Sviluppo, implementazione e valutazione funzionale di un nuovo modello protesico di caviglia

Total ankle arthroplasty (TAA) is still not as satisfactory as total hip and total knee arthroplasty. For the TAA to be considered a valuable alternative to ankle arthrodesis, an effective range of ankle mobility must be recovered. The disappointing clinical results of the current generation of TAA are mostly related to poor understanding of the structures guiding ankle joint mobility. A new design (BOX Ankle) has been developed, uniquely able to restore physiologic ankle mobility and a natural relationship between the implanted components and the retained ligaments. For the first time the shapes of the tibial and talar components in the sagittal plane were designed to be compatible with the demonstrated ligament isometric rotation. This resulted in an unique motion at the replaced ankle where natural sliding as well as rolling motion occurs while at the same time full conformity is maintained between the three components throughout the flexion arc. According to prior research, the design features a spherical convex tibial component, a talar component with radius of curvature in the sagittal plane longer than that of the natural talus, and a fully conforming meniscal component. After computer-based modelling and preliminary observations in several trial implantation in specimens, 126 patients were implanted in the period July 2003 – December 2008. 75 patients with at least 6 months follow-up are here reported. Mean age was 62,6 years (range 22 – 80), mean follow-up 20,2 months. The AOFAS clinical score systems were used to assess patient outcome. Radiographs at maximal dorsiflexion and maximal plantar flexion confirmed the meniscalbearing component moves anteriorly during dorsiflexion and posteriorly during plantarflexion. Frontal and lateral radiographs in the patients, show good alignment of the components, and no signs of radiolucency or loosening. The mean AOFAS score was observed to go from 41 pre-op to 74,6 at 6 month follow-up, with further improvement at the following follow-up. These early results reveal satisfactory clinical scores, with good recovery of range of motion and reduction of pain. Radiographic assessment reveals good osteointegration. All these preliminary results confirm biomechanical studies and the validity of this novel ligamentcompatible prosthesis design. Surely it will be important to re-evaluate these patients later.

Petrographie und Geochemie des Eckfelder Maares und von Hillscheid und die Einbindung in den Hocheifelvulkanismus

Tertiäre Vulkanite aus dem Eckfelder Maar, dem Hillscheider Diatrem und dem Hillscheid Basalt (Schlot) wurden petrologisch und geochemisch untersucht. Bis auf tonige Klasten aus dem Bohrkern des Eckfelder Maares handelt es sich bei allen weiteren Proben um undifferenzierte basische Vulkanite. Die tonigen Klasten aus dem Bohrkern müssen der ehemaligen Landoberfläche vor der Eruption des Eckfelder Maares zugerechnet werden, in dessen Krater sie während der Eruption hineingefallen sind. Bis auf die Proben des Hillscheid Basaltes sind die Proben alteriert. Die Alteration zeigt sich an der Bildung von Zeolithen und Calcitmineralisationen, die primär und sekundär gebildete Hohlräume aufgefüllt haben oder an einer vertonten Grundmasse der Proben, die daneben Mineraleinschlüsse (Spinell) und kantige Fremdgesteinsbruchstücke enthalten können. Bei den Proben mit vertonter Grundmasse handelt es sich um Palagonite, Umwandlungsprodukte aus Sideromelan (basaltischem Glas). Geochemische Analysen an Grundmassepräparaten der alterierten bis vertonten Proben zeigen, dass außer den immobilen Elementen Ti, Nb, Zr, Y alle weiteren Elemente teilweise bis vollständig abgereichert worden sind. Eine Ausnahme bildet Barium (Ba), welches z.T. in beträchtlichen Mengen in Zeolithen (Harmotom) angereichert wurde. Bei den Proben aus dem Eckfelder Maar kann die Alteration bis Vertonung der Proben alleine mit der Palagonitisierung und Verwitterung erklärt werden. Es gibt keine Hinweise auf Materialzufuhr und damit für sich anschließende hydrothermale Prozesse. Die Proben des Hillscheider Diatrem sind wesentlich geringer alteriert (glasige Grundmasse). Neuste Erkenntnisse aus einer Bohrung im Sommer 1999 im vermuteten Zentrum des Hillscheider Diatrems beschränken das Diatrem maximal auf einen kleineren Bereich im Nordosten der bisherigen Lokation. Bei der Bohrung stieß man nach 20 Meter auf Anstehendes. Im Hangschutt darüber fand man Blöcke des Hillscheid Basaltes. Eine geringere Größe der Lokation zusammen mit der geringen Alteration könnten auf deren Entstehung mit einer initialen Maarphase gefolgt von Schlackentätigkeit hinweisen. Die Schlacken könnten die ersten Ablagerungen vor Verwitterung geschützt haben. Allerdings gibt es keine Funde die eine Schlackentätigkeit belegen. Beim sogenannten 'Hillscheider Diatrem' könnte es sich aber auch um Hangschutt aus der Randbreccie des Hillscheider Basaltes handeln. Zusammen mit Bruchstücken aus dem Schlot des Hillscheid Basaltes wären die Palagonite des sogenannten 'Hillscheider Diatrem' erst in jüngster Zeit im Bereich einer Uferböschung zur Ablagerung gekommen. Dies würde allerdings das sogenannte 'Hillscheider Diatrem' in seiner Existenz in Frage stellen. Vergleiche der Proben des Hillscheid Basaltes mit basischen Hocheifelvulkaniten deuten auf kogenetische Beziehung aller Proben untereinander und ordnen die Proben des Hillscheid Basaltes geochemisch dem Hocheifelvulkanismus zu. REE- und weitere Spurenelementgehalte und auch deren Elementverhältnisse weisen für alle tertiären Eifelvulkanite gemeinsam auf Mantelschmelzen aus dem Bereich eines Granatperidotits mit niedrigen Aufschmelzgraden um ein Prozent hin. Vergleich der Elementverhältnisse hochinkompatibler Elemente im Bezug auf die Bildung mafischer Schmelzen mit primitivem Mantel deuten darauf hin, dass der Mantel im Bereich der Hocheifel verarmt ist an K, Rb, Sr und angereichert an Ba und eventuell an Nb. Ursachen für diese von typisch primären Mantelzusammensetzung abweichenden Verhältnisse könnten durch Mischungen von Mantelschmelzen mit lithosphärischem Mantel (K-Anomalie) und durch Anreicherungen mit fluiden Phasen (Ba-Anomalie) oder auch Schmelzen aus einem tieferliegenden Plume (Kelberger Hoch) verursacht worden sein. Englischer Zusammenfassung:

Active processes, morphology, and dynamics of icy debris fans: Landform evolution along rapidly degrading escarpments in alpine regions undergoing recent deglaciation

In the past few decades the impacts of climate warming have been significant in alpine glaciated regions. Many valley glaciers formerly linked as distributary glaciers to high-level icecaps have decoupled at their icefalls, exposing major escarpments and generating a suite of dynamic landforrns dominated by mass wasting. Ice-dominated landforms, here termed icy debris fans, develop rapidly by ice avalanching, rockfall, and icy debris flow. Field-based reconnaissance studies at two alpine settings, the Wrangell Mountains of Alaska and the Southern Alps of New Zealand, provide a preliminary morphogenetic model of spatial and temporal evolution of icy debris fans in a range of alpine settings. The influence of these processes on landform evolution is largely unrecognized in the literature dealing with post-glacial landform adjustment known as the paraglacial. A better understanding of these dynamic processes will be increasingly important because of the extreme geohazards characterizing these areas. Our field studies show that after glacier decoupling, icy debris fans begin to form along the base of bedrock escarpments at the mouths of catchments and prograde over valley glaciers. The presence of a distinct catchment, apex, and fan morphology distinguishes these landforms from other landforms common in periglacial hillslope settings receiving abundant clastic debris and ice. Ice avalanching is the most abundant process involved in icy debris fan formation. Fans developed below weakly incised catchments are dominated by ice avalanching and are composed primarily of ice with minor lithic detritus. Typically, avalanches fall into the fan catchments where sediments transform into grainflows that flow onto the fans. Once on the fans, avalanche deposits ablate rapidly, flattening and concentrating lithic fragments at the surface. Icy debris fans may become thick enough to become glaciers with splay crevasse systems. Fans developed below larger, more complex catchments are composed of higher proportions of lithic detritus resulting from temporary storage of ice and lithic detritus deposits within the catchment. Episodic outbursts of meltwater from the icecap may mix with the stored sediments and mobilize icy debris flows (mixture of ice and lithic clasts) onto the fans. Our observations indicate that the entire evolutionary cycle of icy debris fans probably occurs during an early paraglacial interval (i.e., decades to 100 years). Observations comparing avalanche frequency, volume, and fan morphologic evolution at the Alaska site between 2006 and 2010 illustrate complex response between icy debris fans even within the same cirque - where one fan may be growing while others are downwasting because of differences in ice supply controlled by their respective catchments and icecap contributions. As ice supply from the icecap diminishes through time, icy debris fans rapidly downwaste and eventually evolve into talus cones that receive occasional but ephemeral ice avalanches.

Hindfoot varus and neurologic disorders

Muscle imbalance from numerous underlying neurologic disorders can cause dynamic and static hindfoot varus deformity. Most etiologies are congenital, and therefore affect bone morphology and the shape of the foot during growth. Weak and strong muscle groups, bone deformity, and soft-tissue contractures have to be carefully assessed and considered for successful management. Because of the variety of the etiologies and the differences in presentation, treatment decisions in varus hindfoot caused by neurologic disorders must be individualized. Deformity correction includes release of soft tissue contractures, osteotomies and arthrodeses, and tenotomies or tendon transfers to balance muscle strength and prevent recurrence. To decrease elevated anteromedial ankle joint contact stress and provide lateral hindfoot stability during the entire gait cycle, the goal of static and dynamic hindfoot varus realignment is to fully correct all components of the deformity, but particularly the varus tilt of the talus.

Geophysical Investigation of Subsurface Three-Dimensional Architecture of Icy Debris Fans With Ground Penetrating Radar in the Wrangell Mountains, Alaska

Icy debris fans have are newly-described landforms (Kochel and Trop, 2008 and 2012) as landforms developed immediately after deglaciation on Earth and similar features have been observed on Mars. Subsurface characteristics of Icy debris fans have not been previously investigated. Ground penetrating radar (GPR) was used to non-invasively investigate the subsurface characteristics of icy debris fans near McCarthy, Alaska, USA. The three fans investigated in Alaska are the East, West, and Middle fans (Kochel and Trop, 2008 and 2012) which below the Nabesna ice cap and on top of the McCarthy Creek Glacier. Icy debris fans in general are a largely unexplored suite of paraglacial landforms and processes in alpine regions. Recent field studies focused on direct observations and depositional processes. Their results showed that the fan's composition is primarily influenced by the type and frequency of depositional processes that supply the fan. Photographic studies show that the East Fan receives far more ice and snow avalanches whereas the Middle and West Fans receive fewer mass wasting events but more clastic debris is deposited on the Middle and West fan from rock falls and icy debris flows. GPR profiles and Wide-angle reflection and refraction (WARR) surveys consisting of both, common mid-point (CMP), and common shot-point (CSP) surveys investigated the subsurface geometry of the fans and the McCarthy Creek Glacier. All GPR surveys were collected in July of 2013 with 100MHz bi-static antennas. Four axial profiles and three cross-fan profiles were done on the West and Middle fans as well as the McCarthy Creek Glacier in order to investigate the relationship between the three features. GPR profiles yielded reflectors that were continuous for 10+ m and hyperbolic reflections in the subsurface. The depth to these reflections in the subsurface requires knowledge of the velocity of the subsurface. To find the velocity of the subsurface eight WARR surveys collected on the fans and on the McCarthy Creek glacier to provide information on variability of subsurface velocities. The profiles of the Middle and West fan have more reflections in their profiles compared to profiles done on the McCarthy Creek Glacier. Based on the WARR surveys, we interpret the lower energy return in the glacier to be caused by two reasons. 1) The increased attenuation due to wet ice versus drier ice and on the fan with GPR velocities >0.15m/ns. 2) Lack of interfaces in the glacier compared to those in the fans which are inferred to be produced by the alternating layers of stratified ice and lithic-rich layers. The GPR profiles on the West and Middle Fans show the shallow subsurface being dominated by lenticular reflections interpreted to be consistent with the shape of surficial deposits. The West Fan is distinguished from the Middle Fan by the nature of its reflections patterns and thicknesses of reflection packages that clearly shows the Middle fan with a greater thickness. The changes in subsurface reflections between the Middle and West Fans as well as the McCarthy Creek Glacier are thought to reflect the type and frequency of depositional processes and surrounding bedrock and talus slopes.

Etude des relations entre la pluie, le sol, le relief, la couverture végétale et l'érosion dans la région de Mandraka

Le relief accidenté, le climat agressif favorisé par l’Alizé, ainsi que l’étroite dépendance de la population de l’exploitation forestière et de l’exploitation agricole sans dispositifs de protection antiérosifs, sont les contextes qui permettent de dire que la région de Mandraka est sujette au problème d’érosion. L’étude a pour objectif de déterminer les relations entre les caractéristiques du sol, son mode d’occupation, les précipitations ainsi que l’érosion dans la région de Mandraka et ce en vue d’un aménagement rationnel. Des dispositifs pour la mesure de pertes en terre et de ruissellement ont été matérialisés sur des parcelles d’expérimentation. A cet effet, le choix de ces parcelles a porté sur le mode d’occupation du sol (sous terrains aménagés, sous « tavy », sous « savoka », et sous forêt naturelle), sur la similitude des pentes et sur leur localisation de manière à ce qu’elles soient situées sur les mi-versants. Les résultats ont montré que le sol dans cette région contient un taux de matière organique satisfaisant à élevé (2,41 à 3,74% de MO), lui permettant une bonne stabilité structurale (Is = 0,85 et K = 0,08). Les pertes en terre (0,13 à 20,93t/ha/an) et les ruissellements (0,3 à 5%) obtenus indiquent que l’érosion est faible à accélérée suivant le mode d’occupation du sol. En deux ans d’aménagement, les terrasses se sont stabilisées et les racines de Vetiveria zizanoides peuvent remplacer les fascines initialement installées pour tenir les talus. Toutefois, l’exposition du sol à la battance de la pluie et la mauvaise infiltration d’eau de ruissellement dans le sol accélèrent le phénomène d’érosion. Par ailleurs, il y a l’efficacité de la SCV sans brûlis bien qu’il s’agit de la première année d’expérience. Dans ces conditions, un plan d’aménagement simplifié a été proposé en vue (i) de protéger le sol contre la battance de la pluie, (ii) de réduire les transports solides par l’érosion et (iii) d’améliorer l’infiltration d’eau du sol.

Regional surface morphology of comet 67P/Churyumov-Gerasimenko from Rosetta/OSIRIS images

Aims. The OSIRIS camera onboard the Rosetta spacecraft has been acquiring images of the comet 67P/Churyumov-Gerasimenko (67P)'s nucleus at spatial resolutions down to similar to 0.17 m/px ever since Aug. 2014. These images have yielded unprecedented insight into the morphological diversity of the comet's surface. This paper presents an overview of the regional morphology of comet 67P. Methods. We used the images that were acquired at orbits similar to 20-30 km from the center of the comet to distinguish different regions on the surface and introduce the basic regional nomenclature adopted by all papers in this Rosetta special feature that address the comet's morphology and surface processes. We used anaglyphs to detect subtle regional and topographical boundaries and images from close orbit (similar to 10 km from the comet's center) to investigate the fine texture of the surface. Results. Nineteen regions have currently been defined on the nucleus based on morphological and/or structural boundaries, and they can be grouped into distinctive region types. Consolidated, fractured regions are the most common region type. Some of these regions enclose smooth units that appear to settle in gravitational sinks or topographically low areas. Both comet lobes have a significant portion of their surface covered by a dusty coating that appears to be recently placed and shows signs of mobilization by aeolian-like processes. The dusty coatings cover most of the regions on the surface but are notably absent from a couple of irregular large depressions that show sharp contacts with their surroundings and talus-like deposits in their interiors, which suggests that short-term explosive activity may play a significant role in shaping the comet's surface in addition to long-term sublimation loss. Finally, the presence of layered brittle units showing signs of mechanical failure predominantly in one of the comet's lobes can indicate a compositional heterogeneity between the two lobes.

Facies analysis on sediment core CRP-3 from the Ross Sea, Antarctica

Cape Roberts Project drill core 3 (CRP-3) was obtained from Roberts ridge, a sea-floor high located at 77°S, 12 km offshore from Cape Roberts in western McMurdo Sound, Antarctica. The recovered core is about 939 m long and comprises strata dated as being early Oligocene (possibly latest Eocene) in age, resting unconformably on ~116 m of basement rocks consisting of Palaeozoic Beacon Supergroup sediments. The core includes ten facies commonly occurring in five major associations that are repeated in particular sequences throughout the core and which are interpreted as representing different depositional environments through time. Depositional systems inferred to be represented in the succession include: outer shelf, inner shelf, nearshore to shoreface each under iceberg influence, deltaic and/or grounding-line fan, and ice proximal-ice marginal-subglacial (mass flow/rainout diamictite/subglacial till) singly or in combination. The record is taken to represent the initial talus/alluvial fan setting of a glaciated rift margin adjacent to the block-uplifted Transantarctic Mountains. Development of a deltaic succession upcore was probably associated with the formation of palaeo-Mackay valley with temperate glaciers in its headwaters. At that stage glaciation was intense enough to support glaciers ending in the sea elsewhere along the coast, but a local glacier was fluctuating down to the sea by the time the youngest part of CRP-3 was being deposited. Changes in palaeoenvironmental interpretations in this youngest part of the core are used to estimate relative glacial proximity to the drillsite through time. These inferred glacial fluctuations are compared with the global d180 and Mg/Ca curves to evaluate the potential of glacial fluctuations on Antarctica for influencing these records of global change. Although the comparisons are tentative at present, the records do have similarities, but there are also some differences that require further evaluation.

Stable oxygen and carbon isotope compositions of Campanian grainstones and rudstones

Petrographic descriptions and stable oxygen and carbon isotope compositions of microsamples of Campanian-age sediment gravity-flow deposits from Northeast Providence Channel, Bahamas, indicate deep-marine cementation of shallow-marine skeletal grains that were transported to the channel during the Late Cretaceous. Shallow-marine components are represented by mollusks, especially rudists, and shallow-water benthic foraminifers as well as sparse echinoderm and algal grains. The sole evidence of diagenesis in shallow-marine environments consists of micrite envelopes around skeletal grains. Shallow-marine skeletal grains have mean stable isotope values of -3.1 per mil d18O and +2.6 per mil d13C. The d18O values are consistent with precipitation in equilibrium with warm (20°-30°C), shallow-marine water. Deep-marine components are represented by equant calcite spar cements and rip-up clasts of slope sediments. Spar cements, exhibiting hexagonal morphology with scalenohedral terminations, most commonly occur as thin isopachous linings in the abundant porosity. Deep-marine cements have mean stable isotope values of - 1.1 per mil d18O and +2.7 per mil d13C. Deep-marine cements are 18O-enriched relative to shallow-marine skeletal grains, consistent with precipitation in equilibrium with colder (10°-20°C), deep-marine waters. The cement .source during lithification appears to have been dissolution of aragonite and high-magnesium calcite skeletal grains, which made up part of the transported sediment. Interbedded periplatform ooze remains uncemented, or poorly cemented, probably because of lower permeability. Equant spar cements that occur in gravity-flow deposits recovered from Hole 634A have stable isotope compositions similar to spars in Lower and mid-Cretaceous shallow-water limestones exposed on the Bahama Escarpment, to Campanian-Paleocene deep-marine hardgrounds recovered during DSDP Leg 15 in the Caribbean, and to spars in Aptian-Albian talus deposits at the base of the Campeche Escarpment recovered during DSDP Leg 77.

Slope stability analyses based on sediment cores of the Ligurian Margin, Southern France

Submarine slope failures of various types and sizes are common along the tectonic and seismically active Ligurian margin, northwestern Mediterranean Sea, primarily because of seismicity up to ~M6, rapid sediment deposition in the Var fluvial system, and steepness of the continental slope (average 11°). We present geophysical, sedimentological and geotechnical results of two distinct slides in water depth >1,500 m: one located on the flank of the Upper Var Valley called Western Slide (WS), another located at the base of continental slope called Eastern Slide (ES). WS is a superficial slide characterized by a slope angle of ~4.6° and shallow scar (~30 m) whereas ES is a deep-seated slide with a lower slope angle (~3°) and deep scar (~100 m). Both areas mainly comprise clayey silt with intermediate plasticity, low water content (30-75 %) and underconsolidation to strong overconsolidation. Upslope undeformed sediments have low undrained shear strength (0-20 kPa) increasing gradually with depth, whereas an abrupt increase in strength up to 200 kPa occurs at a depth of ~3.6 m in the headwall of WS and ~1.0 m in the headwall of ES. These boundaries are interpreted as earlier failure planes that have been covered by hemipelagite or talus from upslope after landslide emplacement. Infinite slope stability analyses indicate both sites are stable under static conditions; however, slope failure may occur in undrained earthquake condition. Peak earthquake acceleration from 0.09 g on WS and 0.12 g on ES, i.e. M5-5.3 earthquakes on the spot, would be required to induce slope instability. Different failure styles include rapid sedimentation on steep canyon flanks with undercutting causing superficial slides in the west and an earthquake on the adjacent Marcel fault to trigger a deep-seated slide in the east.

(Table 1, page 434-435) Bulk chemical composition of S.W. Pacific island arc Mn-oxide crusts

Hydrothermal Mn-oxide crusts have been removed from the Tonga-Kermadec Ridge, the first such hydrothermal deposits to be reported in the S.W. Pacific island arc. In several respects the deposits are similar to hydrothermal Mn-crusts from oceanic spreading centre settings. They are limited in areal extent, comprise well-crystalline birnessite and generally display extreme fractionation of Mn from Fe. They are strongly depleted in many elements compared to hydrogenous Mn deposits but are comparatively enriched in Li, Zn, Mo and Cd. The Group IA and Group IIA metals show strong intercorrelations and the behaviour of Mg in the purest samples may indicate the extent to which normal seawater has influenced the composition of the deposits. Certain aspects of the deposits are not typical of hydrothermal Mn deposits. In particular at least some of the crusts have developed on a sediment or unconsolidated talus substrate. Some crusts, or specific layers within some crusts, display a chemical composition which suggests a significant input from normal seawater.

Porosity, permeability, trace elements, and carbon-oxygen isotopes at DSDP Hole 77-536

Talus deposits recovered from Site 536 show evidence of aragonite dissolution, secondary porosity development, and calcite cementation. Although freshwater diagenesis could account for the petrographic features of the altered talus deposits, it does not uniquely account for isotopic or trace-element characteristics. Also, the hydrologic setting required for freshwater alteration is not easily demonstrated for the Campeche Bank. A mixing-zone model does not account for the available trace-element data, but does require somewhat less drastic assumptions about the size of the freshwater lens. Although a seawater (bottom-water) alteration model requires no hydrologic difficulties, unusual circumstances are required to account for the geochemical characteristics of the talus deposits using this model.