Fractura avulsión del troquin humeral : a propósito de un caso

La fractura-avulsión aislada del troquín humeral sin luxación escápulo-humeral, es una entidad rara, descrita muy pocas veces en la literatura internacional. Su mecanismo de producción es similar al de otras lesiones por avulsión: contracción violenta de un músculo sobre una relativamente pequeña apófisis de inserción; en este caso, el músculo subescapular a nivel del troquín. La combinación de abducción más rotación externa del húmero con una contractura súbita y violenta del músculo subescapular, podría provocar un arrancamiento del troquín con mayor o menor grado de desplazamiento. Aunque el tratamiento ortopédico mediante simple inmovilización puede indicarse en algunos casos, la reparación quirúrgica precoz, con osteosíntesis del fragmento óseo, o resección del fragmento óseo, permite obtener un excelente resultado. En este caso, el tratamiento se realizó mediante fijación con un único tornillo maleolar.Isolated avulsion fracture of the lesser tuberosity of the humerus, in absence of dislocation, is a extremely rare entity, with very few references in the international literature. This injury is produced by a similar mechanism to other avulsion injuries; violent muscular contraction upon small insertion apophysis; in this case, the subescapularis muscle on the lesser tuberosity of the humerus. This abdution and external rotation of the humerus combined with sudden and violent contracture of the subescapularis muscle can produce avulsion of the lesser tuberosity with more o less displacement. Although, some cases can be treated conservatively, surgical treatment by internal fixation or bone fragment excision provides excellent results. This case was treated by fixation with a single malleolar screw

Climate and atmospheric history of the past 420,000 years from the Vostok ice core,

Antarctica has allowed the extension of the ice record of atmospheric composition and climate to the past four glacial-interglacial cycles. The succession of changes through each climate cycle and termination was similar, and atmospheric and climate properties oscillated between stable bounds. Interglacial periods differed in temporal evolution and duration. Atmospheric concentrations of carbon dioxide and methane correlate well with Antarctic air-temperature throughout the record. Present-day atmospheric burdens of these two important greenhouse gases seem to have been unprecedented during the past 420,000 years. The late Quaternary period (the past one million years) is punctuated by a series of large glacial-interglacial changes with cycles that last about 100,000 years (ref. 1). Glacial-interglacial climate changes are documented by complementary climate records 1,2 largely derived from deep sea sediments, continental deposits of flora, fauna and loess, and ice cores. These studies have documented the wide range of climate variability on Earth. They have shown that much of the variability occurs with periodicities corresponding to that of the precession, obliquity and eccentricity of the Earth's orbit 1,3 . But understanding how the climate system responds to this initial orbital forcing is still an important issue in palaeoclimatology, in particular for the generally strong ϳ100,000-year (100-kyr) cycle. Ice cores give access to palaeoclimate series that includes local temperature and precipitation rate, moisture source conditions, wind strength and aerosol fluxes of marine, volcanic, terrestrial, cosmogenic and anthropogenic origin. They are also unique with their entrapped air inclusions in providing direct records of past changes in atmospheric trace-gas composition. The ice-drilling project undertaken in the framework of a long-term collaboration between Russia, the United States and France at the Russian Vostok station in East Antarctica (78Њ S, 106Њ E, elevation 3,488 m, mean temperature −55 ЊC) has already provided a wealth of such information for the past two glacial-interglacial cycles [4][5][6][7][8][9] Here we present a series of detailed Vostok records covering this ϳ400-kyr period. We show that the main features of the more recent Vostok climate cycle resemble those observed in earlier cycles. In particular, we confirm the strong correlation between atmospheric greenhouse-gas concentrations and Antarctic temperature, as well as the strong imprint of obliquity and precession in most of the climate time series. Our records reveal both similarities and differences between the successive interglacial periods. They suggest the lead of Antarctic air temperature, and of atmospheric greenhousegas concentrations, with respect to global ice volume and Greenland air-temperature changes during glacial terminations. The ice record The data are shown in Figs 1, 2 and 3 (see Supplementary Information for the numerical data). They include the deuterium content of the ice (dD ice , a proxy of local temperature change), the dust content (desert aerosols), the concentration of sodium (marine aerosol), and from the entrapped air the greenhouse gases CO 2 and CH 4 , and the d 18 O are defined in the legends to Figs 1 and 2, respectively.) All these measurements have been performed using methods previously described except for slight modifications (see The detailed record of dD ic

Retrieving the paleoclimatic signal from the deeper part of the EPICA Dome C ice core

International audienceAn important share of paleoclimatic information is buried within the lowermost layers of deep ice cores. Because improving our records further back in time is one of the main challenges in the near future, it is essential to judge how deep these records remain unaltered, since the proximity of the bedrock is likely to interfere both with the recorded temporal sequence and the ice properties. In this paper, we present a multiparametric study (δD-δ18Oice , δ18Oatm , total air content, CO2 , CH4 , N2O, dust, high-resolution chemistry , ice texture) of the bottom 60 m of the EPICA (European Project for Ice Coring in Antarctica) Dome C ice core from central Antarctica. These bottom layers were subdivided into two distinct facies: the lower 12 m showing visible solid inclusions (basal dispersed ice facies) and the upper 48 m, which we will refer to as the " basal clean ice facies ". Some of the data are consistent with a pristine paleocli-matic signal, others show clear anomalies. It is demonstrated that neither large-scale bottom refreezing of subglacial water , nor mixing (be it internal or with a local basal end term from a previous/initial ice sheet configuration) can explain the observed bottom-ice properties. We focus on the high-resolution chemical profiles and on the available remote sensing data on the subglacial topography of the site to propose a mechanism by which relative stretching of the bottom-ice sheet layers is made possible, due to the progressively confining effect of subglacial valley sides

Retrieving the paleoclimatic signal from the deeper part of the EPICA Dome C ice core

An important share of paleoclimatic information is buried within the lowermost layers of deep ice cores. Because improving our records further back in time is one of the main challenges in the near future, it is essential to judge how deep these records remain unaltered, since the proximity of the bedrock is likely to interfere both with the recorded temporal sequence and the ice properties. In this paper, we present a multiparametric study (δD-δ18Oice, δ18Oatm, total air content, CO2, CH4, N2O, dust, high-resolution chemistry, ice texture) of the bottom 60 m of the EPICA (European Project for Ice Coring in Antarctica) Dome C ice core from central Antarctica. These bottom layers were subdivided into two distinct facies: the lower 12 m showing visible solid inclusions (basal dispersed ice facies) and the upper 48 m, which we will refer to as the "basal clean ice facies". Some of the data are consistent with a pristine paleoclimatic signal, others show clear anomalies. It is demonstrated that neither large-scale bottom refreezing of subglacial water, nor mixing (be it internal or with a local basal end term from a previous/initial ice sheet configuration) can explain the observed bottom-ice properties. We focus on the high-resolution chemical profiles and on the available remote sensing data on the subglacial topography of the site to propose a mechanism by which relative stretching of the bottom-ice sheet layers is made possible, due to the progressively confining effect of subglacial valley sides. This stress field change, combined with bottom-ice temperature close to the pressure melting point, induces accelerated migration recrystallization, which results in spatial chemical sorting of the impurities, depending on their state (dissolved vs. solid) and if they are involved or not in salt formation. This chemical sorting effect is responsible for the progressive build-up of the visible solid aggregates that therefore mainly originate "from within", and not from incorporation processes of debris from the ice sheet's substrate. We further discuss how the proposed mechanism is compatible with the other ice properties described. We conclude that the paleoclimatic signal is only marginally affected in terms of global ice properties at the bottom of EPICA Dome C, but that the timescale was considerably distorted by mechanical stretching of MIS20 due to the increasing influence of the subglacial topography, a process that might have started well above the bottom ice. A clear paleoclimatic signal can therefore not be inferred from the deeper part of the EPICA Dome C ice core. Our work suggests that the existence of a flat monotonic ice-bedrock interface, extending for several times the ice thickness, would be a crucial factor in choosing a future "oldest ice" drilling location in Antarctica

Síndrome Canalar ocasionado por Músculo Abductor Largo Accesorio del 5º dedo : a propósito de un caso

En este artículo se analiza un caso clínico de síndrome canalar del túnel carpiano causado por un músculo aberrante (abductor largo accesorio del 5° dedo) tratado quirúrgica. mente, que posteriormente (8 meses) se complicó con un síndrome compresivo cubital a nivel del canal de Guyón por no resecar en su totalidad dicho músculo en el acto quirúrgico inicial. Revisión, bibliografía y conclusiones

Marine Isotope Stage (MIS) 11 in the Vostok ice core: CO2 forcing and stability of East Antarctica

ISBN 0875909949; 279 p.International audienc

The EDC3 chronology for the EPICA Dome C ice core

The EPICA (European Project for Ice Coring in Antarctica) Dome C drilling in East Antarctica has now been completed to a depth of 3260 m, at only a few meters above bedrock. Here we present the new EDC3 chronology, which is based on the use of 1) a snow accumulation and mechanical flow model, and 2) a set of independent age markers along the core. These are obtained by pattern matching of recorded parameters to either absolutely dated paleoclimatic records, or to insolation variations. We show that this new time scale is in excellent agreement with the Dome Fuji and Vostok ice core time scales back to 100 kyr within 1 kyr. Discrepancies larger than 3 kyr arise during MIS 5.4, 5.5 and 6, which points to anomalies in either snow accumulation or mechanical flow during these time periods. We estimate that EDC3 gives accurate event durations within 20% (2 sigma) back to MIS11 and accurate absolute ages with a maximum uncertainty of 6 kyr back to 800 kyr

Last Glacial Inception as a function of initial and surface conditions

We investigate the sensitivity of simulations of the last glacial inception (LGI) with respect to initial (size of the Greenland ice sheet) and surface (state of ocean/vegetation) conditions and two different CO2 reconstructions. Utilizing the CLIMBER-2 Earth system model, we obtain the following results: (a) ice-sheet expansion in North America at the end of the Eemian can be reduced or even completely suppressed when pre-industrial or Eemian ocean/vegetation is prescribed. (b) A warmer surrounding ocean and, in particular, a large Laurentide ice sheet reduce the size of the Greenland ice sheet before and during the LGI. (c) A changing ocean contributes much stronger to the expansion of the Laurentide ice sheet when we apply the CO2 reconstruction according to Barnola et al. (Nature 329:408-414, 1987) instead of Petit et al. (Nature 399:429-436, 1999). (d) In the fully coupled model, the CO2 reconstruction used has only a small impact on the simulated ice sheets but it does impact the course of the climatic variables. (e) For the Greenland ice sheet, two equilibrium states exist under the insolation and CO2 forcing at 128,000 years before present (128 kyear BP); the one with an ice sheet reduced by about one quarter as compared to its simulated pre-industrial size and the other with nearly no inland ice in Greenland. (f) Even the extreme assumption of no ice sheet in Greenland at the beginning of our transient simulations does not alter the simulated expansion of northern hemispheric ice sheets at the LGI

Transient simulation of the last glacial inception. Part II: Sensitivity and feedback analysis

The sensitivity of the last glacial-inception (around 115 kyr BP, 115,000 years before present) to different feedback mechanisms has been analysed by using the Earth system model of intermediate complexity CLIMBER-2. CLIMBER-2 includes dynamic modules of the atmosphere, ocean, terrestrial biosphere and inland ice, the last of which was added recently by utilising the three-dimensonal polythermal ice-sheet model SICOPOLIS. We performed a set of transient experiments starting at the middle of the Eemiam interglacial and ran the model for 26,000 years with time-dependent orbital forcing and observed changes in atmospheric CO2 concentration (CO2 forcing). The role of vegetation and ocean feedback, CO2 forcing, mineral dust, thermohaline circulation and orbital insolation were closely investigated. In our model, glacial inception, as a bifurcation in the climate system, appears in nearly all sensitivity runs including a run with constant atmospheric CO2 concentration of 280 ppmv, a typical interglacial value, and simulations with prescribed present-day sea-surface temperatures or vegetation cover—although the rate of the growth of ice-sheets growth is smaller than in the case of the fully interactive model. Only if we run the fully interactive model with constant present-day insolation and apply present-day CO2 forcing does no glacial inception appear at all. This implies that, within our model, the orbital forcing alone is sufficient to trigger the interglacial–glacial transition, while vegetation, ocean and atmospheric CO2 concentration only provide additional, although important, positive feedbacks. In addition, we found that possible reorganisations of the thermohaline circulation influence the distribution of inland ic