Improvement of the fatigue life of welded tubular T-joints in offshore platforms due to weld toe grinding and TIG dressing is studied physically and experimentally. It is shown that the two methods of treatment can im...Improvement of the fatigue life of welded tubular T-joints in offshore platforms due to weld toe grinding and TIG dressing is studied physically and experimentally. It is shown that the two methods of treatment can improve the fatigue strength of welded tubular joints not only in the environment of air but even in the envirnment of seawater accordingly.展开更多
The electron beam local post-weld heat treatment (EBLPWHT) is a rather new method that provides the advantages of high precision, flexibility and efficiency, energy saving and higher productivity. This paper studies t...The electron beam local post-weld heat treatment (EBLPWHT) is a rather new method that provides the advantages of high precision, flexibility and efficiency, energy saving and higher productivity. This paper studies the effect of two post-weld heat treatment processes on the microstructure, mechanical properties and fracture toughness of an electron beam welded joints in 30CrMnSiNi2A steel. EBLPWHT, in a vacuum chamber, immediately after welding and a traditional furnace whole post-weld heat treatment (FWPWHT) were compared. The experimental results show that, after EBLPWHT treatment, the main microstructure of weld was changed from coarse acicular martensite into lath martensite, HAZ was changed from lath martensite, bainite into lower bainite, and base metal was changed from ferrite and pearlite into upper bainite and residual austenite. The microstructures of different zones of joints in FWPWHT condition were tempered sorbite. The properties of welded joints can be improved by the EBLPWHT in some extent, and especially largely for the fracture toughness of welded joints. However the value of fracture toughness of base metal is comparatively low, so appropriate heat treatment parameters should be explored in the future.展开更多
Background: Functional treatment of proximal femur fractures (PFF) is being discontinued with advances in surgery and anesthesia. Suspension traction is used as a waiting treatment before surgery when technical, mater...Background: Functional treatment of proximal femur fractures (PFF) is being discontinued with advances in surgery and anesthesia. Suspension traction is used as a waiting treatment before surgery when technical, material and financial conditions are not met. The surgical treatment of these fractures must ensure a stable reduction and fixation, to allow early support to the patient who will quickly regain his previous autonomy. Objective: To specify the indications for surgical treatment of proximal fractures in adult in order to evaluate the results in the context of Burkina Faso. Patients and Methods: We conducted a retrospective study including adult patients hospitalized and followed up for proximal femoral fracture (PFF) in the orthopedic-traumatology department of the Yalgado Ouedraogo University Hospital Center at Ouagadougou. Among 310 patients presenting with PFF in 5.5 years, (56 cases a year (10.4%)), we focused on those whose PFFs were treated by surgical methods and followed up. Patients treated with orthopedic (40.1%) or functional (6.8%) methods, patients with incomplete records and those having signed a discharge against medical advice were excluded. A total of 94 patients, with 95 PFFs treated by surgical methods, constituted our study population. Road traffic accidents (51.1%) and domestic accidents (48.9%) were the predominant etiologies. The functional criteria of Postel Merle d’Aubigné (PMA) were used for the evaluation of the results (Table 1). Results: A total of 65 men and 29 women (sex ratio 2.2), aged of average 56 years, were recorded. Trochanteric mass fractures were predominant with 63 cases (66.3%), including one case of bilateral fracture and one case of an open fracture;we also reported 32 femoral neck fractures (33.7%). Osteosynthesis was performed in 66 patients (70.2%) and hip arthroplasty in the remaining 28 patients (29.8%). Osteosynthesis with DHS plate screws was performed in 49 cases (73.1%) and Moore type cephalic arthroplasty in 18 cases (64.3%). Two patients (2.1%) died, one in shock state and the second by pulmonary embolism. The main complications were 3 superficial infections (3.16%), 10 painful coxitis (35.7%) and one pseudarthrosis (dismantling of the material). Despite these complications, functional outcomes were satisfactory in 88.7%, poor in 9.7% and fair in 1.6%. Conclusion: Surgical treatment of proximal femoral fractures allows early removal and rapid functional rehabilitation;which improves functional outcomes and increases the quality of life in elderly patients.展开更多
BACKGROUND As the perioperative risk of elderly patients with extremely unstable hip fractures(EUHFs)is relatively high and therapeutic effect is not satisfactory,new therapeutic strategies need to be proposed urgentl...BACKGROUND As the perioperative risk of elderly patients with extremely unstable hip fractures(EUHFs)is relatively high and therapeutic effect is not satisfactory,new therapeutic strategies need to be proposed urgently to improve the efficacy and clinical outcomes of such patients.AIM To determine the influence of two surgical treatment modalities on postoperative cognitive function(CF)and delirium in elderly patients with EUHFs.METHODS A total of 60 elderly patients consecutively diagnosed with EUHF between September 2020 and January 2022 in the Chongqing University Three Gorges Hospital were included.Of them,30 patients received conventional treatment(control group;general consultation+fracture type-guided internal fixation),and the other 30 received novel treatment(research group;perioperative multidisciplinary treatment diagnosis and treatment+individualized surgical plan+risk prediction).Information on hip function[Harris hip score(HHS)],perioperative risk of orthopedic surgery[Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity(POSSUM)],CF[Montreal cognitive assessment scale(MoCA)],postoperative delirium[mini-cognitive(Mini-Cog)],adverse events(AEs;internal fixation failure,infection,nonunion,malunion,and postoperative delirium),and clinical indicators[operation time(OT),postoperative hospital length of stay(HLOS),ambulation time,and intraoperative blood loss(IBL)]were collected from both groups for comparative analyses.RESULTS The HHS scores were similar between both groups.The POSSUM score at 6 mo after surgery was significantly lower in the research group compared with the control group,and MoCA and Mini-Cog scores were statistically higher.In addition,the overall postoperative complication rate was significantly lower in the research than in the control group,including reduced OT,postoperative HLOS,ambulation time,and IBL.CONCLUSION The new treatment modality has more clinical advantages over the conventional treatment,such as less IBL,faster functional recovery,more effectively optimized perioperative quality control,improved postoperative CF,mitigated postoperative delirium,and reduced operation-related AEs.展开更多
BACKGROUND Osteoporosis is a global disease affecting 6.6%of the total population.Osteoporosis complications include fractures,increased bone fragility,and reduced bone strength.The most commonly affected parts are th...BACKGROUND Osteoporosis is a global disease affecting 6.6%of the total population.Osteoporosis complications include fractures,increased bone fragility,and reduced bone strength.The most commonly affected parts are the vertebral body,hip,and wrist.AIM To examine the effect of alendronate sodium combined with InterTan for osteoporotic femoral intertrochanteric fractures on bone and fracture recurrence METHODS In total,126 cases of osteoporotic femoral intertrochanteric fractures were selected and divided into two groups according to the 1:1 principle by the simple random method.They were admitted to the Department of Orthopedics,First Affiliated Hospital of Xingtai Medical College,from January 2018 to September 2020.The control group was treated with InterTan fixation combined with placebo,and the observation group with alendronate sodium based on InterTan fixation.Operation-related indicators,complications,and recurrent fractures were compared between the groups.Changes in bone metabolism markers,t value for hip bone mineral density,and Harris Hip Score were observed.RESULTS Operation time,intraoperative blood loss,postoperative ambulation time,and complications were compared between the groups,and no significant difference was found.The fracture healing time was significantly shorter in the observation group than in the control group.β-Collagen-specific sequence(β-CTX)and total aminoterminal propeptide of type I procollagen(T-PINP)in the control group at 3 mo after operation were compared with those before operation,and the difference was not significant.Six months after the operation,theβ-CTX level decreased and T-PINP level increased.β-CTX level at 3 and 6 mo in the observation group after operation was lower,and TPINP level was higher,than that before operation.Compared with the control group,T-PINP level of the observation group was significantly higher andβ-CTX level was significantly lower at 3 and 6 mo after operation.The t value of hip bone mineral density was compared in the control group before and 1 mo after operation,and significant difference was not found.Compared with the control group,the t value of hip bone mineral density in the observation group was significantly higher at 1,3,6,and 12 mo after operation.Compared with the control group,the Harris score of the observation group was significantly higher at 1,3,6,and 12 mo after operation.The recurrence rate of fractures in the observation group within 12 mo was 0.00%,which was significantly lower than 6.35%in the control group.CONCLUSION Alendronate sodium combined with InterTan in the treatment of osteoporotic femoral intertrochanteric fractures can increase bone mineral density,improve hip joint function,promote fracture healing,and reduce fracture recurrence.展开更多
文摘Improvement of the fatigue life of welded tubular T-joints in offshore platforms due to weld toe grinding and TIG dressing is studied physically and experimentally. It is shown that the two methods of treatment can improve the fatigue strength of welded tubular joints not only in the environment of air but even in the envirnment of seawater accordingly.
文摘The electron beam local post-weld heat treatment (EBLPWHT) is a rather new method that provides the advantages of high precision, flexibility and efficiency, energy saving and higher productivity. This paper studies the effect of two post-weld heat treatment processes on the microstructure, mechanical properties and fracture toughness of an electron beam welded joints in 30CrMnSiNi2A steel. EBLPWHT, in a vacuum chamber, immediately after welding and a traditional furnace whole post-weld heat treatment (FWPWHT) were compared. The experimental results show that, after EBLPWHT treatment, the main microstructure of weld was changed from coarse acicular martensite into lath martensite, HAZ was changed from lath martensite, bainite into lower bainite, and base metal was changed from ferrite and pearlite into upper bainite and residual austenite. The microstructures of different zones of joints in FWPWHT condition were tempered sorbite. The properties of welded joints can be improved by the EBLPWHT in some extent, and especially largely for the fracture toughness of welded joints. However the value of fracture toughness of base metal is comparatively low, so appropriate heat treatment parameters should be explored in the future.
文摘Background: Functional treatment of proximal femur fractures (PFF) is being discontinued with advances in surgery and anesthesia. Suspension traction is used as a waiting treatment before surgery when technical, material and financial conditions are not met. The surgical treatment of these fractures must ensure a stable reduction and fixation, to allow early support to the patient who will quickly regain his previous autonomy. Objective: To specify the indications for surgical treatment of proximal fractures in adult in order to evaluate the results in the context of Burkina Faso. Patients and Methods: We conducted a retrospective study including adult patients hospitalized and followed up for proximal femoral fracture (PFF) in the orthopedic-traumatology department of the Yalgado Ouedraogo University Hospital Center at Ouagadougou. Among 310 patients presenting with PFF in 5.5 years, (56 cases a year (10.4%)), we focused on those whose PFFs were treated by surgical methods and followed up. Patients treated with orthopedic (40.1%) or functional (6.8%) methods, patients with incomplete records and those having signed a discharge against medical advice were excluded. A total of 94 patients, with 95 PFFs treated by surgical methods, constituted our study population. Road traffic accidents (51.1%) and domestic accidents (48.9%) were the predominant etiologies. The functional criteria of Postel Merle d’Aubigné (PMA) were used for the evaluation of the results (Table 1). Results: A total of 65 men and 29 women (sex ratio 2.2), aged of average 56 years, were recorded. Trochanteric mass fractures were predominant with 63 cases (66.3%), including one case of bilateral fracture and one case of an open fracture;we also reported 32 femoral neck fractures (33.7%). Osteosynthesis was performed in 66 patients (70.2%) and hip arthroplasty in the remaining 28 patients (29.8%). Osteosynthesis with DHS plate screws was performed in 49 cases (73.1%) and Moore type cephalic arthroplasty in 18 cases (64.3%). Two patients (2.1%) died, one in shock state and the second by pulmonary embolism. The main complications were 3 superficial infections (3.16%), 10 painful coxitis (35.7%) and one pseudarthrosis (dismantling of the material). Despite these complications, functional outcomes were satisfactory in 88.7%, poor in 9.7% and fair in 1.6%. Conclusion: Surgical treatment of proximal femoral fractures allows early removal and rapid functional rehabilitation;which improves functional outcomes and increases the quality of life in elderly patients.
基金Supported by the Chongqing Medical Scientific Research Project(Joint Project of Chongqing Health Commission and Science and Technology Bureau),No.2020FYYX211Medical Research Project of Wanzhou District(Joint Project of Health Commission and Science and Technology Bureau),No.wzstc-kw2020023.
文摘BACKGROUND As the perioperative risk of elderly patients with extremely unstable hip fractures(EUHFs)is relatively high and therapeutic effect is not satisfactory,new therapeutic strategies need to be proposed urgently to improve the efficacy and clinical outcomes of such patients.AIM To determine the influence of two surgical treatment modalities on postoperative cognitive function(CF)and delirium in elderly patients with EUHFs.METHODS A total of 60 elderly patients consecutively diagnosed with EUHF between September 2020 and January 2022 in the Chongqing University Three Gorges Hospital were included.Of them,30 patients received conventional treatment(control group;general consultation+fracture type-guided internal fixation),and the other 30 received novel treatment(research group;perioperative multidisciplinary treatment diagnosis and treatment+individualized surgical plan+risk prediction).Information on hip function[Harris hip score(HHS)],perioperative risk of orthopedic surgery[Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity(POSSUM)],CF[Montreal cognitive assessment scale(MoCA)],postoperative delirium[mini-cognitive(Mini-Cog)],adverse events(AEs;internal fixation failure,infection,nonunion,malunion,and postoperative delirium),and clinical indicators[operation time(OT),postoperative hospital length of stay(HLOS),ambulation time,and intraoperative blood loss(IBL)]were collected from both groups for comparative analyses.RESULTS The HHS scores were similar between both groups.The POSSUM score at 6 mo after surgery was significantly lower in the research group compared with the control group,and MoCA and Mini-Cog scores were statistically higher.In addition,the overall postoperative complication rate was significantly lower in the research than in the control group,including reduced OT,postoperative HLOS,ambulation time,and IBL.CONCLUSION The new treatment modality has more clinical advantages over the conventional treatment,such as less IBL,faster functional recovery,more effectively optimized perioperative quality control,improved postoperative CF,mitigated postoperative delirium,and reduced operation-related AEs.
基金Supported by Special Projects for Social Development Areas.
文摘BACKGROUND Osteoporosis is a global disease affecting 6.6%of the total population.Osteoporosis complications include fractures,increased bone fragility,and reduced bone strength.The most commonly affected parts are the vertebral body,hip,and wrist.AIM To examine the effect of alendronate sodium combined with InterTan for osteoporotic femoral intertrochanteric fractures on bone and fracture recurrence METHODS In total,126 cases of osteoporotic femoral intertrochanteric fractures were selected and divided into two groups according to the 1:1 principle by the simple random method.They were admitted to the Department of Orthopedics,First Affiliated Hospital of Xingtai Medical College,from January 2018 to September 2020.The control group was treated with InterTan fixation combined with placebo,and the observation group with alendronate sodium based on InterTan fixation.Operation-related indicators,complications,and recurrent fractures were compared between the groups.Changes in bone metabolism markers,t value for hip bone mineral density,and Harris Hip Score were observed.RESULTS Operation time,intraoperative blood loss,postoperative ambulation time,and complications were compared between the groups,and no significant difference was found.The fracture healing time was significantly shorter in the observation group than in the control group.β-Collagen-specific sequence(β-CTX)and total aminoterminal propeptide of type I procollagen(T-PINP)in the control group at 3 mo after operation were compared with those before operation,and the difference was not significant.Six months after the operation,theβ-CTX level decreased and T-PINP level increased.β-CTX level at 3 and 6 mo in the observation group after operation was lower,and TPINP level was higher,than that before operation.Compared with the control group,T-PINP level of the observation group was significantly higher andβ-CTX level was significantly lower at 3 and 6 mo after operation.The t value of hip bone mineral density was compared in the control group before and 1 mo after operation,and significant difference was not found.Compared with the control group,the t value of hip bone mineral density in the observation group was significantly higher at 1,3,6,and 12 mo after operation.Compared with the control group,the Harris score of the observation group was significantly higher at 1,3,6,and 12 mo after operation.The recurrence rate of fractures in the observation group within 12 mo was 0.00%,which was significantly lower than 6.35%in the control group.CONCLUSION Alendronate sodium combined with InterTan in the treatment of osteoporotic femoral intertrochanteric fractures can increase bone mineral density,improve hip joint function,promote fracture healing,and reduce fracture recurrence.
