Search results for: natural fractures

Authors: Anny Zambrano, German Gonzalez, Yair Quintero

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The continuum damage concept is used to study the interaction between hydraulic fractures and natural fractures, the objective is representing the path and relation among this two fractures types and predict its complex behavior without the need to pre-define their direction as occurs in other finite element applications, providing results more consistent with the physical behavior of the phenomenon. The approach uses finite element simulations through Abaqus software to model damage fracturing, the fracturing process by damage propagation in a rock. The modeling the phenomenon develops in two dimensional (2D) so that the fracture will be represented by a line and the crack front by a point. It considers nonlinear constitutive behavior, finite strain, time-dependent deformation, complex boundary conditions, strain hardening and softening, and strain based damage evolution in compression and tension. The complete governing equations are provided and the method is described in detail to permit readers to replicate all results. The model is compared to models that are published and available. Comparisons are focused in five interactions between natural fractures (NF) and hydraulic fractures: Fractured arrested at NF, crossing NF with or without offset, branching at intersecting NFs, branching at end of NF and NF dilation due to shear slippage. The most significant new finding is, that is not necessary to use pre-defined addresses propagation and stress condition can be evaluated as a dominant factor in the process. This is important because it can model in a more real way the generated complex hydraulic fractures, and be a valuable tool to predict potential problems and different geometries of the fracture network in the process of fracturing due to fluid injection.

Keywords: continuum damage, hydraulic fractures, natural fractures, complex fracture network, stiffness

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Authors: Eyal Rosen

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This study is aimed to report a possible effect of the presence of dental implants on the development of crown or root fractures in adjacent natural teeth. A series of 26 cases of teeth diagnosed with crown or root fractures following the placement of adjacent dental implants is presented. In addition, a comprehensive systematic review of the literature was performed to detect other studies that evaluated this possible complication. The case series analysis revealed that all crown-fractured teeth were non-endodontically treated teeth (n=18), and all root fractured teeth were endodontically treated teeth (n=8). The time from implant loading to the diagnosis of a fracture in an adjacent tooth was longer than 1 year in 78% of cases. The majority of crown or root fractures occurred in female patients, over 50 years of age, with an average age of 59 in the crown fractures group, and 54 in the root fractures group. Most of the patients received 2 or more implants. Nine (50%) of the teeth with crown fracture were molars, 7 (39%) were mandibular premolars, and 2 (11%) were incisor teeth. The majority of teeth with root fracture were premolar or mandibular molar teeth (6 (75%)). The systematic review of the literature did not reveal additional studies that reported on this possible complication. To the best of the author’s knowledge this case series, although limited in its extent, is the first clinical report of a possible serious complication of implants, associated fractures in adjacent endodontically and non-endodontically treated natural teeth. The most common patient profile found in this series was a woman over 50 years of age, having a fractured premolar tooth, which was diagnosed more than 1 year after reconstruction that was based on multiple adjacent implants. Additional clinical studies are required in order to shed light on this potential serious complication.

Keywords: complications, dental implants, endodontics, fractured teeth

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Authors: Tarek Duzan

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Fractures are a fundamental property of most reservoirs. Despite their abundance, they remain difficult to detect and quantify. The most effective characterization of fractured reservoirs is accomplished by integrating geological, geophysical, and engineering data. Detection of fractures and defines their relative contribution is crucial in the early stages of exploration and later in the production of any field. Because fractures could completely change our thoughts, efforts, and planning to produce a specific field properly. From the structural point of view, all reservoirs are fractured to some point of extent. North Gialo field is thought to be a naturally fractured reservoir to some extent. Historically, natural fractured reservoirs are more complicated in terms of their exploration and production efforts, and most geologists tend to deny the presence of fractures as an effective variable. Our aim in this paper is to determine the degree of fracturing, and consequently, our evaluation and planning can be done properly and efficiently from day one. The challenging part in this field is that there is no enough data and straightforward well testing that can let us completely comfortable with the idea of fracturing; however, we cannot ignore the fractures completely. Logging images, available well testing, and limited core studies are our tools in this stage to evaluate, model, and predict possible fracture effects in this reservoir. The aims of this study are both fundamental and practical—to improve the prediction and diagnosis of natural-fracture attributes in N. Gialo hydrocarbon reservoirs and accurately simulate their influence on production. Moreover, the production of this field comes from 2-phase plan; a self depletion of oil and then gas injection period for pressure maintenance and increasing ultimate recovery factor. Therefore, well understanding of fracturing network is essential before proceeding with the targeted plan. New analytical methods will lead to more realistic characterization of fractured and faulted reservoir rocks. These methods will produce data that can enhance well test and seismic interpretations, and that can readily be used in reservoir simulators.

Keywords: natural fracture, sandstone reservoir, geological, geophysical, and engineering data

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Authors: S. Ayeko, J. Milton, C. Hughes, K. Anderson, R. G. Middleton

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Background: Periprosthetic femoral fractures (PFF) in association with hip hemiarthroplasty or total hip arthroplasty is a common and serious complication. In the Vancouver Classification system algorithm, B1 fractures should be treated with Open Reduction and Internal Fixation (ORIF) and preferentially revised in combination with ORIF if B2 or B3. This study aims to assess patient outcomes after plate osteosynthesis alone for Vancouver B1 and B2 fractures. The main outcome is the 1-year re-revision rate, and secondary outcomes are 30-day and 1-year mortality. Method: This is a retrospective single-centre case-series review from January 2016 to June 2021. Vancouver B1 and B2, non-malignancy fractures in adults over 18 years of age treated with polyaxial Non-Contact Bridging plate osteosynthesis, have been included. Outcomes were gathered from electronic notes and radiographs. Results: There were 50 B1 and 64 B2 fractures. 26 B2 fractures were managed with ORIF and revision, 39 ORIF alone. Of the revision group, one died within 30 days (3.8%), one at one year (3.8%), and two were revised within one year (7.7). Of the B2 ORIF group, three died within 30-day mortality (7.96%), eight at one year (21.1%), and 0 were revised in 1 year. Conclusion: This study has demonstrated that satisfactory outcomes can be achieved with ORIF, excluding revision in the management of B2 fractures.

Keywords: arthroplasty, bridging plate, periprosthetic fracture, revision surgery

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Authors: Gulnara Azizova, Naila Hasanova, Nazenin Hasanzade

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The aim of study is to investigate the role of osteoactivin as a more sensitive and modern diagnostic biomarker that has a prognostic value in metabolic and repair processes occurring in bone and cartilage tissue in osteoporosis and osteoporotic fractures. Osteoactivin (OA) is a new glycoprotein that is highly expressed during osteoblast differentiation. It was first discovered in an osteopetrotic rat model using mRNA . This study was carried out on patients between the ages of 45-83 from the Department of Traumatology and placed in 3 groups: group I - 14 patients with osteoporosis, group II - 15 patients with non-osteoporotic fractures, group III - 25 patients with osteoporotic fractures. The control group consisted of 14 healthy people. To monitor changes in osteoactivin, blood samples were taken at 3 stages: on day 1 before treatment, on day 10 of treatment, and 1 month after treatment. The concentration of OA in the blood serum was determined by ELISA method on the immunoassay analyzer “Mindray MR- 96A” using a set of reagents from the company Boster ( ELISA Kit PicoKine, USA). The statistical evaluation was performed by using SPSS 22.0 program (IBM SPSS Inc., USA). Compared to the control, osteoactivin concentration increased by 66.2% in patients with osteoporosis, 54.1% in patients with non-osteoporotic fractures, and 80.2% in patients with osteoporotic fractures, indicating that it plays an important role in the pathogenesis of osteoporotic fractures. At 1 month after treatment, osteoactivin concentration increased by 81.6% in patients with non-osteoporotic fractures. The lack of a significant change in osteoporotic fractures is explained by the late healing of these fractures. Based on the sensitivity and specificity indicators, the ROC curve was created and it was determined that osteoactivin is a test with high general diagnostic value, specificity and informativeness in the prognosis of osteoporosis and osteoporotic fractures, and can be used throughout the treatment period.

Keywords: osteoactivin, bone, osteoporosis., cartilage

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Authors: M. Wigwe, M. Y Soloman, E. Pirayesh, R. Eghorieta, N. Stegent

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The moving reference point (MRP) technique has been used in the analyses of the first three stages of two fracturing jobs. The results obtained verify the proposition that a hydraulic fracture in shale grows in spurts rather than in a continuous pattern as originally interpreted by Nolte-Smith technique. Rather than a continuous Mode I fracture that is followed by Mode II, III or IV fractures, these fracture modes could alternate throughout the pumping period. It is also shown that the Nolte-Smith time parameter plot can be very helpful in identifying the presence of natural fractures that have been intersected by the hydraulic fracture. In addition, with the aid of a fracture length-time plot generated from any fracture simulation that matches the data, the distance from the wellbore to the natural fractures, which also translates to the actual fracture length for the stage, can be determined. An algorithm for this technique is developed. This procedure was used for the first 9 minutes of the simulated frac job data. It was observed that after 7mins, the actual fracture length is about 150ft, instead of 250ft predicted by the simulator output. This difference gets larger as the analysis proceeds.

Keywords: shale, fracturing, reservoir, simulation, frac-length, moving-reference-point

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Authors: Obulesh Avuku, Satwik Sunnam, Sri Charan Mohan Janthuka, Keerthi Yalamaddi

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In the United States alone, there are over 1.5 million spine fractures per year, resulting in about 17,730 spinal cord injuries. The cervical spine is where fractures in the spine most frequently occur. The prevalence of spinal fractures in the elderly has increased, and in this population, fractures may be harder to see on imaging because of coexisting degenerative illness and osteoporosis. Nowadays, computed tomography (CT) is almost completely used instead of radiography for the imaging diagnosis of adult spine fractures (x-rays). To stop neurologic degeneration and paralysis following trauma, it is vital to trace any vertebral fractures at the earliest. Many approaches have been proposed for the classification of the cervical spine [2d models]. We are here in this paper trying to break the bounds and use the vision transformers, a State-Of-The-Art- Model in image classification, by making minimal changes possible to the architecture of ViT and making it 3D-enabled architecture and this is evaluated using a weighted multi-label logarithmic loss. We have taken this problem statement from a previously held Kaggle competition, i.e., RSNA 2022 Cervical Spine Fracture Detection.

Keywords: cervical spine, spinal fractures, osteoporosis, computed tomography, 2d-models, ViT, multi-label logarithmic loss, Kaggle, public score, private score

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Authors: Rajendra Kumar Kanojia

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Background; Massive bone gaps are common following road side accidents and injury to the tibia, specially open grade three fractures. It has been seen that the diaphyseal fractures in the tibia are prone to non-union, there are certain reasons known very well, like less soft tissues around the lower third tibia, less vascularity, less options of fixation of the fractures after trauma and prolonged surgical time, operation theatre time and special surgical means. Aim of study; To know the suitability of the ilizarov ring fixators in staged treatment of the fracture of the both bones leg, including tibia, we wish to see the role of ilizarov in management of open grade three fractures which have been operated and debrided, for getting the length use of ilizaorv ring in a tertiary canter is the aim of the study.

Keywords: open fracture, staged management, ilizarov, bone grafting, lengthening

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Authors: A. Duncan, A. Blake, A. O'Gara, J. Fitzgerald

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Introduction: Acute traumatic rib fractures have significant morbidity and mortality and are a commonly seen injury in trauma patients. Rib fracture pain can often be acute and can prove challenging to manage. We performed an audit on patients with acute traumatic rib fractures with the aim of composing a referral and treatment pathway for such patients. Methods: From January 2021 to January 2022, the pain medicine service encouraged early referral of all traumatic rib fractures to the pain service for a multi-modal management approach. A retrospective audit of analgesic management was performed on a select cohort of 24 patients, with a mean age of 67, of which 19 had unilateral rib fractures. Results: 17 of 24 patients (71%) underwent local, regional block as part of a multi-modal analgesia regime. Only one regional complication was observed, seen with hypotension occurring in one patient with a thoracic epidural. The group who did not undergo regional block had a length of stay (LOS) 17 days longer than those who did (27 vs. 10) and higher rates of pneumonia (29% vs. 18%). Conclusion: Early referral to pain specialists is an important component of the effective management of acute traumatic rib fractures. From our audit, it is evident that regional blocks can be effectively used in these cases as part of a multi-modal analgesia regime and may confer benefits in terms of respiratory complications and length of stay.

Keywords: rib fractures, regional blocks, thoracic epidural, erector spina block

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Authors: Meysam Lak, Mohammad Fatehi Marji, Alireza Yarahamdi Bafghi, Abolfazl Abdollahipour

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A wellbore is a hole that is drilled to aid in the exploration and recovery of natural resources including oil and gas. Occasionally, in order to increase productivity index and porosity of the wellbore and reservoir, the well stimulation methods have been used. Hydraulic fracturing is one of these methods. Moreover, several explosions at the end of the well can stimulate the reservoir and create fractures around it. In this study, crack initiation in rock around the wellbore has been numerically modeled due to explosion. One, two, three, and four pairs of explosion have been set at the end of the wellbore on its wall. After each stage of the explosion, results have been presented and discussed. Results show that this method can initiate and probably propagate several fractures around the wellbore.

Keywords: crack initiation, explosion, finite difference modelling, well productivity

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Authors: Tarek Aly

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Introduction: Maintenance of the length, providing rotational stability, and preserving functional range of forearm motion is the mainstay of both bone forearm fractures treatment. Conservative treatment in older children may lead to malunion with poor remodeling capacity. Recent studies emphasized that the rate of complications with IM nailing was obviously increased in old children. Open reduction and internal fixation have been criticized for the amount of soft tissue dissection and periosteal stripping needed for fixation and excessive scar formation. The aim of this study was to evaluate the anatomical and functional outcomes of hybrid fixation in the treatment of closed proximal radius and ulna fractures in adolescents between 12 and 17 years of age. Patients and Methods: 30 cases of diaphyseal both bone forearm fractures treated with hybrid fixation (Nail radius – Plate ulna) and were available for a follow-up period of fewer than 24 months. Results: Clinically, 72% of cases had an excellent function, 22% had a good function, 4% had a fair function, and 2% had a poor function. Radiologically, signs of the union had appeared in the radius 2weeks earlier than in the ulna in 55% of cases. Conclusion: A hybrid fixation technique in adolescent proximal both-bones forearm fractures could be a viable option in managing these injuries.

Keywords: hyprid fixation, both bones, forearm, fractures

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Authors: Iqbal Pramukti, Mamat Lukman, Hasniatisari Harun, Kusman Ibrahim

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Introduction: People living with HIV had a higher risk of osteoporotic fracture than the general population. The purpose of this study was to predict the 10-year risk of fracture among people living with HIV (PLWH) using FRAX™ and to identify characteristics related to the fracture risk. Methodology: This study consisted of 75 subjects. The ten-year probability of major osteoporotic fractures (MOF) and hip fractures was assessed using the FRAX™ algorithm. A cross-tabulation was used to identify the participant’s characteristics related to fracture risk. Results: The overall mean 10-year probability of fracture was 2.4% (1.7) for MOF and 0.4% (0.3) for hip fractures. For MOF score, participants with parents’ hip fracture history, smoking behavior and glucocorticoid use showed a higher MOF score than those who were not (3.1 vs. 2.5; 4.6 vs 2.5; and 3.4 vs 2.5, respectively). For HF score, participants with parents’ hip fracture history, smoking behavior and glucocorticoid use also showed a higher HF score than those who were not (0.5 vs. 0.3; 0.8 vs. 0.3; and 0.5 vs. 0.3, respectively). Conclusions: The 10-year risk of fracture was higher among PLWH with several factors, including the parent’s hip. Fracture history, smoking behavior and glucocorticoid used. Further analysis on determining factors using multivariate regression analysis with a larger sample size is required to confirm the factors associated with the high fracture risk.

Keywords: HIV, PLWH, osteoporotic fractures, hip fractures, 10-year risk of fracture, FRAX

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Authors: Md. Selim Reza, Mohammad Zohir Uddin

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Geophysical logging technique was conducted in a borehole in the north-western part of Bangladesh. The main objectives of this study were to identify the subsurface lithology and the presence of magnetic minerals within the basement complex. In this survey, full waveform sonic, magnetic susceptibility and natural gamma logs were conducted up to the depth of 660 m. From sonic log, three distinct velocity zones were observed at depths ranging from 20 m to 81 m, 81m to 360 m and 420 m to 660 m having the average velocity of 1600 m/s indicating unconsolidated sediment, 2500 m/s indicating hard, compact and matured sediments and 6300 m/s indicating basement complex respectively. Some low-velocity zones within the basement were identified as fractures/fissures. Natural gamma log was carried out only in the basement complex. According to magnetic susceptibility log, broadly three important zones were identified which had good agreement with the natural gamma, sonic as well as geological logs. The zone at the depth from 460 m to 470 m had the average susceptibility value of 3445 cgs unit. The average natural gamma value and sonic velocity in this zone are 150 cps and 3000 m/s respectively. The zone at the depth from 571 m to 598 m had the average susceptibility value of 5158 cgs unit with the average natural gamma value and sonic velocity are 160 cps and 6000 m/s respectively. On the other hand, the zone at the depth from 598 m to 620 m had the average susceptibility value of 1998 cgs unit with the average natural gamma value and sonic velocity show 200 cps and 3000 m/s respectively. From the interpretation of geophysical logs the 1st and 3rd zones within the basement complex are considered to be less significant whereas the 2nd zone is described as the most significant for magnetic minerals. Therefore, more drill holes are recommended on the anomalous body to delineate the extent, thickness and reserve of the magnetic body and further research are needed to determine the quality of mineral resources.

Keywords: basement complex, fractures/fissures, geophysical logging, lithology, magnetic susceptibility

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Authors: R. Gwynn, P. Panwalkar, K. Veravalli , M. Tofighi, R. Clement, A. Mofidi

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The aim of this study was to access the impact of Covid-19 and lockdown on the incidence, injury pattern, and treatment of tibial plateau fractures in a combined rural and urban population in wales. Methods: Retrospective study was performed to identify tibial plateau fractures in 15-month period of Covid-19 lockdown 15-month period immediately before lockdown. Patient demographics, injury mechanism, injury severity (based on Schatzker classification), and associated injuries, treatment methods, and outcome of fractures in the Covid-19 period was studied. Results: The incidence oftibial plateau fracture was 9 per 100000 during Covid-19, and 8.5 per 100000, and both were similar to previous studies. The average age was 52, and female to male ratio was 1:1 in both control and study group. High energy injury was seen in only 20% of the patients and 35% in the control groups (2=12, p<0025). 14% of the covid-19 population sustained other injuries as opposed 16% in the control group(2=0.09, p>0.95). Lower severity isolated lateral condyle fracturesinjury (Schatzker 1-3) were seen in 40% of fractures this was 60% in the control populations. Higher bicondylar and shaft fractures (Schatzker 5-6) were seen in 60% of the Covid-19 group and 35% in the control groups(2=7.8, p<0.02). Treatment mode was not impacted by Covid-19. The complication rate was low in spite of higher number of complex fractures and the impact of covid-19 pandemic. Conclusion: The associated injuries were similar in spite of a significantly lower mechanism of injury. There were unexpectedly worst tibial plateau fracture based Schatzker classification in the Covid-19 period as compared to the control groups. This was especially relevant for medial condyle and shaft fractures. This was postulated to be caused by reduction in bone density caused by lack of vitamin D and reduction in activity. The treatment mode and outcome was not impacted by the impact of Covid-19 on care for tibial plateau fractures.

Keywords: Covid-19, knee, tibial plateau fracture, trauma

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Authors: Arif İsmailov, Naila Hasanova, Gunay Orujalieva

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Homocysteine (HCY) is an indicator of prognostic value in monitoring regenerative processes in osteoporosis and osteoporotic fractures. The osteoporosis is known to be a serious health and economic problem, especially for women in the postmenopausal period. The study was carried out on patients 45-83 years old divided into 3 groups: group I – 14 patients with osteoporosis , group II – 15 patients with non-osteoporotic fractures, group III – 25 patients with osteoporotic fractures. The control group consisted of practically healthy 14 people. A blood sample was taken at 3 stages to monitor the dynamics of HCY level: on the 1st day before treatment, on the 10th day of treatment and 1 month after it. Blood levels of Hcy were determined at a wavelength of 450 nm by the ELİSA(Cloud Clone Corp.Elisa kits,USA). The statistical evaluation was performed by using SPSS 26.0 program (IBM SPSS Inc., USA).The results showed that on the 1st day before the treatment HCY concentration was statistically increased 2.7 times(PU = 0.108) in group I, 5.6 times (PU <0.001) in group II and 6.5 times (PU <0.001) in group III compared to the control group. Thus, the average value of HCY in group I was 1.76 ± 0.56 μg/ml; in group II – 3.57 ± 0.62 μg/ml; in group III – 4.2 ± 0.50 μg/ml. HCY level increases more sharply after fractures,especially in osteoporotic patients. In treatment period Vitamin D plays an important role in synthesis of the Cystathionine β‐synthase enzyme, which regulates HCY metabolism. Increased Hcy levels could lead to an increase in the risk of fracture through the interference in collagen cross-linking.

Keywords: homocysteine, osteoporosis, osteoporotic fractures, Vitamin D

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Authors: Herng-Sheng Lee, Chi-Yi Chen, Wan-Ting Huang, Li-Jen Chang, Solomon Chih-Cheng Chen, Hsin-Yi Yang

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A variety of gastrointestinal disorders, such as Crohn’s disease, ulcerative colitis, and coeliac disease, are recognized as risk factors for osteoporosis and osteoporotic fractures. One recent study suggests that individuals with irritable bowel syndrome (IBS) might also be at increased risk of osteoporosis and osteoporotic fractures. Up to now, the association between IBS and the risk of fractures at different anatomic sites occurrences is not completely clear. We conducted a population-based cohort analysis to investigate the fracture risk of IBS in comparison with non-IBS group. We identified 29,505 adults aged ≥ 20 years with newly diagnosed IBS using the Taiwan National Health Insurance Research Database in 2000-2012. A comparison group was constructed of patients without IBS who were matched according to gender and age. The occurrence of fracture was monitored until the end of 2013. We analyzed the risk of fracture events to occur in IBS by using Cox proportional hazards regression models. Patients with IBS had a higher incidence of osteoporotic fractures compared with non-IBS group (12.34 versus 9.45 per 1,000 person-years) and an increased risk of osteoporotic fractures (adjusted hazard ratio [aHR] = 1.27, 95 % confidence interval [CI] = 1.20 – 1.35). Site specific analysis showed that the IBS group had a higher risk of fractures for spine, forearm, hip and hand than did the non-IBS group. With further stratification for gender and age, a higher aHR value for osteoporotic fractures in IBS group was seen across all age groups in males, but seen in elderly females. In addition, female, elderly, low income, hypertension, coronary artery disease, cerebrovascular disease, and depressive disorders as independent osteoporotic fracture risk factors in IBS patients. The IBS is considered as a risk factor for osteoporotic fractures, particularly in female individuals and fracture sites located at the spine, forearm, hip and hand.

Keywords: irritable bowel syndrome, fracture, gender difference, longitudinal health insurance database, public health

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Authors: Hasanzade Nazenin, Hasanova Naila

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According to the WHO, osteoporosis is one of the most important health problems in the world and occupies the 4th place in its importance after cardiovascular pathology, oncological diseases and diabetes mellitus. The significance of osteoporosis is determined by its prevalence among the population, the severity of the course, the cause of death, disability, reduced quality of life, high economic costs for prevention and treatment. Osteoporosis is a systemic skeletal disease characterized by a decrease in bone mass and a violation of the structure of bone tissue, leading to an increase in bone fragility and the risk of fractures. Osteoporosis is manifested by low-traumatic fractures. Due to the complexity of the recovery process, the treatment of osteoporotic fractures is one of the important problems of modern traumatology. Diagnostic markers are needed to monitor the recovery period. Human cartilage glycoprotein -39, which has been studied so far in inflammatory processes in the bones, may allow the development of the correct treatment regimen, reflecting the level of metabolic processes in the bone tissue. The study was performed to examine the dynamics of human cartilage glycoprotein-39 (HCgp39) in the blood serum during osteoporosis and fracture healing. The material of the study is formed by the examination results of 68 people aged 38-83. Group I - control group consisted of 14 practically healthy people, group II - 14 patients with osteoporosis, group III - 15 patients with non-osteoporotic fractures, group IV - 25 patients with osteoporotic fractures. In groups, they were analyzed by enzyme-linked immunosorbent assay 3 times during the first month. As a result, in the first month of the recovery period, no significant difference was observed in the HCgp39 dynamics for groups II and IV (p> 0.05). However, there was a significant reduction in group III (p <0.05). As no osteoporotic changes were observed in this patient group, bone healing was rapid and it was possible to monitor the dynamics of HCgp39 changes within 1 month. Patients with osteoporosis and other bone fractures in the process of complete recovery need to study HCgp39 more as a diagnostic indicator.

Keywords: osteoporosis, osteoporotic fractures, human cartilage glycoprotein, HCgp39

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Authors: Lajeesh Jabbar, Shibu T. Varghese

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Being under pain is a very distressing factor that it prolongs the healing of any kind of trauma and add to the post traumatic stressful state. Alleviating the pain from acute traumatic conditions like fracture, degloving injury etc will help in faster recovery and also decrease the incidence of post traumatic stress disorder. Most of the emergency departments in INDIA are using IV opioid analgesics to relieve the patient from pain in cases of acute traumatic injuries. None of the Emergency Departments practice regional blocks in the country. In this study, we are comparing the efficacy of Regional Blocks in relieving the pain in lower limb fractures versus the use of IV analgesics for the same in the emergency department. The site of study is Malabar Institute Of Medical Sciences in Calicut in Kerala in India and is a place which receives approximately 10-20 traumatic fracture cases per day. The fracture sites used for the study purpose are femur fracture and phalangeal fractures.

Keywords: regional blocks, IV analgesia, acute traumatic pain, femur fractures, phalanx fractures

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Authors: S. Anwar Sathik, K. Manoj Deepak, K. Venkatachalam

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Our study is a prospective study on the use of bio absorbable pins for the treatment of osteochondral fractures after patellar dislocation.22 patients who presented with osteochondral fractures were treated in our institution. They were followed for a minimum of 12 months by regular radiological evaluation. Of the 22 patients, 2 had fragments that detached from the fracture site which was treated arthroscopically. All the patients underwent open reduction and fixation of the pins using bio absorbable crews. They were immobilized in the cast for a minimum of 6 weeks after which mobilization was started according to our protocol. Fracture consolidation was found to occur in 20 of the 22 patients. Thus, Bio absorbable screws can be used as a reliable method of fixation of the osteochondral fragments.

Keywords: osteochondral fracture, bio absorbable pins, patella dislocation, physiotherapy

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Authors: Guijie Sang, Geo Davis, Momchil Terziev

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Geological CO2 storage has been regarded as a promising strategy to mitigate the emission of greenhouse gas generated from traditional power stations and energy-intensive industry. Caprocks with very low permeability and ultra-fine pores create viscous and capillary barriers to guarantee CO2 sealing efficiency. However, caprock fractures, either naturally existing or artificially induced due to injection, could provide preferential paths for CO₂ escaping. Seeking an efficient technique to seal and strengthen caprock fractures is crucial. We apply microbial-induced-calcite-precipitation (MICP) technique for sealing and strengthening caprock fractures in the laboratory scale. The MICP bio-grouting technique has several advantages over conventional cement grouting methods, including its low viscosity, micron-size microbes (accessible to fine apertures), and low carbon footprint, among others. Different injection strategies are tested to achieve relatively homogenous calcite precipitation along the fractures, which is monitored dynamically based on laser ultrasonic technique. The MICP process in caprock fractures, which integrates the coupled flow and bio-chemical precipitation, is also modeled and validated through the experiment. The study could provide an effective bio-mediated grouting strategy for caprock sealing and thus ensuring a long-term safe geological CO2 storage.

Keywords: caprock sealing, geological CO2 storage, grouting strategy, microbial induced calcite precipitation

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Authors: P. Panwalkar, K. Veravalli, R. Gwynn, M. Tofighi, R. Clement, A. Mofidi

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When operating on tibial plateau fracture especially medial tibial plateau, it has regularly been said “where do I put my thumb to reduce the fracture”. This refers to the ideal placement of the buttress device to hold the fracture till union. The aim of this study was to see if one can identify this sweet spot using a CT scan. Methods: Forty-five tibial plateau fractures with medial plateau involvement were identified and included in the study. The preoperative CT scans were analysed and the medial plateau involvement pattern was classified based on modified radiological classification by Yukata et-al of stress fracture of medial tibial plateau. The involvement of part of plateau was compared with position of buttress plate position which was classified as medial posteromedial or both. Presence and position of the buttress was compared with ability to achieve and hold the reduction of the fracture till union. Results: Thirteen fractures were type-1 fracture, 19 fractures were type-2 fracture and 13 fractures were type-3 fracture. Sixteen fractures were buttressed correctly according to the potential deformity and twenty-six fractures were not buttressed and three fractures were partly buttressed correctly. No fracture was over butressed! When the fracture was buttressed correctly the rate of the malunion was 0%. When fracture was partly buttressed 33% were anatomically united and 66% were united in the plane of buttress. When buttress was not used, 14 were malunited, one malunited in one of the two planes of deformity and eleven anatomically healed (of which 9 were non displaced!). Buttressing resulted in statistically significant lower mal-union rate (x2=7.8, p=0.0052). Conclusion: The classification based on involvement of medial condyle can identify the placement of buttress plate in the tibial plateau. The correct placement of the buttress plate results in predictably satisfactory union. There may be a correlation between injury shape of the tibial plateau and the fracture type.

Keywords: knee, tibial plateau, trauma, CT scan, surgery

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Authors: Hong Je Kang, Young Chae Choi, Jin Sung Park, Isac Kim

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Purpose: Osteoporotic fractures are an important among postmenopausal women. When osteoporotic distal radial fractures occur, osteoporosis must be treated to prevent the hip and spine fractures. Intravenous injection of Zoledronic acid is expected to improve preventing osteoporotic fractures. Many articles reported the effect of intravenous Zoledronic acid to BMD of the hip and spine fracture or non-fracture patients with low BMD. However, that with distal radial fractures has rarely been reported. Therefore, the authors decided to study the effect of Zoledronic acid in BMD score, bone union, and bone turnover markers in the patients who underwent volar plating due to osteoporotic distal radial fractures. Materials: From April 2018 to May 2022, postmenopausal women aged 55 years or older who had osteoporotic distal radial fractures and who underwent surgical treatment using volar plate fixation were included. Zoledronic acid (5mg) was injected intravenously between 3 and 5 days after surgery. BMD scores after 1 year of operation were compared with the initial scores. Bone turnover markers were measured before surgery, after 3 months, and after 1 year. Radiological follow-up was performed every 2 weeks until the bone union and at 1 year postoperatively. Clinical outcome indicators were measured one year after surgery, and the occurrence of side effects was observed. Result: Total of 23 patients were included, with a lumbar BMD T score of -2.89±0.2 before surgery to -2.27±0.3 one year after surgery (p=0.012) and a femoral neck BMD T score of -2.45±0.3 before surgery to -2.36±0.3 (p=0.041) after one year, and all were statistically significant. Measured as bone resorption markers, serum CTX-1 was 337.43±10.4 pg/mL before surgery, 160.86±8.7 pg/mL (p=0.022) after three months, and 250.12±12.7 pg/mL (p=0.031) after one year. Urinary NTX-1 was 39.24±2.2 ng/mL before surgery, 24.46±1.2 ng/mL (p=0.014) after three months and 30.35±1.6 ng/mL (p=0.042) after one year. Measured as bone formation markers, serum osteocalcin was 13.04±1.1 ng/mL before surgery, 8.84±0.7 ng/mL (p=0.037) after 3 months and 11.1±0.4 ng/mL (p=0.026) after one year. Serum bone-specific ALP was 11.24±0.9 IU/L before surgery, 8.25±0.9 IU/L (p=0.036) after three months, and 10.2±0.9 IU/L (p=0.027) after one year. All were statistically significant. All cases showed bone union within an average of 6.91±0.3 weeks without any signs of failure. Complications were found in 5 out of 23 cases (21.7%), such as headache, nausea, muscle pain, and fever. Conclusion: When Zoledronic acid was used, BMD was improved in both the spine and femoral neck. This may reduce the likelihood and subsequent morbidity of additional osteoporotic fractures. This study is meaningful in that there was no difference in the duration of bone union and radiological characteristics in patients with distal radial fractures administrated with intravenous BP early after the fractures, and improvement in BMD and bone turnover indicators was measured.

Keywords: zeoldreonic acid, BMD, osteoporosis, distal radius

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Authors: Mohit Kumar

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Natural fractures are classified in two broad categories of joints and faults on the basis of shear movement in the deposited strata. Natural fracture always has high structural relationship with extensional or non-extensional tectonics and sometimes the result is seen in the form of micro cracks. Geological evidences suggest that both large and small-scale fractures help in to analyze the seismic anisotropy which essentially contribute into characterization of petro physical properties behavior associated with directional migration of fluid. We generally question why basement study is much needed as historically it is being treated as non-productive and geoscientist had no interest in exploration of these basement rocks. Basement rock goes under high pressure and temperature, and seems to be highly fractured because of the tectonic stresses that are applied to the formation along with the other geological factors such as depositional trend, internal stress of the rock body, rock rheology, pore fluid and capillary pressure. Sometimes carbonate rocks also plays the role of basement and igneous body e.g basalt deposited over the carbonate rocks and fluid migrate from carbonate to igneous rock due to buoyancy force and adequate permeability generated by fracturing. So in order to analyze the complete petroleum system, FMC (Fluid Migration Characterization) is necessary through fractured media including fracture intensity, orientation and distribution both in basement rock and county rock. Thus good understanding of fractures can lead to project the correct wellbore trajectory or path which passes through potential permeable zone generated through intensified P-T and tectonic stress condition. This paper deals with the analysis of these fracture property such as intensity, orientation and distribution in basement rock as large scale fracture can be interpreted on seismic section, however, small scale fractures show ambiguity in interpretation because fracture in basement rock lies below the seismic wavelength and hence shows erroneous result in identification. Seismic attribute technique also helps us to delineate the seismic fracture and subtle changes in fracture zone and these can be inferred from azimuthal anisotropy in velocity and amplitude and spectral decomposition. Seismic azimuthal anisotropy derives fracture intensity and orientation from compressional wave and converted wave data and based on variation of amplitude or velocity with azimuth. Still detailed analysis of fractured basement required full isotropic and anisotropic analysis of fracture matrix and surrounding rock matrix in order to characterize the spatial variability of basement fracture which support the migration of fluid from basement to overlying rock.

Keywords: basement rock, natural fracture, reservoir characterization, seismic attribute

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Authors: S. alireza Mirghasemi, Shervin Rashidinia, Mohammadsaleh Sadeghi, Mohsen Talebizadeh, Narges Rahimi Gabaran, S. Shahin Eftekhari, Sara Shahmoradi

Abstract:

Purpose: There are various pin-in-plaster methods for treating distal radius fractures. This study is meant to introduce a modified technique of pin-in-plaster. Materials and methods: Fifty-four patients with distal radius fractures were followed up for one year. Patients were excluded if they had type B fractures according to AO classification, multiple injuries or pathological fractures, and were treated more than 7 days after injury. Range of motion and functional results were evaluated. Radiographic parameters including radial inclination, tilt, and height, were measured preoperatively and postoperatively. Results: The average radial tilt was 10.6° and radial height was 10.2 mm at the sixth month postoperatively. Three cases of pin tract infection were recorded, who were treated totally with oral antibiotics. There was no case of pin loosening. Of total 73 patients underwent surgery, three cases of radial nerve irritation were recorded at the time of cast removal. All of them resolved at the 6th month follow up. No median nerve compression and carpal tunnel syndrome have found. We also had no case of tendon injury. Conclusion: Our modified technique is effective to restore anatomic congruity and maintain reduction.

Keywords: distal radius fracture, percutaneous pinning, pin-in-plaster, modified method of pin-in-plaster, operative treatment

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Authors: Krishna Prasad Regmi, Jun-Bo Tu, Cheng-Qun Hou, Li-Feng Li

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Maxillofacial trauma in a pediatric group of patients is particularly challenging, as these patients have significant differences from adults as far as the facial skeleton is concerned. Mandibular condylar fractures are common presentations to hospitals across the globe and remain the most important cause of temporomandibular joint (TMJ) ankylosis. The etiology and epidemiology of pediatric trauma involving the diacapitular condylar fractures (DFs) have been reported in a large series of patients. Nevertheless, little is known about treatment protocols for DFs in children. Accordingly, the treatment modalities for the management of pediatric fractures also differ. We suggest following the PDA and intracapsular ABC classification of condylar fracture to increase the overall postoperative satisfaction level that bypasses the change of subjective feelings of patients’ from preoperative to the postoperative condition. At the same time, use of 3-D technology and surgical navigation may also increase treatment accuracy.

Keywords: maxillofacial trauma, diacapitular fracture, condylar fracture, PDA classification

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Authors: Srikanta Tagore Sarkar, Prasanta Kumar Mandal, Dibakar Roy

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The association of a capitate fracture with a scaphoid fracture has been termed as the naviculocapitate syndrome. The existence of some nondisplaced fractures of scaphoid and capitate with or without the fracture of lunate or radius suggests that there is a spectrum of these injuries, and this confuses the terminology. With our case; we report an unusual variety of this naviculocapitate syndrome with distal radial Colles fracture in addition to the nondisplaced fractures of the scaphoid, capitate and the dorsal lip of radial fracture. When we looked at the literature there is no another Colles fracture reported together with undisplaced scapho-capitate syndrome. The coronal and sagittal images that obtained from the MDCT (Multidetector computed tomography) is useful and effective imaging modality to diagnose complex wrist fractures with more details that are not detected in X-rays.

Keywords: scaphoid, capitate, Colles’ fracture, syndrome, MDCT, unusual

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Authors: Fabiha Tanzeem

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BACKGROUND: Osteoporosis is a skeletal disease that is associated with a reduction in bone mass and microstructures of the bone and deterioration of bone tissue. Fragility fracture due to osteoporosis is the most significant complication of osteoporosis. The increasing prevalence of fragility fractures presents a growing burden on the global economy. There is a rapidly evolving need to improve awareness of the costs associated with these types of fractures and to review current policies and practices for the prevention and management of the disease. This systematic review will identify and describe the direct and indirect costs associated with osteoporotic fragility fractures from a global perspective from the included studies. The review will also find out whether the costs required for the treatment of fragility fractures due to osteoporosis impose an economic burden on the global healthcare system. METHODS: Four major databases were systematically searched for direct and indirect costs of osteoporotic fragility fracture studies in the English Language. PubMed, Cochrane Library, Embase and Google Scholar were searched for suitable articles published between 1990 and July 2020. RESULTS: The original search yielded 1166 papers; from these, 27 articles were selected for this review according to the inclusion and exclusion criteria. In the 27 studies, the highest direct costs were associated with the treatment of pelvic fractures, with the majority of the expenditure due to hospitalization and surgical treatments. It is also observed that most of the articles are from developed countries. CONCLUSION: This review indicates the significance of the economic burden of osteoporosis globally, although more research needs to be done in developing countries. In the treatment of fragility fractures, direct costs were the main reported expenditure in this review. The healthcare costs incurred globally can be significantly reduced by implementing measures to effectively prevent the disease. Raising awareness in children and adults by improving the quality of the information available and standardising policies and planning of services requires further research.

Keywords: systematic review, osteoporosis, cost of illness

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Authors: Iklass Hamaili, Fehdi Chemseddine

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Morphostructural, hydrogeological and hydrochemical approaches were applied in this study to characterize the groundwater system of Hammamet Plain, Eastern part of Algeria and its potential for exploitation. The analysis of the fractures in several Mountains forming the natural boundaries of Hammamet plain, with faults of markedly different sizes and joints measured at 21 stations, demonstrate the presence of two principal directions of fractures (NNW-SSE and NNE-SSW). From a hydrogeological standpoint, these two mountains constitute a unit limited by faults-oriented ENE-WSW, NNW-SSE and NNE-SSW. Specifically, fractures of the latter two directions influence the compartmentalization and the hydrogeological functioning of this unit. According to the degree of fracturing and/or karstification, two basic types of aquiferous behavior have been distinguished: fissured aquifer (Essen Mountain and Troubia Mountain), and porous aquifer (Hammamet basin). After sampling and measurement operations, the quantity of chemical components was determined. Thus, the study of the hydrochemical characteristics of this groundwater shows on Piper’s diagram that the majority of them are mainly HCO₃- and Ca₂+ water types. The ionic speciation and mineral dissolution/precipitation were calculated by PHREEQC package software. The chemical composition of the water is influenced by the dissolution and/or precipitation processes during the water-rock interaction and by the cationic exchange reactions between groundwater and alluvial sediments. The high content of CO₂ in the water samples suggests that they circulate in a geochemical opened system.

Keywords: aquifer, hydrogeology, hydrochemistry, Hammamet, Tebessa, Algeria

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Authors: Weiyao Zhu, Qian Qi, Ming Yue, Dongxu Ma

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Due to the nano-micro pore structures and the massive multi-stage multi-cluster hydraulic fracturing in shale gas reservoirs, the multi-scale seepage flows are much more complicated than in most other conventional reservoirs, and are crucial for the economic development of shale gas. In this study, a new multi-scale non-linear flow model was established and simplified, based on different diffusion and slip correction coefficients. Due to the fact that different flow laws existed between the fracture network and matrix zone, a three-zone composite model was proposed. Then, according to the conformal transformation combined with the law of equivalent percolation resistance, the productivity equation of a horizontal fractured well, with consideration given to diffusion, slip, desorption, and absorption, was built. Also, an analytic solution was derived, and the interference of the multi-cluster fractures was analyzed. The results indicated that the diffusion of the shale gas was mainly in the transition and Fick diffusion regions. The matrix permeability was found to be influenced by slippage and diffusion, which was determined by the pore pressure and diameter according to the Knudsen number. It was determined that, with the increased half-lengths of the fracture clusters, flow conductivity of the fractures, and permeability of the fracture network, the productivity of the fractured well also increased. Meanwhile, with the increased number of fractures, the distance between the fractures decreased, and the productivity slowly increased due to the mutual interference of the fractures. In regard to the fractured horizontal wells, the free gas was found to majorly contribute to the productivity, while the contribution of the desorption increased with the increased pressure differences.

Keywords: multi-scale, fracture network, composite model, productivity

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Authors: M. K. Kim, C. H. Shin, W. G. Park

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Recently, natural gas resources are issued due to alternative and eco-friendly energy policies, and development of even unconventional gas resources including tight gas, coal bed methane and shale gas is being rapidly expanded from North America all over the world. For developing these gas reservoirs, it is necessary to investigate reservoir characteristics by using reservoir simulation. In reservoir simulation, calculation of permeability of fractured zone is very important to predict the gas production. However, it is difficult to accurately calculate the permeability by using conventional methods which use analytic solution for laminar flow. The flow in gas reservoirs exhibits complex flow behavior such as slip around the wall roughness effect and turbulence because the size of the apertures of fractures is ranged over various scales from nano-scale to centi-scale. Therefore, it is required to apply new reservoir flow analysis methods which can accurately consider complex gas flow owing to the geometric characteristics and distributions of various pores and flow paths within gas reservoirs. Hence, in this study, the flow characteristics and the relation between each characteristic variable was investigated and multi-effect was quantified when the fractures are compounded for devising a new calculation model of permeability of fractured zone in gas reservoirs by using CFD.

Keywords: fractured zone, gas reservoir, permeability, CFD

Procedia PDF Downloads 252