El Sallah, Zagane Mohammed;Smail, Benbarek;Abderahmane, Sahli;Bouiadjra, B. Bachir;Boualem, Serier
Structural Engineering and Mechanics
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제60권3호
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pp.405-412
/
2016
Bone is a living material with a complex hierarchical structure that gives it remarkable mechanical properties. Bone constantly undergoes mechanical. Its quality and resistance to fracture is constantly changing over time through the process of bone remodeling. Numerical modeling allows the study of the bone mechanical behavior and the prediction of different trauma caused by accidents without expose humans to real tests. The aim of this work is the modeling of the femur fracture under static solicitation to create a numerical model to simulate this element fracture. This modeling will contribute to improve the design of the indoor environment to be better safe for the passengers' transportation means. Results show that vertical loading leads to the femur neck fracture and horizontal loading leads to the fracture of the femur diaphysis. The isotropic consideration of the bone leads to bone fracture by crack propagation but the orthotropic consideration leads to the fragmentation of the bone.
There were some controversies about direct cause of hip fracture. We attempted to look at 40 osteoporotic proximal femur fractures in women over 50 years between March in 1999 and Febuary in 2000. The bone density of the fracture group and the healthy 85 control group was measured by Dual Energy X-ray absorptiometry(DEXA). The result was compared using age matched paired T test. The results were as follows ; 1. The femoral neck fractures were 14 cases and the trochanteric fractures were 26 cases. Mean age at a fracture was 67.1 years in neck fracture group and 76.5 years in trochanteric fracture. 2. In the control group, the bone density of both side of the proximal femur was measured and it showed statistically no difference between both sides in same person. 3. The bone density of neck, Ward's triangle, trochanter(P<0.05) and lumbar spine(P<0.001) was significantly reduced in the proximal femoral fracture group comparing with the control group. 4. The bone density of neck, Ward's triangle, trochanter(P<0.05) was significantly reduced in the proximal femoral neck fracture group comparing with the control group, but there was no statistical difference in lumbar spine comparing with the control group. 5. The bone density of neck, Ward's triangle, trochanter and lumbar spine(P<0.001) was significantly reduced in the proximal femoral neck fracture group comparing with the control group. We concluded that the bone mineral densities(BMD) of proximal femur and lumbar spine had decreased in hip fractures but that the bone mineral density and T-score % of the proximal femur were statistically lower than that of the lumbar spine. We suggest that measuring the bone mineral density of the proximal femur may reflect the weakness of the proximal femur more precisely than measuring the bone mineral density of the lumbar spine.
Background: All nasal bone fractures have the potential for worsening of olfactory function. However, few studies have studied the olfactory outcomes following reduction of nasal bone fractures. This study evaluates posttraumatic olfactory dysfunction in patients with nasal bone fracture before and after closed reduction. Methods: A prospective study was conducted for all patients presenting with nasal bone fracture (n=97). Each patient consenting to the study underwent the Korean version of Sniffin' Sticks test (KVSS II) before operation and at 6 month after closed reduction. The nasal fractures were divided according to the nasal bone fracture classification by Haug and Prather (Types I-IV). The olfactory scores were compared across fracture types and between preoperative and postoperative settings. Results: Olfactory dysfunction was frequent after nasal fracture (45/97, 46.4%). Our olfactory assessment using the KVSS II test revealed that fracture reduction was not associated with improvements in the mean test score in Type I or Type II fractures. More specifically, the mean posttraumatic Threshold, discrimination and identification score decreased from 28.8 points prior to operation to 23.1 point at 6 months for Type II fracture with septal fracture. Conclusion: Our study has revealed two alarming trends regarding post-nasal fracture olfactory dysfunction. First, our study demonstrated that almost half (46.4%) of nasal fracture patients experience posttraumatic olfactory dysfunction. Second, closed reduction of these fractures does not lead to improvements olfaction at 6 months, which suggest that olfactory dysfunction is probably due to factors other than the fracture itself. The association should be further explored between injuries that lead to nasal fracture and the mechanism behind posttraumatic olfactory dysfunction.
Purpose: The clinical utility of brain computed tomography (CT) in detecting temporal bone fracture is not well established. We performed this study to determine the utility of brain computed tomography (CT) in detecting fractures of the temporal bones in correlation with fracture patterns. We used high resolution computed tomography (HRCT) as the gold standard for diagnosing temporal bone fracture and its pattern. Methods: From January 2007 to December 2009, patients who underwent both brain CT and HRCT within 10 days of head trauma were investigated. Among them, 58 cases of temporal bone fracture confirmed by HRCT were finally included. Fracture patterns (transverse or non-transverse, otic capsule sparing or otic capsule violating) were determined by HRCT. Brain CT findings in correlation with fracture patterns were analyzed. Results: Among 58 confirmed cases of temporal bone fracture by HRCT, 14 cases (24.1%) were not detected by brain CT. Brain CT showed a significantly lower ability to detect temporal bone fracture with transverse component than without transverse component (p=0.020). Moreover, brain CT showed lower ability to detect otic capsule violating pattern than otic capsule sparing pattern (p=0.015). Among the 14 cases of temporal bone fracture that were not detected by brain CT, 4 cases lacked any objective physical findings (facial palsy, hemotympanum, external auditory canal bleeding) suggesting fractures of the temporal bones. Conclusion: Brain CT showed poor ability to detect temporal bone fracture with transverse component and otic capsule violating pattern, which is associated with a poorer clinical outcome than otic capsule sparing pattern. Routine use of HRCT to identify temporal bone fracture is warranted, even in cases without evidence of temporal bone fracture on brain CT scans or any objective physical findings suggestive of temporal bone fracture.
Al-Sobayil, Fahd;Sadan, Madeh A.;El-Shafaey, El-Sayed;Ahmed, Ahmed F.
Journal of Veterinary Science
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제21권6호
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pp.90.1-90.11
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2020
Background: Mandibular fractures are common in camels, leading to considerable economic losses. This study explored methods of improving mandibular fractures repair, adjuvant with interdental wire, or bone plate fixation. Autologous bone marrow (BM) injection enhances osteogenesis and rapid healing. Objectives: To investigate the effect of autologous BM aspirate as an adjuvant treatment for repairing mandibular fractures in camels with interdental wire, or bone plate fixation. Methods: Thirty dromedary camels aged 5-8 years and of both sexes were randomly divided into 4 treatment groups: group 1 (n = 10) treated with stainless steel wire fixation and BM injection at the fracture line, group 2 (n = 10) treated with plate fixation and BM injection at the fracture line, group 3 (n = 5) treated with stainless steel bone wire fixation and placebo saline injection at the fracture line, and group 4 (n = 5) treated with plate fixation and placebo injection at the fracture line. The mandibular fractures were followed weekly for 12 weeks postoperatively to assess improvement and healing based on clinical evaluation, radiographic union scale, and bone turnover markers (i.e., bone alkaline phosphatase, osteocalcin, pyridinoline, and deoxypyridinoline). Results: Compared to other groups, elevated bone turnover markers in group 1 were demonstrated (p < 0.05) on the seventh postoperative day. Likewise, compared to other groups, both clinical findings and radiographic union scale significantly improved (p < 0.05) in group 1 on the 56th postoperative day. Conclusions: BM aspirate has a promising beneficial osteogenic effect on mandibular fracture repair in camels, most notably when combined with interdental wire fixation.
Choi, Min Hyub;Cheon, Ji Seon;Son, Kyung Min;Cho, Woo Young
대한두개안면성형외과학회지
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제21권1호
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pp.7-14
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2020
Background: It is difficult to completely fix nasal bone fractures with closed reduction, as it is often accompanied by septal cartilage damage, and this often results in postoperative secondary deformities. Thus, patients are often reluctant to undergo closed reduction surgery. The present study aimed to evaluate aesthetic and functional satisfaction, as well as satisfaction with and complications of closed reduction, according to nasal bone fracture type. Methods: The subjects were patients who underwent closed reduction under general anesthesia from January 2017 to December 2018. Based on the modified Murray classification, patients were classified into five groups according to the fracture site, septal fracture, and deviation. A total of 211 patients were sent a web-based survey on postoperative satisfaction and complications, as well as intention for revision and cosmetic surgery. Sixty-one patients (28.9%) responded. Results: There were no significant differences in aesthetic and functional satisfaction or satisfaction with closed reduction according to the fracture type, site, or severity. Postoperative functional complications developed in 14 of 61 patients (22.95%). With 10 out of 24 (41.67%) patients (p = 0.044), the bilateral fracture with septal fracture or prominent septal deviation type had a higher incidence of complications than the other types. Conclusion: The incidence of complications is higher for bilateral fracture with septal fracture or prominent septal deviation compared to the other nasal bone fracture types. Therefore, long-term follow-up after closed reduction surgery for this fracture type can aid in establishing additional postoperative treatment plans and improving patient satisfaction.
The purpose of this investigation was to examine the effects of osteocalcin (serum bone GLA-protein, BGP) and procollagen carboxy-terminal propeptide (PICP) on new bone formation of canine fracture models. Serum osteocalcin and PICP were measured by standard RIA. The values of osteocalcin and PICP in the non-union and delayed-union fracture models were measured biweekly for 20 weeks in 14 dogs. The unions were radiographed for fracture healing. In non-union fracture group, the activity of BGP was markedly increased at four to eight weeks and decreased at twelve to twenty weeks and the activity of PICP was markedly increased at two to six weeks and slightly decreased at sixteen to twenty weeks. In delayed-union fracture group, the activity of BGP was markedly increased at two to eight weeks after treatment and maintained for the level until twenty weeks and the activity of PICP was markedly increased at two to six weeks after treatment and maintained for the level until twenty weeks. Radiologically, non-union group was not achieved until twenty weeks after fracture, delayed-union group was successfully achieved in eighteen weeks after fracture. These results suggested that the. activities of osteocalcin and PICP are useful parameters for biochemical markers of bone formation in dogs.
This study was conducted to investigate the incidence of bone-fracture from pig carcass slaughtered in eight processing plants located in Daejeon and Chungnam area, Korea, during the year 2013 and 2014, and to evaluate the quality of semimembranous muscle from bone-fractured carcasses. Twenty semimembranous muscles were collected from bone-fractured carcasses and none bone-fractured (control) ones, respectively, after storage of pig carcass at $5^{\circ}C$ for 24 h. The pH, cooking loss, and color of semimembranous muscle were measured as quality parameters. In total 4,865,502 of pig carcasses, the occurrence of bone fracture was 0.328% (15,975 heads) and scored the highest defect (26.31%) in total abnormal carcasses. The pH and cooking loss of semimembranous muscle from bone-fractured carcasses were significantly lower than those of control (p<0.05). $L^*$ and $a^*$ values of semimembranous muscle were not significantly different between bone-fractured carcass and control whereas that of $b^*$ values was significantly higher in bone-fractured carcass than control (p<0.05). Eight out of twenty semimembranous muscle collected from bone-fractured carcasses were confirmed as PSE whereas only one in control. In conclusion, the incidence of bone-fracture pre- and during slaughter of pig may cause serious defects in final meat quality. Therefore, the proper handling and treatment should be implicated to avoid and/or decrease the incidence of bone-fracture of pigs.
Background: Nasal fractures have a tendency of resulting in structural or functional complications, and the results can vary according to the type of nasal bone fracture. The aim of this study was to evaluate the objective postoperative results according to the type of nasal bone fractures. Methods: We reviewed 313 patients who had a closed reduction of nasal bone fracture. The classification of nasal bone fracture by Stranc and Robertson was used to characterize the fracture type: frontal impact group type I (FI), frontal impact group type II (FII), lateral impact group type I (LI), lateral impact group type II (LII), and comminuted fracture group (C). For each patient, we tried to use the same axial image section of computed tomographic (CT) scans before and immediately after operation. Postoperative outcomes were classified into 4 grades: excellent (E), good (G), fair (F), and poor (P). We also analyzed postoperative complications by fracture type. Results: Regarding the postoperative CT images, 189 subjects showed E results, 99 subjects showed G, 18 subjects showed F, and 7 subjects showed P reduction. The rate of operation results graded as E by each fracture type was 66.67% in FI, 52.0% in FII, 64.21% in LI, 62.79% in LII, and 21.74% in C. Complications of FI (7.14%), LII (13.95%), and C (13.04%) groups occurred more than in the FII (4.00%) and LI (4.21%) groups. Conclusion: It seems that the operation result by fracture type was better in the FI, LI, and LII type than the FII and C type; after one month, however, LII type showed more complications than other types. The septal fracture can be thought to affect early reduction results in nasal bone fractures.
Objectives The purpose of this study is to evaluate the bone healing effect of Dohongsamul-tang (Taohongsiwu-tang; DH) on femur fractured mice. Methods Mice were randomly divided into 4 groups (naive, control, positive control and DH). All groups except naive group were subjected to bone fracture on both hind limb femurs. Naive group received no treatment at all. Control group was fed with normal saline, and positive control group was orally medicated with tramadol. DH-treated group was orally medicated with DH. We analysed the levels of BMP2, COX2, Col2a1, Sox9, Runx2, and Osterix genes on 3, 7 and 14 days after fracture. Alkaline phosphatase, aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen, creatinine, total cholesterol, and triglyceride levels were measured for safety assessment. Results In morphological, histological analysis, callus formation process of DH-treated group was faster than the control group. BMP2, Sox9 gene expression were significantly increased at 7 days after fracture compared to the control group. COX2, Col2a1 gene expression were significantly increased at 14 days after fracture compared to the control group. Total cholesterol was significantly increased by DH at 3 days. Triglyceride was significantly decreased by DH at 3, 7 days after fracture compared to the control group. Conclusions Dohongsamul-tang promoted bone healing process after fracture by stimulating the bone regeneration factors. And DH shows no hepatotoxicity, nephrotoxicity and serum lipid abnormality. In conclusion, it seems that DH helps to promote fracture regeneration after bone fracture by regulating gene expressions related to bone repair.
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