While management of appendicular fractures has been well described in the setting of osteopetrosis, there is limited information on managing fractures of the axial spine. Here we present an osteopetrotic patient with ...While management of appendicular fractures has been well described in the setting of osteopetrosis, there is limited information on managing fractures of the axial spine. Here we present an osteopetrotic patient with multiple traumatic multiple, comminuted, unstable cervical spinal fractures managed with non-operative stabilization, and provide a review of the pathophysiology, genetic characteristics, and special considerations that must be explored when determining operative versus non-operative management of spinal injury in osteopetrosis. A PubMed query was performed for English articles in the literature published up to June 2016, and used the following search terms alone and in combination： ＂osteopetrosis＂, ＂spine＂, ＂fractures＂, ＂osteoclasts＂, and ＂operative management＂. Within four months after initial injury, treatment with halo vest allowed for adequate healing. The patient was asymptomatic with cervical spine dynamic radiographs confirming stability at four months. On four-year follow up examination, the patient remained without neck pain, and CT scan demonstrated partially sclerotic fracture lines with appropriate anatomical alignment. In conclusion, external halo stabilization may be an effective option for treatment of multiple unstable acute traumatic cervical spine fractures in patients with osteopetrosis. Given the challenge of surgical stabilization in osteopetrosis, further research is necessary to elucidate the optimal form of treatment in this select patient population.展开更多
Catheter fracture is a rare but serious complication of a peripherally inserted central catheter （PICC）. An adolescent patient was sent to Tianjin Medical University General Hospital （Tianjin, China） because the P...Catheter fracture is a rare but serious complication of a peripherally inserted central catheter （PICC）. An adolescent patient was sent to Tianjin Medical University General Hospital （Tianjin, China） because the PICC was fractured when removed by a nurse. Chest X-ray showed that the PICC fragment slid into the right pulmonary artery. Through emergency surgery, the remainder of the PICC was successfully retrieved by an interventional operation percutaneously via the right femoral vein. PICC fracture is less common and always without significant discomfort if not found timely, and it may lead to serious complications, such as pulmonary embolism, and even death. Thus, nurses, patients and their family members should pay enough attention to the daily maintenance of PICC and have a deep understanding of the reasons associated with PICC fracture as well as how to prevent it. Interventional operation is minimally invasive, which is a good choice for the removal of intravascular foreign bodies, leading to fewer complications and a good prognosis.展开更多
For figuring out the stress interference of multiphase fracture combinations and its effect on the fracture initiation pressure of subsequent hydraulic fracturing,a calculation model for the coupled stress field with ...For figuring out the stress interference of multiphase fracture combinations and its effect on the fracture initiation pressure of subsequent hydraulic fracturing,a calculation model for the coupled stress field with multiple induced fractures preexisted was established based on the calculation model for the stress field with single induced fracture preexisted,and the change laws of circumferential stress field around the wellbore under the effect of induced stress were analyzed.Then,the fracture initiation pressure of subsequent hydraulic fracturing was calculated according to the fracturing mechanics criterion.Finally,the effects of the length,phase,horizontal principal stress difference co-efficient and quantity of preexisting fractures on its initiation pressure were analyzed.And the following research results were obtained.First,the circumferential stress difference in the area near the fractures behind the preexisting fractures increase greatly and even the horizontal principal stress is reversed.Second,as the length of new preexisting fractures increases,the initiation pressure of initial preexisting fractures rises first and then drops.And when the length of new preexisting fractures is equal to that of the initial preexisting fractures,the initiation pressure of initial preexisting fractures drops quickly first and then slowly.Third,the initiation pressure of high phase fractures is lower than that of low phase fractures.Fourth,with the increase of fracture quantity,the initiation pressure of new preexisting fractures drops gradually,but the decline trend of initiation pressure difference is not obvious.Fifth,the stress interference of multiphase fractures influences the fracture initiation pressure,and high-phase long fractures and low-phase short fractures are both favorable for the simultaneous initiation of multiphase fractures.Sixth,syn-chronous propagation of multiple fractures can generate more complicated stress interference and excite the evolution of hydraulic fracture network,so as to realize uniform fracturing stimulation.In conclusion,the research results can provide a theoretical guidance for the design of fracturing operation,e.g.perforation phase of blasting induced fracturing,scale of induced fractures,and pump pressure of subsequent hydraulic fracturing.展开更多
Objective To study the effect of operative timing on clinical outcomes in elderly hip fracture.Methods Two hundred sixty-seven patients with hip fracture were treated from July 2006 to May 2008.The patients who had an...Objective To study the effect of operative timing on clinical outcomes in elderly hip fracture.Methods Two hundred sixty-seven patients with hip fracture were treated from July 2006 to May 2008.The patients who had an operation within展开更多
文摘While management of appendicular fractures has been well described in the setting of osteopetrosis, there is limited information on managing fractures of the axial spine. Here we present an osteopetrotic patient with multiple traumatic multiple, comminuted, unstable cervical spinal fractures managed with non-operative stabilization, and provide a review of the pathophysiology, genetic characteristics, and special considerations that must be explored when determining operative versus non-operative management of spinal injury in osteopetrosis. A PubMed query was performed for English articles in the literature published up to June 2016, and used the following search terms alone and in combination： ＂osteopetrosis＂, ＂spine＂, ＂fractures＂, ＂osteoclasts＂, and ＂operative management＂. Within four months after initial injury, treatment with halo vest allowed for adequate healing. The patient was asymptomatic with cervical spine dynamic radiographs confirming stability at four months. On four-year follow up examination, the patient remained without neck pain, and CT scan demonstrated partially sclerotic fracture lines with appropriate anatomical alignment. In conclusion, external halo stabilization may be an effective option for treatment of multiple unstable acute traumatic cervical spine fractures in patients with osteopetrosis. Given the challenge of surgical stabilization in osteopetrosis, further research is necessary to elucidate the optimal form of treatment in this select patient population.
文摘Catheter fracture is a rare but serious complication of a peripherally inserted central catheter （PICC）. An adolescent patient was sent to Tianjin Medical University General Hospital （Tianjin, China） because the PICC was fractured when removed by a nurse. Chest X-ray showed that the PICC fragment slid into the right pulmonary artery. Through emergency surgery, the remainder of the PICC was successfully retrieved by an interventional operation percutaneously via the right femoral vein. PICC fracture is less common and always without significant discomfort if not found timely, and it may lead to serious complications, such as pulmonary embolism, and even death. Thus, nurses, patients and their family members should pay enough attention to the daily maintenance of PICC and have a deep understanding of the reasons associated with PICC fracture as well as how to prevent it. Interventional operation is minimally invasive, which is a good choice for the removal of intravascular foreign bodies, leading to fewer complications and a good prognosis.
基金Project supported by the National Natural Science Foundation of China,“Microscopic Damage Mechanism of Saturated Brittle Rock during Blasting Induced Fracturing and Its Control Law on Macroscopic Damage”(No.51874339)the Natural Science Foundation of Shandong Province,“Study on the Coupled Response Mechanism of Crack Propagation and Rock Damage in the fracturing condition of multistage strong pulse”(No.ZR2016EEQ04)the Fundamental Research Funds for the Central Universities,China,“Study on the Mechanical Mechanism of Multistage Blasting Induced SRV in Deep-Seated Tight Reservoirs with High Horizontal Stress Difference”(No.17CX05004).
文摘For figuring out the stress interference of multiphase fracture combinations and its effect on the fracture initiation pressure of subsequent hydraulic fracturing,a calculation model for the coupled stress field with multiple induced fractures preexisted was established based on the calculation model for the stress field with single induced fracture preexisted,and the change laws of circumferential stress field around the wellbore under the effect of induced stress were analyzed.Then,the fracture initiation pressure of subsequent hydraulic fracturing was calculated according to the fracturing mechanics criterion.Finally,the effects of the length,phase,horizontal principal stress difference co-efficient and quantity of preexisting fractures on its initiation pressure were analyzed.And the following research results were obtained.First,the circumferential stress difference in the area near the fractures behind the preexisting fractures increase greatly and even the horizontal principal stress is reversed.Second,as the length of new preexisting fractures increases,the initiation pressure of initial preexisting fractures rises first and then drops.And when the length of new preexisting fractures is equal to that of the initial preexisting fractures,the initiation pressure of initial preexisting fractures drops quickly first and then slowly.Third,the initiation pressure of high phase fractures is lower than that of low phase fractures.Fourth,with the increase of fracture quantity,the initiation pressure of new preexisting fractures drops gradually,but the decline trend of initiation pressure difference is not obvious.Fifth,the stress interference of multiphase fractures influences the fracture initiation pressure,and high-phase long fractures and low-phase short fractures are both favorable for the simultaneous initiation of multiphase fractures.Sixth,syn-chronous propagation of multiple fractures can generate more complicated stress interference and excite the evolution of hydraulic fracture network,so as to realize uniform fracturing stimulation.In conclusion,the research results can provide a theoretical guidance for the design of fracturing operation,e.g.perforation phase of blasting induced fracturing,scale of induced fractures,and pump pressure of subsequent hydraulic fracturing.
文摘Objective To study the effect of operative timing on clinical outcomes in elderly hip fracture.Methods Two hundred sixty-seven patients with hip fracture were treated from July 2006 to May 2008.The patients who had an operation within
