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.

Estudo retrospectivo de cães com luxação patelar medial tratados cirurgicamente

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Reducao fechada e fixacao percutanea em fraturas supracondilianas do umero em criancas. Estudo retrospectivo de 32 casos

This retrospective study evaluated 32 cases of supracondylar fractures of the humerus in children, according to percutaneous crossed Kirschner-wire fixation. Follow-up was performed by radiographs of Baumann's angle and clinical evaluation of joint movement and carrying angle. According to Flynn's criteria, results were satisfactory in all cases, indicating that this method is a safe and efficient method in the treatment of such fractures.

Lateral external fixation: a new surgical technique for displaced unreducible supracondylar humeral fractures in children

BACKGROUND: Percutaneous Kirschner wire fixation represents the classic treatment for displaced supracondylar humeral fractures in childhood. This type of treatment first requires satisfactory reduction of the fracture. Failure to achieve a satisfactory reduction or inadequate stabilization can result in instability of the fracture fragments, which can result in either an unsatisfactory cosmetic or functional outcome. In our experience, these problems can be overcome with the use of a small lateral external fixator. METHODS: Between 1999 and 2005, thirty-one of 170 Gartland type-III supracondylar humeral fractures were treated with a lateral external fixator. The outcome of treatment was analyzed with regard to limb alignment, elbow movement, cosmetic appearance, and patient satisfaction. RESULTS: In twenty-eight of the thirty-one patients, a satisfactory reduction was achieved with closed methods. All children except one had a normal or good range of movement. The cosmetic result was excellent in all cases. All of the children and their parents stated that they would choose this treatment again. CONCLUSIONS: The use of a small lateral external fixator seems to be a safe alternative for the treatment of displaced supracondylar fractures of the humerus when a closed reduction appears to be unattainable by means of manipulation alone or when sufficient stability is not achieved with standard methods of Kirschner wire fixation.

The transpedicular approach as an alternative route for intervertebral disc regeneration

STUDY DESIGN Descriptive anatomical study on ovine and human cadaveric lumbar spinal segments. OBJECTIVE To describe the alternative transpedicular approach to deliver therapeutic agents into intervertebral disc (IVD). SUMMARY OF BACKGROUND DATA The present delivery approach of therapeutic agents (growth factors/cells/hydrogels) within the IVD is through injection, via the annulus fibrosus (AF). However, it has recently been demonstrated that small needle puncture of the AF leads to further degeneration and disc herniation. In addition, the injected material has a high chance to be extruded through the AF injury. METHODS Lumbar ovine and human spinal segments were used. Under fluoroscopy, a 2-mm Kirschner wire was introduced in the caudal vertebra through the pedicle and the inferior endplate to the nucleus pulposus. Gross anatomy analysis and high-resolution peripheral quantitative computed tomography (HR-pQCT) were performed to assess the right position of the wire in pedicles. Discography and nucleotomy were performed using a 14G cannula insertion or a 2-mm arthroscopic shaver blade, respectively. Nucleoplasty was also performed with agarose gel/contrast agent and imaged with HR-pQCT. RESULTS Gross anatomy, fluoroscopy, and HR-pQCT images showed that the nucleus pulposus could be approached through the endplate via the pedicle without affecting the spinal canal and the neural foramina. The contrast agent was delivered into the IVD and nucleus pulposus was removed from the disc and filled with agarose gel. CONCLUSION This study describes how a transpedicular approach can be used as an alternative route to deliver therapeutic agents to the disc without disruption of the AF showing the potential use of this technique in preclinical research and highlighting its clinical relevance for IVD regeneration.

Proximal Femoral Osteotomies with the Paediatric Hip Plate (LCP): Valgus osteotomy.

OBJECTIVE Proximal femoral osteotomy with stable fixation and sufficient correction. Low complication rates due to exact preoperative planning. INDICATIONS Congenital or traumatic femoral neck pseudarthrosis. Coxa vara. CONTRAINDICATIONS None. In severe deformities, a single femoral osteotomy may not solve the problem; thus, additional correction, e.g., a pelvic osteotomy, is required. SURGICAL TECHNIQUE Correct planning of the correction angle. Lateral approach. Subperiosteal detachment of vastus lateralis muscle. Place guide wire on the femoral neck to judge anteversion. Insert positioning wire 5 mm distal to trochanteric physis. Insert 2.8 mm Kirschner wire in the femoral neck. Osteotomy of the femur after marking the rotation by Kirschner wires or oscillating saw. Slide LC plate over Kirschner wires. Replace Kirschner wires with screws. Reduction of the femoral shaft to the plate with bone forceps. Definitive fixation of the plate to the femoral shaft by cortex or locking screws. Readaptation of vastus lateralis muscle over the plate. POSTOPERATIVE MANAGEMENT Partial weightbearing for 4-6 weeks depending on the age of the patient without any external fixation (e. g. cast) is possible. RESULTS Recent studies support the authors' findings of sufficient correction and stable fixation after proximal femoral osteotomy with the LCP pediatric hip plate. Low complication rates and stable fixation.

Missed Chopart dislocation: the importance of being aware of midtarsal injuries

Chopart (midtarsal) joint dislocations are relatively rare but potentially serious injuries. Their low prevalence and the possible absence of evident radiological findings cannot justify misdiagnosis because an adequate and correct treatment is required to achieve a proper clinical outcome. A midtarsal joint dislocation in a 19-year-old-woman is described, in which diagnosis was performed at 8 weeks of evolution. An open reduction was performed by a double approach (medial and lateral) and a Kirschner wire joint stabilization. At one-year of follow-up, loss of reduction was not observed and the patient was pain-free, although she referred to functional limitation when running. Besides describing the treatment of this particular injury, this study is aimed at increasing the level of clinical suspicion in order to avoid misdiagnosis such as occurred in our case.

The extrusion of continuous lengths of YBa2Cu3O7-x wire using hydroxypropyl methylcellulose

Wires of YBa2Cu3O7-x were fabricated by extrusion using a hydroxypropyl methylcellulose (HPMC) binder. As little as 2 wt.% binder was added to an oxide prepared by a novel co-precipitation process, to produce a plastic mass which readily gave continuous extrusion of long lengths of wire in a reproducible fashion. Critical temperatures of 92K were obtained for wires given optimum high-temperature heat treatments. Critical current densities greater than 1000 A cm-1 were measured at 77.3K using heat treatments at around 910°C for 10h. These transport critical current densities, measured on centimeter-long wires, were obtained with microstructures showing a relatively dense and uniform distribution of randomly oriented, small YBa2Cu3O7-x grains. © 1993.

Bi-2223 precursor billets for pit wire production

High temperature superconductor precursor billets (feed rods) have been developed for loading into silver tubes. The billets are loaded prior to rolling or drawing operations in PIT wire manufacture. Investigations have shown that wires and tapes prepared from feed rod loaded tubes show enhanced uniformity of electrical transport properties when compared with conventional powder packing, especially in wires drawn to long lengths. Analysis on production feed rods have shown carbon content to be as low as 110 ppm. © 1999 IEEE.

Microwave plasma discharge produced and sustained by the surface wave propagating along a metal wire

A theoretical model of the plasma discharge in a metal cylinder pumped by an operating gas of an arbitrary nature is presented. The ionization is carried out by the surface wave (SW) propagating along a coaxial metal wire. The model includes the local dispersion relation, the energy balance equation, and the relation between the absorbed power per unit length and the local plasma density. Two typical regimes of the discharge are analyzed. In both regimes the axial and radial profiles of the plasma density of the electromagnetic field components and of the SW intensity are obtained. The possible use of the obtained results in plasma technology are discussed.

MATLAB/Simulink simulation and C2000 code generation model for a grid-interactive 3-phase 4-wire inverter

This work is a MATLAB/Simulink model of a controller for a three-phase, four-wire, grid-interactive inverter. The model provides capacity for simulating the performance of power electroinic hardware, as well as code generation for an embedded controller. The implemented hardware topology is a three-leg bridge with a neutral connection to the centre-tap of the DC bus. An LQR-based current controller and MAF-based phase detector are implemented. The model is configured for code generation for a Texas Instruments TMS320F28335 Digital Signal Processor (DSP).

Constitutive modeling of shape memory alloy wire with non-local rate kinetics

A constitutive modeling approach for shape memory alloy (SMA) wire by taking into account the microstructural phase inhomogeneity and the associated solid-solid phase transformation kinetics is reported in this paper. The approach is applicable to general thermomechanical loading. Characterization of various scales in the non-local rate sensitive kinetics is the main focus of this paper. Design of SMA materials and actuators not only involve an optimal exploitation of the hysteresis loops during loading-unloading, but also accounts for fatigue and training cycle identifications. For a successful design of SMA integrated actuator systems, it is essential to include the microstructural inhomogeneity effects and the loading rate dependence of the martensitic evolution, since these factors play predominant role in fatigue. In the proposed formulation, the evolution of new phase is assumed according to Weibull distribution. Fourier transformation and finite difference methods are applied to arrive at the analytical form of two important scaling parameters. The ratio of these scaling parameters is of the order of 10(6) for stress-free temperature-induced transformation and 10(4) for stress-induced transformation. These scaling parameters are used in order to study the effect of microstructural variation on the thermo-mechanical force and interface driving force. It is observed that the interface driving force is significant during the evolution. Increase in the slopes of the transformation start and end regions in the stress-strain hysteresis loop is observed for mechanical loading with higher rates.

Delay time of a vacuum gap triggered by an exploding wire

The experimental results of delay time of a vacuum gap triggered by an exploding wire plasma have been reported. It consists of explosion delay time and propagation delay time. The explosion delay time has been found to be dependent on the parameters of the exploding wire and the exploding wire circuit and is independent of vacuum gap configuration. The propagation delay time depends on the properties of the exploding wire plasma and vacuum gap parameters such as the number of injection slots, gap spacing, gap polarity, etc. In the absence of prebreakdown current in the vacuum gap, the breakdown can be initiated only after the plasma completely bridges the gap spacing. Under this specific condition, it has been shown that the delay time data can be used to calculate the plasma velocity.

Influence of Band Non-Parabolicity on Few Ballistic Properties of III-V Quantum Wire Field Effect Transistors Under Strong Inversion

A simplified yet analytical approach on few ballistic properties of III-V quantum wire transistor has been presented by considering the band non-parabolicity of the electrons in accordance with Kane's energy band model using the Bohr-Sommerfeld's technique. The confinement of the electrons in the vertical and lateral directions are modeled by an infinite triangular and square well potentials respectively, giving rise to a two dimensional electron confinement. It has been shown that the quantum gate capacitance, the drain currents and the channel conductance in such systems are oscillatory functions of the applied gate and drain voltages at the strong inversion regime. The formation of subbands due to the electrical and structural quantization leads to the discreetness in the characteristics of such 1D ballistic transistors. A comparison has also been sought out between the self-consistent solution of the Poisson's-Schrodinger's equations using numerical techniques and analytical results using Bohr-Sommerfeld's method. The results as derived in this paper for all the energy band models gets simplified to the well known results under certain limiting conditions which forms the mathematical compatibility of our generalized theoretical formalism.

Dynamics and control of buckling type devices using SMA wire integrated beam

An analysis and design study using Shape Memory Alloy (SMA) wire integrated beam and its buckling shape control are reported. The dynamical system performance is analyzed with a mathematical set-up involving nonlocal and rate sensitive kinetics of phase transformation in the SMA wire. A standard phenomenological constitutive model reported by Brinson (1993) is modified by considering certain consistency conditions in the material property tensors and by eliminating spurious singularity. Considering the inhomogeneity effects, a finite element model of the SMA wire is developed. Simulations are carried out to study the buckling shape control of a beam integrated with SMA wire.