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Visualization and characterization of experimental hydraulic fractures interacting with karst fracture-cavity distributions
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作者 Hanzhi Yang Xin Chang +4 位作者 Chunhe Yang Wuhao Guo Lei Wang Guokai Zhao Yintong Guo 《Journal of Rock Mechanics and Geotechnical Engineering》 SCIE CSCD 2024年第5期1667-1683,共17页
Karst fracture-cavity carbonate reservoirs,in which natural cavities are connected by natural fractures to form cavity clusters in many circumstances,have become significant fields of oil and gas exploration and explo... Karst fracture-cavity carbonate reservoirs,in which natural cavities are connected by natural fractures to form cavity clusters in many circumstances,have become significant fields of oil and gas exploration and exploitation.Proppant fracturing is considered as the best method for exploiting carbonate reservoirs;however,previous studies primarily focused on the effects of individual types of geological formations,such as natural fractures or cavities,on fracture propagation.In this study,true-triaxial physical simulation experiments were systematically performed under four types of stress difference conditions after the accurate prefabrication of four types of different fracture-cavity distributions in artificial samples.Subsequently,the interaction mechanism between the hydraulic fractures and fracture-cavity structures was systematically analyzed in combination with the stress distribution,cross-sectional morphology of the main propagation path,and three-dimensional visualization of the overall fracture network.It was found that the propagation of hydraulic fractures near the cavity was inhibited by the stress concentration surrounding the cavity.In contrast,a natural fracture with a smaller approach angle(0°and 30°)around the cavity can alleviate the stress concentration and significantly facilitate the connection with the cavity.In addition,the hydraulic fracture crossed the natural fracture at the 45°approach angle and bypassed the cavity under higher stress difference conditions.A new stimulation effectiveness evaluation index was established based on the stimulated reservoir area(SRA),tortuosity of the hydraulic fractures(T),and connectivity index(CI)of the cavities.These findings provide new insights into the fracturing design of carbonate reservoirs. 展开更多
关键词 Karst fracture-cavity reservoir fracturing experiment fracture propagation Cross-sectional morphology Stimulation effectiveness
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Epidemiologic investigation of pediatric distal humerus fractures: An American insurance claims database study
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作者 Kyle Jay Klahs Jake E Dertinger +4 位作者 Grant T Mello Kevin Thapa Alexis B Sandler E'Stephan J Jesus Garcia Nata Parnes 《World Journal of Orthopedics》 2024年第1期52-60,共9页
BACKGROUND Distal humerus elbow fractures are one of the most common traumatic fractures seen in pediatric patients and present as three main types:Supracondylar(SC),lateral condyle(LC),and medial epicondyle(ME)fractu... BACKGROUND Distal humerus elbow fractures are one of the most common traumatic fractures seen in pediatric patients and present as three main types:Supracondylar(SC),lateral condyle(LC),and medial epicondyle(ME)fractures.AIM To evaluate the epidemiology of pediatric distal humerus fractures(SC,LC,and ME)from an American insurance claims database.METHODS A retrospective review was performed on patients 17 years and younger with the ICD 9 and 10 codes for SC,LC and ME fractures based on the IBM Truven MarketScan®Commercial and IBM Truven MarketScan Medicare Supplemental databases.Patients from 2015 to 2020 were queried for treatments,patient age,sex,length of hospitalization,and comorbidities.RESULTS A total of 1133 SC,154 LC,and 124 ME fractures were identified.SC fractures had the highest percentage of operation at 83%,followed by LC(78%)and ME fractures(41%).Male patients were,on average,older than female patients for both SC and ME fractures.CONCLUSION In the insurance claims databases used,SC fractures were the most reported,followed by LC fractures,and finally ME fractures.Age was identified to be a factor for how a pediatric distal humerus fractures,with patients with SC and LC fractures being younger than those with ME fractures.The peak age per injury per sex was similar to reported historic central tendencies,despite reported trends for younger physiologic development. 展开更多
关键词 supracondylar humerus fracture Lateral condyle fracture Medial epicondyle fracture Pediatric elbow Truven Epidemiology
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Clinical Study of Tianji Robotic-Assisted Surgery for Upper Cervical Spine Fractures
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作者 Chengkua Huang Yuanjian Huang +6 位作者 Weikang Yang Qianhou Zhou Xianhai Zeng Junlei Tan Mei Zhang Guosheng Su Sheng Nong 《Natural Science》 2024年第9期150-161,共12页
Object: To compare the safety, clinical efficacy, and complication rate of “Tianji” robot-assisted surgery with traditional open surgery in the treatment of cervical vertebrae fracture. Methods: 60 patients with upp... Object: To compare the safety, clinical efficacy, and complication rate of “Tianji” robot-assisted surgery with traditional open surgery in the treatment of cervical vertebrae fracture. Methods: 60 patients with upper cervical vertebrae fracture admitted to Baise People’s Hospital between November 2018 and April 2024 were retrospectively analyzed. Among these patients, 29 underwent “Tianji” robot-assisted surgery (Robot group), and 31 underwent traditional C-arm fluoroscopy-assisted open surgery (Open group). Statistical analysis of the data was performed using SPSS 27.0 software to compare general data (gender, age, BMI), preoperative and postoperative visual analogue scale (VAS) scores, neck disability index (NDI), intraoperative blood loss, accuracy of screw placement on imaging, and the number of complications in both groups for comprehensive evaluation. A P value < 0.05 was deemed to have achieved statistical significance. Results: There was no significant difference in preoperative VAS scores between the two groups (Robot group: 8.34 ± 0.61;Open group: 8.26 ± 0.68, P = 0.317). There was also no significant difference in VAS scores at 1 week postoperatively (Robot group: 6.90 ± 0.31;Open group: 6.94 ± 0.36, P = 0.3237). Preoperative NDI scores showed no significant difference between the two groups (Robot group: 43.31 ± 2.67;Open group: 43.84 ± 2.67, P = 0.2227), and the difference in NDI scores at 1 week postoperatively was also not significant (Robot group: 35.69 ± 4.24;Open group: 37.35 ± 3.48, P = 0.0509). Intraoperative blood loss in the Robot group was significantly lower than in the Open group (246.21 ± 209 ml vs 380.65 ± 328.04 ml, P = 0.0308), with a statistically significant difference. The operation time was longer in the Robot group (3.75 ± 0.74 h) compared to the Open group (2.74 ± 0.86 h). In terms of screw placement accuracy, the Robot group had a higher accuracy rate for Class A screws compared to the Open group (102 screws vs 94 screws, P = 0.0487), and the accuracy rate for Class B screws was also higher in the Robot group (13 screws vs 29 screws, P = 0.0333), with both differences being statistically significant. There was no significant difference in the number of complications between the two groups (Robot group: 8 cases;Open group: 10 cases, P = 0.6931). Conclusion: Patients treated with “Tianji” robot-assisted surgery for upper cervical vertebrae fracture had lower intraoperative blood loss and higher screw placement accuracy compared to those undergoing traditional C-arm fluoroscopy-assisted open surgery, indicating that this robot-assisted surgery can effectively reduce intraoperative blood loss and improve screw placement accuracy. 展开更多
关键词 Tiangui Robot Assisted surgery Upper Cervical Spine fracture Clinical Study fracture Repair
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Management of Mandibular Fractures in Children in Ivory Coast: Experience of the Stomatology and Maxillofacial Surgery Department at the University Hospital of Cocody from 2000 to 2019
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作者 Bakary Ouattara Camille Assouan +8 位作者 Laurent Boka Koffi Konan René Kouakou Ake Lucien Jonathan Yapo Annick Zoglo-Bro Ahi Morel Mounin Chapo Affoué Linda Marie Pierre Koffi Kahder Morel Diarra Atse Kobo N’Guessan Konan Marc Koffi 《Open Journal of Stomatology》 2024年第7期341-349,共9页
Introduction: Mandibular fractures in children are becoming increasingly common. Treatment of these fractures is difficult due to their anatomical and physiological complexity. Therefore, there is a need for well-codi... Introduction: Mandibular fractures in children are becoming increasingly common. Treatment of these fractures is difficult due to their anatomical and physiological complexity. Therefore, there is a need for well-codified management. Our main aim was to develop a decision algorithm for the management of mandibular fractures in children based on our experience. Materials and Methods: This was a retrospective descriptive study carried out in the Department of Stomatology and Maxillofacial Surgery at the University Hospital of Cocody over a period of 20 years (2000-2019). Results: We enrolled 58 patients. The mean age of the patients was 9.35 ± 2.3 years with a sex ratio of 2.22. Traffic accidents were the main cause of mandibular fractures (60.35%). Condylar fractures were the most common (46.87%). Treatment was orthopedic in 45.76% of cases, mixed (orthopedic and surgical) in 24.14% and surgical in 5.17%. Patients were followed up weekly for 1 month, then monthly for 6 months and annually for 3 years, with panoramic radiographs of the maxilla starting at 21 days. We observed 2 cases of complications: temporomandibular ankylosis and gingival stomatitis. Conclusion: Mandibular fractures are common in children. Management is difficult due to anatomical and physiological peculiarities. The choice of treatment depends on several criteria. 展开更多
关键词 fractures MANDIBLE CHILDREN Treatment Ivory Coast
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Results of Open Surgical Treatment of Humeral Paddle Fractures about 63 Cases
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作者 Mansi Zied Chermiti Wajdi +4 位作者 Rbai Hedi Saadana Jacem Zaidi Bacem Sindi Sihem Gazzah Wael 《Open Journal of Orthopedics》 2024年第1期83-91,共9页
Fractures of the humeral paddle, common to young adults, are most often complex, linked to violence and an increase in road accidents. The objective of our work is to evaluate our functional results, in the medium ter... Fractures of the humeral paddle, common to young adults, are most often complex, linked to violence and an increase in road accidents. The objective of our work is to evaluate our functional results, in the medium term, correlated with a review of the literature. This is a retrospective study of 63 patients, carried out in the traumatology-orthopedics department 1 of the IBN EL JAZZAR hospital in KAIROUAN, over a period of 7 years from January 2015 to December 2021. The average age of patients was 39 years (17 - 68 years). Predominantly male. The etiologies are dominated by falls and accidents on public roads. Fractures are classified according to the Müller and Allgöwer classification where type C is found in 51% of cases. All our patients undergo an olecranon osteotomy in 71% of cases. Osteosynthesis using a Lecestre plate combined with screwing or plugging is used in 84% of cases. The evolution is marked by complications observed in eight patients (16%), including two cases of sepsis, four cases of elbow stiffness (8%), one case of joint callus and one case of pseudarthrosis. Our results are evaluated according to the Mayo Elbow Performance Score, they are excellent and good in 71% of cases, average in 18% of cases and poor in 11% of cases. Fractures of the humeral paddle are fractures with a satisfactory functional prognosis, requiring ad integrum anatomical restoration and solid osteosynthesis allowing early rehabilitation of the elbow. One case of joint callus and one case of pseudarthrosis. 展开更多
关键词 fracturE Humeral Paddle surgical Treatment
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Evaluation of Surgical Treatment of Distal Humeral Fractures in Adults
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作者 Abdoulaye Camara Karinka Kéita +7 位作者 Mamady Doukouré Abdoul Karim Baldé Léopold Lamah Fatoumata Camara Alpha Mamadou Felah Diallo Ibrahima Marie Camara Mamadou Madiou Diallo Mamadou Cellou Diallo 《Open Journal of Orthopedics》 2024年第7期287-294,共8页
Introduction: Fractures of the distal end of the humerus are becoming increasingly frequent in young subjects because of the increase in road traffic accidents, and in elderly subjects because of osteoporosis related ... Introduction: Fractures of the distal end of the humerus are becoming increasingly frequent in young subjects because of the increase in road traffic accidents, and in elderly subjects because of osteoporosis related to aging populations. Materials and Methods: It was a prospective, monocentric study from January 2018 to December 2020 involving 14 patients who received and were treated surgically for distal humeral fractures and followed up. Results: We collected 14 patients, including 11 men (78.57%) and 3 women (21.43%), with a sex ratio of 3.7. The mean age was 36.41 years. The circumstances of onset were dominated by road traffic accidents, with 12 cases (85.71%). The dominant side was right-handed, with 11 cases (78.57%). Standard elbow radiography revealed 8 cases of type A fractures (57.14%), 4 cases of type B and 2 cases of type C fractures of the AO. We performed Lecestre plate osteosynthesis in 12 patients and external fixator in 2 others, using the trans-olecranial and transtricipital approaches. Elbow stiffness was the most frequent complication, with 6 cases (42.86%). After six months’ follow-up, our results were excellent and good in 78.57% of cases (MEPS). Conclusion: Surgical treatment with posterior approaches enabled us to achieve restitution of the articular surfaces, solid restraint and early mobilization of the elbow with satisfactory functional results. 展开更多
关键词 fracturE Distal Humerus Lecestre Plate External Fixator Trans-Olecranial Transtricipital
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Functional Outcomes of Adult Tibia Shaft Fractures Treated with Solid Intramedullary Nails versus Hollow Nails: A Systematic Review
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作者 Kwadwo Aning Abu Bernard Hammond +5 位作者 Mohammed Issah Suglo Bukari Kizito Kakra Vormawor Ronald Awoonor-Williams David Anyitey-Kokor Paa Kwesi Baidoo Dominic Konadu-Yeboah 《Open Journal of Orthopedics》 2024年第3期149-172,共24页
Introduction: The management of fractures of the tibia shaft is an important aspect of orthopaedic care, and the selection of the surgical method for fixation can substantially impact patient outcomes. The current rev... Introduction: The management of fractures of the tibia shaft is an important aspect of orthopaedic care, and the selection of the surgical method for fixation can substantially impact patient outcomes. The current review aims to compare the outcomes of adult tibia fractures treated with solid nails to those treated with hollow nails. Methods: A search on Scopus, PubMed, and Cochrane Library, using three keywords (Outcome, Tibia shaft fractures, Nail) was conducted in April 2023. Results were compiled and two independent reviewers screened and selected eligible articles After removing duplicates, titles and abstracts were read to exclude ineligible studies. Full-text articles of the remaining papers were read to select eligible studies which were further critically appraised to ascertain their methodological quality. The data extracted from the selected papers were synthesized using a combination of pooling of results, tests of statistical difference (t-test and chi-square) and narrative synthesis methods. Results: A total of 2295 articles were obtained from the databases and citation searching. A total of 9 papers were identified as eligible and included in the review. Findings revealed that there is no statistical difference in the outcomes of tibia fractures treated with either solid or hollow nail groups such as duration of surgery (p = 0.541), rate of delayed and non-union (p = 0.342), and rate of surgical site infections (p = 0.395). Conclusion: Intramedullary nailing of tibia shaft fractures with either solid or hollow nails have similar functional outcomes. 展开更多
关键词 Tibia Shaft fractures Functional Outcome SIGN Nail Hollow Nail
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Subclavian vessels injury:An underestimated complication of clavicular fractures
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作者 Byron Chalidis Vasileios Davitis +1 位作者 Pericles Papadopoulos Charalampos Pitsilos 《World Journal of Critical Care Medicine》 2024年第4期35-43,共9页
Clavicle fractures are frequent orthopedic injuries,often resulting from direct trauma or a fall.Most clavicle fractures are treated conservatively without any complications or adverse effects.Concomitant injuries of ... Clavicle fractures are frequent orthopedic injuries,often resulting from direct trauma or a fall.Most clavicle fractures are treated conservatively without any complications or adverse effects.Concomitant injuries of the subclavian vein or artery are rarely encountered and most commonly associated with high-energy trauma or comminuted clavicle fractures.They are potentially life-threatening conditions leading to hemorrhage,hematoma,pseudoaneurysm or upper limb ischemia.However,the clinical presentation might be obscure and easily missed,particularly in closed and minimally displaced clavicular fractures,and timely diagnosis relies on early clinical suspicion.Currently,computed tomography angiography has largely replaced conventional angiography for the assessment of subclavian vessel patency,as it demonstrates high accuracy and temporal resolution,acute turnaround time,and capability of multiplanar reconstruction.Depending on the hemodynamic stability of the patient and the severity of the injury,subclavian vessel lesions can be treated conservatively with observation and serial evaluation or operatively.Interventional vascular techniques should be considered in patients with serious hemorrhage and limb ischemia,followed by stabilization of the displaced clavicle fracture.This review aims to provide a comprehensive overview of the incidence,clinical presentation,diagnostic approaches,and current management strategies of clavicle fractures associated with subclavian vessel injuries. 展开更多
关键词 CLAVICLE fracturE subclavian artery subclavian vein fracture non-union Postoperative complications
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Health economics for intra-capsular hip fractures undertaking fixation
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作者 Anatole Wiik Thomas Ashdown Ian Holloway 《World Journal of Orthopedics》 2024年第1期30-38,共9页
BACKGROUND Hip fracture is a common musculoskeletal injury in the elderly requiring surgery worldwide.The operative mainstay of intra-capsular hip fractures is arthroplasty with a smaller proportion for fixation.AIM T... BACKGROUND Hip fracture is a common musculoskeletal injury in the elderly requiring surgery worldwide.The operative mainstay of intra-capsular hip fractures is arthroplasty with a smaller proportion for fixation.AIM To determine the most beneficial method of fixation for patients with intracapsular hip fractures.METHODS A registered audit from 2012-2018 was conducted on all intra-capsular hip fractures treated with 2 commonly used fixation methods.Patient notes,electronic records and clinical codes for cost benefit were evaluated.A validated quality of life measure was collected at least 1 year after surgery.RESULTS A total of 83 patients were identified with intra-capsular fractures undergoing fixation during the retrospective period.There were 47 cannulated cancellous screw and 36 sliding hip screw fixations with the case mix comparable for age,gender,co-morbidities and fracture configuration.There was no significant difference in blood loss,tip apex distance,radiation exposure,length of stay,radiological union time,collapse,avascular necrosis or re-operation between fixation methods.Logistic regression analysis demonstrated displaced intracapsular hip fractures correlated significantly with an undesirable outcome conferring a relative odds ratio of 7.25.There were 9(19%)and 4(11%)patients respectively,who required re-operation.There was no significant difference in health resource group tariff and implant cost with comparable EQ-5D and visual CONCLUSION No significant advantage was identified with differing fixation type,but irrespective there were a high number of patients requiring re-operation.This was predicted by initial fracture displacement and patient age.Arthroplasty may need to be carefully considered for health economics and patient benefit. 展开更多
关键词 Hip fracture FIXATION Patient reported outcome measure COST
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PFNA2 versus 95 Degree Condylar Blade Plate in the Management of Unstable Trochanteric Fractures
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作者 Piyush Gadegone Wasudeo Gadegone +1 位作者 Vijayanand Lokhande Virender Kadian 《Open Journal of Orthopedics》 2024年第2期93-104,共12页
Purpose: The proximal femoral nail anti-rotation (PFNA) is known to have advantages in enhancing the anchorage ability of internal fixation in elderly unstable osteoporotic intertrochanteric fracture patients. However... Purpose: The proximal femoral nail anti-rotation (PFNA) is known to have advantages in enhancing the anchorage ability of internal fixation in elderly unstable osteoporotic intertrochanteric fracture patients. However whether it is superior to condylar blade fixation is not clear. This study aimed to determine which treatment has better clinical outcomes in older patients. Materials and Methods: A total of 86 patients over the age of 60 with unstable trochanteric fractures within the past 3 weeks, were included in this prospective study conducted from June 1, 2018, to May 31, 2021. All the intertrochanteric fractures were classified according to AO/OTA classification. Among them, 44 cases were treated with the Proximal Femoral Nail (PFNA2) with or without an augmentation screw, and 42 cases were treated with the Condylar Blade Plate. In addition, the operative time, intraoperative blood loss, intraoperative and postoperative blood transfusion, postoperative weight-bearing time, hospitalization time, Harris score of hip function, Kyle’s criteria and postoperative complications were compared between the two groups. Results: The mean duration of surgery for the PFN group was 66.8 minutes (on average), whereas for the condylar blade plate group, it was 99.30 minutes (on average). The PFNA2 group experienced less blood loss (average of 80 mL) compared to the condylar blade plate group (average of 120 mL). Union and partial weight-bearing occurred earlier in the PFNA2 group (14.1 weeks and 10.6 weeks, respectively) compared to the Condylar blade plate group (18.7 weeks and 15.8 weeks). In two patients from the PFNA2 group, screw backing out and varus collapse complications were encountered;however, these patients remained asymptomatic and did not require revision surgery. In two other patients, screw cut out and breakage of the nail at the helical screw hole leading to non-union of the proximal femur were observed during the nine-month follow-up, necessitating revision surgery with prosthetic replacement. Among the condylar blade plate group, three patients experienced complications, including blade breakage at the blade and plate junction. In two cases, the fracture united in varus, and in one case, the blade cut through, resulting in non-union of the femoral head, which required revision surgery. According to the Harris hip score and Kyle’s criteria, a good-excellent outcome was observed in 92.85% of cases in the PFNA2 group and 90.90% of cases in the condylar blade plate group. Conclusion: Both the Proximal Femoral Nail A2 and Condylar blade plate are effective implants for the treatment of unstable trochanteric fractures. The intramedullary implant promotes biological healing and allows for early ambulation with minimal complications. Similarly satisfactory restoration of anatomy and favorable radiological and functional results can be achieved with the biological fixation provided by the 95-degree condylar blade plate. However, the use of PFNA2 internal fixation technique has the advantage of less trauma in elderly patients than the 95-degree condylar blade plate. 展开更多
关键词 Proximal Femoral Nail Anti-Rotation Condylar Blade Plate Internal Fixation Unstable Intertrochanteric fracture OSTEOPOROTIC
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Value of negative pressure sealing drainage on wound healing of Gustilo IIIB and IIIC open fractures
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作者 Bo Fang Yong-Sheng Wang +2 位作者 Wei Li Kai Ying Gang Zong 《World Journal of Clinical Cases》 SCIE 2024年第20期4199-4205,共7页
BACKGROUND Gustilo III fractures have a high incidence and are difficult to treat.Patients often experience difficulty in wound healing.Negative pressure drainage technology can help shorten wound healing time and has... BACKGROUND Gustilo III fractures have a high incidence and are difficult to treat.Patients often experience difficulty in wound healing.Negative pressure drainage technology can help shorten wound healing time and has positive value in improving patient prognosis.AIM To explore the clinical value of the negative pressure sealing drainage technique in wound healing of Gustilo IIIB and IIIC open fractures.METHODS Eighty patients with Gustilo IIIB and IIIC open fractures with skin and soft tissue injuries who were treated in the Second People’s Hospital of Dalian from March 2019 to December 2021 were selected as the research subjects.They were divided into a study group(n=40,healed with negative pressure closed drainage)and a control group(n=40,healed with conventional dressing changes)according to the variation in the healing they received.The efficacy of the clinical interventions,the variations in the regression indicators(time to wound healing,time to fracture healing,time to hospitalization),and the conversion and healing of bacterial wounds were compared 1-3 mo after the intervention.RESULTS The total effective rate of patients among the study group was 95.00%(38/40),which was notably higher than 75.00%(30/40)among the control group(P<0.05).The wound healing time,fracture healing time,and hospital stay of the patients in the study group was shorter than the control group(P<0.05).After the intervention,the negative bacterial culture at the wound site rate and wound healing rate of the patients among the study group increased compared to the control group(P<0.05).CONCLUSION Negative pressure sealing and drainage technology has a good therapeutic effect on patients with Gustilo IIIB and IIIC open fracture wounds with skin and soft tissue injury.It can notably enhance the wound healing rate and the negative rate of bacteria on the wound surface and help to speed up the recovery process of patients. 展开更多
关键词 Negative pressure closed drainage Gustilo type III open fracture Wound healing Clinical outcome Research value
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Outcomes of early versus late irrigation and debridement of pediatric open long bone fractures
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作者 Riya Savla Yen-Hong Kuo Nasim Ahmed 《World Journal of Orthopedics》 2024年第6期539-546,共8页
BACKGROUND Open long bone fractures are a major concern for pediatric patients due to the risk of surgical site infection(SSI).Early studies have recommended irrigation and debridement of open fractures within 6 hours... BACKGROUND Open long bone fractures are a major concern for pediatric patients due to the risk of surgical site infection(SSI).Early studies have recommended irrigation and debridement of open fractures within 6 hours-8 hours for the prevention of SSI.According to the American College of Surgeons(ACS)Best Practice Guidelines,in 2015,irrigation and debridement should be done within 24 hours.AIM To identify whether early irrigation and debridement,within 8 hours,vs late,between 8 hours and 24 hours,for pediatric open long bone fractures impacts rate of SSI.METHODS Using retrospective data review from the National Trauma Data Bank,Trauma Quality Improvement Project(TQIP)of 2019.TQIP database is own by the ACS and it is the largest database for trauma quality program in the world.Propensity matching analysis was performed for the study.RESULTS There were 390 pediatric patients with open long bone fractures who were incl-uded in the study.After completing propensity score matching,we had 176 patients in each category,irrigation and debridement within 8 hours and irrigation and debridement between 8 hours and 24 hours.We found no significant differences between each group for the rate of deep SSI which was 0.6%for patients who received surgical irrigation and debridement within 8 hours and 1.1%for those who received it after 8 hours[adjusted odd ratio(AOR):0.5,95%CI:0.268-30.909,P>0.99].For the secondary outcomes studied,in terms of length of hospital stay,patients who received irrigation and debridement within 8 hours stayed for an average of 3.5 days,and those who received it after 8 hours stayed for an average of 3 days,with no significant difference found,and there were also no sig-nificant differences found between the discharge dispositions of the patients.CONCLUSION Our findings support the recommendation for managing open long bone fractures from the ACS:Complete surgical irrigation and debridement within 24 hours. 展开更多
关键词 Pediatric trauma Open tibia fracture Irrigation and debridement Timing of intervention surgical site infection
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Application of Grooved Negative Pressure Drainage Tube in Surgical Stabilization of Rib Fractures
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作者 Shi Xu Shanshan Xu Fuman Cai 《Journal of Clinical and Nursing Research》 2024年第9期208-216,共9页
Objective: To explore the application value of disposable grooved negative pressure drainage tubes in rib fracture incision and internal fixation. Methods: Seventy-five patients admitted to our Department of Trauma Su... Objective: To explore the application value of disposable grooved negative pressure drainage tubes in rib fracture incision and internal fixation. Methods: Seventy-five patients admitted to our Department of Trauma Surgery from June 2022 to April 2024 who underwent rib fracture osteotomy and internal fixation were selected. According to the types of drainage tubes left in the patients after the operation, they were divided into the observation group (35 cases who were left with disposable grooved negative pressure drainage tubes) and the control group (40 cases who were left with closed silicone thoracic drainage tubes). Comparison of chest drainage, pain, postoperative complications, secondary chest penetration rate, drain placement time, hospitalization time, and treatment costs were compared between the two groups. Results: The total postoperative chest drainage volume of the observation group was less than that of the control group (P < 0.05);the degree of pain, the incidence of postoperative complications, and the rate of secondary chest puncture in the observation group were lower than that of the control group three days after the operation (P < 0.05);and the time of drain placement in the observation group was shorter than that of the control group (P < 0.05). Conclusion: The application of disposable grooved negative pressure drainage tubes in rib fracture incision and internal fixation can significantly improve patients’ postoperative pain and discomfort, reduce complications, lower the rate of secondary chest penetration, promote patients’ postoperative recovery, decrease the amount of postoperative chest drainage, and shorten the time of drain placement, which is worthy of clinical promotion and application. 展开更多
关键词 Grooved drainage tube Postoperative drainage Rib fracture Internal fixation
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Production induced fracture closure of deep shale gas well under thermo-hydro-mechanical conditions 被引量:1
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作者 Shi-Ming Wei Yang Xia +4 位作者 Yan Jin Xu-Yang Guo Jing-Yu Zi Kai-Xuan Qiu Si-Yuan Chen 《Petroleum Science》 SCIE EI CAS CSCD 2024年第3期1796-1813,共18页
Deep shale gas reservoirs have geological characteristics of high temperature,high pressure,high stress,and inferior ability to pass through fluids.The multi-stage fractured horizontal well is the key to exploiting th... Deep shale gas reservoirs have geological characteristics of high temperature,high pressure,high stress,and inferior ability to pass through fluids.The multi-stage fractured horizontal well is the key to exploiting the deep shale gas reservoir.However,during the production process,the effectiveness of the hydraulic fracture network decreases with the closure of fractures,which accelerates the decline of shale gas production.In this paper,we addressed the problems of unclear fracture closure mechanisms and low accuracy of shale gas production prediction during deep shale gas production.Then we established the fluid—solid—heat coupled model coupling the deformation and fluid flow among the fracture surface,proppant and the shale matrix.When the fluid—solid—heat coupled model was applied to the fracture network,it was well solved by our numerical method named discontinuous discrete fracture method.Compared with the conventional discrete fracture method,the discontinuous discrete fracture method can describe the three-dimensional morphology of the fracture while considering the effect of the change of fracture surface permeation coefficient on the coupled fracture—matrix flow and describing the displacement discontinuity across the fracture.Numerical simulations revealed that the degree of fracture closure increases as the production time proceeds,and the degree of closure of the secondary fractures is higher than that of the primary fractures.Shale creep and proppant embedment both increase the degree of fracture closure.The reduction in fracture surface permeability due to proppant embedment reduces the rate of fluid transfer between matrix and fracture,which has often been overlooked in the past.However,it significantly impacts shale gas production,with calculations showing a 24.7%cumulative three-year yield reduction.This study is helpful to understand the mechanism of hydraulic fracture closure.Therefore,it provides the theoretical guidance for maintaining the long-term effectiveness of hydraulic fractures. 展开更多
关键词 Shalegas fracture closure Fluid-solid-heat coupling Discontinuous discrete fracture
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Numerical modeling of fracture propagation of supercritical CO_(2)compound fracturing 被引量:1
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作者 Hao Chen Yong Kang +2 位作者 Wanchun Jin Changhai Li Can Cai 《Journal of Rock Mechanics and Geotechnical Engineering》 SCIE CSCD 2024年第7期2607-2628,共22页
The exploitation of shale gas is promising due to depletion of the conventional energy and intensification of the greenhouse effect.In this paper,we proposed a heat-fluid-solid coupling damage model of supercritical C... The exploitation of shale gas is promising due to depletion of the conventional energy and intensification of the greenhouse effect.In this paper,we proposed a heat-fluid-solid coupling damage model of supercritical CO_(2)(SC-CO_(2))compound fracturing which is expected to be an efficient and environmentally friendly way to develop shale gas.The coupling model is solved by the finite element method,and the results are in good agreement with the analytical solutions and fracturing experiments.Based on this model,the fracture propagation characteristics at the two stages of compound fracturing are studied and the influence of pressurization rate,in situ stress,bedding angle,and other factors are considered.The results show that at the SC-CO_(2)fracturing stage,a lower pressurization rate is conducive to formation of the branches around main fractures,while a higher pressurization rate inhibits formation of the branches around main fractures and promotes formation of the main fractures.Both bedding and in situ stress play a dominant role in the fracture propagation.When the in situ stress ratio(δ_(x)/δ_(y))is 1,the presence of bedding can reduce the initiation pressure and failure pressure.Nevertheless,it will cause the fracture to propagate along the bedding direction,reducing the fracture complexity.In rocks without bedding,hydraulic fracturing has the lengthening and widening effects for SC-CO_(2)induced fracture.In shale,fractures induced at the hydraulic fracturing stage are more likely to be dominated by in situ stresses and have a shorter reorientation radius.Therefore,fracture branches propagating along the maximum principal stress direction may be generated around the main fractures induced by SC-CO_(2)at the hydraulic fracturing stage.When the branches converge with the main fractures,fracture zones are easily formed,and thus the fracture complexity and damage area can be significantly increased.The results are instructive for the design and application of SC-CO_(2)compound fracturing. 展开更多
关键词 Compound fracturing fracture propagation Finite element method Damage evolution
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Effect of fracture fluid flowback on shale microfractures using CT scanning 被引量:2
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作者 Jiale He Zhihong Zhao +6 位作者 Yiran Geng Yuping Chen Jianchun Guo Cong Lu Shouyi Wang Xueliang Han Jun Zhang 《Journal of Rock Mechanics and Geotechnical Engineering》 SCIE CSCD 2024年第2期426-436,共11页
The field data of shale fracturing demonstrate that the flowback performance of fracturing fluid is different from that of conventional reservoirs,where the flowback rate of shale fracturing fluid is lower than that o... The field data of shale fracturing demonstrate that the flowback performance of fracturing fluid is different from that of conventional reservoirs,where the flowback rate of shale fracturing fluid is lower than that of conventional reservoirs.At the early stage of flowback,there is no single-phase flow of the liquid phase in shale,but rather a gas-water two-phase flow,such that the single-phase flow model for tight oil and gas reservoirs is not applicable.In this study,pores and microfractures are extracted based on the experimental results of computed tomography(CT)scanning,and a spatial model of microfractures is established.Then,the influence of rough microfracture surfaces on the flow is corrected using the modified cubic law,which was modified by introducing the average deviation of the microfracture height as a roughness factor to consider the influence of microfracture surface roughness.The flow in the fracture network is simulated using the modified cubic law and the lattice Boltzmann method(LBM).The results obtained demonstrate that most of the fracturing fluid is retained in the shale microfractures,which explains the low fracturing fluid flowback rate in shale hydraulic fracturing. 展开更多
关键词 SHALE Flowback of fracturing fluid MICROfracturE Lattice Boltzmann method(LBM)
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Complication rates after direct anterior vs posterior approach for hip hemiarthroplasty in elderly individuals with femoral neck fractures 被引量:3
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作者 Tatiana Charles Nicolas Bloemers +1 位作者 Bilal Kapanci Marc Jayankura 《World Journal of Orthopedics》 2024年第1期22-29,共8页
BACKGROUND Dislocation rates after hemiarthroplasty reportedly vary from 1%to 17%.This serious complication is associated with increased morbidity and mortality rates.Approaches to this surgery are still debated,with ... BACKGROUND Dislocation rates after hemiarthroplasty reportedly vary from 1%to 17%.This serious complication is associated with increased morbidity and mortality rates.Approaches to this surgery are still debated,with no consensus regarding the superiority of any single approach.AIM To compare early postoperative complications after implementing the direct anterior and posterior approaches(PL)for hip hemiarthroplasty after femoral neck fractures.METHODS This is a comparative,retrospective,single-center cohort study conducted at a university hospital.Between March 2008 and December 2018,273 patients(a total of 280 hips)underwent bipolar hemiarthroplasties(n=280)for displaced femoral neck fractures using either the PL(n=171)or the minimally invasive direct anterior approach(DAA)(n=109).The choice of approach was related to the surgeons’practices;the implant types were similar and unrelated to the approach.Dislocation rates and other complications were reviewed after a minimum followup of 6 mo.RESULTS Both treatment groups had similarly aged patients(mean age:82 years),sex ratios,patient body mass indexes,and patient comorbidities.Surgical data(surgery delay time,operative time,and blood loss volume)did not differ significantly between the groups.The 30 d mortality rate was higher in the PL group(9.9%)than in the DAA group(3.7%),but the difference was not statistically significant(P=0.052).Among the one-month survivors,a significantly higher rate of dislocation was observed in the PL group(14/154;9.1%)than in the DAA group(0/105;0%)(P=0.002).Of the 14 patients with dislocation,8 underwent revision surgery for recurrent instability(posterior group),and one of them had 2 additional procedures due to a deep infection.The rate of other complications(e.g.,perioperative and early postoperative periprosthetic fractures and infection-related complications)did not differ significantly between the groups.CONCLUSION These findings suggest that the DAA to bipolar hemiarthroplasty for patients with femoral neck fractures is associated with a lower dislocation rate(<1%)than the PL. 展开更多
关键词 HEMIARTHROPLASTY Femoral neck fracture Direct anterior approach Posterior approach DISLOCATION MORTALITY
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Evaluating the stability and volumetric flowback rate of proppant packs in hydraulic fractures using the lattice Boltzmann-discrete element coupling method 被引量:1
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作者 Duo Wang Sanbai Li +2 位作者 Rui Wang Binhui Li Zhejun Pan 《Journal of Rock Mechanics and Geotechnical Engineering》 SCIE CSCD 2024年第6期2052-2063,共12页
The stability and mobility of proppant packs in hydraulic fractures during hydrocarbon production are numerically investigated by the lattice Boltzmann-discrete element coupling method(LB-DEM).This study starts with a... The stability and mobility of proppant packs in hydraulic fractures during hydrocarbon production are numerically investigated by the lattice Boltzmann-discrete element coupling method(LB-DEM).This study starts with a preliminary proppant settling test,from which a solid volume fraction of 0.575 is calibrated for the proppant pack in the fracture.In the established workflow to investigate proppant flowback,a displacement is applied to the fracture surfaces to compact the generated proppant pack as well as further mimicking proppant embedment under closure stress.When a pressure gradient is applied to drive the fluid-particle flow,a critical aperture-to-diameter ratio of 4 is observed,above which the proppant pack would collapse.The results also show that the volumetric proppant flowback rate increases quadratically with the fracture aperture,while a linear variation between the particle flux and the pressure gradient is exhibited for a fixed fracture aperture.The research outcome contributes towards an improved understanding of proppant flowback in hydraulic fractures,which also supports an optimised proppant size selection for hydraulic fracturing operations. 展开更多
关键词 Numerical simulation Hydraulic fracturing Proppant flowback Closure stress Particulate flow
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A coupled thermo-mechanical peridynamic model for fracture behavior of granite subjected to heating and water-cooling processes 被引量:1
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作者 Luming Zhou Zhende Zhu 《Journal of Rock Mechanics and Geotechnical Engineering》 SCIE CSCD 2024年第6期2006-2018,共13页
Thermal damage and thermal fracture of rocks are two important indicators in geothermal mining projects.This paper investigates the effects of heating and water-cooling on granite specimens at various temperatures.The... Thermal damage and thermal fracture of rocks are two important indicators in geothermal mining projects.This paper investigates the effects of heating and water-cooling on granite specimens at various temperatures.The laboratory uniaxial compression experiments were also conducted.Then,a coupled thermo-mechanical ordinary state-based peridynamic(OSB-PD)model and corresponding numerical scheme were developed to simulate the damage of rocks after the heating and cooling processes,and the change of crack evolution process was predicted.The results demonstrate that elevated heating temperatures exacerbate the thermal damage to the specimens,resulting in a decrease in peak strength and an increase in ductility of granite.The escalating occurrence of thermal-induced cracks significantly affects the crack evolution process during the loading phase.The numerical results accurately reproduce the damage and fracture characteristics of the granite under different final heating temperatures(FHTs),which are consistent with the test results in terms of strength,crack evolution process,and failure mode. 展开更多
关键词 Peridynamics(PD) GRANITE Heating and cooling Damage and fracture Uniaxial compression
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Discontinuity development patterns and the challenges for 3D discrete fracture network modeling on complicated exposed rock surfaces 被引量:1
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作者 Wen Zhang Ming Wei +8 位作者 Ying Zhang Tengyue Li Qing Wang Chen Cao Chun Zhu Zhengwei Li Zhenbang Nie Shuonan Wang Han Yin 《Journal of Rock Mechanics and Geotechnical Engineering》 SCIE CSCD 2024年第6期2154-2171,共18页
Natural slopes usually display complicated exposed rock surfaces that are characterized by complex and substantial terrain undulation and ubiquitous undesirable phenomena such as vegetation cover and rockfalls.This st... Natural slopes usually display complicated exposed rock surfaces that are characterized by complex and substantial terrain undulation and ubiquitous undesirable phenomena such as vegetation cover and rockfalls.This study presents a systematic outcrop research of fracture pattern variations in a complicated rock slope,and the qualitative and quantitative study of the complex phenomena impact on threedimensional(3D)discrete fracture network(DFN)modeling.As the studies of the outcrop fracture pattern have been so far focused on local variations,thus,we put forward a statistical analysis of global variations.The entire outcrop is partitioned into several subzones,and the subzone-scale variability of fracture geometric properties is analyzed(including the orientation,the density,and the trace length).The results reveal significant variations in fracture characteristics(such as the concentrative degree,the average orientation,the density,and the trace length)among different subzones.Moreover,the density of fracture sets,which is approximately parallel to the slope surface,exhibits a notably higher value compared to other fracture sets across all subzones.To improve the accuracy of the DFN modeling,the effects of three common phenomena resulting from vegetation and rockfalls are qualitatively analyzed and the corresponding quantitative data processing solutions are proposed.Subsequently,the 3D fracture geometric parameters are determined for different areas of the high-steep rock slope in terms of the subzone dimensions.The results show significant variations in the same set of 3D fracture parameters across different regions with density differing by up to tenfold and mean trace length exhibiting differences of 3e4 times.The study results present precise geological structural information,improve modeling accuracy,and provide practical solutions for addressing complex outcrop issues. 展开更多
关键词 Complicated exposed rock surfaces Discontinuity characteristic variation Three-dimensional discrete fracture network modeling Outcrop study Vegetation cover and rockfalls
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