Although open leg fractures are very common in orthopedics and traumatology, bilateral open leg fractures are extremely rare and are usually associated with an increased risk of complications. We report a case of a si...Although open leg fractures are very common in orthopedics and traumatology, bilateral open leg fractures are extremely rare and are usually associated with an increased risk of complications. We report a case of a simultaneous, asymmetrical, comminuted and bilateral open fracture of the tibia and fibula by a firearm that occurred during an escape attempt in a 29-year-old prisoner. The pre-operative radiological assessment found an open fracture of both legs of the ballistic type;multiple traumatic gunshot wounds with a narrow entry hole and a wide exit hole. Early surgical intervention of intravenous antibiotics, tetanus prophylaxis and open fracture irrigation and debridement was performed within the 6 hour rule. The treatment consisted of a posterior splint followed by trimming andosteosynthesis using a FESSA external fixator from the military health service. A second operation was not needed. Evolution was favorable with ambulation starting from the 45th day. Simultaneous and bilateral tibia-fibula fractures by a firearm are exceptional, therefore, the treatment was surgical with the pre-operative and post-operative protocols well managed.展开更多
A simultaneous experimental and numerical study of shear fracture of concrete-like materials is carried out using Brazilian disc specimens with initial double edge cracks and fourpoint bending beam specimens with doub...A simultaneous experimental and numerical study of shear fracture of concrete-like materials is carried out using Brazilian disc specimens with initial double edge cracks and fourpoint bending beam specimens with double edge-notches.The interference effects of two cracks/notches are investigated through varied ligament angles and crack lengths.It is shown that shear fracturing paths change remarkably with the initial ligament angles and crack lengths.The cracked specimens are numerically simulated by an indirect boundary element method.A comparison between the numerical results and the experimental ones shows good agreement.展开更多
文摘Although open leg fractures are very common in orthopedics and traumatology, bilateral open leg fractures are extremely rare and are usually associated with an increased risk of complications. We report a case of a simultaneous, asymmetrical, comminuted and bilateral open fracture of the tibia and fibula by a firearm that occurred during an escape attempt in a 29-year-old prisoner. The pre-operative radiological assessment found an open fracture of both legs of the ballistic type;multiple traumatic gunshot wounds with a narrow entry hole and a wide exit hole. Early surgical intervention of intravenous antibiotics, tetanus prophylaxis and open fracture irrigation and debridement was performed within the 6 hour rule. The treatment consisted of a posterior splint followed by trimming andosteosynthesis using a FESSA external fixator from the military health service. A second operation was not needed. Evolution was favorable with ambulation starting from the 45th day. Simultaneous and bilateral tibia-fibula fractures by a firearm are exceptional, therefore, the treatment was surgical with the pre-operative and post-operative protocols well managed.
基金Project supported by Iran's National Elites Foundation(INEF)Partial supports of center of excellent for structures and earthquake engineering at Sharif University of technology
文摘A simultaneous experimental and numerical study of shear fracture of concrete-like materials is carried out using Brazilian disc specimens with initial double edge cracks and fourpoint bending beam specimens with double edge-notches.The interference effects of two cracks/notches are investigated through varied ligament angles and crack lengths.It is shown that shear fracturing paths change remarkably with the initial ligament angles and crack lengths.The cracked specimens are numerically simulated by an indirect boundary element method.A comparison between the numerical results and the experimental ones shows good agreement.
