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

Experimental Constraints on the Crystallization of Silica Phases in Silicic Magmas

International audienceLow-pressure silica polymorphs, e.g. quartz (Qtz), tridymite (Trd), and cristobalite (Crs), are common in silicic magmas, but the conditions of their formation are still unclear. The stability fields of these polymorphs have been determined in the SiO2, SiO2–H2O, and haplogranite systems, but these simple systems are not directly applicable to silica polymorph crystallization in natural silicic magmas. The present study compiles an experimental database of new and previously-published data documenting the crystallization of silica phases in natural silicic magmas and simple synthetic systems. Silica polymorphs are identified using Raman spectroscopy and their pressure-temperature domains of occurrence and chemical compositions are determined at pressures between 0·1 and 200 MPa, temperatures between 685 to 1200° C, and under H2O-saturated and H2O-undersaturated conditions. Qtz is the stable silica polymorph at pressures higher than 25–30 MPa, temperatures between ∼700 and 950° C, and occurs for a narrow range of melt SiO2 contents (∼79–81 wt %). Constraints on Qtz stability derived from simple systems are mutually compatible with, and thus applicable to natural compositions. This is consistent with Qtz compositions being close to ‘pure’ SiO2, both in experiments and nature. In volcanic systems, Qtz crystallization may occur in magmatic reservoirs and deep volcanic conduits. Trd did not crystallize in the experiments conducted as part of this study despite several experiments having been performed in the Trd stability field. This is consistent with results from the literature which show that Trd crystallization is kinetically inhibited in particular relative to Crs. Natural Trd have compositions deviating substantially from ‘pure’ SiO2, so that stability limits determined in simple systems should not be applied directly to natural cases. Crs was encountered at pressures below 20–30 MPa (or H2O contents < ∼1·5 wt %), from sub-solidus (∼800° C) to near-liquidus (up to 1040° C), and coexisting with melts having a large range of SiO2 contents (70–81 wt %). The Crs stability field is much larger in natural magmas compared to pure SiO2 systems. Crs is a metastable phase stabilized by components (Al, Na, K; about 3 wt %) present in the silicic melt. In volcanic systems, Crs crystallization may thus be restricted to subsurface manifestations such as lava domes