Correlation of Pullout Force of Kirschner (K-) Wire to Other Factors Indicative of Bone Quality

More than 250,000 hip fractures occur annually in the United States and the most common fracture location is the femoral neck, the weakest region of the femur. Hip fixation surgery is conducted to repair hip fractures by using a Kirschner (K-) wire as a temporary guide for permanent bone screws. Variation has been observed in the force required to extract the K-wire from the femoral head during surgery. It is hypothesized that a relationship exists between the K-wire pullout force and the bone quality at the site of extraction. Currently, bone mineral density (BMD) is used as a predictor for bone quality and strength. However, BMD characterizes the entire skeletal system and does not account for localized bone quality and factors such as lifestyle, nutrition, and drug use. A patient’s BMD may not accurately describe the quality of bone at the site of fracture. This study aims to investigate a correlation between the force required to extract a K-wire from femoral head specimens and the quality of bone. A procedure to measure K-wire pullout force was developed and tested with pig femoral head specimens. The procedure was implemented on 8 human osteoarthritic femoral head specimens and the average pullout force for each ranged from 563.32 ± 240.38 N to 1041.01 ± 346.84 N. The data exhibited significant variation within and between each specimen and no statistically significant relationships were determined between pullout force and patient age, weight, height, BMI, inorganic to organic matter ratio, and BMD. A new testing fixture was designed and manufactured to merge the clinical and research environments by enabling the physician to extract the K-wire from each bone specimen himself. The new device allows the physician to gather tactile feedback on the relative ease of extraction while load history is recorded similar to the previous procedure for data acquisition. Future work will include testing human bones with the new device to further investigate correlations for predicting bone quality.

Reattachment of the tuberosities with cable wires and bone graft in hemiarthroplasties done for proximal humeral fractures with cable wire and bone graft: 58 patients with a 22-month minimum follow-up

OBJECTIVE: The stability of 2 fixation techniques for the tuberosities in patients with 3- or 4-part proximal humerus fractures treated with hemiarthroplasties was compared. DESIGN: Retrospective review of a nonrandomized sequential series of patients. SETTING: Level I university orthopaedic surgery department. PATIENTS: A consecutive series of 58 patients (average age, 64 years) from 1990 to 1999 with 3- and 4-part fractures of the proximal humerus. INTERVENTION: In group 1, 31 patients were treated with either a Neer or Aequalis shoulder prosthesis using nonabsorbable sutures and no bone graft for the reattachment of the tuberosities. In group 2, 27 patients were treated with either an Aequalis or Epoca shoulder prosthesis and a combination of cable fixation and bone grafting. MAIN OUTCOME MEASUREMENTS: At follow-up (average, 32 months), radiographs were taken to confirm tuberosity fixation or degree of displacement or resorption. Functional outcome was assessed by the Constant-Murley Score. RESULTS: Significantly more dislocated tuberosities were found radiographically in group 1 (10 of 13 in total, P = 0.011), and significantly more tuberosities were resorbed in group 1 (9 of 12 in total, P = 0.012). Significant differences in functional results among healed versus failed tuberosity fixation were observed for activity of daily living (P = 0.05), range of motion (P = 0.002), strength (P = 0.01), the total score (P = 0.008), and the passive rotation amplitude (P = 0.04). CONCLUSION: In hemiarthroplasties for proximal humeral fractures, the reattachment of the tuberosities with cable wire and bone grafting gives consistently better radiographic and functional results than with suture fixation alone.

The use of intramedullary helix wire for the treatment of proximal humerus fractures

OBJECTIVE: To present the functional and radiographic outcome 1 and 6 years after application of a new intramedullary fixation device for proximal humerus fractures. DESIGN: Retrospective case series. SETTING: Level II orthopaedic surgery hospital. PATIENTS: Twenty-six consecutive patients (average age 68.9 years) with 2-, 3- and 4-part fractures of the proximal humerus were operated at a single institution. Follow-up was performed after 1 year (26 patients) and 6 years (16 patients). INTERVENTION: All patients were treated with closed reduction and intramedullary helix wires. MAIN OUTCOME MEASUREMENTS: The Constant-Murley score and the University of California Los Angeles (UCLA) score. Clinical complications and radiological posttraumatic arthritis were recorded. RESULTS: The average Constant-Murley score was 70.3 (points) and 70.7 after 1 and 6 years, respectively; the average UCLA score was 27.2 and 31.5 after 1 and 6 years, respectively. Major complications were 4 revisions for 3 secondary fragment displacements and 1 nonunion with partial avascular osteonecrosis in the first postoperative year. Complications were found predominantly in 4-part fractures (3/5, 60%). There were no further complications or progressive posttraumatic arthritis up to 6 years following surgery. CONCLUSION: The helix wire is well suited for displaced or unstable 2- and 3-part proximal humerus fractures. Adequate functional outcome, a low number of implant displacements, a low number of application morbidity, and infrequent implant removals were recorded. The use of this device is not recommended for 4-part fractures.

Microscopic wire guide-based orotracheal mouse intubation: description, evaluation and comparison with transillumination

Airway access is needed for a number of experimental animal models, and the majority of animal research is based on mouse models. Anatomical conditions in mice are small, and the narrow glottic opening allows intubation only with a subtle technique. We therefore developed a microscopic endotracheal intubation method with a wire guide technique in mice anaesthetized with halothane in oxygen. The mouse is hung perpendicularly with its incisors on a thread fixed on a vertical plate. The tongue is placed with a pair of forceps between the left hand's thumb and forefinger and slightly pulled, while the neck and thorax are positioned using the third and fourth fingers. By doing so, the neck can be slightly stretched, which allows optimal visualization of the larynx and the vocal cords. To ensure a safe intubation, a fine wire guide is placed under vision between the vocal cords and advanced about 5 mm into the trachea. An intravenous 22G x 1 in. plastic or Teflon catheter is guided over this wire. In a series of 41 mice, between 21 and 38 g, the success rate for the first intubation attempt was >95%. Certainty of the judgement procedure was 100% and success rate was higher using the described method when compared with a transillumination method in a further series. The technique is safe, less invasive than tracheostomy and suitable for controlled ventilation and pulmonary substance application.

Endovascular stent reconstruction of a chronic total occlusion of the inferior vena cava using bidirectional wire access and a balloon puncture by a re-entry device.

Venous angioplasty with stenting of iliac veins is an important treatment option for patients suffering from post-thrombotic syndrome due to chronic venous obstruction. Interventional treatment of a chronically occluded vena cava, however, is challenging and often associated with failure. We describe a case of a chronic total occlusion of the entire inferior vena cava that was successfully recanalized using bidirectional wire access and a balloon puncture by a re-entry catheter to establish patency of the inferior vena cava.

Cuando la ciudad habla : Pensando el capitalismo tardío, el crimen y lo urbano a través de The Wire

The Wire, la serie concebida por David Simon a comienzo de la década pasada y emitida por HBO, es una de las pocas que puede presumir de ser llamada la mejor ficción creada para la televisión. Pero más allá de sus bondades artísticas, o precisamente por ellas, la mirada expansiva y total que realiza el programa sobre Baltimore, Maryland, en vísperas de nuestro siglo invita a que la utilicemos como punto de acceso para pensar el capitalismo, el crimen y la cuestión urbana en la actualidad. Pero por sobre todo, elaborar cómo estos términos interactúan en relaciones dialécticas que, en definitiva, producen la ciudad contemporánea

Cuando la ciudad habla : Pensando el capitalismo tardío, el crimen y lo urbano a través de The Wire

The Wire, la serie concebida por David Simon a comienzo de la década pasada y emitida por HBO, es una de las pocas que puede presumir de ser llamada la mejor ficción creada para la televisión. Pero más allá de sus bondades artísticas, o precisamente por ellas, la mirada expansiva y total que realiza el programa sobre Baltimore, Maryland, en vísperas de nuestro siglo invita a que la utilicemos como punto de acceso para pensar el capitalismo, el crimen y la cuestión urbana en la actualidad. Pero por sobre todo, elaborar cómo estos términos interactúan en relaciones dialécticas que, en definitiva, producen la ciudad contemporánea

Cuando la ciudad habla : Pensando el capitalismo tardío, el crimen y lo urbano a través de The Wire

The Wire, la serie concebida por David Simon a comienzo de la década pasada y emitida por HBO, es una de las pocas que puede presumir de ser llamada la mejor ficción creada para la televisión. Pero más allá de sus bondades artísticas, o precisamente por ellas, la mirada expansiva y total que realiza el programa sobre Baltimore, Maryland, en vísperas de nuestro siglo invita a que la utilicemos como punto de acceso para pensar el capitalismo, el crimen y la cuestión urbana en la actualidad. Pero por sobre todo, elaborar cómo estos términos interactúan en relaciones dialécticas que, en definitiva, producen la ciudad contemporánea

Cuando la ciudad habla : Pensando el capitalismo tardío, el crimen y lo urbano a través de The Wire

The Wire, la serie concebida por David Simon a comienzo de la década pasada y emitida por HBO, es una de las pocas que puede presumir de ser llamada la mejor ficción creada para la televisión. Pero más allá de sus bondades artísticas, o precisamente por ellas, la mirada expansiva y total que realiza el programa sobre Baltimore, Maryland, en vísperas de nuestro siglo invita a que la utilicemos como punto de acceso para pensar el capitalismo, el crimen y la cuestión urbana en la actualidad. Pero por sobre todo, elaborar cómo estos términos interactúan en relaciones dialécticas que, en definitiva, producen la ciudad contemporánea

Dynamic analysis using finite elements to calculate the critical wear section of the contact wire in suburban railway overhead conductor rails

The purpose of this study is to determine the critical wear levels of the contact wire of the catenary on metropolitan lines. The study has focussed on the zones of contact wire where localised wear is produced, normally associated with the appearance of electric arcs. To this end, a finite element model has been developed to study the dynamics of pantograph-catenary interaction. The model includes a zone of localised wear and a singularity in the contact wire in order to simulate the worst case scenario from the point of view of stresses. In order to consider the different stages in the wire wear process, different depths and widths of the localised wear zone were defined. The results of the dynamic simulations performed for each stage of wear let the area of the minimum resistant section of the contact wire be determined for which stresses are greater than the allowable stress. The maximum tensile stress reached in the contact wire shows a clear sensitivity to the size of the local wear zone, defined by its width and depth. In this way, if the wear measurements taken with an overhead line recording vehicle are analysed, it will be possible to calculate the potential breakage risk of the wire. A strong dependence of the tensile forces of the contact wire has also been observed. These results will allow priorities to be set for replacing the most critical sections of wire, thereby making maintenance much more efficient. The results obtained show that the wire replacement criteria currently borne in mind have turned out to be appropriate, although in some wear scenarios these criteria could be adjusted even more, and so prolong the life cycle of the contact wire.

Cohesive-frictional modelling of bond and splitting action of prestressing wire

This work shows a numerical procedure for bond between indented wires and concrete, and the coupled splitting of the concrete. The bond model is an interface, non-associative, plasticity model. It is coupled with a cohesive fracture model for concrete to take into account the splitting of such concrete. The radial component of the prestressing force, increased by Poisson’s effect, may split the surrounding concrete, decreasing the wire confinement and diminishing the bonding. The combined action of the bond and the splitting is studied with the proposed model. The results of the numerical model are compared with the results of a series of tests, such as those which showed splitting induced by the bond between wire and concrete. Tests with different steel indentation depths were performed. The numerical procedure accurately reproduces the experimental records and improves knowledge of this complex process.

Bare wire anodes for electrodynamic tethers

The collection of electrons from the ionosphere is the major problem facing high-power electrodynamic tethers. This article discusses a simple electron-collection concept which is free of most of the physical uncertainties associated with plasma contactors in the rarefied, magnetized environment of an orbiting tether. The idea is to leave exposed a fraction of the tether length near its anodic end, such that, when a positive bias develops locally with respect to the ambient plasma, and for a tether radius small compared with both thermal gyroradius and Debye length, electrons are collected in an orbital-motion-limited regime. It is shown that large currents can be drawn in this way with only moderate voltage drops. The concept is illustrated through a discussion of performance characteristics for generators and thrusters.