Bilateral Tibial Stress Fractures and Osteoporosis in a Young Patient

Stress fractures result from microscopic bone injury due to repetitive submaximal stress and include fatigue and insufficiency fracture components. Fatigue fractures generally occur in runners and athletes and are caused by abnormal physical load on the bone. On the other hand, insufficiency fractures are generally seen in the elderly secondary to osteoporosis, typically involving the pelvis and surrounding bones. Insufficiency fracture occurs as a result of normal loading in the abnormal bone. In this case report, we describe a young patient with bilateral tibial stress fractures with both fatigue and insufficiency components.

Features of sacral alar fatigue fractures in adolescent athletes with overuse

Three types of sacral alar fatigue fractures are elderly, postnatal, and sport-related. They are most prevalent in athletes during adulthood; there are few reports of sacral alar fatigue fractures in young athletes. The purpose of this study was to analyze sacral alar fatigue fractures in adolescent athletes. Of the 920 patients hospitalized with low back pain, 13 were diagnosed with sacral alar fatigue fractures with magnetic resonance imaging (MRI) abnormalities. We investigated age, sex, sports discipline, span from symptom onset to consultation, laterality, complication with spondylolysis, computed tomography (CT) findings, and treatment span. The average age was 14.5 years old (8-men and 5-women). The most frequent discipline was basketball. The span to consultation was 13.2 days. The number of right-side cases was 9. Seven cases were complicated by bilateral spondylolysis. MRI abnormalities were observed in all the cases. Only two patients showed abnormal findings on CT. Averagely 67 days after treatment, participants returned to their sports. Sacral alar fatigue fractures suggest that the span from onset to consultation is short. Fracture lines are often unclear on CT, and MRI is useful for diagnosis. More than half of the cases in this study were complicated by lumbar spondylolysis.

Prophylaxis of Pain and Fractures within Feet in the Course of Osteoporosis: The Issue of Diagnosing

Background. Considering the enormous risk of fractures in the course of osteoporosis in the area of the feet, an important aspect of prophylaxis is periodic and, in special cases, ongoing monitoring of defects and deformations as well as pressure distribution. The purpose of this article is to indicate the role of the examination of posture and pressure distribution during standing, postural balance, and gait, in the prevention of fatigue fractures in the course of osteoporosis, based on the literature review and examples of patients. Methods. The manuscript consists of two parts; it has a review-analytical character. The first part reviews the literature. The data were obtained using the MEDLINE (PubMed), as well as Cochrane and Embase databases. The database review was carried out focusing mainly on English-language publications, while taking into account the topicality of scientific and research works in the area of osteoporosis. The problem of multiaspects in the area of bone density was pointed out. Considering the above, in the second part, the authors analyzed 11 exemplary patients with osteoporosis, referring to the assessment of foot and lower limb defects using traditional posturological methods and including pedobarography to diagnostic procedures that are used in the assessment of pressure distribution, standing and moving, and an attempt to balance. Results. Analysis of the research and scientific literature proved the lack of unambiguous diagnostic procedures of the locomotor system recommended for the prevention of fatigue fractures in the course of osteoporosis. The main diagnostic recommendations are imaging tests (most often X-ray), which are recommended in the case of specific clinical symptoms. The analysis of exemplary patients with osteoporosis showed numerous disorders in the distribution of pressure in the plantar part of the feet, which are related, among other things, with their individual defects and lower limbs. Conclusions. Detailed posture diagnostics and gait estimation, along with the analysis of pressure distribution within the feet are a very important aspect of the prevention of structural degradation and fatigue fractures within the feet. An important postulate for further research and scientific work is the elaboration of the procedures that will serve the preventive diagnostics of the locomotor system, aimed at early detection of threats of fatigue fractures.

DYNAMICS OF TRACTION DEVICE OF MINE SUSPENDED MONOREL ROAD

During the operation of the mine suspension monorail track and traction device form a mechanical system experiencing high dynamic loads associated with implementation of traction and braking forces. Emerging dynamic loads lead to formation of elastic deformations and oscillations that cause vibrations, which leads to displacement of drive wheels and reduces the implementation of traction. The study of the dynamics of traction device is an important step in improving safety and reliability of monorail transport. The aim of the work is to study dynamics of a friction-type traction device moving along a suspended monorail to assess influence of parameters of the elements of device on the vibrations and nature of interaction of drive wheels with monorail. Research methods. Mathematical modeling of the oscillatory processes resulting from interaction of the running gear of the traction device with the monorail is used. Stages of research include drawing up a design diagram oscillations of drive wheels of the traction device interacting with the monorail, developing a mathematical model for the analysis of vibrations caused by moving loads, also assessing the influence of structural parameters of mechanical system under consideration on nature of oscillations. Research results. The developed mathematical model of friction-type traction device movement allows us to establish relationship between parameters of structural elements of its running gear and pressure mechanism, as well as nature of vibrations that arise. As a result, frequencies of the mechanical system under consideration and maximum deviations were found, which allows you to set optimal device parameters to increase traction and increase lifespan of monorail suspended roads. Findings. It was determined that the frequency range of vibration of drive wheels mainly corresponds to the mid-frequency local vibrations of 16–36 Hz. Increasing length of lever for fixing axles of wheels and reducing their radius leads to formation of low-frequency vibrations with a frequency of less than 15 Hz. When length of lever of drive wheels is more than 0.5 m, shoulder of the spring is more than 0.6 m and radius of drive wheels is less than 0.25 m, vibrations with frequencies below 5 Hz can occur. It was found that increasing the length of lever for securing spring increases the oscillation frequency of one drive wheel and reduces frequency of the other. The difference between these frequencies significantly affects changes in the pressure of the wheels against monorail. When difference between frequencies is more than 10–12 Hz, direction of load changes pulsed, with a maximum swing of 0.02 rad, which reduces formation of fatigue fractures of tire wheels, and moments of decrease and increase in pressing force have a negative effect on traction, leading to slippage of drive wheels. When difference between frequencies is less than 10–12 Hz, direction of the load changes sharply, with a maximum swing of 0.03 rad, which increases deformation and formation of fatigue fractures of tire wheels, and short moments of weakening and increase of pressing force, constituting 0.1–0.3 s does not have a significant negative effect on traction.

Experimental study of factors affecting the failure of the cyclical nature of rotary endodontic instruments

Relevance. The properties of shape memory, superelasticity and plasticity in nickel-titanium tools make the visual prediction of breakage as difficult as possible. Therefore, an important role is given to research, the purpose of which is to predict the time of their work and to identify the main factors affecting the probability of a fracture.Aim. Comparison of cyclic fatigue resistance of Ni-Ti rotary endodontic instruments of various manufacturers.Materials and methods. The influence of the autoclaving procedure and the angle of bending of the root canal on the resistance of a rotating endodontic instrument to cyclic loads was studied using an author's patented device that simulates the rotation of an instrument in a real channel; the number of cycles completed by each instrument before its fracture was recorded. The morphology of fractures, the microstructure of specimens under fractures, and the microhardness of specimens of endodontic instruments after testing were studied.Results. It has been established that resistance to fatigue fractures of instruments of various endodontic systems decreases with an increase in the bending angle of the root canal. For Endostar E3 Basic Rotary System tools, the number of cycles decreased by 1.2 times, for Protaper Universal tools by 2.9 times. The tools of the Protaper Next system reduced the number of cycles at a bending angle of the artificial root canal of 60 degrees by 1.5 times compared with the number of cycles at a bending angle of 45 degrees. At the same time, statistical data and the study of the microstructure of samples of new and past 6 cycles of autoclave tools did not show a connection between the autoclaving procedure and a decrease in their resistance to cyclic loads.Conclusions. When working in complex bent over 45 degrees channels, it is rational to choose an endodontic instrument that has undergone heat treatment at the production stage (in the framework of this study, it was Protaper Next 25/06 M-Wire alloy). This will reduce the likelihood of a file fracture and associated dangerous complications of endodontic treatment.