 patients requiring tenolysis. Despite the lack of a perfect geometric recreation of the base of the middle phalanx with the hamate, patients recover acceptable PIPJ motion and have minimal pain. Hemihamate arthroplasty is a good option for any patient with minimal motion of their PIPJ and a chronic, unstable fracture dislocation.

Obtaining strain-rate dependent traction-separation law parameters of epoxy adhesive joints and predicting fracture for dissimilar bonding adherends

This study investigated the mode I fracture behavior of double cantilever beam (DCB) epoxy adhesive joints with similar adherends on the both sides (i.e., aluminum-aluminum or copper-copper) at different strain rates; i.e., quasi-static (∼10 −3 s −1 ), low (∼7 s −1 ) and intermediate (∼14 s −1 ) rates. The fracture energy of the DCB joint in Al-adhesive-Al specimens decreased (i.e., by ∼62%, p = 0.0013) with an increase in the applied strain rate from quasi-static to low values, while it remained almost unchanged with further increase of stain rate to intermediate range (p > 0.05). For Cu-adhesive-Cu cases, however, the fracture energy was found to be almost insensitive to the applied strain rate over the range tested (p > 0.05). A cohesive zone model (CZM) was built and strain-rate dependent parameters of traction-separation (TS) law were obtained. These parameters were then used to predict the fracture of epoxy adhesive joints bonded with dissimilar substrates (i.e., copper-aluminum). Predicted fracture loads of the Cu-adhesive-Al cases obtained from the stain-rate dependent model were in reasonable agreement with measured forces (i.e., from ∼0 to 24%) at a given strain rate. Therefore, once TS law parameters for Al-adhesive and Cu-adhesive interfaces were determined, the CZM could predict the fracture of the joint bonded with Al and Cu on its sides. • Fracture tests were performed on 5 cm long, 250 μm thick epoxy adhesive joints at different strain rates. • Fracture energy of the Al–Al joints decreased significantly by increasing strain rate from quasi-static to low values. • By increase in the strain rate, J ci of Cu–Cu joints did not change significantly. • TS law parameters of Al–Al and Cu–Cu joints were determined by a CZM. • Fracture of Cu–Al joints were predicted using TS law parameters in a CZM at various strain rates.

Evaluation of welded joints of dissimilar titanium alloy Ti-5Al-2.5Sn and stainless-steel 304 at different multi-interlayer modes

Products manufactured by joining titanium and stainless steel are of great attention to the modern-day industries (aerospace and nuclear) due to their several benefits like high strength, low cost, and corrosion resistance. However, it is difficult to join these alloys owing to the formation of TiFe, Ti2Fe, and TiFe2 compounds which damage their mechanical properties. This study aims to evaluate the microstructural and mechanical properties of titanium alloy Ti-5Al-2.5Sn and stainless steel 304 joints. Joining was performed through pulse–gas tungsten arc welding (P-GTAW) by inserting the Nb-Cu multi-interlayer. The effects of welding speed, two multi-interlayer application modes, and arc offset on the microstructure and mechanical properties such as tensile strength and microhardness were investigated. The mechanical properties were evaluated through tensile and hardness tests while microstructural analysis using scanning electron microscopy (SEM) supported by electron dispersive spectroscopy (EDS). The results revealed that sound and high-quality welds were achieved using a multi-interlayer, which inhibited the formation of TiFe, Ti2Fe, and TiFe2 brittle intermetallic compounds (IMCs). Maximum joint strength of 327 MPa was achieved at a welding speed of 200 mm min−1, mode of multi-interlayer (Nb used as a foil and Cu as a wire) at no arc offsetting, whereas a low joint strength was obtained in the multi-interlayer mode (Nb and Cu both as foils), and arc offset towards SS. The SEM and EDS results revealed that a Cu solid solution was obtained in the fusion zone, which improved the tensile strength. Joint fracture surface analysis indicated that ductile fracture was obtained for high-strength and brittle fracture for the low-strength weld. It is evident that high hardness (400 HV) was obtained at a low welding speed (150 mm min−1) and an arc offset to the stainless steel side owing to the formation of TiCu and Ti2Cu phases, as revealed by the x-ray diffraction phase analysis.

Computed Tomography Changes Diagnosis, Management and Surgical Planning of Ankle Fractures

Category: Trauma; Ankle; Other Introduction/Purpose: Ankle fractures correspond to a substantial portion of traumatic injuries assisted in a primary health care unit. These fractures are usually promptly recognized by physical exams and conventional radiographs. Nevertheless, the number and pattern of the lesions and the identification of possible associated injuries still fail when using only these methods. CT scans have developed into an excellent instrument to analyze joint fractures in recent years. This study aims to compare ankle fracture assessment using CR in isolation with CT and CR in combination. This comparison will be performed considering diagnosis, lesions features, and treatment. We hypothesize that CT, in conjunction with CR, can significantly modify the diagnosis, therapeutics, and operative planning of ankle fractures when confronted with isolated CR. Methods: A total of 53 patients (mean age: 42 years, 15 - 75) diagnosed with an ankle fracture between 2011 and 2016, were assessed with CT and CR. Evaluations of the fractures using CR in isolation and CR combined with CT were compared using seven different readers. Fractures were assessed in terms of type, displacement, size, associated injuries, treatment, patient position, the implant of choice, and surgical planning considering the presence or absence of malleolar fractures and potential associated injuries. The concordance was measured for the own examiner's evaluations and between the examiners' assessments (intra-observer and inter-observer) by the Kappa coefficient. The results were determined by relative frequency distribution analysis (in percentage terms) and compared using a two-proportions test. Results: The Kappa index was higher than 0.75 for all interobserver and intra-observer reliabilities. Medial malleolus fractures characteristics (posteromedial fragment and anterior colliculus), the presence of posterior malleolus fracture and its characteristics (displacement, size, posteromedial or posterolateral segment) (ps&lt;0.042), syndesmosis injury (p&lt;0.001), and the absence of deltoid ligament lesion (p&lt;0.001), were more evident with the combination of CT and radiographs. There was an increase in an operative indication (p=0.007), prone positioning (p=0.002), posterior malleolus surgical treatment (p&lt;0.001), posterolateral approach for the lateral malleolus (p=0.003), and syndesmosis fixation (p=0.020) with the association of CT and CR, among all groups of expertise, with high inter-observer reliability (&gt;0.75). Conclusion: Conventional radiographs may fail to demonstrate subtle and more complex lesions of the ankle joint, such as posterior and medial malleolus fractures, undermining its capability to determine the appropriate treatment plan. This study showed evidence that a CT scan, a widespread available exam, and the standard for the study of other articular fractures, increased the diagnostic capability in ankle fractures when used with radiographs. In addition, the combination of methods may improve the quality of the information received by the orthopedic surgeon, providing more details for a proper surgical or non- surgical treatment, positively affecting patient care.

Improvements in Brazed-Joint Properties of Silicon Nitride and Titanium Alloys Using Laser-Induced Microscale Rice Leaf Structures.

Si3N4 ceramics with a microscale rice leaf structure (MRLS) and titanium alloy were connected via brazing, and the influence of the surface microstructure on the ceramic connection was analyzed. MRLS fabrication is an efficient and high-degree-of-freedom method that can be used to change a material’s surface morphology and wettability. The MRLS was obtained at a laser power of 110 W, with line spacings of 100 and 50 μm. The laser-treated surface included nanoparticles and micro particles, exhibiting a coral-like structure after agglomeration. When the MRLS was used to braze the titanium alloy, no defects were observed at the brazing interface, and the formation was excellent. Throughout the brazed joint, the MRLS remained intact and formed a strong metallurgical bond with the brazing filler metal. A finite element analysis was performed to study the cross-sectional morphology after joint fracture; from the load-time curve, it was found that the MRLS on the surface not only helped improve the mechanical occlusion and brazing area at the interface, but also helped generate compressive stress on the Si3N4 side. Crack propagation was hindered, thereby increasing the joint strength.

Application of Spectral Entropy in Haul Truck Joint Damage Detection.

Early detection of machine failures is often beneficial, both financially and in terms of worker safety. The article presents the problem of frequently damaged joints in haul trucks, which are a real threat to the health and life of drivers. It was decided to investigate the problem in terms of dynamic overloads using two NGIMU inertial sensors and placing them in two places on the machine in close proximity to a joint. The data were captured during the standard operation of various machines in several mining departments, which allowed for the detection of a variety of factors influencing vibration. A hypothesis was developed that any changes in the joint would cause a change in the characteristics of vibrations, which were measured using the spectral entropy of vertical vibrations. Analyses have shown that there is a relationship between the change in spectral entropy difference (between the front and back of the vehicle) and joint events: nut tightening, nut replacement, and even joint fracture and replacement. The presented results offer the potential to create a tool for joint diagnostics and the early detection of damage or backlash.

Pedobarography — monitoring method of functional restoration of unstable ankle joint injuries

The pedobarography method makes it possible to objectify the dynamics of restoring the functional capacity of an injured limb. The value of the method is gaining popularity in determining the functional results of surgical treatment of the patients with ankle joint injuries. The details of pedobarographic monitoring during the treatment allow to obtain digital indices, which with careful statistical analysis can significantly improve not only the diagnostic process, but also control the process of functional recovery of the patients with injuries of the lower extremities. Changes in quantitative digital static and dynamic indices of pedobarography mean progress in the functional restoration of the injured limb or the need in the correction of the rehabilitation process. However, there is a problem in the interpretation and specification of the known indices and indices in accordance with the pathology. A review of the scientific publications based on the Scopus, Web of Science and The Cochrane Library databases is designed to analyze the possibilities of using the pedobarography method in the diagnosis of ankle joint injuries, tibial bone fractures, which in accordance with quantitative indices make 20-28 % of all fractures of human bones. The kinematic features of the human body in normal and pathological conditions should be carefully analyzed and practically used in the monitoring process of the recovery of walking during the rehabilitation period in the patients with ankle joint fractures and not only. Control and detection of the deviations of pedobarographic indices should be analyzed in details with the aim of early detection of an unresolved problem before the appearance of clinical signs of chronic instability. The literature search proves that the analysis of the entire range of static and dynamic indices of pedobarography of damaged and healthy limbs during the period of postoperative recovery of walking makes it possible to evaluate the effectiveness of rehabilitation measures aimed at functional restoration of unstable injuries of the ankle joint.

Effect of rubber modification on fracture toughness of epoxy adhesives under mode I and mode II loading

In the present study, the effects of rubber modification on the joint strength and fracture toughness of epoxy adhesives under mode I and II loading were investigated using Arcan-type adhesively bonded joints. The results of the fracture tests under mode I loading revealed the occurrence of stress whitening owing to triaxial tensile stresses near the crack tip. The joint strength and fracture toughness were calculated using the J-integral value, where the adhesive layer was considered as an elastic–plastic material. The crack-growth energy was also calculated using the J-integral value, where the adhesive layer was considered as an elastic material. The results revealed that rubber modification under mode I loading induced an increase in the joint strength, fracture toughness, and crack-growth energy. Rubber modification under mode II loading did not induce stress whitening near the crack tip owing to low triaxial tensile stresses. However, macroscopic void growth and significant plastic deformation were observed in the adhesive layer. Rubber modification induced a slight decrease in the joint strength; however, it induced a significant increase in the fracture toughness owing to the growth of the plastic zone in the adhesive layer. The calculated crack-growth energy decreased slightly, in accordance with the joint strength. It was concluded that rubber modification contributed to an increase in the crack-growth resistance under mode I loading and not under mode II loading. Furthermore, a correlation was observed between the joint strength and crack-growth energy.

Analysis of the relationship between the morphology of the proximal tibiofibular joint and lateral hinge fracture in open wedge high tibial osteotomy

BackgroundOne of the complications of open wedge high tibial osteotomy is lateral hinge fracture, which causes delayed bone healing. In this study, we focused on the morphology of the proximal tibiofibular joint to clarify the influence of this morphology on the occurrence of lateral hinge fracture in open wedge high tibial osteotomy. MethodsThe proximal tibiofibular joint of 58 knees in 55 patients who underwent open wedge high tibial osteotomy was classified as either horizontal or oblique, depending on the morphology of the fibular head. Lateral hinge fracture of Takeuchi classification type II or III was defined as unstable lateral hinge fracture. We analyzed whether patient background and bone morphological factors, including the morphology of the proximal tibiofibular joint, were associated with the occurrence of unstable lateral hinge fracture. ResultsThe horizontal and oblique types were found in 34 and 24 knees, respectively. There was no difference in the percentage of hinge points within the safe zone between the horizontal and oblique types; however, there was a significant difference in the unstable lateral hinge fracture incidence between the two groups. Unstable lateral hinge fracture occurred in seven knees, mostly in patients with an oblique proximal tibiofibular joint. The factors associated with the occurrence of unstable lateral hinge fracture were analyzed using logistic regression analysis; the fibular head of the oblique type was a significant factor. ConclusionOpen wedge high tibial osteotomy for oblique-type proximal tibiofibular joints may be more likely to cause unstable lateral hinge fracture than the horizontal type.

Risk Assessment of Water Inrush in Tunnels: A Case Study of a Tunnel in Guangdong Province, China

Fractured tectonic zones with developed groundwater are one of the major causes of water inrush in the construction of igneous tunnels; thus, it is highly important to assess the risk of water inrush. In this study, a total of six evaluation attributes, groundwater level, amount of inrush water, permeability coefficient, strength of the surrounding rock, rock integrity, and width of the jointed and fault fracture zone, were selected for the risk assessment of water inrush, and fuzzy theory was applied to the treatment of the uncertainty in the evaluation attributes. On this basis, the MULTIMOORA (multiple multi-objective optimization by ration analysis) and the model of nearness degree of incidence were combined to obtain the new model of MULTIMOORA–nearness degree of incidence for the risk assessment of water inrush. A deep-underground, extra-long tunnel under construction in southern China was used as an example for validation. The six tunnel sections assessed on site were ZK91 + 195~236, K91 + 169~186.5, K91 + 203~238, ZK94 + 238~198, K94 + 112~82, and K94 + 076~034. K94 + 112~82 was assessed at risk Level III, while the remainder were assessed at risk Level IV. The site conditions were also Level III for section K94 + 112~82 and Level IV for the remainder. The assessment results for the above six tunnel sections are consistent with the field conditions, which verified the validity of the model of the MULTIMOORA–nearness degree of incidence.

FUNCTIONAL OUTCOMES OF BIPOLAR HEMIARTHROPLASTY IN UNSTABLE INTERTROCHANTERIC FRACTURES IN ELDERLY PATIENTS

Background: Intertrochanteric fractures account for about 45% to 50% of all hip joint fractures in elderly patients. Conservative treatment carries the disadvantages of non-union and malunion, which in turn will increase the morbidity and mortality. Currently hemiarthroplasty and internal xation are the two considerable surgical options for xation for hip fractures. The purpose of this study was primarily to study functional recovery in patients with unstable intertrochanteric fractures treated with bipolar hemiarthroplasty while studying other relevant intraoperative and postoperative parameters of patients in these groups. 16 patients underwent bipolar Methods: hemiarthroplasty for unstable intertrochanteric femur fracture. Patients were evaluated in post-operative period for mobilization and full weight bearing. Harris hip score was used for functional evaluation on follow up visit for a period of 12months In our study the mean age (years) was Results: 73.31 ± 7.79. Seven (43.8%) of the participants had AO Type: A2.2 fracture, four patients (25.0%) had AO Type: A2.3, two (12.5%) of the participants had AO Type: A3.1. and three of them (18.8%) had AO Type: A3.3 fracture. The mean (SD) of Surgical Time (Minutes) was 111.50. The mean (SD) of Blood Loss (ml) was 491.25. The mean (SD) of Full Weight Bearing Day was 3.81. During the nal follow-up Excellent to fair results were obtained in 13 (81.25 %) cases and in 3 (18.75%) cases, results were poor. Bipolar hemiarthroplasty is suitable for intertroc Conclusions: hanteric fractures in elderly patients who have mechanically weak and porotic bones. Bipolar hemiarthroplasty has fair functional outcomes in unstable intertrochanteric femur fractures.

Hand-Specific External Fixation for Treatment of Complex Proximal Interphalangeal Joint Injuries

BackgroundComplex proximal interphalangeal joint (PIPJ) fractures are challenging injuries to treat. There are multiple established treatment methods available for these injuries, including dynamic external fixation. This study reports the outcomes of complex PIPJ fractures treated with a hand-specific external fixation device. MethodsTwenty-five fingers in 25 patients were treated with the DigiFix external fixator device for treatment of a PIPJ dorsal fracture dislocation (n = 16) or pilon fracture (n = 9). There were 16 males and 9 females with a mean age of 40 years (range: 14–75 years) at the time of injury. The median time from injury to surgery was 10 days (interquartile range [IQR]: 5; range: 3–49). Chart and radiographic data were reviewed retrospectively. ResultsThe average duration of external fixation was 41 days (range: 26–62 days). At a mean follow-up of 28 weeks (range: 12–105 weeks), the mean PIPJ flexion was 82 (range: 30–105 degrees), extension was −10° (range: −30 to 0 degrees), and flexion/extension arc of motion was 72 degrees (range: 30–95 degrees). Final mean Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score was 21.5 (range: 0–65.8). There were zero major complications and six (24%) minor complications, including superficial cellulitis (4) and stiffness (2). ConclusionDynamic external fixation for the treatment of complex PIPJ injuries allows for early range of motion and leads to favorable outcomes. This hand-specific external fixator has a reproducible technique which results in predictable and reliable PIPJ distraction.

Operative treatment of hamate fractures with hamatometacarpal fracture dislocation using a self-designed dorsal buttress locking plate with trans-metacarpal pin insertion: short-term follow-up results

Purpose: Fracture and dislocation of the hamatometacarpal joint are rare; therefore, the diagnosis is frequently missed and the treatment is not clearly established. The authors performed operative treatment of hamate fractures with hamatometacarpal fracture dislocation using a self-designed dorsal buttress locking plate. Herein, we report the clinical and radiological results.Methods: From May 2016 to February 2022, we experienced 12 cases of hamatometacarpal fracture dislocation that underwent operative treatment with a self-designed dorsal buttress locking plate. All 12 patients were male, with an average age of 30.3 years and an average postoperative follow-up period of 6 months and 1 week. Open reduction and internal fixation were performed using a self-designed dorsal buttress locking plate with trans-metacarpal pin insertion according to the patient, and the results of the treatment were evaluated radiologically and clinically.Results: All cases showed bony union in radiological evaluations at the last follow-up. In functional evaluations using the modified Mayo wrist score, the results were excellent in 11 cases and good in 1 case. There were no complications such as fixation failure, nonunion, or infection.Conclusion: In cases of hamate fracture with hamatometacarpal fracture dislocation, the dorsal displaced fragment is very small, and it is often difficult to maintain reduction by direct fixation. In these fractures, operative treatment using a self-designed dorsal buttress locking plate with trans-metacarpal pin insertion can obtain good results.

Clinical Application of Graphene Composite in Internal Fixation of Ankle Fracture in Sports

The ankle joint consists of the tibia, the fibrous lower end, and the talus. Osteoporotic fractures and deboning are common injuries in orthopaedic surgery, often due to abnormal disorders following an ankle fracture. Various fractures can occur depending on the shape, size, and position of the foot at the time of the injury. With the continuous development of science and the continuous improvement of modern sports level, scientists and sports workers worldwide recognize the importance of applying new materials in sports equipment. Composite material is a combination of multiphase combination material. In short, two or more components with different properties and different forms are used in a multimaterial combination of composite means. The organic combination of related scientific equipment and composite materials promotes the development of sports equipment and the probability of reducing sports injury. The function of the existing graphene composite is analyzed and applied, and the combination of graphene composite and sports is realized theoretically. The clinical application of graphene composite in sports is studied to promote sports development. This article mainly studies the clinical application of graphene composite in ankle fracture internal fixation in sports. It is found that with the increasingly mature application of graphene rubber composite, graphene fiber composite, and other graphene composite materials, it can be widely used in all aspects of sports equipment. Graphene composite materials can be used more easily in sports equipment. In this article, the thermal material conversion algorithm, Schrodinger equation in quantum mechanics, and the use method of graphene composite materials are used to study the clinical application of graphene composite in the internal fixation of ankle joint fracture in sports. The frequent injury and instability of ankle and knee joints are signs of ankle and knee joint injury. The main factors that affect the instability of ankle and knee function are the comprehensive effects of motion range, muscle force valgus, and body feeling, and graphene composite materials are widely used in the internal fixation of ankle joint fracture in sports. The results show that graphene composite can be used in sports equipment and has a great space and high feasibility through the analysis of four groups of sports equipment. It shows that advanced materials play a very important role in the research of sports equipment.

Clinical utility of minimally invasive posterior internal fixation within the pelvic ring using S2 alar iliac screws for unstable pelvic ring fracture

IntroductionPosterior internal fixation for unstable pelvic ring fractures is often associated with complications, including pelvic hemorrhage and gluteal necrosis. Pelvic ring fixation using the S2 alar iliac screw (SAIS) without fixation of the lumbosacral vertebrae may have potential as a novel, minimally invasive technique for treating unstable pelvic ring fractures. The present study compared clinical outcomes in patients who underwent SAIS fixation within the pelvic ring with a historical control group of patients who underwent conventional trans-iliac plate fixation for the treatment of unstable pelvic ring fractures. Materials and methodsThirty-two patients diagnosed with unstable pelvic fractures with sacral fracture or sacroiliac joint fracture dislocation were retrospectively evaluated. Eight consecutive patients underwent trans-iliac plate fixation from April 2012 to March 2015, and 24 consecutive patients underwent SAIS fixation from April 2015 to February 2020. Rates of soft tissue complications, intraoperative blood loss, and intraoperative blood transfusion volume were compared in these two groups. ResultsMean intraoperative blood loss was significantly lower in patients who underwent SAIS fixation than in those who underwent trans-iliac plate fixation (141.0 ml vs 315.0 ml; P = 0.027), although there were no between-group differences in intraoperative blood transfusion volume (0.0 ml vs 140 ml; P = 0.105), incidence rate of soft tissue complications (4.2% vs 0%; P = 1.000), and operation time (88.5 min vs 93.0 min; P = 0.862). Bone healing was confirmed in all patients who underwent SAIS fixation without dislocation of the fracture site, whereas one patient who underwent trans-iliac plate fixation experienced a dislocation of the fracture site during follow-up (0% vs 12.5%; P = 0.250). ConclusionsSAIS fixation reduces intraoperative blood loss and ensures bone healing without major complications, including dislocation of the fracture site. SAIS fixation may therefore be an alternative, minimally invasive method of treating unstable pelvic fractures.