65 research outputs found
Congenital bipartite lunate presenting as a misdiagnosed lunate fracture: a case report
<p>Abstract</p> <p>Introduction</p> <p>A rare case of congenital bipartite lunate in a child is reported. Carpal variants are very uncommon as independent entities, with only three previous reports of this condition in the English literature.</p> <p>Case presentation</p> <p>An 11-year-old Caucasian boy presented with pain in the left wrist after a fall. Radiographs in the emergency department demonstrated a lunate that was divided into palmar and dorsal parts, causing a misdiagnosis of fractured lunate. Magnetic resonance imaging was then used to differentiate between the two diagnoses.</p> <p>Conclusion</p> <p>Very few cases of bipartite lunate have been reported in the literature, and unless awareness is raised about congenital anomalies such as this variant, confusion may arise.</p
Understanding acute ankle ligamentous sprain injury in sports
This paper summarizes the current understanding on acute ankle sprain injury, which is the most common acute sport trauma, accounting for about 14% of all sport-related injuries. Among, 80% are ligamentous sprains caused by explosive inversion or supination. The injury motion often happens at the subtalar joint and tears the anterior talofibular ligament (ATFL) which possesses the lowest ultimate load among the lateral ligaments at the ankle. For extrinsic risk factors to ankle sprain injury, prescribing orthosis decreases the risk while increased exercise intensity in soccer raises the risk. For intrinsic factors, a foot size with increased width, an increased ankle eversion to inversion strength, plantarflexion strength and ratio between dorsiflexion and plantarflexion strength, and limb dominance could increase the ankle sprain injury risk. Players with a previous sprain history, players wearing shoes with air cells, players who do not stretch before exercising, players with inferior single leg balance, and overweight players are 4.9, 4.3, 2.6, 2.4 and 3.9 times more likely to sustain an ankle sprain injury. The aetiology of most ankle sprain injuries is incorrect foot positioning at landing – a medially-deviated vertical ground reaction force causes an explosive supination or inversion moment at the subtalar joint in a short time (about 50 ms). Another aetiology is the delayed reaction time of the peroneal muscles at the lateral aspect of the ankle (60–90 ms). The failure supination or inversion torque is about 41–45 Nm to cause ligamentous rupture in simulated spraining tests on cadaver. A previous case report revealed that the ankle joint reached 48 degrees inversion and 10 degrees internal rotation during an accidental grade I ankle ligamentous sprain injury during a dynamic cutting trial in laboratory. Diagnosis techniques and grading systems vary, but the management of ankle ligamentous sprain injury is mainly conservative. Immobilization should not be used as it results in joint stiffness, muscle atrophy and loss of proprioception. Traditional Chinese medicine such as herbs, massage and acupuncture were well applied in China in managing sports injuries, and was reported to be effective in relieving pain, reducing swelling and edema, and restoring normal ankle function. Finally, the best practice of sports medicine would be to prevent the injury. Different previous approaches, including designing prophylactice devices, introducing functional interventions, as well as change of games rules were highlighted. This paper allows the readers to catch up with the previous researches on ankle sprain injury, and facilitate the future research idea on sport-related ankle sprain injury
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Aspiration requirements for the transportation of retrievably stored waste in the TRUPACT-2 package
The Transuranic Package Transporter-II (TRUPACT-II) is the shipping package to be used for the transportation of contact-handled transuranic (CH TRU) waste between the various US Department of Energy (DOE) sites, and to the Waste Isolation Pilot Plant (WIPP) located near Carlsbad, New Mexico. Waste (payload) containers to be transported in the TRUPACT-II package are required to be vented prior to being shipped. Venting'' refers to the installation of one or more carbon composite filters in the lid of the container, and the puncturing of a rigid liner (if present). This ensures that there is no buildup of pressure or potentially flammable gas concentrations in the container prior to transport. Payload containers in retrievable storage that have been stored in an unvented condition at the DOE sites, may have generated and accumulated potentially flammable concentrations of gases (primarily due to generation of hydrogen by radiolysis) during the unvented storage period. Such payload containers need to be aspirated for a sufficient period of time until safe pre-transport conditions (acceptably low hydrogen concentrations) are achieved. The period of time for which a payload container needs to be in a vented condition before qualifying for transport in a TRUPACT-II package is defined as the aspiration time.'' This paper presents the basis for evaluating the minimum aspiration time for a payload container that has been in unvented storage. Three different options available to the DOE sites for meeting the aspiration requirements are described in this paper. 4 refs., 2 figs
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Geochemistry of Salado Formation brines recovered from the Waste Isolation Pilot Plant (WIPP) repository
Intergranular brines recovered from the repository horizon of the Waste Isolation Pilot Plant (WIPP) have major- and trace-element compositions that reflect seawater evaporation and diagenetic processes. Brines obtained from repository drill holes are heterogenous with respect to composition, but their compositional fields are distinct from those obtained from fluid inclusions in WIPP halite. The heterogeneity of brine compositions within the drill-hole population indicates a lack of mixing and fluid homogenization within the salt at the repository level. Compositional differences between intergranular (drill hole) and intragranular (fluid inclusions) brines is attributed to isolation of the latter from diagenetic fluids that were produced from dehydration reactions involving gypsum and clay minerals. Modeling of brine-rock equilibria indicates that equilibration with evaporite minerals controls the concentrations of major elements in the brine. Drill-hole brines are in equilibrium with the observed repository minerals halite, anhydrite, magnesite, polyhalite and quartz. The equilibrium model supports the derivation of drill-hole brines from near-field fluid, rather than large-scale vertical migration of fluids from the overlying Rustler or underlying Castile Formations. 13 refs., 6 figs., 6 tabs
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