Background: It is recommended that the management of open lower-leg fractures should occur within six hours to avoid complications affecting both prognosis and functionality. This study aimed to evaluate the time take...Background: It is recommended that the management of open lower-leg fractures should occur within six hours to avoid complications affecting both prognosis and functionality. This study aimed to evaluate the time taken for each step of management, identify causes of delay, and propose solutions to reduce the rate of complications. Patients and methods: This was a prospective study involving 153 patients treated from January 2011 to December 2012. Standardized data collection forms documented the times taken for each management step from the accident until surgical intervention. Results: For patients admitted directly to our institution, median time to surgical debridement from arrival was 5 hours. Median time for bone fixation was 24 hours. External fixation was used in 119 patients. There were several causes of delay;lack of financial resources was the most common. Certain causes of delay were significantly correlated with time to debridement. However, although 86.7% of patients who developed an infection had a time from injury to debridement greater than six hours, there was no statistically significant association between infection and delay beyond six hours (p = 0.403). Conclusion: By identifying causes of treatment delay, we hope to be able to avoid complications, and therefore reduce the socio- economic impact of these important surgical emergencies.展开更多
针对汽车碰撞事故中驾驶员下肢损伤防护需求,本研究通过有限元仿真与生物力学分析相结合的方法,探讨护膝板结构参数对小腿保护的优化机理。基于C-NCAP正面碰撞工况构建包含Hybrid III 50th假人小腿模型的碰撞仿真系统,重点研究护膝板材...针对汽车碰撞事故中驾驶员下肢损伤防护需求,本研究通过有限元仿真与生物力学分析相结合的方法,探讨护膝板结构参数对小腿保护的优化机理。基于C-NCAP正面碰撞工况构建包含Hybrid III 50th假人小腿模型的碰撞仿真系统,重点研究护膝板材料刚度对胫骨反力指标的影响规律。通过调整护膝板内缓冲件杨氏模量发现:采用密度为88kg/m^(3)、杨氏模量4.5MPa海绵材料作为缓冲层可使碰撞能量吸收效率显著提升,曲面曲率半径在100-120 mm范围内可有效降低剪切载荷。优化后的楔形护膝板结构使小腿反力Fx峰值控制在1.0kN以下,较传统设计降低60%。研究结果为汽车内饰安全件的生物力学优化提供了新的设计思路和理论依据,对提升车辆被动安全性能具有重要工程应用价值。展开更多
文摘Background: It is recommended that the management of open lower-leg fractures should occur within six hours to avoid complications affecting both prognosis and functionality. This study aimed to evaluate the time taken for each step of management, identify causes of delay, and propose solutions to reduce the rate of complications. Patients and methods: This was a prospective study involving 153 patients treated from January 2011 to December 2012. Standardized data collection forms documented the times taken for each management step from the accident until surgical intervention. Results: For patients admitted directly to our institution, median time to surgical debridement from arrival was 5 hours. Median time for bone fixation was 24 hours. External fixation was used in 119 patients. There were several causes of delay;lack of financial resources was the most common. Certain causes of delay were significantly correlated with time to debridement. However, although 86.7% of patients who developed an infection had a time from injury to debridement greater than six hours, there was no statistically significant association between infection and delay beyond six hours (p = 0.403). Conclusion: By identifying causes of treatment delay, we hope to be able to avoid complications, and therefore reduce the socio- economic impact of these important surgical emergencies.
文摘针对汽车碰撞事故中驾驶员下肢损伤防护需求,本研究通过有限元仿真与生物力学分析相结合的方法,探讨护膝板结构参数对小腿保护的优化机理。基于C-NCAP正面碰撞工况构建包含Hybrid III 50th假人小腿模型的碰撞仿真系统,重点研究护膝板材料刚度对胫骨反力指标的影响规律。通过调整护膝板内缓冲件杨氏模量发现:采用密度为88kg/m^(3)、杨氏模量4.5MPa海绵材料作为缓冲层可使碰撞能量吸收效率显著提升,曲面曲率半径在100-120 mm范围内可有效降低剪切载荷。优化后的楔形护膝板结构使小腿反力Fx峰值控制在1.0kN以下,较传统设计降低60%。研究结果为汽车内饰安全件的生物力学优化提供了新的设计思路和理论依据,对提升车辆被动安全性能具有重要工程应用价值。
