Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

The flow behavior and microstructural evolution of Ti-5Al-5Mo-5V-3Cr during subtransus isothermal forging

High-strength metastable beta alloys, for example, Ti-5Al-5Mo-5V-3Cr, have replaced steel as the material of choice for large components, such as the main truck beam on the latest generation of airframes. The production of these components is carried out by hot near-net-shape forging, during which process variable control is essential to achieve the desired microstructural condition and subsequent mechanical properties. The flow behavior and microstructural evolution during subtransus isothermal forging of Ti-5Al-5Mo-5V-3Cr has been investigated for two different starting microstructures and analysis has incorporated previously published results. The flow behavior, irrespective of initial microstructural condition, is found to be very similar at strains a parts per thousand yen0.35. It is thought that this is due to a common microstructural state being reached, where dynamic recovery of the beta phase is the dominating deformation mechanism. At strains < 0.35, the flow behavior is believed to be dominated by the morphology and volume fraction of the alpha phase. Small globular alpha particles are thought to have little effect on the flow behavior, while the observed flow softening is directly linked to the fragmentation of acicular alpha precipitates