Neglected congenital bilateral knee dislocation treated by quadricepsplasty with semitendinosus and sartorius transfer:A case report

BACKGROUND Congenital knee dislocation(CKD)is a rare condition,which accounts for 1%of congenital hip dislocations.It can present as an isolated condition or coexist with other genetic disorders.Treatment options include serial casting,percutaneous quadriceps recession,and V-Y quadricepsplasty(VYQ).The pathogenesis and hereditary patterns of CKD are not fully understood,with most cases being familial.CKD is usually managed immediately after birth.However,in this report,the patient was neglected for 2 years.CASE SUMMARY A 2-year-old girl with bilateral CKD after birth presented to our hospital after failed serial casting;the patient had seizures and limited access to healthcare because of her family’s low socioeconomic status.Her birth was noted for a breech presentation accompanied by oligohydramnios.The delivery took a long time,requiring immediate medical interventions.As an infant,she had chronic diseases,including a small patent ductus arteriole,multicystic dysplastic kidney disease,and epilepsy.She was found to have a bilateral knee dislocation of approximately-90°on hyperextension.A multidisciplinary team was involved,and medical care was optimized.She underwent VYQ plus semitendinosus and sartorius transfer.After four postoperative follow-ups,her knees were regaining mobility,and she could walk for 2-3 steps without assistance.CONCLUSION This report highlights the importance of early intervention and recommends extensive studies of the management in similar cases.

High density dislocations enhance creep ageing response and mechanical properties in 2195 alloy sheet

The creep strain of conventionally treated 2195 alloy is very low,increasing the difficulty of manufacturing Al-Cu-Li alloy sheet parts by creep age forming.Therefore,finding a solution to improve the creep formability of Al-Cu-Li alloy is vital.A thorough comparison of the effects of cryo-deformation and ambient temperature large pre-deformation(LPD)on the creep ageing response in the 2195 alloy sheet at 160℃with different stresses has been made.The evolution of dislocations and precipitates during creep ageing of LPD alloys are revealed by X-ray diffraction and transmission electron microscopy.High-quality 2195 alloy sheet largely pre-deformed by 80%without edge-cracking is obtained by cryo-rolling at liquid nitrogen temperature,while severe edge-cracking occurs during room temperature rolling.The creep formability and strength of the 2195 alloy are both enhanced by introducing pre-existing dislocations with a density over 1.4×10^(15)m^(−2).At 160℃and 150 MPa,creep strain and creep-aged strength generally increases by 4−6 times and 30−50 MPa in the LPD sample,respectively,compared to conventional T3 alloy counterpart.The elongation of creep-aged LPD sample is low but remains relevant for application.The high-density dislocations,though existing in the form of dislocation tangles,promote the formation of refined T1 precipitates with a uniform dispersion.

Ionic Liquid-Enhanced Assembly of Nanomaterials for Highly Stable Flexible Transparent Electrodes

The controlled assembly of nanomaterials has demon-strated significant potential in advancing technological devices.However,achieving highly efficient and low-loss assembly technique for nanomate-rials,enabling the creation of hierarchical structures with distinctive func-tionalities,remains a formidable challenge.Here,we present a method for nanomaterial assembly enhanced by ionic liquids,which enables the fabrication of highly stable,flexible,and transparent electrodes featuring an organized layered structure.The utilization of hydrophobic and non-volatile ionic liquids facilitates the production of stable interfaces with water,effectively preventing the sedimentation of 1D/2D nanomaterials assembled at the interface.Furthermore,the interfacially assembled nanomaterial monolayer exhibits an alternate self-climbing behavior,enabling layer-by-layer transfer and the formation of a well-ordered MXene-wrapped silver nanowire network film.The resulting composite film not only demonstrates exceptional photoelectric performance with a sheet resistance of 9.4Ωsq^(-1) and 93%transmittance,but also showcases remarkable environmental stability and mechanical flexibility.Particularly noteworthy is its application in transparent electromagnetic interference shielding materials and triboelectric nanogenerator devices.This research introduces an innovative approach to manufacture and tailor functional devices based on ordered nanomaterials.

A drug-loaded flexible substrate improves the performance of conformal cortical electrodes

Cortical electrodes are a powerful tool for the stimulation and/or recording of electrical activity in the nervous system.However,the inevitable wound caused by surgical implantation of electrodes presents bacterial infection and inflammatory reaction risks associated with foreign body exposure.Moreover,inflammation of the wound area can dramatically worsen in response to bacterial infection.These consequences can not only lead to the failure of cortical electrode implantation but also threaten the lives of patients.Herein,we prepared a hydrogel made of bacterial cellulose(BC),a flexible substrate for cortical electrodes,and further loaded antibiotic tetracycline(TC)and the anti-inflammatory drug dexamethasone(DEX)onto it.The encapsulated drugs can be released from the BC hydrogel and effectively inhibit the growth of Gram-negative and Gram-positive bacteria.Next,therapeutic cortical electrodes were developed by integrating the drug-loaded BC hydrogel and nine-channel serpentine arrays;these were used to record electrocorticography(ECoG)signals in a rat model.Due to the controlled release of TC and DEX from the BC hydrogel substrate,therapeutic cortical electrodes can alleviate or prevent symptoms associated with the bacterial infection and inflammation of brain tissue.This approach facilitates the development of drug delivery electrodes for resolving complications caused by implantable electrodes.

Amorphous Iridium Oxide-Integrated Anode Electrodes with Ultrahigh Material Utilization for Hydrogen Production at Industrial Current Densities

Herein,ionomer-free amorphous iridium oxide(IrO_(x))thin electrodes are first developed as highly active anodes for proton exchange membrane electrolyzer cells(PEMECs)via low-cost,environmentally friendly,and easily scalable electrodeposition at room temperature.Combined with a Nafion 117 membrane,the IrO_(x)-integrated electrode with an ultralow loading of 0.075 mg cm^(-2)delivers a high cell efficiency of about 90%,achieving more than 96%catalyst savings and 42-fold higher catalyst utilization compared to commercial catalyst-coated membrane(2 mg cm^(-2)).Additionally,the IrO_(x)electrode demonstrates superior performance,higher catalyst utilization and significantly simplified fabrication with easy scalability compared with the most previously reported anodes.Notably,the remarkable performance could be mainly due to the amorphous phase property,sufficient Ir^(3+)content,and rich surface hydroxide groups in catalysts.Overall,due to the high activity,high cell efficiency,an economical,greatly simplified and easily scalable fabrication process,and ultrahigh material utilization,the IrO_(x)electrode shows great potential to be applied in industry and accelerates the commercialization of PEMECs and renewable energy evolution.

Dislocation of primary total hip arthroplasty:Analysis of risk factors and preventive options

Total hip arthroplasty(THA)is one of the most successful elective operations in orthopedic surgery for improving pain and functional disability in patients with end-stage joint disease.However,dislocation continues to be a troublesome complication after THA,as it is a leading cause of revision and is associated with substantial social,health,and economic costs.It is a relatively rare,usually early occurrence that depends on both the patients’characteristics and the surgical aspects.The most recent and important finding is the special attention to be given preoperatively to spinopelvic mobility,which is closely related to the incidence of dislocation.Consequently,clinical and radiographic assessment of the lumbar spine is mandatory to identify an altered pelvic tilt that could suggest a different positioning of the cup.Lumbar spinal fusion is currently considered a risk factor for dislocation and revision regardless of whether it is performed prior to or after THA.Surgical options for its treatment and prevention include the use of prostheses with large diameter of femoral head size,dual mobility constructs,constrained liners,and modular neck stems.

Recent progress of self-supported air electrodes for flexible Zn-air batteries

Smart wearable devices are regarded to be the next prevailing technology product after smartphones and smart homes,and thus there has recently been rapid development in flexible electronic energy storage devices.Among them,flexible solid-state zinc-air batteries have received widespread attention because of their high energy density,good safety,and stability.Efficient bifunctional oxygen electrocatalysts are the primary consideration in the development of flexible solid-state zinc-air batteries,and self-supported air cathodes are strong candidates because of their advantages including simplified fabrication process,reduced interfacial resistance,accelerated electron transfer,and good flexibility.This review outlines the research progress in the design and construction of nanoarray bifunctional oxygen electrocatalysts.Starting from the configuration and basic principles of zinc-air batteries and the strategies for the design of bifunctional oxygen electrocatalysts,a detailed discussion of self-supported air cathodes on carbon and metal substrates and their uses in flexible zinc-air batteries will follow.Finally,the challenges and opportunities in the development of flexible zinc-air batteries will be discussed.

A high Li-ion diffusion kinetics in multidimensional and compact-structured electrodes via vacuum filtration casting

Manufacturing process,diffusion co-efficient and areal capacity are the three main criteria for regulating thick electrodes for lithium-ion batteries(LIBs).However,simultaneously regulating these criteria for LIBs is desirable but remains a significant challenge.In this work,niobium pentoxide(Nb_(2)O_(5))anode and lithium iron phosphate(LiFePO_(4))cathode materials were chosen as the model materials and demonstrate that these three parameters can be simultaneously modulated by incorporation of micro-carbon fibers(MCF)and carbon nanotubes(CNT)with both Nb_(2)O_(5) and LFP via vacuum filtration approach.Both as-prepared MNC-20 anode and MLC-20 cathode achieves high reversible areal capacity of≈5.4 m A h cm^(-2)@0.1 C and outstanding Li-ion diffusion coefficients of≈10~(-8)cm~2 s~(-1)in the half-cell configuration.The assembled MNC-20‖MLC-20 full cell LIB delivers maximum energy and power densities of244.04 W h kg^(-1)and 108.86 W kg^(-1),respectively.The excellent electrochemical properties of the asprepared thick electrodes can be attributed to the highly conductive,mechanical compactness and multidimensional mutual effects of the MCF,CNT and active materials that facilitates rapid Li-ion diffusion kinetics.Furthermore,electrochemical impedance spectroscopy(EIS),symmetric cells analysis,and insitu Raman techniques clearly validates the enhanced Li-ion diffusion kinetics in the present architecture.

Elastodynamic behaviors of steady moving straight dislocation within thin nano film

The elastodynamic dislocation behaviors are of great interest for understanding the performances of structural alloys under intense dynamic loading conditions.The formation,propagations,and interactions of dislocations(such as injected dislocation,accelerating dislocation,steady moving dislocation at high constant speed)are quite different from static dislocations.For steady-moving dislocation within the isotropic infinite medium,the effects of surface and interface on steady-moving dislocations within limited space are still known.In this paper,we investigate the elastodynamic image stress simulation of steady moving dislocation within film of limited thickness at constant speed using Eigenstrain theory,Lorentz transformation,and steady dynamic equilibrium equations.We propose an efficient solution method that involves complex Fourier series,transforming partial differential equations into ordinary differential equations,and ultimately into a set of algebraic equations in spectral space.The effects of dislocation speed and position near the free surface on the image stress of steady-moving climbing and gliding dislocations within the thin film are examined.The results show that relativistic effects are significant for certain dislocation configurations and stress components,whereas other stress components are less sensitive to relativistic effects near the transonic speed region.

Elbow Dislocation in Children: About Two Cases and Review of the Literature

Background: Elbow dislocations in pediatric patients are rare injuries. This is a therapeutic emergency because a delay in treatment can have disastrous consequences on the functional level of the upper limb. Objective: To present the management of elbow dislocation in children in cases of limited resources. Presentation of the Cases: These were 2 older male children aged 7 and 9 years old, admitted to the emergency room for painful functional impotence of the right elbow after a fall and landing on the right hand. Clinical and radiological examinations were in favor of posterior elbow dislocations. The reductions were carried out under sedation and immobilization in Jersey. According to Robert’s criteria, the functional result was excellent in both patients. Conclusion: Emergency reduction and immobilization whatever the means ensure an excellent functional prognosis even in cases of limited resources.

Roughness characterization and shearing dislocation failure for rock-backfill interface

Shearing dislocation is a common failure type for rock–backfill interfaces because of backfill sedimentation and rock strata movement in backfill mining goaf.This paper designed a test method for rock–backfill shearing dislocation.Using digital image techno-logy and three-dimensional(3D)laser morphology scanning techniques,a set of 3D models with rough joint surfaces was established.Further,the mechanical behavior of rock–backfill shearing dislocation was investigated using a direct shear test.The effects of interface roughness on the shear–displacement curve and failure characteristics of rock–backfill specimens were considered.The 3D fractal dimen-sion,profile line joint roughness coefficient(JRC),profile line two-dimensional fractal dimension,and the surface curvature of the frac-tures were obtained.The correlation characterization of surface roughness was then analyzed,and the shear strength could be measured and calculated using JRC.The results showed the following:there were three failure threshold value points in rock–backfill shearing dis-location:30%–50%displacement before the peak,70%–90%displacement before the peak,and 100%displacement before the peak to post-peak,which could be a sign for rock–backfill shearing dislocation failure.The surface JRC could be used to judge the rock–backfill shearing dislocation failure,including post-peak sliding,uniform variations,and gradient change,corresponding to rock–backfill disloca-tion failure on the field site.The research reveals the damage mechanism for rock–backfill complexes based on the free joint surface,fills the gap of existing shearing theoretical systems for isomerism complexes,and provides a theoretical basis for the prevention and control of possible disasters in backfill mining.

Effects of interstitial cluster mobility on dislocation loops evolution under irradiation of austenitic steel

The evolution of dislocation loops in austenitic steels irradiated with Fe^(+)is investigated using cluster dynamics(CD)simulations by developing a CD model.The CD predictions are compared with experimental results in the literature.The number density and average diameter of the dislocation loops obtained from the CD simulations are in good agreement with the experimental data obtained from transmission electron microscopy(TEM)observations of Fe~+-irradiated Solution Annealed 304,Cold Worked 316,and HR3 austenitic steels in the literature.The CD simulation results demonstrate that the diffusion of in-cascade interstitial clusters plays a major role in the dislocation loop density and dislocation loop growth;in particular,for the HR3 austenitic steel,the CD model has verified the effect of temperature on the density and size of the dislocation loops.

Rare Case of Injury Association of Hip Dislocation and Femoral Controlateral Fracture

Introduction: Traumatic hip dislocation associated with femur fracture is a rare and complex injury that occurs in the context of multiple trauma. Public road accidents represent more than 64% of the circumstances (automobiles 46% and two-wheelers 18%). Objective: Report a rare case of injury association and the speed of treatment (less than 6 hours). Clinical case: 26-year-old patient, victim of a road traffic accident. Admitted to the emergency room one hour after the trauma in a context of severe pain and absolute functional impotence of both pelvic limbs. Clinical examination reveals closed trauma to both pelvic limbs, with deformation of the right thigh, a vicious attitude of the contralateral lower limb in adduction, shortening and medial rotation. Conclusion: This is a rare injury association, which benefited from treatment within less than 6 hours.

C1C2 Wiring and Posttraumatic Atlantoaxial Dislocation: An Effective and Cheap Surgical Procedure in a Developing Country

Objectives: Atlantoaxial dislocation remains a rare and serious condition with a high preoperative and postoperative morbidity and mortality. Its successful surgical management is still challenging and gratifying for neurosurgeons. Several technics have been described such as wiring, trans articular screwing, C1C2 screwing with plate and screw introduced by Goel et al., and modified by insertion of polyaxially screw and rod many years later by Harms. Unavailability and expensiveness of upper cervical spine instrumentation device led us to C1C2 Wiring resulting in a good outcome. Finally, a quadriplegic patient with a more comfortable financial condition had ordered devices from abroad and benefit for Goel and Harms screwing technique and improved dramatically from ASIA A to ASIA E. Material and methods: This is a retrospective study of patients managed in our department by a same neurosurgeon from January 2019 to April 2024. Results: We defined 6 men and 1 woman with an average age of 33 years. Unrestrained driver in a rollover motor vehicle accident was most common. Only one patient was neurologically intact on admission. Neurovegetative disorders were noticed in one patient. Dislocation was associated to a fracture of the dens in two patients. Three patients have been successfully operated with remarkable outcome, mostly from ASIA A to E. Conclusion: C1C2 dislocation is a serious condition and C1C2 Wiring represents an effective and cheaper technic. Therefore, this technic should deserve consideration above all in low incomes countries when screwing devices are not available. Seatbelt should be demanded for motor vehicle drivers and passengers.

Solute atom segregation to I1 stacking fault and its bounding partial dislocations in a Mg–Bi alloy

Stacking faults(SFs)and the interaction between solute atoms and SFs in a Mg–Bi alloy are investigated using aberration-corrected scanning transmission electron microscopy.It is found that abundant I_(1)SFs are generated after cold rolling and are mainly distributed inside{1012}twins.After aging treatment,the formation of single-layer and three-layer Bi atom segregation in the vicinity of I_(1)fault are clearly observed.Bi segregation also occurs at the 1/6<2203>bounding Frank partial dislocation cores.The segregation behaviors in I_(1)fault and Frank dislocations are discussed and rationalized using first-principles calculations.

Testicular dislocation:A rare complication of scrotal trauma

Scrotal trauma,though uncommon,can have severe consequences,and one such complication is testicular dislocation.This occurs when the testicle is displaced from its normal anatomical position within the scrotum due to a traumatic event.Understanding the mechanisms,diagnosis,and management of testicular dislocation is paramount in providing optimal care for affected individuals[1].Traumatic incidents,such as sports injuries,motor vehicle accidents,or direct blows to the scrotum,can result in testicular trauma[2].The condition demands immediate medical attention to prevent further complications,including vascular compromise and testicular ischemia.Diagnosing testicular dislocation involves a thorough physical examination and often necessitates imaging studies,such as ultrasound,to precisely determine the extent of the displacement and assess potential vascular compromise.Once diagnosed,prompt intervention is crucial to reposition the dislocated testicle and restore blood flow.Treatment options may include manual reduction or surgical intervention,depending on the severity of the dislocation and associated injuries[3].Close monitoring in the post-treatment period is essential to identify and manage any complications promptly.

Moiré superlattices arising from growth induced by screw dislocations in layered materials

Moiré superlattices(MSLs) are modulated structures produced from homogeneous or heterogeneous two-dimensional layers stacked with a twist angle and/or lattice mismatch. Enriching the methods for fabricating MSL and realizing the unique emergent properties are key challenges in its investigation. Here we recommend that the spiral dislocation driven growth is another optional method for the preparation of high quality MSL samples. The spiral structure stabilizes the constant out-of-plane lattice distance, causing the variations in electronic and optical properties. Taking SnS_(2) MSL as an example, we find prominent properties including large band gap reduction(~ 0.4 e V) and enhanced optical activity. Firstprinciples calculations reveal that these unusual properties can be ascribed to the locally enhanced interlayer interaction associated with the Moiré potential modulation. We believe that the spiral dislocation driven growth would be a powerful method to expand the MSL family and broaden their scope of application.

Comparison of Surgical Techniques Used in Treating Acromioclavicular Dislocation in Patients Participating in Sports: A Systematic Review

Introduction: The acromioclavicular joint is a superficial diarthrodial joint that surrounds the medial articular facet of the acromion and the distal portion of the clavicle. Due to its anatomy and biomechanics, it is highly susceptible to trauma and in young men who play contact sports, acromioclavicular dislocation is common. This article aimed to systematically review the literature and compare the surgical techniques used in the treatment of acromioclavicular dislocation in patients who practice sports. Methods: This systematic review was conducted according to the International Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Eligible studies for this systematic review included articles in English or Spanish published between 2013 and 2023, which mention the occurrence of acromioclavicular dislocation during sports practices. Additionally, only studies that addressed the surgical treatment of acromion-clavicular dislocation and contained original data on the topic were included. Results: We found 144 eligible studies after searching the LILACS and PubMed databases. Based on the inclusion and exclusion criteria and the reviewers’ consensus, we selected four studies for the systematic review. 133 patients with AC joint displacement were evaluated. Mean Age: approximately 31.90 years. 81.92 of these injuries occurred during sports practice. Surgical Procedures Used: titanium plates fixation (49 patients), arthroscopy (24), single tunnel technique (30) and coracoid sling technique (30). The results of the visual analog scale and Constant-Murley scores varied between the techniques used. Twenty-two complications after surgical treatment were identified. Conclusion: A significant variability of operative techniques can be used in the surgical approach of acromioclavicular dislocation, such as arthroscopy, single tunnel, coracoid sling and titanium plates. Although it presented excellent functional results compared to the other three techniques evaluated by this review, using titanium plates is not the gold standard since other techniques not assessed by this work may be more effective.

Quantification of grain boundary effects on the geometrically necessary dislocation density evolution and strain hardening of polycrystalline Mg-4Al using in situ tensile testing in scanning electron microscope and HR-EBSD

In situ tensile testing in a scanning electron microscope(SEM)in conjunction with high-resolution electron backscatter diffraction(HR-EBSD)under load was used to characterize the evolution of geometrically necessary dislocation(GND)densities at individual grain boundaries as a function of applied strain in a polycrystalline Mg-4Al alloy.The increase in GND density was investigated at plastic strains of 0%,0.6%,2.2%,3.3% from the area including 76 grains and correlated with(i)geometric compatibility between slip systems across grain boundaries,and(ii)plastic incompatibility.We develop expressions for the grain boundary GND density evolution as a function of plastic strain and plastic incompatibility,from which uniaxial tensile stress-strain response of polycrystalline Mg-4Al are computed and compared with experimental measurement.The findings in this study contribute to understanding the mechanisms governing the strain hardening response of single-phase polycrystalline alloys and more reliable prediction of mechanical behaviors in diverse microstructures.

Traumatic Neglected Antero-Medial Knee Dislocation: Case Report

Introduction: Neglected knee dislocation is an unusual injury, only a few cases have been reported in the literature. The circumstances of onset are generally an unnoticed knee dislocation in a polytrauma context or a delay in consultation after the initial trauma. Presentation of case: We report the case of a 48-year-old female patient who sustained a knee injury during a domestic accident. Initial treatment was traditional and was followed for 3 years. She then consulted hospital, where a neglected knee dislocation was identified and treated with femorotibial arthrodesis. Discussion and conclusion: The treatment options of neglected knee dislocation include open reduction and fixation, arthrodesis and total knee arthroplasty. That the choice depends on the old unreduced of dislocation.