A variant of a type V lateral clavicle fracture involving a posteriorly displaced medial segment. A case report

The clavicle connects the shoulder girdle to the axial skeleton, providing support and mobility for optimal upper extremity function. Fractures of the clavicle account for up to 4% of all fractures and comprise up to 44% of all injuries to the shoulder girdle. We present a 63-year-old female patient who suffered what appeared to be a minimally displaced Type V lateral clavicle fracture after a fall as evidenced by an anteroposterior shoulder radiograph. However, an axillary projection demonstrated the proximal segment to be posteriorly displaced and buttonholed through the trapezius musculature with tenting of the skin. The patient underwent an open reduction and Kirschner wire fixation of the fracture with complete healing, subsequent removal of the hardware and return to her previous level of function six months following surgery. After an extensive literature search, we believe this is the first case report documenting a variant of a Type V lateral clavicle fracture, specifically with significant posterior displacement of the proximal segment, mimicking a Type IV AC separation. This fracture pattern is unstable and represents a double disruption of the superior shoulder suspensory complex. Surgical management was successful in returning our patient back to her previous activity of daily living

Treatment of chronic lateral ankle instability: a modified brostrom technique using three suture anchors

Ankle sprains are very common injuries seen in the athletic and young population. Majority of patients will improve with a course of rest and physical therapy. However, with conservative management about twenty percent of all patients will go on to develop chronic lateral ankle instability. This manuscript describes our detailed surgical technique of a modification to the original Brostrom procedure using three suture anchors to anatomically reconstruct the lateral ankle ligaments to treat high demand patients who have developed chronic lateral ankle instability. The rationale for this modification along with patient selection and workup are discussed. Both the functional outcomes at the two year follow up along with the complications and the detailed postoperative rehabilitation protocol for the high demand athletes are also presented. This modified Brostrom procedure is shown in both illustrative format and intra-operative photos

Treatment of chronic lateral ankle instability: a modified broström technique using three suture anchors

Ankle sprains are very common injuries seen in the athletic and young population. Majority of patients will improve with a course of rest and physical therapy. However, with conservative management about twenty percent of all patients will go on to develop chronic lateral ankle instability. This manuscript describes our detailed surgical technique of a modification to the original Broström procedure using three suture anchors to anatomically reconstruct the lateral ankle ligaments to treat high demand patients who have developed chronic lateral ankle instability. The rationale for this modification along with patient selection and workup are discussed. Both the functional outcomes at the two year follow up along with the complications and the detailed postoperative rehabilitation protocol for the high demand athletes are also presented. This modified Broström procedure is shown in both illustrative format and intra-operative photos

Bilateral Simultaneous Anterior Cruciate Ligament Injury: A Case Report and National Survey of Orthopedic Surgeon Management Preference

Unilateral anterior cruciate ligament (ACL) tear is a common injury seen by sports medicine orthopedic surgeons. However, a bilateral simultaneous ACL injury is extremely rare and has been reported only three times in the literature. We present a young female skier with simultaneous bilateral ACL tears that were managed with staged ACL reconstruction. We then conducted a nationwide survey (United States) to determine the prevalence of simultaneous bilateral ACL tear and preferred management strategies by sports medicine orthopedic surgeons. Sports medicine fellowship directors were contacted and asked to send an 8-item survey to colleagues (sports medicine fellowship trained surgeons) asking about overall number of ACL reconstructions performed, number of bilateral simultaneous ACL injuries seen and optimal management strategies of such an injury. Out of 43 responses, only 22 (51.2%) surgeons had seen a bilateral simultaneous ACL injury. Of these, 16 (76.2%) preferred staged reconstruction. Graft choice was mixed between autograft and allograft, but a large majority preferred either patellar tendon autograft (58%) or hamstring autograft (41%) were the most common choice. Staged reconstruction is the treatment of choice by surgeons surveyed in our study

Medial pelvic migration of the lag screw in a short gamma nail after hip fracture fixation: a case report and review of the literature

Hip fractures are a common injury among the elderly. Internal fixation with an intramedullary (IM) system has gained popularity for the treatment of intertrochanteric femur fractures. Multiple complications associated with IM fracture fixation have been described, however, we report a rare complication of medial pelvic migration of the lag screw of a short IM nail in a stable construct ten weeks post surgery. The patient was subsequently treated with Lag Screw removal and revision surgery with a shorter Lag Screw and an accessory cannulated screw acting as a de-rotational device. The patient did well with the revision surgery and was able to return to full activities

Capacity Expansion of High Renewable Penetrated Energy Systems Considering Concentrating Solar Power for Seasonal Energy Balance

With the increasing proportion of variable renewable energy which owns fluctuation characteristics and the promotion of the Clean Heating policy, the seasonal energy imbalance of the system has been more and more challenging. There is a lack of effective means to mitigate this challenge under the background of gradual compression of the traditional thermal unit construction. Concentrating solar power (CSP) is a promising technology to replace thermal units by integrating emergency boilers to cope with extreme weather, and can meet long-time energy balance as a seasonal peak regulation source. In this paper, we propose a long-term high-resolution expansion planning model of the energy system under high renewable penetration which integrates CSP technology for seasonal energy balance. With the projection to 2050, by taking the energy system in Xinjiang province which is a typical area of the Clean Heating project with rich irradiance as a case study, it shows that the optimal deployment of CSP and electric boiler (EB) can reduce the cost, peak-valley difference of net load and renewable curtailment by 8.73%, 19.72% and 58.24% respectively at 65% renewable penetration compared to the base scenario.Comment: 17 pages, 13 figure

Collaborative planning and optimization for electric-thermal-hydrogen-coupled energy systems with portfolio selection of the complete hydrogen energy chain

Under the global low-carbon target, the uneven spatiotemporal distribution of renewable energy resources exacerbates the uncertainty and seasonal power imbalance. Additionally, the issue of an incomplete hydrogen energy chain is widely overlooked in planning models, which hinders the complete analysis of the role of hydrogen in energy systems. Therefore, this paper proposes a high-resolution collaborative planning model for electricity-thermal-hydrogen-coupled energy systems considering both the spatiotemporal distribution characteristics of renewable energy resources and the multi-scale bottom-to-top investment strategy for the complete hydrogen energy chain. Considering the high-resolution system operation flexibility, this paper proposes a hydrogen chain-based fast clustering optimization method that can handle high-dimensional data and multi-time scale operation characteristics. The model optimizes the geographical distribution and capacity configuration of the Northeast China energy system in 2050, with hourly operational characteristics. The planning optimization covered single-energy devices, multi-energy-coupled conversion devices, and electric-hydrogen transmission networks. Last but not least, this paper thoroughly examines the optimal portfolio selection of different hydrogen technologies based on the differences in cost, flexibility, and efficiency. In the Pareto analysis, the proposed model reduces CO2 emissions by 60% with a competitive cost. This paper provides a zero-carbon pathway for multi-energy systems with a cost 4% less than the social cost of carbon $44.6/ton, and the integration of the complete hydrogen energy chain reduces the renewable energy curtailment by 97.0%. Besides, the portfolio selection results indicate that the system favors the SOEC with the highest energy efficiency and the PEMFC with the fastest dynamic response when achieving zero-carbon emissionsComment: 32 pages, 17 figure

Multi-source Education Knowledge Graph Construction and Fusion for College Curricula

The field of education has undergone a significant transformation due to the rapid advancements in Artificial Intelligence (AI). Among the various AI technologies, Knowledge Graphs (KGs) using Natural Language Processing (NLP) have emerged as powerful visualization tools for integrating multifaceted information. In the context of university education, the availability of numerous specialized courses and complicated learning resources often leads to inferior learning outcomes for students. In this paper, we propose an automated framework for knowledge extraction, visual KG construction, and graph fusion, tailored for the major of Electronic Information. Furthermore, we perform data analysis to investigate the correlation degree and relationship between courses, rank hot knowledge concepts, and explore the intersection of courses. Our objective is to enhance the learning efficiency of students and to explore new educational paradigms enabled by AI. The proposed framework is expected to enable students to better understand and appreciate the intricacies of their field of study by providing them with a comprehensive understanding of the relationships between the various concepts and courses.Comment: accepted by ICALT202