Complex trimalleolar ankle fractures are a major orthopaedic challenge,with an incidence of 4.22 per 10000 person-years in the United States and an annual cost of 3.4 billion dollars.This review synthesizes current ev...Complex trimalleolar ankle fractures are a major orthopaedic challenge,with an incidence of 4.22 per 10000 person-years in the United States and an annual cost of 3.4 billion dollars.This review synthesizes current evidence on diagnostic protocols and management strategies,highlighting optimal approaches and emerging trends.Initial care emphasizes soft tissue assessment,often guided by the Tscherne classification,and fracture classification systems.External fixation may be required in open injuries,while early open reduction and internal fixation within six days is linked to improved outcomes.Minimally invasive techniques for the lateral malleolus,including intramedullary nailing and locking plates,are effective,while medial malleolus fractures are commonly managed with screw fixation or tension-band wiring.Posterior malleolus fragments involving more than 25%of the articular surface usually warrant fixation.Alternatives to syndesmotic screws,such as cortical buttons or high-strength sutures,reduce the need for secondary procedures.Arthroscopic-assisted open reduction and internal fixation benefits younger,active patients by enabling concurrent management of intra-articular and ligamentous injuries.Postoperative care prioritizes early weight-bearing and validated functional scores.Despite advances,complications remain common,and further research is needed to refine surgical strategies and improve outcomes.展开更多
BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges f...BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges from nonoperative methods to surgical interventions such as intramedullary K-wires,which promote faster rehabilitation and improved elbow mobility.AIM To evaluate the outcomes of managing humeral shaft fractures using closed reduction and internal fixation with flexible intramedullary K-wires.METHODS This was a retrospective cohort study analyzing the medical records of patients with humeral shaft fractures managed with flexible intramedullary K-wires at King Abdulaziz Medical City,using non-random sampling and descriptive analysis for outcome evaluation.RESULTS This study assessed the clinical outcomes of 20 patients treated for humeral shaft fractures with intramedullary K-wires.Patients were predominantly male(n=16,80%),had an average age of 39.2 years,and a mean body mass index of 29.5 kg/m^(2).The fractures most frequently occurred in the middle third of the humerus(n=14,70%),with oblique fractures being the most common type(n=7,35%).All surgeries used general anesthesia and a posterior approach,with no intraoperative complications reported.Postoperatively,all patients achieved clinical and radiological union(n=20,100%),and the majority(n=13,65%)reached an elbow range of motion from 0 to 150 degrees.CONCLUSION These results suggest that intramedullary K-wire fixation may be an effective option for treating humeral shaft fractures,with favorable outcomes in range of motion recovery,fracture union,and a low rate of intraoperative complications.展开更多
The research presented in this paper aimed to analyze the evolution of fractures in strata in relation to the progress of longwall mining.To achieve this objective,an introscopic probe equipped with a highresolution c...The research presented in this paper aimed to analyze the evolution of fractures in strata in relation to the progress of longwall mining.To achieve this objective,an introscopic probe equipped with a highresolution camera was developed,along with additional equipment that enables continuous recording of the internal surfaces of drainage boreholes exceeding 100 m in depth.The probe was utilized to test two methane drainage boreholes in the Z-3b longwall,which operates within the 501/3 coal seam of the Jankowice mine in Poland.Automatic image analysis methods were applied to evaluate the recorded images,based on a newly developed classificationsystem for fractures categorized by size and number.The results were compared with an analysis of changes in the methane capture rate from the drainage boreholes,which correlated with longwall mining progress.A strong correlation was observed between the number of fractures and the lithology of the strata layers.The largest number of fractures and their evolution were recorded in the coal layers,followed by the shale layers,while the sandstone layers exhibited the least number of fractures.Based on parallel measurements of the methane capture rate from the drainage boreholes during the progress of longwall mining,the extent of the strata's fracture zone was determined to range from 6 m to 36 m.Within the fracture zone,the strata are highly fractured,which leads to an increase in methane emissions through seepage and diffusion processes.展开更多
Objective:To analyze the clinical application value of autologous periosteum graft combined with platelet-rich plasma(PRP)in the treatment of long bone fractures in the extremities.Methods:A total of 40 patients with ...Objective:To analyze the clinical application value of autologous periosteum graft combined with platelet-rich plasma(PRP)in the treatment of long bone fractures in the extremities.Methods:A total of 40 patients with long bone fractures in the extremities admitted to Santai Hospital Affiliated to North Sichuan Medical College from January 2023 to January 2025 were included,including cases of upper extremity forearm fractures and lower extremity femoral and tibial fractures.The patients were evenly divided using a random number table,with the control group undergoing open reduction and internal fixation(ORIF)combined with autologous periosteum graft,and the observation group undergoing ORIF,autologous periosteum graft,and PRP injection.Surgical indicators,complication rates,excellent fracture healing rates,functional satisfaction,and joint range of motion were compared between the two groups.Results:The surgical indicators in the observation group were similar to those in the control group(p>0.05).The complication rate in the observation group was lower than that in the control group,while the excellent fracture healing rate and functional satisfaction were higher in the observation group(p<0.05).Conclusion:Autologous periosteum graft combined with PRP technology is safe and reliable for the treatment of long bone fractures in the extremities,with satisfactory clinical outcomes.展开更多
Internal structural defects in engineering rock masses vary in size,exhibit complex shapes,and are unevenly distributed.Dominant fractures within a rock mass often play a critical to its mechanical behavior,directly a...Internal structural defects in engineering rock masses vary in size,exhibit complex shapes,and are unevenly distributed.Dominant fractures within a rock mass often play a critical to its mechanical behavior,directly affecting the macromechanical properties and failure modes.These fractures affect the instability and failure of the surrounding rock,significantlyimpacting the overall stability of engineering structures.Herein,sand-powder three-dimensional(3D)printing technology was used to prepare rock-like specimens with internal fracture networks.Triaxial compression testing,post-failure fracture mapping,and fractal dimension analysis of the fracture surfaces were conducted to investigate the effects of dominant fracture angles on the strength and deformation of rocks with internal fracture networks under triaxial stress.The results indicate that the dominant fracture angle has a pronounced effect on the mechanical behavior of rock.With increasing angle,both compressive strength and elastic modulus exhibit an initial decline followed by an increase.Moreover,higher confiningpressure significantlyimproves the compressive strength of fractured rock.This enhancement weakens as the confiningpressure further increases.Moreover,with increasing confiningpressure,the differences between the maximum and minimum values of elastic moduli and lateral strain ratios in fractured rock gradually decrease.Thus,the impact of the dominant fracture angle on rock mass deformation decreases with increasing confiningpressure.This research elucidates the effects of dominant fracture angles on the mechanical and failure properties of complex fractured rock masses and the influenceof the confiningpressure on these relationships.It provides valuable theoretical insights and practical guidance for stability analyses in engineering rock masses.展开更多
One of the key challenges for underground rock reservoirs is ensuring prevention of the unwanted fluid leakage through rock fracture networks during their service life.Microbial-induced calcium carbonate precipitation...One of the key challenges for underground rock reservoirs is ensuring prevention of the unwanted fluid leakage through rock fracture networks during their service life.Microbial-induced calcium carbonate precipitation(MICP)technology has emerged as a promising bio-healing method for rock fractures with small apertures.In this study,a new“three-stage”injection strategy-based MICP(TS-MICP)bio-healing method was proposed,aiming to achieve a“three-high”performance that includes high bridging rate,high mechanical strength,and high homogeneity.A series of meter-scale rock fracture models were prepared to conduct TS-MICP grouting tests.Compared with the traditional injection strategy-based biohealing methods,the TS-MICP method significantly improved the bridging rate(32.1%e89.5%),mechanical properties(0.138e1.023 MPa),and homogeneity of CaCO_(3)precipitation(334.4%).Additionally,it achieved a higher material utilization rate(1.72 times higher),reducing the consumption of cementation solution(CS)by 258.8%,thereby demonstrating greater potential for field applications.The underlying mechanism for achieving high bridging rate and high homogeneity in CaCO_(3)precipitation can be attributed to the synergistic effects of the coupling injection strategy,which optimizes the advantages at each stage.In stage I,under the influence of gravity,the rapid flocculation and hydrogen bonding interactions of organic matter lead to formation of the dense and high-strength CaCO_(3)precipitation at the bottom using a low-concentration bacterial suspension(BS).This process establishes bridging steps along the wall sides for subsequent uniform CaCO_(3)precipitation.In stage II,concentrated BS is utilized to produce looser CaCO_(3)flocculation,which precipitates uniformly on the pre-existing bridging steps.In stage III,a two-step injection strategy was employed to reinforce the loose CaCO_(3)crystals formed in stages I and II,and finally forms a strong bridging effect with“three-high”performance.展开更多
BACKGROUND In pediatric age group patients(<18 years old)treated operatively for distal radius/both bone fractures extending imaging beyond the initial postoperative period-particularly in uncomplicated cases-appea...BACKGROUND In pediatric age group patients(<18 years old)treated operatively for distal radius/both bone fractures extending imaging beyond the initial postoperative period-particularly in uncomplicated cases-appears to provide limited additional benefit.AIM To determine the necessary number of follow-up X-rays to use resources efficiently.METHODS Participants included in this study are pediatric age group patients who were treated operatively for distal radius/both bone fractures and were identified from a prospected collected data from the operating room database between the years 2009 and 2017.The data in the study included patients who had distal radius fractures and underwent fixation surgery(n=88).RESULTS When assessing the difference in the odds of conducting 1 or less X-ray compared to 2 or more X-rays in regard to the type of fixation,the only significant difference is the closed reduction fixation method.Patients who underwent closed reduction method procedure have significantly lower odds of having 2 more X-rays compared to those who didn’t have closed reduction method.Open reduction,internal fixation,and other fixation methods(close reduction and internal fixation,debridement,or epiphysiodesis)have higher odds of having two or more X-rays compared to patients who did not receive these methods;however,these odds are not statistically significant.CONCLUSION The findings of this study reveal notable absence of a statistically significant association between the frequency of postoperative X-rays and the outcome of children with distal radius fractures.展开更多
Objective The aim of this study was to explore the influence of working length(determined by the screw position)on the stiffness and interfragmentary strain(IFS)of femoral locking compression plate(LCP)external fixato...Objective The aim of this study was to explore the influence of working length(determined by the screw position)on the stiffness and interfragmentary strain(IFS)of femoral locking compression plate(LCP)external fixators for lower tibial fractures under full weight-bearing conditions,with the goal of providing a reference basis for clinical applications.Methods Finite element analysis software was used to construct a model of a lower tibial fracture with external femoral LCP fixation.The models were divided into four groups according to the different working lengths(external femoral locking plate fixation 1[EF1],EF2,EF3,and EF4).Stress distribution clouds,fracture end displacements,stiffness and IFS were tested for each model group at different loads.Results Compared with those in the EF1 group,the stiffnesses in the EF2,EF3,and EF4 groups decreased by 28%,31%,and 37%,respectively,under axial compression loading.Compared with those in the EF1 group,the stiffnesses in the EF2,EF3,and EF4 groups decreased by 19%,33%,and 35%,respectively,under axial torsion loading.Compared with those in the EF1 group,the stiffnesses in the EF2,EF3,and EF4 groups decreased by 32%,33%,and 35%,respectively,under a three-point bending load.The IFS of the four finite element models increased with the working length of the plate,with EF1(76%)<EF2(107%)<EF3(110%)<EF4(122%).Finite element analysis revealed that under full weight-bearing conditions,the structural stiffness of the femoral LCP external fixator decreased with increasing working length,leading to an increase in the IFS,which resulted in an IFS that exceeded the ideal range required for secondary healing.Conclusion For unstable lower tibial fractures,screws in the femoral LCP external fixator should be placed as close to the fracture end as possible to increase stability and promote fracture healing.展开更多
BACKGROUND Radial head fractures constitute approximately one-third of all elbow fractures,significantly impacting the young and active population.While open reduction and internal fixation is the preferred treatment ...BACKGROUND Radial head fractures constitute approximately one-third of all elbow fractures,significantly impacting the young and active population.While open reduction and internal fixation is the preferred treatment for displaced fractures,its high complication rate in comminuted fractures has led to the increasing use of radial head arthroplasty(RHA).RHA provides improved functional outcomes with fewer complications,yet its long-term efficacy remains a topic of debate.AIM To evaluate the functional outcomes of patients undergoing RHA with a modular metallic prosthesis for comminuted Mason type III and IV radial head fractures.METHODS A prospective and retrospective hospital-based study was conducted at Dayanand Medical College and Hospital,Ludhiana over 32 months(January 2021-August 2023).A total of 26 patients with Mason type III and IV fractures were included,with six retrospective and 20 prospective cases.Functional outcomes were assessed using the Mayo Elbow Performance Score(MEPS),elbow range of motion,pain via Visual Analog Scale,and activities of daily living at immediate postoperative,three-month,and six-month follow-ups.RESULTS MEPS at 6 months follow up for 4 cases(15.38%)had good scores,and 22 cases(84.62%)had excellent scores,with a mean±SD of 97.31±6.67.Comparisons showed significant improvement from immediate post-operative to 3 months(P<0.0001),from immediate post-operative to 6 months(P<0.0001),and between 3 months and 6 months(P<0.0001).None of the patients had elbow instability after radial head replacement and 22 cases(84.62%)had no complications,while 3 cases(11.54%)had a stiff elbow,and 1 case(3.85%)had heterotopic ossification.CONCLUSION RHA is an effective treatment for comminuted radial head fractures,providing stable elbow function with minimal complications.展开更多
BACKGROUND Supracondylar humeral fractures(SCHF)are the second most common fractures in childhood and can lead to short-and long-term complications.Despite their prevalence,the anatomical factors that predispose child...BACKGROUND Supracondylar humeral fractures(SCHF)are the second most common fractures in childhood and can lead to short-and long-term complications.Despite their prevalence,the anatomical factors that predispose children to SCHF remain unclear.This study aimed to determine whether there are significant morpho-logical differences in the elbow by comparing the radiographic angular measure-ments of the contralateral elbows of patients with SCHF to those of patients with distal radius fractures(DRF)and a healthy control group.We sought to explore if these morphological variations contribute to the occurrence of SCHF.Radiographs of 78 SCHF patients were analyzed for angular measurements of the contralateral elbow.Two control groups were used:98 healthy children and 40 patients with DRF.Angular measurements included Baumann angle(BA),hu-meroulnar angle(HUA),humerus metaphysis-diaphysis angle(HMDA),humerus shaft-condylar angle(HSCA),and lateral capitellohumeral angle.Only BA,HUA,and HMDA were measured in the DRF group.Statistical analysis was performed to compare differences among groups.RESULTS Significant differences were found in elbow measurements between SCHF and control groups(P<0.05).However,the mean values for all groups fell within the ranges described in the literature.CONCLUSION While statistically significant differences were found in elbow morphology between SCHF patients and controls,these differences don't translate into clinically meaningful morphological deviations.展开更多
BACKGROUND Traumatic injuries,such as falling,car accidents,and crushing mostly cause spinal fractures in young and middle-aged people,and>50%of them are thoracolumbar fractures.This kind of fracture is easily comb...BACKGROUND Traumatic injuries,such as falling,car accidents,and crushing mostly cause spinal fractures in young and middle-aged people,and>50%of them are thoracolumbar fractures.This kind of fracture is easily combined with serious injuries to peripheral nerves and soft tissues,which causes paralysis of the lower limbs if there is no timely rehabilitation treatment.Young patients with thoracolumbar fractures find it difficult to recover after the operation,and they are prone to depression,low self-esteem,and other negative emotions.AIM To investigate the association between anxiety,depression,and social stress in young patients with thoracolumbar spine fractures and the effect on rehabilitation outcomes.METHODS This study retrospectively analyzed 100 patients admitted to the orthopedic department of Honghui Hospital,Xi’an Jiaotong University who underwent thoracolumbar spine fracture surgery from January 2022 to June 2023.The general data of the patients were assessed with the Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),life events scale,and social support rating scale(SSRS)to identify the correlation between anxiety,depression scores,and social stress and social support.The Japanese Orthopedic Association(JOA)was utilized to evaluate the rehabilitation outcomes of the patients and to analyze the effects of anxiety and depression scores on rehabilitation.RESULTS According to the scores of HAMD and HAMA in all patients,the prevalence of depression in patients was 39%(39/100),and the prevalence of anxiety was 49%(49/100).Patients were categorized into non-depression(n=61)and depression(n=39),non-anxiety(n=51),and anxiety(n=49)groups.Statistically significant differences in gender,occupation,Pittsburgh Sleep Quality Index(PSQI)score,and monthly family income were observed between the non-depression and depression groups(P<0.05).A significant difference in occupation and PSQI score was found between the non-anxiety and anxiety groups.Both depression(r=0.207,P=0.038)and anxiety scores(r=0.473,P<0.001)were significantly and positively correlated with negative life events.The difference in negative life event scores as well as SSRS total and item scores was statist-ically significant between patients in the non-depression and depression groups(P<0.05).The difference between the non-anxiety and anxiety groups was statistically significant(P<0.05)in the negative life event scores as well as the total SSRS scores.Additionally,JOA scores were significantly lower in both anxious and depressed patients.CONCLUSION Young patients with thoracolumbar fractures are prone to anxiety and depression.Patients’anxiety and depression are closely associated with social pressure,which reduces the life pressure of young patients with thoracolumbar fractures,enhances social support,and improves the psychology of anxiety and depression.,which affects patients’recovery.展开更多
Hydraulic fracturing is a crucial technique for efficient development of coal reservoirs.Coal rocks typically contain a high density of natural fractures,which serve as conduits for fracturing fluid.Upon injection,the...Hydraulic fracturing is a crucial technique for efficient development of coal reservoirs.Coal rocks typically contain a high density of natural fractures,which serve as conduits for fracturing fluid.Upon injection,the fluid infiltrates these natural fractures and leaks out,resulting in complex fracture morphology.The prediction of hydraulic fracture network propagation for coal reservoirs has important practical significance for evaluating hydraulic fracturing.This study proposes a novel inversion method for predicting fracture networks in coal reservoirs,explicitly considering the distribution of natural fractures.The method incorporates three distinct natural fracture opening modes and employs a fractal probability function to constrain fracture propagationmorphology.Based on thismethod,the study compares hydraulic fracture networkmorphologies in coal reservoirs with andwithout the presence of natural fractures.Theresults showthatwhile both reservoir types exhibitmulti-branch fracture networks,reservoirs containing natural fractures demonstrate greater branching and a larger stimulated reservoir volume(SRV).Additionally,the study employs a fractal dimension calculation method to quantitatively describe the geometric distribution characteristics of fractures.The analysis reveals that the geometry and distribution of natural fractures,as well as reservoir geological parameters,significantly influence the fracture networkmorphology and fractal dimension.The contact angle between natural and hydraulic fractures affects propagation direction;specifically,when the contact angle isπ/2,the fractal dimension of the hydraulic fracture network is maximized.Moreover,smaller lengths and spacings of natural fracture led to higher fractal dimensions,which can significantly increase the SRV.The proposed method offers an effective tool for evaluating the hydraulic fracturing of coal reservoirs.展开更多
Prophylactic fixation(ProFix)of the proximal femur in elderly patients with osteoporosis presents a forward-thinking approach to preventing debilitating fractures and their associated complications.By addressing fract...Prophylactic fixation(ProFix)of the proximal femur in elderly patients with osteoporosis presents a forward-thinking approach to preventing debilitating fractures and their associated complications.By addressing fracture risk before an injury occurs,ProFix has the potential to enhance patient outcomes,promote long-term mobility,and reduce healthcare costs.Early intervention in individuals at high risk can significantly lower hospital admissions,shorten recovery periods,and preserve independence,mitigating challenges such as chronic pain and reduced life expectancy.Given the high prevalence of undiagnosed osteoporosis,prioritising early risk assessment and targeted prevention is essential.Advancements in minimally invasive surgical techniques and safer anaesthesia methods further support ProFix as a feasible and effective strategy to decrease fracturerelated morbidity,improve overall patient well-being,and optimise the use of healthcare resources.This opinion review details the evidence supporting this concept,its efficacy,the challenges in its implementation,and a strategic plan for future implementation.展开更多
A DFN-DEC(discrete fracture network-distinct element code)method based on the MATLAB platform is developed to generate heterogeneous DFN.Subsequently,the effects of the spatial variability(the meanμand the standard d...A DFN-DEC(discrete fracture network-distinct element code)method based on the MATLAB platform is developed to generate heterogeneous DFN.Subsequently,the effects of the spatial variability(the meanμand the standard deviationσ)of the geometric properties(i.e.,the fracture dip D,the trace length T and the spacing S)of both the gently-dipping(denoted with 1)and the steeply-dipping(denoted with 2)fractures on the stability of granite slope are investigated.Results indicate that the proposed DFN-DEC method is robust,generating fracture networks that resemble reality.In addition,the spatial variability of fracture geometry,influencing the structure of granite slope,plays a significant role in slope stability.The mean stability of the slope decreases with the increase ofμ_(D_(1))(the mean of gently-dipping fracture dip),σ_(D_(2))(the mean of steeply-dipping fracture dip),μ_(T_(1))(the mean of gently-dipping fracture trace length),μ_(T_(2))(the mean of steeply-dipping fracture trace length),σ_(T_(1))(the standard deviation of gently-dipping fracture trace length),σ_(T_(2))(the standard deviation of steeply-dipping fracture trace length),and the decrease ofσ_(D_(1))(the standard deviation of gently-dipping fracture dip),μ_(D_(2))(the standard deviation of steeply-dipping fracture dip),μ_(S_(1))(the mean of gently-dipping fracture spacing)andμ_(S_(2))(the mean of steeply-dipping fracture spacing).Among them,μ_(T_(1)),μ_(D_(1))andμ_(S_(1))have the major impact.When the fracture spacing is large,the variability in the fracture geometry becomes less relevant to slope stability.When within some ranges of the fracture spacing,the spatial varying of dips can increase the slope stability by forming an interlaced structure.The results also show that the effects of the variability of trace length on slope stability depend on the variability of dip.These findings highlight the importance of spatial variability in the geometry of fractures to rock slope stability analysis.展开更多
Despite extensive research on computational geomechanics and fluid dynamics,accurately simulating convection-diffusion(CD)processes in complex fractured systems remains a significant challenge.This study develops a 3D...Despite extensive research on computational geomechanics and fluid dynamics,accurately simulating convection-diffusion(CD)processes in complex fractured systems remains a significant challenge.This study develops a 3D numerical framework for modelling CD processes in fractured geological media.The framework integrates Darcy's law and Fick's law,considering flux interactions between the matrix and fractures.The meshing strategy generates high-quality grids even in scenarios involving intersecting fractures.Then,a unified numerical scheme for solving the CD system is proposed.The novelties of this work include:(1)The proposed framework enables effective simulation of 3D fractured media,including more complex fractured vuggy media;(2)The numerical method precisely discretizes the CD terms in governing equations;(3)A Non-Orthogonal Correction(NOC)method,combined with an adaptive time integration scheme,is proposed for eliminating errors induced by skewed grids;and(4)The effects of fracture patterns and heterogeneity on flow are thoroughly analysed.The proposed method is validated through benchmark tests,demonstrating the superiority of the NOC method compared to classical methods.Further analysis reveals the evolution characteristics of pressure and concentration,offering insights into the effects of fracture patterns and heterogeneity on flow and diffusion processes.展开更多
To compare the clinical efficacy of locking plate(LP)fixation and intramedullary nail(IMN)fixation for the treatment of post-traumatic nonunion of diaphyseal fractures of the femur and tibia.Methods:This single-center...To compare the clinical efficacy of locking plate(LP)fixation and intramedullary nail(IMN)fixation for the treatment of post-traumatic nonunion of diaphyseal fractures of the femur and tibia.Methods:This single-center retrospective comparative study included 50 adult patients with aseptic nonunion of femoral or tibial diaphyseal fractures treated at our institution between January 2015 and January 2025.Patients underwent either locking-plate(LP)fixation(n=25)or intramedullary nailing(IMN)(n=25).The primary outcome was radiographic union at 12 months postoperatively.Secondary outcomes included time to union,operative time,intraoperative blood loss,length of hospital stay,incidence of complications(superficial/deep infection,implant failure,malunion),and 12-month functional status assessed by the Lower Extremity Functional Scale(LEFS).Statistical comparisons used Welch t tests for continuous variables and χ^(2) or Fisher exact tests for categorical variables.The protocol received institutional review board approval with waiver of informed consent.Results:Among 50 patients(LP=25;IMN=25),the 12-month union rate was 88.00%(22/25)in the LP group and 96.00%(24/25)in the IMN group(p=0.609).Time to union was shorter with IMN(6.20±1.83 vs 7.51±2.12 months;p=0.023).Operative time(110.52±25.23 vs 145.81±30.21 min;p<0.01)and intraoperative blood loss(250.41±80.64 vs 350.22±95.30 ml;p<0.01)favored IMN.Length of hospital stay was similar(6.24±1.83 vs 6.82±2.11 days;p=0.284).The incidence of superficial wound infection did not differ significantly(12.00%vs 4.00%;p=0.609).Twelve-month LEFS scores were comparable(65.44±10.21 vs 67.10±9.83;p=0.451).Conclusion:Both locking plate and intramedullary nail fixation are effective in the treatment of femoral and tibial nonunion,with high rates of union and good functional outcomes.Intramedullary nailing may be associated with a shorter time to union,reduced operative time and blood loss,and a lower risk of superficial wound infection compared to locking plate fixation.The choice of implant should be individualized based on fracture characteristics,patient factors,and surgeon preference.展开更多
The mineralogy and texture of granite have been found to have a pronounced effect on its mechanical behavior.However,the precise manner in which the texture of granite affects the shear behavior of fractures remains e...The mineralogy and texture of granite have been found to have a pronounced effect on its mechanical behavior.However,the precise manner in which the texture of granite affects the shear behavior of fractures remains enigmatic.In this study,fine-grained granite(FG)and coarse-grained granite(CG)were used to create tensile fractures with surface roughness(i.e.joint roughness coefficient(JRC))within the range of 5.48-8.34 and 12.68-16.5,respectively.The pre-fractured specimens were then subjected to direct shear tests under normal stresses of 1-30 MPa.The results reveal that shear strengths are smaller and stick-slip behaviors are more intense for FG fractures than for CG fractures,which is attributed to the different conditions of the shear surface constrained by the grain size.The smaller grain size in FG contributes to the smoother fracture surface and lower shear strength.The negative friction rate parameter a-b for both CG and FG fractures and the larger shear stiffness for FG than for CG fractures can account for the more intense stick-slip behaviors in FG fractures.The relative crack density for the post-shear CG fractures is greater than that of the FG fractures under the same normal stress,both of which decrease with the distance away from the shear surface following the power law.Moreover,the damage of CG fracture extends to a larger extent beneath the surface compared with the FG fracture.Our findings demonstrate that the grain size of the host rock exerts a significant influence on the fracture roughness,and thus should be incorporated into the assessment of fault slip behavior to better understand the role of mineralogy and texture in seismic activities.展开更多
Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularl...Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularly lumbosacral plexus.The introduction of minimally invasive surgical approaches,such as the lateral rectus approach,not only contributes to preserving lumbar plexus integrity in operated patients but also positively impacts their psychological well-being.Patients treated by surgical reduction of pelvic fractures with lumbosacral plexus injury often experience states of anxiety and depression.The lateral rectus approach is associated with lower levels of anxiety and depression compared to more invasive surgical techniques used for similar fractures.展开更多
Lacustrine shale oil reservoirs of the Upper Triassic Chang 7 Member in the Ordos Basin have demonstrated significant potential for hydrocarbon resources.Natural fractures play a crucial role in hydrocarbon enrichment...Lacustrine shale oil reservoirs of the Upper Triassic Chang 7 Member in the Ordos Basin have demonstrated significant potential for hydrocarbon resources.Natural fractures play a crucial role in hydrocarbon enrichment and production.Outcrops,cores,borehole image logs,thin sections,and FE-SEM images were used to investigate the types and characteristics of natural fractures in the Chang 7 Member.The factors controlling fracture development and the mechanisms of bedding-parallel fracture formation were revealed by integrating TOC analysis,XRD analysis,and rock pyrolysis.Results show that natural fractures in the study area include high-angle tectonic fractures and nearly horizontal bedding-parallel fractures.Brittle minerals and bed thickness control the occurrence and attributes of tectonic fractures.High TOC content and thermal maturity positively affect the development of bedding-parallel fractures,formed through the conversion of organic matter to hydrocarbons or the smectite-to-illite transformation.Additionally,the dominant orientations of tectonic fractures intersect the present-day maximum horizontal principal stress at a small angle,resulting in large apertures and good effectiveness.Bedding-parallel fractures contribute to enhance porosity and provide favorable pathways for lateral hydrocarbon migration.Collectively,this study could provide valuable insights for finding promising exploration areas in lacustrine shale oil reservoirs in the Ordos Basin and worldwide.展开更多
BACKGROUND Acromegaly,a disease of excess growth hormone,is known to alter bone structure and increase the risk of osteoporosis and fractures.This study aimed to assess the prevalence of vertebral,non-vertebral,and hi...BACKGROUND Acromegaly,a disease of excess growth hormone,is known to alter bone structure and increase the risk of osteoporosis and fractures.This study aimed to assess the prevalence of vertebral,non-vertebral,and hip fragility fractures,as well as osteoporosis,in a cohort of patients with acromegaly.AIM To assess the prevalence of vertebral fragility fractures,non-vertebral fragility fractures,hip fragility fractures,and osteoporosis in patients diagnosed with acromegaly.METHODS Data were collected on age,sex,body mass index(BMI),time from diagnosis of acromegaly,insulin-like growth factor(IGF-1)levels,disease control,pharmacological management,risk factors for osteoporosis,vertebral fragility fractures,non-vertebral fragility fractures,hip fragility fractures,and osteoporosis.RESULTS A total of 124 patients with acromegaly were included(67 men and 57 women).The mean age at diagnosis was 44±12 years;the mean time from diagnosis was 12±8 years;and the mean BMI was 27±4 kg/m².Fragility fractures were found in 27 patients(21%).There were no significant differences in the presence of osteoporosis or fragility fractures according to age,sex,BMI,duration of acrom egaly,or IGF-1 levels at diagnosis.A higher percentage of patients with osteoporosis were treated with somatostatin analogs compared to those without osteoporosis(46%vs 15%;P<0.05).CONCLUSION A high prevalence of osteoporosis and fragility fractures was found in patients with acromegaly,regardless of age,sex,BMI,time from diagnosis,IGF-1 levels,and disease control.More patients with osteoporosis were treated with somatostatin analogs compared to those without osteoporosis.Taken together,our results suggest that the severity of the disease and the need for second-line therapies,may be associated with the increased risk of osteoporosis.展开更多
文摘Complex trimalleolar ankle fractures are a major orthopaedic challenge,with an incidence of 4.22 per 10000 person-years in the United States and an annual cost of 3.4 billion dollars.This review synthesizes current evidence on diagnostic protocols and management strategies,highlighting optimal approaches and emerging trends.Initial care emphasizes soft tissue assessment,often guided by the Tscherne classification,and fracture classification systems.External fixation may be required in open injuries,while early open reduction and internal fixation within six days is linked to improved outcomes.Minimally invasive techniques for the lateral malleolus,including intramedullary nailing and locking plates,are effective,while medial malleolus fractures are commonly managed with screw fixation or tension-band wiring.Posterior malleolus fragments involving more than 25%of the articular surface usually warrant fixation.Alternatives to syndesmotic screws,such as cortical buttons or high-strength sutures,reduce the need for secondary procedures.Arthroscopic-assisted open reduction and internal fixation benefits younger,active patients by enabling concurrent management of intra-articular and ligamentous injuries.Postoperative care prioritizes early weight-bearing and validated functional scores.Despite advances,complications remain common,and further research is needed to refine surgical strategies and improve outcomes.
基金approved by King Abdullah International Medical Research Center Ethics Committee(approval No.0000074524).
文摘BACKGROUND Humeral shaft fractures are common and vary by age,with high-energy trauma observed in younger adults and low-impact injuries in older adults.Radial nerve palsy is a frequent complication.Treatment ranges from nonoperative methods to surgical interventions such as intramedullary K-wires,which promote faster rehabilitation and improved elbow mobility.AIM To evaluate the outcomes of managing humeral shaft fractures using closed reduction and internal fixation with flexible intramedullary K-wires.METHODS This was a retrospective cohort study analyzing the medical records of patients with humeral shaft fractures managed with flexible intramedullary K-wires at King Abdulaziz Medical City,using non-random sampling and descriptive analysis for outcome evaluation.RESULTS This study assessed the clinical outcomes of 20 patients treated for humeral shaft fractures with intramedullary K-wires.Patients were predominantly male(n=16,80%),had an average age of 39.2 years,and a mean body mass index of 29.5 kg/m^(2).The fractures most frequently occurred in the middle third of the humerus(n=14,70%),with oblique fractures being the most common type(n=7,35%).All surgeries used general anesthesia and a posterior approach,with no intraoperative complications reported.Postoperatively,all patients achieved clinical and radiological union(n=20,100%),and the majority(n=13,65%)reached an elbow range of motion from 0 to 150 degrees.CONCLUSION These results suggest that intramedullary K-wire fixation may be an effective option for treating humeral shaft fractures,with favorable outcomes in range of motion recovery,fracture union,and a low rate of intraoperative complications.
基金the PICTO project(RFCR-CT-2018-800711)funded by the European Research Fund for Coal and Steel(RFCS)and the Polish Ministry of Science and Higher Education(W93/FBWiS/2018).
文摘The research presented in this paper aimed to analyze the evolution of fractures in strata in relation to the progress of longwall mining.To achieve this objective,an introscopic probe equipped with a highresolution camera was developed,along with additional equipment that enables continuous recording of the internal surfaces of drainage boreholes exceeding 100 m in depth.The probe was utilized to test two methane drainage boreholes in the Z-3b longwall,which operates within the 501/3 coal seam of the Jankowice mine in Poland.Automatic image analysis methods were applied to evaluate the recorded images,based on a newly developed classificationsystem for fractures categorized by size and number.The results were compared with an analysis of changes in the methane capture rate from the drainage boreholes,which correlated with longwall mining progress.A strong correlation was observed between the number of fractures and the lithology of the strata layers.The largest number of fractures and their evolution were recorded in the coal layers,followed by the shale layers,while the sandstone layers exhibited the least number of fractures.Based on parallel measurements of the methane capture rate from the drainage boreholes during the progress of longwall mining,the extent of the strata's fracture zone was determined to range from 6 m to 36 m.Within the fracture zone,the strata are highly fractured,which leads to an increase in methane emissions through seepage and diffusion processes.
文摘Objective:To analyze the clinical application value of autologous periosteum graft combined with platelet-rich plasma(PRP)in the treatment of long bone fractures in the extremities.Methods:A total of 40 patients with long bone fractures in the extremities admitted to Santai Hospital Affiliated to North Sichuan Medical College from January 2023 to January 2025 were included,including cases of upper extremity forearm fractures and lower extremity femoral and tibial fractures.The patients were evenly divided using a random number table,with the control group undergoing open reduction and internal fixation(ORIF)combined with autologous periosteum graft,and the observation group undergoing ORIF,autologous periosteum graft,and PRP injection.Surgical indicators,complication rates,excellent fracture healing rates,functional satisfaction,and joint range of motion were compared between the two groups.Results:The surgical indicators in the observation group were similar to those in the control group(p>0.05).The complication rate in the observation group was lower than that in the control group,while the excellent fracture healing rate and functional satisfaction were higher in the observation group(p<0.05).Conclusion:Autologous periosteum graft combined with PRP technology is safe and reliable for the treatment of long bone fractures in the extremities,with satisfactory clinical outcomes.
基金supported by the National Key Research and Development Program Young Scientist Project(Grant No.2024YFC2911000)the National Natural Science Foundation of China(Grant No.52474103)the Major Basic Research Project of the Natural Science Foundation of Shandong Province(Grant No.ZR2024ZD22).
文摘Internal structural defects in engineering rock masses vary in size,exhibit complex shapes,and are unevenly distributed.Dominant fractures within a rock mass often play a critical to its mechanical behavior,directly affecting the macromechanical properties and failure modes.These fractures affect the instability and failure of the surrounding rock,significantlyimpacting the overall stability of engineering structures.Herein,sand-powder three-dimensional(3D)printing technology was used to prepare rock-like specimens with internal fracture networks.Triaxial compression testing,post-failure fracture mapping,and fractal dimension analysis of the fracture surfaces were conducted to investigate the effects of dominant fracture angles on the strength and deformation of rocks with internal fracture networks under triaxial stress.The results indicate that the dominant fracture angle has a pronounced effect on the mechanical behavior of rock.With increasing angle,both compressive strength and elastic modulus exhibit an initial decline followed by an increase.Moreover,higher confiningpressure significantlyimproves the compressive strength of fractured rock.This enhancement weakens as the confiningpressure further increases.Moreover,with increasing confiningpressure,the differences between the maximum and minimum values of elastic moduli and lateral strain ratios in fractured rock gradually decrease.Thus,the impact of the dominant fracture angle on rock mass deformation decreases with increasing confiningpressure.This research elucidates the effects of dominant fracture angles on the mechanical and failure properties of complex fractured rock masses and the influenceof the confiningpressure on these relationships.It provides valuable theoretical insights and practical guidance for stability analyses in engineering rock masses.
基金supported by the National Key Research and Development Program of China(Grant No.2023YFC3007102)the National Natural Science Foundation of China(Grant Nos.42477188 and 41925012).
文摘One of the key challenges for underground rock reservoirs is ensuring prevention of the unwanted fluid leakage through rock fracture networks during their service life.Microbial-induced calcium carbonate precipitation(MICP)technology has emerged as a promising bio-healing method for rock fractures with small apertures.In this study,a new“three-stage”injection strategy-based MICP(TS-MICP)bio-healing method was proposed,aiming to achieve a“three-high”performance that includes high bridging rate,high mechanical strength,and high homogeneity.A series of meter-scale rock fracture models were prepared to conduct TS-MICP grouting tests.Compared with the traditional injection strategy-based biohealing methods,the TS-MICP method significantly improved the bridging rate(32.1%e89.5%),mechanical properties(0.138e1.023 MPa),and homogeneity of CaCO_(3)precipitation(334.4%).Additionally,it achieved a higher material utilization rate(1.72 times higher),reducing the consumption of cementation solution(CS)by 258.8%,thereby demonstrating greater potential for field applications.The underlying mechanism for achieving high bridging rate and high homogeneity in CaCO_(3)precipitation can be attributed to the synergistic effects of the coupling injection strategy,which optimizes the advantages at each stage.In stage I,under the influence of gravity,the rapid flocculation and hydrogen bonding interactions of organic matter lead to formation of the dense and high-strength CaCO_(3)precipitation at the bottom using a low-concentration bacterial suspension(BS).This process establishes bridging steps along the wall sides for subsequent uniform CaCO_(3)precipitation.In stage II,concentrated BS is utilized to produce looser CaCO_(3)flocculation,which precipitates uniformly on the pre-existing bridging steps.In stage III,a two-step injection strategy was employed to reinforce the loose CaCO_(3)crystals formed in stages I and II,and finally forms a strong bridging effect with“three-high”performance.
文摘BACKGROUND In pediatric age group patients(<18 years old)treated operatively for distal radius/both bone fractures extending imaging beyond the initial postoperative period-particularly in uncomplicated cases-appears to provide limited additional benefit.AIM To determine the necessary number of follow-up X-rays to use resources efficiently.METHODS Participants included in this study are pediatric age group patients who were treated operatively for distal radius/both bone fractures and were identified from a prospected collected data from the operating room database between the years 2009 and 2017.The data in the study included patients who had distal radius fractures and underwent fixation surgery(n=88).RESULTS When assessing the difference in the odds of conducting 1 or less X-ray compared to 2 or more X-rays in regard to the type of fixation,the only significant difference is the closed reduction fixation method.Patients who underwent closed reduction method procedure have significantly lower odds of having 2 more X-rays compared to those who didn’t have closed reduction method.Open reduction,internal fixation,and other fixation methods(close reduction and internal fixation,debridement,or epiphysiodesis)have higher odds of having two or more X-rays compared to patients who did not receive these methods;however,these odds are not statistically significant.CONCLUSION The findings of this study reveal notable absence of a statistically significant association between the frequency of postoperative X-rays and the outcome of children with distal radius fractures.
基金supported by the Health Commission of Guizhou Province(No.gzwkj2024-400)the“Open Competition Project”of Bijie Science and Technology Bureau(BST Major Project No.1,2022).
文摘Objective The aim of this study was to explore the influence of working length(determined by the screw position)on the stiffness and interfragmentary strain(IFS)of femoral locking compression plate(LCP)external fixators for lower tibial fractures under full weight-bearing conditions,with the goal of providing a reference basis for clinical applications.Methods Finite element analysis software was used to construct a model of a lower tibial fracture with external femoral LCP fixation.The models were divided into four groups according to the different working lengths(external femoral locking plate fixation 1[EF1],EF2,EF3,and EF4).Stress distribution clouds,fracture end displacements,stiffness and IFS were tested for each model group at different loads.Results Compared with those in the EF1 group,the stiffnesses in the EF2,EF3,and EF4 groups decreased by 28%,31%,and 37%,respectively,under axial compression loading.Compared with those in the EF1 group,the stiffnesses in the EF2,EF3,and EF4 groups decreased by 19%,33%,and 35%,respectively,under axial torsion loading.Compared with those in the EF1 group,the stiffnesses in the EF2,EF3,and EF4 groups decreased by 32%,33%,and 35%,respectively,under a three-point bending load.The IFS of the four finite element models increased with the working length of the plate,with EF1(76%)<EF2(107%)<EF3(110%)<EF4(122%).Finite element analysis revealed that under full weight-bearing conditions,the structural stiffness of the femoral LCP external fixator decreased with increasing working length,leading to an increase in the IFS,which resulted in an IFS that exceeded the ideal range required for secondary healing.Conclusion For unstable lower tibial fractures,screws in the femoral LCP external fixator should be placed as close to the fracture end as possible to increase stability and promote fracture healing.
文摘BACKGROUND Radial head fractures constitute approximately one-third of all elbow fractures,significantly impacting the young and active population.While open reduction and internal fixation is the preferred treatment for displaced fractures,its high complication rate in comminuted fractures has led to the increasing use of radial head arthroplasty(RHA).RHA provides improved functional outcomes with fewer complications,yet its long-term efficacy remains a topic of debate.AIM To evaluate the functional outcomes of patients undergoing RHA with a modular metallic prosthesis for comminuted Mason type III and IV radial head fractures.METHODS A prospective and retrospective hospital-based study was conducted at Dayanand Medical College and Hospital,Ludhiana over 32 months(January 2021-August 2023).A total of 26 patients with Mason type III and IV fractures were included,with six retrospective and 20 prospective cases.Functional outcomes were assessed using the Mayo Elbow Performance Score(MEPS),elbow range of motion,pain via Visual Analog Scale,and activities of daily living at immediate postoperative,three-month,and six-month follow-ups.RESULTS MEPS at 6 months follow up for 4 cases(15.38%)had good scores,and 22 cases(84.62%)had excellent scores,with a mean±SD of 97.31±6.67.Comparisons showed significant improvement from immediate post-operative to 3 months(P<0.0001),from immediate post-operative to 6 months(P<0.0001),and between 3 months and 6 months(P<0.0001).None of the patients had elbow instability after radial head replacement and 22 cases(84.62%)had no complications,while 3 cases(11.54%)had a stiff elbow,and 1 case(3.85%)had heterotopic ossification.CONCLUSION RHA is an effective treatment for comminuted radial head fractures,providing stable elbow function with minimal complications.
文摘BACKGROUND Supracondylar humeral fractures(SCHF)are the second most common fractures in childhood and can lead to short-and long-term complications.Despite their prevalence,the anatomical factors that predispose children to SCHF remain unclear.This study aimed to determine whether there are significant morpho-logical differences in the elbow by comparing the radiographic angular measure-ments of the contralateral elbows of patients with SCHF to those of patients with distal radius fractures(DRF)and a healthy control group.We sought to explore if these morphological variations contribute to the occurrence of SCHF.Radiographs of 78 SCHF patients were analyzed for angular measurements of the contralateral elbow.Two control groups were used:98 healthy children and 40 patients with DRF.Angular measurements included Baumann angle(BA),hu-meroulnar angle(HUA),humerus metaphysis-diaphysis angle(HMDA),humerus shaft-condylar angle(HSCA),and lateral capitellohumeral angle.Only BA,HUA,and HMDA were measured in the DRF group.Statistical analysis was performed to compare differences among groups.RESULTS Significant differences were found in elbow measurements between SCHF and control groups(P<0.05).However,the mean values for all groups fell within the ranges described in the literature.CONCLUSION While statistically significant differences were found in elbow morphology between SCHF patients and controls,these differences don't translate into clinically meaningful morphological deviations.
文摘BACKGROUND Traumatic injuries,such as falling,car accidents,and crushing mostly cause spinal fractures in young and middle-aged people,and>50%of them are thoracolumbar fractures.This kind of fracture is easily combined with serious injuries to peripheral nerves and soft tissues,which causes paralysis of the lower limbs if there is no timely rehabilitation treatment.Young patients with thoracolumbar fractures find it difficult to recover after the operation,and they are prone to depression,low self-esteem,and other negative emotions.AIM To investigate the association between anxiety,depression,and social stress in young patients with thoracolumbar spine fractures and the effect on rehabilitation outcomes.METHODS This study retrospectively analyzed 100 patients admitted to the orthopedic department of Honghui Hospital,Xi’an Jiaotong University who underwent thoracolumbar spine fracture surgery from January 2022 to June 2023.The general data of the patients were assessed with the Hamilton anxiety scale(HAMA),Hamilton depression scale(HAMD),life events scale,and social support rating scale(SSRS)to identify the correlation between anxiety,depression scores,and social stress and social support.The Japanese Orthopedic Association(JOA)was utilized to evaluate the rehabilitation outcomes of the patients and to analyze the effects of anxiety and depression scores on rehabilitation.RESULTS According to the scores of HAMD and HAMA in all patients,the prevalence of depression in patients was 39%(39/100),and the prevalence of anxiety was 49%(49/100).Patients were categorized into non-depression(n=61)and depression(n=39),non-anxiety(n=51),and anxiety(n=49)groups.Statistically significant differences in gender,occupation,Pittsburgh Sleep Quality Index(PSQI)score,and monthly family income were observed between the non-depression and depression groups(P<0.05).A significant difference in occupation and PSQI score was found between the non-anxiety and anxiety groups.Both depression(r=0.207,P=0.038)and anxiety scores(r=0.473,P<0.001)were significantly and positively correlated with negative life events.The difference in negative life event scores as well as SSRS total and item scores was statist-ically significant between patients in the non-depression and depression groups(P<0.05).The difference between the non-anxiety and anxiety groups was statistically significant(P<0.05)in the negative life event scores as well as the total SSRS scores.Additionally,JOA scores were significantly lower in both anxious and depressed patients.CONCLUSION Young patients with thoracolumbar fractures are prone to anxiety and depression.Patients’anxiety and depression are closely associated with social pressure,which reduces the life pressure of young patients with thoracolumbar fractures,enhances social support,and improves the psychology of anxiety and depression.,which affects patients’recovery.
基金This study was supported by the Foundation of National Engineering Laboratory for Exploration and Development of Low-Permeability Oil and Gas Fields(2023-015).
文摘Hydraulic fracturing is a crucial technique for efficient development of coal reservoirs.Coal rocks typically contain a high density of natural fractures,which serve as conduits for fracturing fluid.Upon injection,the fluid infiltrates these natural fractures and leaks out,resulting in complex fracture morphology.The prediction of hydraulic fracture network propagation for coal reservoirs has important practical significance for evaluating hydraulic fracturing.This study proposes a novel inversion method for predicting fracture networks in coal reservoirs,explicitly considering the distribution of natural fractures.The method incorporates three distinct natural fracture opening modes and employs a fractal probability function to constrain fracture propagationmorphology.Based on thismethod,the study compares hydraulic fracture networkmorphologies in coal reservoirs with andwithout the presence of natural fractures.Theresults showthatwhile both reservoir types exhibitmulti-branch fracture networks,reservoirs containing natural fractures demonstrate greater branching and a larger stimulated reservoir volume(SRV).Additionally,the study employs a fractal dimension calculation method to quantitatively describe the geometric distribution characteristics of fractures.The analysis reveals that the geometry and distribution of natural fractures,as well as reservoir geological parameters,significantly influence the fracture networkmorphology and fractal dimension.The contact angle between natural and hydraulic fractures affects propagation direction;specifically,when the contact angle isπ/2,the fractal dimension of the hydraulic fracture network is maximized.Moreover,smaller lengths and spacings of natural fracture led to higher fractal dimensions,which can significantly increase the SRV.The proposed method offers an effective tool for evaluating the hydraulic fracturing of coal reservoirs.
文摘Prophylactic fixation(ProFix)of the proximal femur in elderly patients with osteoporosis presents a forward-thinking approach to preventing debilitating fractures and their associated complications.By addressing fracture risk before an injury occurs,ProFix has the potential to enhance patient outcomes,promote long-term mobility,and reduce healthcare costs.Early intervention in individuals at high risk can significantly lower hospital admissions,shorten recovery periods,and preserve independence,mitigating challenges such as chronic pain and reduced life expectancy.Given the high prevalence of undiagnosed osteoporosis,prioritising early risk assessment and targeted prevention is essential.Advancements in minimally invasive surgical techniques and safer anaesthesia methods further support ProFix as a feasible and effective strategy to decrease fracturerelated morbidity,improve overall patient well-being,and optimise the use of healthcare resources.This opinion review details the evidence supporting this concept,its efficacy,the challenges in its implementation,and a strategic plan for future implementation.
基金supported by the National Natural Science Foundation of China(Nos.41807264,41972289)the Engineering Research Center of Rock-Soil Drilling&Excavation and Protection,Ministry of Education(No.202102)+3 种基金the Key Laboratory of Geological Hazards on Three Gorges Reservoir Area(China Three Gorges University),Ministry of Education(No.2020KDZ01)the Fundamental Research Funds for the Central Universities,China University of Geosciences(Wuhan)(Nos.CUG170686,CUGQY1932)the China Scholarship Council(No.201406410032)the Science and Technology Research Project of Education Department of Hubei Province(Nos.B2019452,B2024509)。
文摘A DFN-DEC(discrete fracture network-distinct element code)method based on the MATLAB platform is developed to generate heterogeneous DFN.Subsequently,the effects of the spatial variability(the meanμand the standard deviationσ)of the geometric properties(i.e.,the fracture dip D,the trace length T and the spacing S)of both the gently-dipping(denoted with 1)and the steeply-dipping(denoted with 2)fractures on the stability of granite slope are investigated.Results indicate that the proposed DFN-DEC method is robust,generating fracture networks that resemble reality.In addition,the spatial variability of fracture geometry,influencing the structure of granite slope,plays a significant role in slope stability.The mean stability of the slope decreases with the increase ofμ_(D_(1))(the mean of gently-dipping fracture dip),σ_(D_(2))(the mean of steeply-dipping fracture dip),μ_(T_(1))(the mean of gently-dipping fracture trace length),μ_(T_(2))(the mean of steeply-dipping fracture trace length),σ_(T_(1))(the standard deviation of gently-dipping fracture trace length),σ_(T_(2))(the standard deviation of steeply-dipping fracture trace length),and the decrease ofσ_(D_(1))(the standard deviation of gently-dipping fracture dip),μ_(D_(2))(the standard deviation of steeply-dipping fracture dip),μ_(S_(1))(the mean of gently-dipping fracture spacing)andμ_(S_(2))(the mean of steeply-dipping fracture spacing).Among them,μ_(T_(1)),μ_(D_(1))andμ_(S_(1))have the major impact.When the fracture spacing is large,the variability in the fracture geometry becomes less relevant to slope stability.When within some ranges of the fracture spacing,the spatial varying of dips can increase the slope stability by forming an interlaced structure.The results also show that the effects of the variability of trace length on slope stability depend on the variability of dip.These findings highlight the importance of spatial variability in the geometry of fractures to rock slope stability analysis.
基金financially supported by the National Natural Science Foundation of China(Grant Nos.51991392 and 42293355).
文摘Despite extensive research on computational geomechanics and fluid dynamics,accurately simulating convection-diffusion(CD)processes in complex fractured systems remains a significant challenge.This study develops a 3D numerical framework for modelling CD processes in fractured geological media.The framework integrates Darcy's law and Fick's law,considering flux interactions between the matrix and fractures.The meshing strategy generates high-quality grids even in scenarios involving intersecting fractures.Then,a unified numerical scheme for solving the CD system is proposed.The novelties of this work include:(1)The proposed framework enables effective simulation of 3D fractured media,including more complex fractured vuggy media;(2)The numerical method precisely discretizes the CD terms in governing equations;(3)A Non-Orthogonal Correction(NOC)method,combined with an adaptive time integration scheme,is proposed for eliminating errors induced by skewed grids;and(4)The effects of fracture patterns and heterogeneity on flow are thoroughly analysed.The proposed method is validated through benchmark tests,demonstrating the superiority of the NOC method compared to classical methods.Further analysis reveals the evolution characteristics of pressure and concentration,offering insights into the effects of fracture patterns and heterogeneity on flow and diffusion processes.
文摘To compare the clinical efficacy of locking plate(LP)fixation and intramedullary nail(IMN)fixation for the treatment of post-traumatic nonunion of diaphyseal fractures of the femur and tibia.Methods:This single-center retrospective comparative study included 50 adult patients with aseptic nonunion of femoral or tibial diaphyseal fractures treated at our institution between January 2015 and January 2025.Patients underwent either locking-plate(LP)fixation(n=25)or intramedullary nailing(IMN)(n=25).The primary outcome was radiographic union at 12 months postoperatively.Secondary outcomes included time to union,operative time,intraoperative blood loss,length of hospital stay,incidence of complications(superficial/deep infection,implant failure,malunion),and 12-month functional status assessed by the Lower Extremity Functional Scale(LEFS).Statistical comparisons used Welch t tests for continuous variables and χ^(2) or Fisher exact tests for categorical variables.The protocol received institutional review board approval with waiver of informed consent.Results:Among 50 patients(LP=25;IMN=25),the 12-month union rate was 88.00%(22/25)in the LP group and 96.00%(24/25)in the IMN group(p=0.609).Time to union was shorter with IMN(6.20±1.83 vs 7.51±2.12 months;p=0.023).Operative time(110.52±25.23 vs 145.81±30.21 min;p<0.01)and intraoperative blood loss(250.41±80.64 vs 350.22±95.30 ml;p<0.01)favored IMN.Length of hospital stay was similar(6.24±1.83 vs 6.82±2.11 days;p=0.284).The incidence of superficial wound infection did not differ significantly(12.00%vs 4.00%;p=0.609).Twelve-month LEFS scores were comparable(65.44±10.21 vs 67.10±9.83;p=0.451).Conclusion:Both locking plate and intramedullary nail fixation are effective in the treatment of femoral and tibial nonunion,with high rates of union and good functional outcomes.Intramedullary nailing may be associated with a shorter time to union,reduced operative time and blood loss,and a lower risk of superficial wound infection compared to locking plate fixation.The choice of implant should be individualized based on fracture characteristics,patient factors,and surgeon preference.
基金the National Natural Science Foundation of China(Grant No.52309130)the Natural Science Foundation of Shandong Province(Grant No.ZR2022QD004).
文摘The mineralogy and texture of granite have been found to have a pronounced effect on its mechanical behavior.However,the precise manner in which the texture of granite affects the shear behavior of fractures remains enigmatic.In this study,fine-grained granite(FG)and coarse-grained granite(CG)were used to create tensile fractures with surface roughness(i.e.joint roughness coefficient(JRC))within the range of 5.48-8.34 and 12.68-16.5,respectively.The pre-fractured specimens were then subjected to direct shear tests under normal stresses of 1-30 MPa.The results reveal that shear strengths are smaller and stick-slip behaviors are more intense for FG fractures than for CG fractures,which is attributed to the different conditions of the shear surface constrained by the grain size.The smaller grain size in FG contributes to the smoother fracture surface and lower shear strength.The negative friction rate parameter a-b for both CG and FG fractures and the larger shear stiffness for FG than for CG fractures can account for the more intense stick-slip behaviors in FG fractures.The relative crack density for the post-shear CG fractures is greater than that of the FG fractures under the same normal stress,both of which decrease with the distance away from the shear surface following the power law.Moreover,the damage of CG fracture extends to a larger extent beneath the surface compared with the FG fracture.Our findings demonstrate that the grain size of the host rock exerts a significant influence on the fracture roughness,and thus should be incorporated into the assessment of fault slip behavior to better understand the role of mineralogy and texture in seismic activities.
文摘Pelvic fractures are rare but severe injuries that severely affect patients’quality of life.Treatment of these fractures often involves invasive approaches with high risk of injuries to nervous structures,particularly lumbosacral plexus.The introduction of minimally invasive surgical approaches,such as the lateral rectus approach,not only contributes to preserving lumbar plexus integrity in operated patients but also positively impacts their psychological well-being.Patients treated by surgical reduction of pelvic fractures with lumbosacral plexus injury often experience states of anxiety and depression.The lateral rectus approach is associated with lower levels of anxiety and depression compared to more invasive surgical techniques used for similar fractures.
基金supported by the National Natural Science Foundation of China(42090025,42302148)State Key Laboratory of Shale Oil and Gas Enrichment Mechanisms and Effective Development(33550000-22-ZC0613-0336)CNPC Innovation Found(2023DQ02-0103)。
文摘Lacustrine shale oil reservoirs of the Upper Triassic Chang 7 Member in the Ordos Basin have demonstrated significant potential for hydrocarbon resources.Natural fractures play a crucial role in hydrocarbon enrichment and production.Outcrops,cores,borehole image logs,thin sections,and FE-SEM images were used to investigate the types and characteristics of natural fractures in the Chang 7 Member.The factors controlling fracture development and the mechanisms of bedding-parallel fracture formation were revealed by integrating TOC analysis,XRD analysis,and rock pyrolysis.Results show that natural fractures in the study area include high-angle tectonic fractures and nearly horizontal bedding-parallel fractures.Brittle minerals and bed thickness control the occurrence and attributes of tectonic fractures.High TOC content and thermal maturity positively affect the development of bedding-parallel fractures,formed through the conversion of organic matter to hydrocarbons or the smectite-to-illite transformation.Additionally,the dominant orientations of tectonic fractures intersect the present-day maximum horizontal principal stress at a small angle,resulting in large apertures and good effectiveness.Bedding-parallel fractures contribute to enhance porosity and provide favorable pathways for lateral hydrocarbon migration.Collectively,this study could provide valuable insights for finding promising exploration areas in lacustrine shale oil reservoirs in the Ordos Basin and worldwide.
文摘BACKGROUND Acromegaly,a disease of excess growth hormone,is known to alter bone structure and increase the risk of osteoporosis and fractures.This study aimed to assess the prevalence of vertebral,non-vertebral,and hip fragility fractures,as well as osteoporosis,in a cohort of patients with acromegaly.AIM To assess the prevalence of vertebral fragility fractures,non-vertebral fragility fractures,hip fragility fractures,and osteoporosis in patients diagnosed with acromegaly.METHODS Data were collected on age,sex,body mass index(BMI),time from diagnosis of acromegaly,insulin-like growth factor(IGF-1)levels,disease control,pharmacological management,risk factors for osteoporosis,vertebral fragility fractures,non-vertebral fragility fractures,hip fragility fractures,and osteoporosis.RESULTS A total of 124 patients with acromegaly were included(67 men and 57 women).The mean age at diagnosis was 44±12 years;the mean time from diagnosis was 12±8 years;and the mean BMI was 27±4 kg/m².Fragility fractures were found in 27 patients(21%).There were no significant differences in the presence of osteoporosis or fragility fractures according to age,sex,BMI,duration of acrom egaly,or IGF-1 levels at diagnosis.A higher percentage of patients with osteoporosis were treated with somatostatin analogs compared to those without osteoporosis(46%vs 15%;P<0.05).CONCLUSION A high prevalence of osteoporosis and fragility fractures was found in patients with acromegaly,regardless of age,sex,BMI,time from diagnosis,IGF-1 levels,and disease control.More patients with osteoporosis were treated with somatostatin analogs compared to those without osteoporosis.Taken together,our results suggest that the severity of the disease and the need for second-line therapies,may be associated with the increased risk of osteoporosis.
