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Radial wellbore fracturing is a promising technology for stimulating tight sandstone reservoirs. However, simultaneous fracturing of multiple radial wellbores often leads to unsuccessful treatments. This paper proposes a novel technology called multi-stage radial wellbore fracturing (MRWF) to address this challenge. A numerical model based on the finite element/meshfree method is established to investigate the effects of various parameters on the fracture propagation of MRWF, including the azimuth of the radial wellbore, the horizontal stress difference, and the rock matrix permeability. The results show that previously created fractures have an attraction for subsequently created fractures, significantly influencing fracture propagation. A conceptual model is proposed to explain the variations in the fracture propagation of MRWF, highlighting three critical effect factors: the attraction effect, the orientation effect of the radial wellbore, and the deflection effect of the maximum horizontal principal stress. Fracture geometry is quantitatively assessed through the deviation distance, which indicates the radial wellbore's ability to guide fracture propagation along its axis. As the azimuth increases, the deviation distances can either increase or decrease, depending on the specific radial wellbore layouts. Decreasing the horizontal stress difference and increasing the rock matrix permeability both increase the deviation distance. [ABSTRACT FROM AUTHOR]

Background and Aim: One of the leading reasons that patients, particularly older persons, are brought to the orthopedic emergency room is a fracture at the end of the radius. In this study, a new traction method for distal radius fractures was compared with manual reduction. Methods: The census method was used in this clinical trial to study 45 patients (46 hands) who were referred to Hamedan Besat Hospital in 2021. Patients were randomly assigned to two groups. The manual reduction (pressure and traction by an assistant and a doctor) method was implemented in Group A, and the new traction procedure (pressure and traction by hardware or a device) was performed in Group B. The radiographic results of reduction in both groups were investigated and compared immediately and in the first and 6 weeks after surgery. Results: The following results were observed in the new and manual groups in the sixth week after surgery: average volar tilt: 4.19 ± 3.79 and 4.08 ± 3.88 (p = 0.926), radial angulation: 2.18 ± 1.27 and 2.21 ± 1.35 (p = 0.934), radial shortening: 10.52 ± 0.65 and 10.56 ± 0.68 (p = 0.828), radial inclination: 22.52 ± 2.46 and 22.71 ± 2.01 (p = 0.787), dorsal angulation: −5.89 ± 0.33 and 5.22 ± −1.91 (p = 1.00), ulnar variance: 1.66 ± 0.90 and 1.67 ± 0.81 (p = 0.958), and average pain score: 2.40 ± 0.68 and 2.47 ± 0.73 (p = 0.737). Conclusion: The new reduction procedure with hardware in patients with distal radius fractures showed the same effect as the traditional method based on pressure and traction by the assistant and doctor in terms of radiographic changes and pain score of the fracture site. [ABSTRACT FROM AUTHOR]

Purpose: Radial head arthroplasty (RHA) reestablishes elbow stability after complex radial head fracture, but complication rates are high, possibly due to inappropriate implant sizing. Knowledge of impact of radial head implant diameter on elbow kinematics is limited and warranted. This study evaluated elbow kinematics of different radial head implant diameters after RHA using dynamic radiostereometric analysis (dRSA). Methods: Eight human donor arms were examined with dRSA during elbow flexion with the forearm in unloaded neutral position, and in supinated‐ and pronated position without and with 10N either varus or valgus load, respectively. Elbow kinematics were examined before and after RHA with head diameters of anatomical size, −2 mm (undersized), and +2 mm (oversized). The ligaments were kept intact by use of step‐cut humerus osteotomy for repeated RHA exchange. Bone models were obtained from CT, and by AutoRSA software bone models were matched with dRSA recordings. The elbow kinematics were described using anatomical coordinate systems. Results: Compared to the native radial head during elbow flexion, the anatomical sized RHA shifted 2.0 mm in ulnar direction during unloaded pronated forearm position. The undersized RHA shifted 1.5 mm in posterior direction and 2.1 mm in ulnar direction during unloaded pronated forearm position and increased the varus angle by 2.4° during supinated loaded forearm position. The oversized RHA shifted 1.6 mm in radial direction during loaded supinated forearm position. Conclusions: The anatomically sized RHA should be preferred as it maintained native elbow kinematics the best. The kinematic changes with oversized and undersized RHA diameters were small, suggesting forgiveness for the RHA diameter size. Level of Evidence: Level III. [ABSTRACT FROM AUTHOR]

Utilizing the discrete fracture model (DFM), a transient flow model is established for fractured horizontal wells in tight oil reservoirs, accounting for threshold pressure gradient (TPG), stress sensitivity effect, hydraulic fracture parameters, and fracture distribution pattern. This model is solved using the finite-volume method (FVM), and an important sensitivity analysis is conducted. The findings reveal that the models incorporated by the threshold pressure gradient result in an upward trend in the pressure-derivative curve. As the threshold pressure gradient increases, this upward trend becomes more pronounced, rendering the distinction between flow regimes more challenging. The stress sensitivity effect predominantly impacts the pressure-derivative curve during the later flow period. Additionally, as the fracture half-length increases, the pressure performance of both fracture radial flow and formation radial flow becomes more difficult. Fracture conductivity has a significant influence during the early flow period, facilitating the identification of flow regimes with the trend of increasing fracture conductivity. [ABSTRACT FROM AUTHOR]

Background: Monteggia fractures entail a proximal ulnar fracture with associated radial head dislocation. Primarily observed as a fracture in the pediatric population, there have been rare occurrences in adults. In rare instances, various associated fractures have been reported with Monteggia fractures. However, during our literature review, a type I Monteggia fracture had not been reported along with ipsilateral diaphyseal humerus and capitellar fractures. Here, we present a successful post-operative outcome for a unique fracture distribution and form of fixation that has yet to be reported in the literature. [ABSTRACT FROM AUTHOR]

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At present, global energy conflicts are prominent and the world's attention is focused on energy security. In order to evaluate the reserves and production capacity of the shale gas, which is a special fossil energy source, the study proposes a reserve and production capacity evaluation design for its reservoirs based on Arps decrement. The study intersects the material balance method and Arps reconciliation decrement method to achieve the evaluation of shale gas reservoir reserves. The shale gas reservoir production capacity was calculated using Integrated Geostatistical and Geomechanical Modeling (IGIG) based on Genliang Guo's fractured horizontal wells, and Effective Fracture Radius (EFR) formula based on large capsule-shaped flow zones. Experimental data showed that the capacity evaluation method based on the binomial dynamic coefficient inverse calculation of formation pressure can calculate the current unobstructed flow rate and allotted production rate to provide data support for the extraction of shale gas reservoirs. [ABSTRACT FROM AUTHOR]

The osteocutaneous radial forearm free flap (OCRFFF) is a versatile flap with the ability to reconstruct complex defects. We detail the techniques necessary to harvest an OCRFFF, including an outline on making 90‐degree osteotomies to maximize bone harvest. In this pictorial essay, we provide illustrations of the anatomy and surgical techniques necessary for OCRFFF harvest. Detailed discussion is provided on how to protect the perforators to the bone and the approach to making osteotomies in a 90‐degree fashion. The approach for prophylactic plating of the radius to prevent radius fractures is outlined. A case presentation on the real‐life utilization of this flap is included. The OCRFFF is an excellent head and neck reconstructive option. While there are limitations to its use for patients requiring dental rehabilitation or long/anterior mandibular defects, for the right patient and indication it has shown great success in reconstructive efforts. [ABSTRACT FROM AUTHOR]

This letter to the editor discusses a scoping review conducted by Zitek et al. on the palmaris profundus muscle variant and its role in carpal tunnel syndrome. The authors of this letter express their appreciation for the thoroughness of the review and highlight the potential misclassification of the flexor carpi radialis brevis (FCRB) variation as the palmaris profundus type 1 variation in surgical reports. They provide detailed anatomical descriptions of both variations and emphasize the importance of correctly identifying these muscles during surgical procedures. The authors suggest that the underrepresentation of palmaris profundus type 1 variations in surgical case reports may be due to the standard scope of the surgical procedure. They also note the potential confusion caused by similarities in nomenclature. The letter concludes by acknowledging the value of Zitek et al.'s work and aims to raise awareness of the potential underrepresentation of palmaris profundus type 1 variations in surgical reports. [Extracted from the article]

Understanding the fracture behavior of rock after coupled water and thermal environment is important for many geotechnical projects. This study examines the influence of coupled water and thermal treatments on the fracture toughness and characteristics of a typical sandstone under mode I and mode II loading conditions. Notched deep beam (NDB) specimens were utilized and subjected to soaking treatments at various water temperatures (23 °C, 60 °C, and 99 °C). The experimental results indicate a significant reduction in both mode I and mode II fracture toughness values, with reductions ranging from 15.4% to 13.2% for mode I and 26.1% to 8.9% for mode II respectively. As the water temperatures increase, a slightly rising trend is observed in both mode I and mode II fracture toughness within the examined temperature range. Sandstone specimens displayed typical brittle fracture characteristics at lower soaking temperatures. For mode I specimens, an increase in ductility was evident with higher soaking temperatures, while the ductile behavior is less pronounced in the mode II specimens. Based on the Maximum Tangential Stress (MTS) criterion and the Generalized Maximum Tangential Stress (GMTS) criterion, the predicted values of mode II fracture toughness and the fracture process zone (FPZ) were discussed. The results show that both the GMTS and MTS criteria exhibit inaccuracies in predicting the mode II fracture toughness of sandstone treated at different soaking water temperatures. However, the GMTS criterion, which incorporates T-stress, demonstrates smaller errors compared to the MTS criterion. The study shows that the radius r0 of the fracture process zone is not a constant under both mode I and mode II loading conditions. The calculation of the fracture process zone radius r0 in the GMTS criterion requires further theoretical and experimental study. [ABSTRACT FROM AUTHOR]

To investigate the influences of geometrical size and discharge voltage of the pulse discharge equipment on the fracture characteristics and mechanisms of sandstone under high-voltage pulses, a series of experiments was conducted using a high-voltage pulse discharge device on sandstone circular disc specimens of sandstone with a thickness of 10 mm. These experiments covered a range of disc diameters ranging from 50 mm to 142 mm and discharge voltages from 15 kV to 40 kV. Through these experiments, the fracture characteristics of sandstone at both macroscopic and microscopic levels were investigated. In the experiments, a quantitative analysis of surface fracture was undertaken based on fracture density and fractal damage. Additionally, using the principle of energy equivalence, numerical simulation methods were used to study the damage evolution process in sandstone. The research results indicate that the formation and distribution of fractures in the sandstone specimens are significantly affected by geometrical size and discharge voltage. By analyzing the interaction between stress waves and fracture propagation, combined with indoor experimental results, the fracture mechanism was revealed. The high temperature and shock wave generated by the plasma channel leads to the crushing zone near the electrode, while the circumferential tensile component of the stress wave can result in radial fractures, and the reflected tensile wave leads to circumferential and radial fractures near the boundary. [ABSTRACT FROM AUTHOR]

Background: In acute treatment of radial head fractures, a radial head prosthesis can be considered if open reduction and internal fixation are not technically feasible. Methods: We reviewed the data of 27 consecutive bipolar Judet radial head prostheses implanted in patients with unreconstructable radial head fractures and no other concomitant fractures (coronoid or olecranon factures). The lesions of the lateral collateral ligament were rated according to the McKee classification. Twenty-three patients with more than ten-year follow-up participated in this retrospective study All patients underwent assessments for pain, range of motion and stability using the Mayo Elbow Performance Score, the QuickDash questionnaire and a Visual Analogue Scale for pain. Radiography assessment was performed to determine the correct setting of the implant, presence of periprosthetic loosening, prosthetic disassembly, heterotopic ossification, capitellum and ulnohumeral degenerative changes. Results: Mean follow-up was 149 months (± 12.2). Mean range of motion in flexion-extension was 111° (± 10.55), mean extension was 18° (± 14.32) and mean flexion was 130° (± 11.4). Mean arc of motion in supination-pronation was 150° (± 12.26). The mean Mayo Elbow Performance Score was 88, the mean QuickDash score was 7.3; 86% of the patients were satisfied. Seven patients (26%) required secondary surgery. The most frequent complication was heterotopic ossification, which had negative consequences on the functional result. Conclusions: Bipolar radial head prostheses are an option for acute treatment of isolated unreconstructable radial head fractures. During follow-up, three patients required implant revision and removal; the capitellum surface presented severe degenerative changes and the prosthesis was not replaced. Another complication was the risk of implant dislocation, in relation to implant design, incorrect positioning of the radial head stem or else to inadequate reconstruction of the lateral collateral ligament. Further work is needed to establish the long-term follow-up results of Judet implants in complex elbow fractures. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this study was to evaluate the range of motion (ROM), elbow function and predictors for good elbow function after conservative treatment of non-displaced radial head fractures. Material and methods: All patients with non-displaced radial head fractures (displacement < 2 mm), that were diagnosed between January 1st 2017 and December 31st 2021 in a level I trauma center, were included in this retrospective case series and the charts were evaluated for ROM and elbow function. Elbow function was categorized as "good" or "bad" depending on the ROM measured defined by Morrey et al. Overall, 73 patients (33 male, 40 female) with an average age of 38 years (+/- 13 years) could be included. Results: Conservative treatment had good clinical results for ROM and elbow function. After 6 weeks mean flexion was 131° (SD 13°), extension 8° (SD 7°), Pronation 83° (SD 11°) and Supination 83° (SD 13). Patients with a good elbow function after one week showed a good elbow function after completing the treatment. Conclusions: A clinical assessment after one week should always be performed and the study showed that it is a good predictor for good elbow function. In cases of bad elbow function further controls should be considered. [ABSTRACT FROM AUTHOR]

Background: Fractures with large bone defects and non-unions are a great challenge for veterinary orthopaedists. In small dog breeds, this complication is commonly encountered in fractures of the radius and ulna due to poorer vascularisation of the distal antebrachium region. Case Description: A case of radius/ulnar non-union in a 1.5-year-old Pinscher occurring after trauma and two successive unsuccessful osteosyntheses is described. During the operative revision, after the removal of existing bone implants, the bone defect was filled with cortical autologous bone graft. Autocancellous bone mixed with erythropoietin was applied proximally and distally to the cortical autograft for stimulation of bone healing. The post-operative period was without complications. As early as the 9th post-operative week, the animal was able to bear weight on the limb, without signs of lameness, pain, and swelling. Radiologically, a very good bridging of the graft was observed. Fifteen weeks after the operative revision, the fracture was completely healed with excellent clinical outcome. Conclusion: The application of autogenous cortical bone graft and cancellous autograft mixed with erythropoietin demonstrated an excellent therapeutic effect and resulted in complete regeneration of the large bone defect over a 15-week period. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To refresh your knowledge of the anatomy of forearm bones and the pathophysiology of bowing fractures • To increase your awareness of the diagnostic challenges and complications associated with bowing fractures • To enhance your understanding of the management of children with bowing fractures. Bowing fractures of the forearm are characterised by numerous micro-fractures on the concave surface of the affected bone(s), usually caused by a fall on an outstretched arm. Children are more susceptible to this type of injury than adults because their long bones have more elasticity. Bowing fractures of the forearm are challenging to diagnose because there are no obvious cortical defects, which can lead to inappropriate management and associated complications, including loss of movement range and loss of function. This article discusses bowing fractures of the forearm in children, including their pathophysiology, diagnosis and management. It aims to enhance emergency nurses’ awareness and knowledge of this type of injury in children and of the challenges surrounding diagnosis and management. [ABSTRACT FROM AUTHOR]

Radial borehole fracturing is a production method that combines ultrashort radius radial boreholes with hydraulic fracturing, which is expected to effectively improve the drainage and transformation effect of tight oil and gas reservoirs. In view of the problem that radial boreholes cannot be fully fractured when high-pressure liquids are injected into them simultaneously, this paper proposes a new method of fracturing the radial boreholes step by step, and this method is verified by the laboratory fracturing experiments. It designed and processed wellbores with both internal and external pipes, conducted 24 sets of radial boreholes step-by-step experiments of double-layer radial boreholes, analyzed the reproducibility of the experimental results, and compared the results of fracturing radial boreholes simultaneously and fracturing radial boreholes step-by-step experiments. The results show that this method can fracture two sets of radial boreholes distributed in different vertical planes. The results demonstrate that this method is feasible and can solve the problem that not all the radial boreholes are fractured when fracturing fluids are simultaneously injected into them. Besides, the azimuth is the key factor affecting fracture geometries. When the azimuths are 0° and 30°, the fractures can cut through radial boreholes in different layers within the rock samples. If the radial boreholes with larger azimuths are fractured, it will generate higher breakdown pressures. Fracturing radial boreholes with smaller azimuths first and then radial boreholes with larger azimuths should be selected. This study provides a theoretical basis for the field application of radial borehole fracturing technology. Highlights: A new method of fracturing the radial boreholes step by step is proposed. The azimuth is the key factor affecting fracture geometries. If the radial boreholes with larger azimuths are fractured, it will generate higher breakdown pressures. [ABSTRACT FROM AUTHOR]

Simple Summary: Three-dimensional printing turns a digital model in a computer file into a physical interpretation of the object. This technology is promising in both human and veterinary medicine, enabling the production of anatomical models, customized surgical instruments, implants, and prostheses. Minimally invasive plate osteosynthesis (MIPO) techniques have been developed to accelerate fracture healing by preserving soft tissue as well as the environment at the fracture site. Achieving acceptable alignment with MIPO can be challenging, because fractures are typically reduced indirectly and implants are inserted submuscularly, starting at one end of the broken bone. In our study, we presented results of comminuted feline radial fracture repair using MIPO with locking bone plates as a reduction tool. The implants were pre-contoured on 3D-printed bone models of the antebrachium of an adult male and a female domestic shorthair cat. A pre-contoured bone plate is a valuable tool for fracture reduction in MIPO. (1) Background: Due to the unique structural and functional characteristics of the forelimb in cats, fractures of the radius and ulna are best repaired using internal fixation and stabilization in accordance with AO principles. This study presents the results of reduction of 42 cadaveric comminuted feline radial fractures reduced by minimally invasive plate osteosynthesis (MIPO). (2) Methods: Radius fractures were created on 21 pairs of forelimbs with intact bones. MIPO was then performed using two locking bone plates pre-contoured on 3D-printed bone models of the antebrachium of a male and a female cat. Pre- and postoperative radiographs were taken, and radius length and anatomical lateral distal radial angle (aLDRA) were measured. (3) Results: All fractures were classified as complex diaphyseal fractures of the radius. The radial bone length did not change significantly after surgery (F1,18 = 0.01, p = 0.933). However, the aLDRA was modified after surgery (F1,18 = 7.51, p = 0.013), but this change was only observed in females, in whom the aLDRA was significantly reduced (p = 0.035) compared to the value determined by the shape of the plate. In males, the pre- and postoperative aLDRA values were similar (p = 0.824). In 40 cases, alignment, adjacency of bone fragments, and apparatus were judged to be satisfactory. In two cases, the plate was fixed to the proximal radius and distal ulna due to misidentification of the distal radius. In both cases, revision surgery and correct fixation of the radius gave proper alignment, adjacency, and apparatus. (4) Conclusion: A pre-contoured plate on a 3D-printed model of the male and female domestic cat antebrachium was suitable for the reduction and stabilization of comminuted radial fractures in a cohort of domestic cat cadavers without the need to print individual antebrachial bone models for each patient. [ABSTRACT FROM AUTHOR]

Background: Monteggia, an Italian surgeon, first to describe the combination of a proximal ulna fracture and dislocated radial head. With the use of Kirschner wires, surgical stabilization could be achieved. The aim of the study was to determine closed reduction and percutaneous k-wire fixation can maintain satisfactory reduction and fixation in pediatric Monteggia fractures. Methods: Twelve patients with Monteggia fractures were admitted to Zagazig University Hospital and Tripoli University Hospital- Libya in this prospective study. All were treated by close reduction and percutaneous k-wire fixation. Postoperatively, patients were weekly dressed and checked for pin sites. AP / Lat X-rays elbow at 6 weeks for fracture union, wires removed. Using the Stewart Hundley, VAS, Mayo, and DASH scoring systems, the elbow and forearm were evaluated for a range of motion in all directions. Results: Age was distributed as 7.88±2.63 years, regarding gender distribution males were 55.6% and females were 44.4%. Mechanism of injury FD was majority with 72.2% and DT 27.8%. Bado classification majority were type I 41.7%, type II 33.3%, type III 25%, and type IV no cases. The time of union was distributed as 2.72±0.80 months. Stewart Hundley's score excellent was the majority with 83.3%, good 8.3%, and fair 8.3%. Mayo's score was distributed as 88.33±10.44; regard Mayo's excellent were majority with 66.7% then good and fair with 16.7% each. And regarding DASH excellent was also the majority but with 61.1% then good 22.2% then fair 11.1% then poor only one case 5.6%. Conclusions: Closed Reduction and Percutaneous Kirschner Wires Fixation of Monteggia Fracture in Children are less invasive, and give satisfactory radiological and clinical outcomes. Percutaneous interventions could be an option for Monteggia Fracture in Children. [ABSTRACT FROM AUTHOR]

The study was conducted on 18 clinical cases of diaphyseal fractures of long bones in dogs. The dogs were divided into three equal groups with six dogs in each group, affected with fractures of the radius, femur, and tibia, respectively. Fractures were diagnosed by clinical, radiological examination and they were stabilized with 3.5 mm locking String of Pearls plates (7-10 holes) and appropriate locking cortical screws (16-32 mm). All dogs had an uneventful recovery with minimal complications. [ABSTRACT FROM AUTHOR]

Brown tumor of the bone is a rare and serious complication of secondary hyperparathyroidism. Here we report a case who had a fracture on the radius due to brown tumors with minimal stress in the operation room. Any complaint of the patient should not be ignored any time. [ABSTRACT FROM AUTHOR]

Objectives(1) To estimate the prevalence of delayed union, non-union and mal-union in canine fractures; (2) to describe fracture, demographic, and treatment characteristics for these outcomes; (3) to identify risk factors for delayed or non-union.Study designRetrospective study.Sample populationFour hundred and forty two dogs (461 fractures).MethodsA review was conducted of clinical records and radiographs from 2 teaching hospitals. "Union," "delayed union," "non-union" and "mal-union" were defined, and fracture, demographic, treatment, and outcome variables described. Differences in proportions or medians between "union," "delayed union" and "non-union" were tested using χ2 and Mann-Whitney U-tests for categorical and continuous variables respectively. Potential explanatory variables for "delayed or non-union" were tested using logistic regression to identify risk factors.ResultsMedian radiographic follow up was 53 days (14-282). Delayed union occurred in 13.9% of fractures (64/461), non-union in 4.6% (21/461), and mal-union in 0.7% (3/461). Risk factors for delayed or non-union were age (OR 1.21, 95% CI 1.12-1.31); comminuted fracture (OR 4.24, 95% CI 2.4-7.5); treatment with bone graft (all types) (OR 3.32, 95% CI 1.3-8.5); surgical site infection (OR 3.24, 95% CI 1.17-8.97), and major implant failure (OR 12.94, 95% CI 5.06-33.1).ConclusionOlder dogs, dogs with comminuted fractures, surgical site infection, or major implant failure were at increased odds of delayed or non-union. Radius and ulna fractures in toy breed dogs were not at increased odds of delayed or non-union.Clinical significanceThe identified risk factors should inform fracture planning and prognosticating. The prognosis for radial fractures in toy breeds appears better than historically believed.

The American Academy of Orthopaedic Surgeons has developed Appropriate Use Criteria for the Treatment of Distal Radius Fractures . Evidence-based information, in conjunction with the clinical expertise of physicians, was used to develop the criteria to determine the appropriateness of various treatments in the management of distal radius fractures. The Appropriate Use Criteria for the Treatment of Distal Radius Fractures were derived by identifying clinical indications typical of patients with a distal radius fracture in clinical practice. These indications were most often variables observable by the clinician, including symptoms or results of diagnostic tests. In addition, patient-level variables (eg, activity level or demographics) can be considered. In total, 2,160 patient scenarios and 9 treatments were developed by the writing panel, a group of clinicians who are specialists in this Appropriate Use Criteria topic. Next, a separate, multidisciplinary, voting panel (made up of specialists and nonspecialists) rated the appropriateness of treatment of each patient scenario using a 9-point scale to designate a treatment as appropriate (median rating, 7 to 9), may be appropriate (median rating, 4 to 6), or rarely appropriate (median rating, 1 to 3).

Introduction: Carbon capture and storage (CCS) is important for achieving net-zero carbon emissions. However, although the current geological storage capacity stands at approximately 3,000 Gt-CO2, the formation pressure increases with CO2 injection, imposing severe constraints on capacity from a geomechanical perspective. This study numerically examined nine cases (combinations of three fracture pressures and three aquifer radius factors) through sensitivity analysis to quantify the effects of these parameters on CO2 injection mass and storage capacity. Methods: The CO2 injection mass was determined as the cumulative CO2 injected until the formation pressure reached a specified fracture pressure. Storage capacity was defined as the amount of CO2 enclosed within the reservoir based on a fill-and-spill analysis encompassing 200 years after the start of injection (2230). Results: Based on the sensitivity analysis, the aquifer radius had a greater impact on the CO2 injection mass and storage capacity than the fracture pressure. A sufficiently high aquifer radius factor can compensate for the capacity limitations imposed by a low fracture pressure. For the lowest fracture pressure (20.95 MPa), considering a safety factor of 0.8, the CO2 injection mass increased approximately 5.5 times, from 3.2 to 17.6 Mt-CO2, depending on the aquifer radius factor ranging from 2 to 7. Discussion: Therefore, geological sites with high aquifer radius factors and low fracture pressures were preferred over those with low aquifer radius factors and high fracture pressures. Nevertheless, when considering space-limited capacity, storage efficiency, defined as the ratio of injected to stored CO2, tends to be higher (approximately 80%) when both parameters are low. The scenario featuring the highest aquifer radius factor and fracture pressure reached an injection mass of 68.9 Mt-CO2. However, the storage efficiency was only 23% due to space constraints. This study provides key insights into two pivotal parameters from pressure- and space-limited perspectives, which must be collectively considered to reliably evaluate CCS projects. [ABSTRACT FROM AUTHOR]

Outburst of coal and gas is a major hazard in underground coal mining where coal seam gas content/pressure is high. A cone‐shaped cavity is often observed in the coal seam after bursting, implying the likely mechanical structure being formed during outburst propagation. Although the mechanism for outburst initiation and propagation is very complex, mining‐induced fracturing and damage of the coal material is an essential component. This paper investigates the mechanical conditions that are essential to initiate fractures around a spherical cavity, a simplified form of the cone‐shaped outburst cavity. The cavity is assumed to be situated in an infinite isotropic homogeneous elastic body under internal gas pressure and far‐field hydrostatic compressive stresses as a further simplification for analytical investigation. The analytical conditions under which circumferential and radial fractures can initiate around the cavity are formulated, based on extensional strain criterion for fracture initiation. Low internal pressure on the cavity surface and high far‐field compression lead to circumferential fractures. In contrast, high internal pressure and low far‐field compression lead to radial fractures. Subsequent numerical simulations with FRACOD3D and FRACOD, the 3D and 2D in‐house fracture simulation codes, were carried out to investigate fracture patterns around a cavity and inclusion. The simulation results confirmed the analytical results, including fracture shapes and the size of fractured zone. These results provide a new angle to understand the complex mechanism of outbursts. [ABSTRACT FROM AUTHOR]

Background: Changes in intra-articular pressure have not been previously described in relation to the management of radial head fractures. We hypothesized that pressure within the radiocapitellar and ulnotrochlear joints would increase with progressive radial head resection, mimicking a displaced radial head fracture, in a cadaveric model. Methods: Ten cadaveric specimens were tested. Intra-articular pressure sensors were used to measure pressure within the radiocapitellar and ulnotrochlear joints with the forearm in full supination. The elbow was loaded to 100 N in extension, 45° of flexion, and 90° of flexion under the following conditions: (1) intact radial head, (2) 20% radial head resection, (3) 40% radial head resection, and (4) 100% radial head resection. Results: The distribution of pressure between the radiocapitellar and ulnotrochlear joints did not change with sequential, partial resection of the radial head (radiocapitellar joint, between 48.92% and 53.79%; ulnotrochlear joint, between 46.21% and 51.08%). After 20% resection, radiocapitellar peak contact pressure (PCP) increased by 22% (from 1,410 to 1,721.5 kPa) and ulnotrochlear PCP increased by 36% (from 1,319 to 1,797.5 kPa). After 40% resection, radiocapitellar PCP increased by 123% (from 1,410 to 3,145 kPa; p = 0.0003) and ulnotrochlear PCP increased by 105% (from 1,319 to 2,702 kPa; p = 0.007). Ulnotrochlear PCP increased by a total of 159% after complete radial head resection (from 1,319 to 3,415.5 kPa; p = 0.003). Conclusions: Pressures in the radiocapitellar and ulnotrochlear joints were equally distributed with an intact radial head and after partial resection. Radiocapitellar and ulnotrochlear pressures increased with increasing radial head resection, significantly exceeding 100% of normal after radial head resection of 40% of the anterolateral diameter. Level of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

Background: This study investigates the surgical state-of-the-art procedure for humeral shaft fractures with primary radial nerve palsy based on its own case series in relation to the current and established literature. Methods: Retrospective review of treated cases between January 2018 and December 2022 describing radial nerve palsy after humerus shaft fractures, radiological fracture classification, intraoperative findings, surgical procedure, patient follow-up and functional outcome. Results: A total of 804 patients (463 women and 341 men) with humerus shaft fractures were identified. A total of 33 patients showed symptomatic lesions of the radial nerve (4.1%). The primary lesion was identified in 17 patients (2.1%). A broad and inhomogeneous distribution of fractures according to the AO classification was found. According to the operative reports, the distraction of the radial nerve was found eleven times, bony interposed three times and soft tissue constricted/compressed three times. In every case the radial nerve was surgically explored, there was no case of complete traumatic nerve transection. Four intramedullary nails and thirteen locking plates were used for osteosynthesis. Complete recovery of nerve function was seen in 12 cases within 1 to 36 months. Three patients still showed mild hypesthesia in the thumb area after 18 months. Two patients were lost during follow-up. Conclusions: With this study, we support the strategy of early nerve exploration and plate osteosynthesis in humeral fractures with primary radial nerve palsy when there is a clear indication for surgical fracture stabilisation. In addition, early exploration appears sensible in the case of palsies in open fractures and secondary palsy following surgery without nerve exposure as well as in the case of diagnostically recognisable nerve damage. Late nerve exploration is recommended if there are no definite signs of recovery after 6 months. An initial wait-and-see strategy with clinical observation seems reasonable for primary radial nerve palsies without indication for surgical fracture stabilisation. [ABSTRACT FROM AUTHOR]

Background: To study the efficacy of teriparatide therapy in surgically corrected comminuted fractures. Materials and Methods: Prospective observational study was conducted in 50 patients of either gender who are skeletally mature presenting with comminuted fracture or nonunion after surgical correction, without comorbidities who are medically fit for taking the teriparatide are included in study. Results: One third of the patients belonged to the age group of 30-39 years and 40-49 years. 82% of the study population were males, 18% of them were females. 70% of the study population were injured on the right side, 30% of them were injured on the left side. 76% of the study population lower limbs were injured, 30% of them had injury on the upper limbs. 74% of the study population had Road Traffic Accident. 36% of the study population had fracture of femur. 6% of them had fracture of both tibia and fibula. 2% of them had fracture of both radius and ulna. Only one patient had fracture neck of humerus. 42% of the study population showed signs of radiological union after 3-4 months of drug administration, followed by within 3 months (30%), 5-6 months (20%). 92% of the study population had achieved complete radiological union at the end of one year follow up. 44% of the study population showed complete radiological union after 7-9 months of drug administration. Complete range of movements was achieved in 52% of the study population. The range of movements was increased in 40% of the study population. 8% of the study population had restricted movements at the end of the study period. 56% of the study population had experienced side effects. 52% of the study population had nausea, 28% of them had dizziness and 18% had hypercalcemia. Conclusion: The present study concluded that the efficacy of teriparatide in surgically treated comminuted fracture healing cases is 92%. The drug was tolerated well with minor side effects like nausea and dizziness. [ABSTRACT FROM AUTHOR]

Pediatric distal forearm fractures, comprising 30% of musculoskeletal injuries in children, are conventionally diagnosed using radiography. Ultrasound has emerged as a safer diagnostic tool, eliminating ionizing radiation, enabling bedside examinations with real-time imaging, and proving effective in non-hospital settings. The objective of this study is to evaluate the diagnostic efficacy of ultrasound for detecting distal forearm fractures in the pediatric population. A systematic review and meta-analysis were conducted through a comprehensive literature search in PubMed, Scopus, Web of Science, and Embase databases until October 1, 2023, following established guidelines. Eligible studies, reporting diagnostic accuracy measures of ultrasound in pediatric patients with distal forearm fractures, were included. Relevant data elements were extracted, and data analysis was performed. The analysis included 14 studies with 1377 patients, revealing pooled sensitivity and specificity of 94.5 (95% CI 92.7–95.9) and 93.5 (95% CI 89.6–96.0), respectively. Considering pre-test probabilities of 25%, 50%, and 75% for pediatric distal forearm fractures, positive post-test probabilities were 83%, 44%, and 98%, while negative post-test probabilities were 2%, 6%, and 15%, respectively. The bivariate model indicated significantly higher diagnostic accuracy in the subgroup with trained ultrasound performers vs. untrained performers (p = 0.03). Furthermore, diagnostic accuracy was significantly higher in the subgroup examining radius fractures vs. ulna fractures (p < 0.001), while no significant differences were observed between 4-view and 6-view ultrasound subgroups or between radiologist ultrasound interpreters and non-radiologist interpreters. This study highlighted ultrasound's reliability in detecting pediatric distal forearm fractures, emphasizing the crucial role of expertise in precisely confirming fractures through ultrasound examinations. [ABSTRACT FROM AUTHOR]

Summary: The purpose of this paper is to describe rates of forearm fractures in adults in Norway 2008–2019. Incidence rate of distal forearm fractures declined over time in both sexes. Forearm fracture constitute a significant health burden and prevention strategies are needed. Purpose: To assess age- and sex-specific incidence rates, and time trends for forearm fractures in Norway, and compare these with incidence rates in other Nordic countries. Methods: Data on all patients aged 20–107 years with forearm fractures treated in Norwegian hospitals from 2008 to 2019 was retrieved from the Norwegian Patient Registry. Fractures were identified based on International Classification of Disease 10th revision code S52. Age- and sex-specific incidence rates and changes in incidence rates were calculated. Results: We identified 181,784 forearm fractures in 45,628,418 person-years. Mean annual forearm fracture incidence rates per 100,000 person-years were 398 (95% CI 390–407) for all, 565 (95% CI 550–580) for women, and 231 (95% CI 228–234) for men above 20 years. Mean annual number of forearm fractures was 15,148 (95% CI 14,575–15,722). From 2008 to 2019, age-adjusted total incidence rates of forearm fractures S52 diagnoses declined by 3.5% (incidence rate ratio (IRR) of 0.997 (95% CI 0.994–0.999)) in men. The corresponding decline in women was not significant (IRR: 0.999 (95% CI 0.997–1.002)). In the same period, the age-adjusted incidence rates of distal forearm fractures declined by 7.0% in men (IRR = 0.930; 95% CI 0.886–0.965) and 4.7% in women (IRR = 0.953; 95% CI 0.919–0.976). The incidence rates of distal forearm fractures were similar to rates in Sweden and Finland. Conclusion: Age-adjusted incidence rates of distal forearm fractures in both sexes declined over time. [ABSTRACT FROM AUTHOR]

Introduction: Terrible triad injuries (TTIs) of the elbow have traditionally been reported to have poor outcomes, hence requiring surgical stabilisation. We identified and reviewed patients with TTIs treated non-operatively within our department. Methods: We retrospectively reviewed patients with TTI treated non-operatively with standardised elbow-instability rehabilitation from 2010 to 2020. We used Mason and Morrey classifications for radial head and coronoid fractures, respectively. Non-operative indications included a congruent joint on CT, significant co-morbidities pre-disposing to high-risk surgery and/or patient preference. Outcomes included Oxford Elbow Score (OES), ROM and complications. Results: Nineteen patients were included (mean age 49; 37% female). At an average of 6 years (range 2–11 years) post-treatment, mean OES was 46 ± 7. At last clinic review, mean 6 months (2–15), average ROM was 131 ± 11° flexion, 8 ± 10° extension, 85 ± 12° supination and 85 ± 13° pronation. One patient required arthrolysis and another had an incongruent ulnohumeral joint which developed clicking with a functional ROM. Conclusion: Our report suggests non-operatively managed and appropriately rehabilitated TTI injuries can achieve good function and ROM. We recommend conservative management as a viable option in cases with joint congruency and no mechanical block in patients with significant co-morbidities or those refusing surgery but patients must be assessed on a case-by-case basis. [ABSTRACT FROM AUTHOR]

The problem of natural vibrations of a fluid in a horizontal well with multiple fractures obtained by hydraulic fracturing is considered. A mathematical model of the natural vibrations of fluid in a horizontal oil well connected to the reservoir by a system of radial hydraulic fractures is constructed and the frequency characteristics of the natural vibrations of fluid as functions of the hydraulic fracture and reservoir parameters are determined. Using a numerical analysis of the frequency characteristics of vibrations, the effect of changes in the fracture width, the number of fractures, and the reservoir permeability on the natural frequencies is demonstrated. [ABSTRACT FROM AUTHOR]

Simple Summary: Radial and ulnar fractures often occur in the middle or distal third of the diaphysis. These fractures are common orthopedic injuries in dogs accounting for up to 17% of canine fractures. The limited soft tissue coverage and intraosseous circulation of the distal third of the diaphysis of the radius may contribute to a higher frequency of healing complications. Minimally invasive plate osteosynthesis (MIPO) techniques can help rapid bone healing. However, the application of MIPO is difficult in attaining and maintaining bone alignment. To compensate for these problems, this study designed a patient-specific 3D reduction guide to align radial diaphyseal fractures using the MIPO method. In this study, we found that the use of a patient-specific 3D reduction guide during MIPO of short oblique radial diaphyseal fractures in dogs is reliable for the alignment and apposition of fractures and reduces the surgical time. This study aims to evaluate the clinical application of three-dimensional (3D)-printed custom reduction guides (3DRG) for minimally invasive plate osteosynthesis (MIPO) of short oblique radial diaphyseal fractures. Canine forelimb specimens (n = 24) were prepared and a diaphyseal short oblique fracture was simulated in the distal radius and ulna. Bone fragments were stabilized with the MIPO technique using a 3DRG (Group A), open reduction (Group B), or closed reduction with circular external skeletal fixation (ESF) (Group C). The diaphyseal short oblique fractures were created in each radius at one-third of the radial length from the distal radial articular surface. Surgical stabilization of the fractures was performed in each group. Pre and postoperative radiographic images were obtained to measure frontal angulation (FA), sagittal angulation (SA), frontal joint reference line angulation (fJRLA), sagittal joint reference line angulation (sJRLA), translational malalignment and fracture gap width. Surgical time was also measured. In the homogeneity test, differences in SA, sJRLA, craniocaudal translation and fracture gap before and after surgery had no significant difference among the three groups. On the other hand, differences in FA, fJRLA, mediolateral translation and surgical time before and after surgery had significant differences among the three groups. In the post hoc test, only surgical time showed a significant difference between the three groups, and group A showed the shortest surgical time. The use of 3DRG for MIPO of short oblique radial diaphyseal fractures in dogs is reliable for the alignment and apposition of fractures and reduces surgical time. [ABSTRACT FROM AUTHOR]

The issue of inter-well fracture channeling in shale reservoirs is becoming increasingly prominent, significantly impacting the production of nearby wells. Therefore, it is crucial to accurately determine the location of fracture channeling in order to effectively design anti-channeling measures and optimize reservoir fracturing. In this paper, a data-driven fracture propagation model and fracture channeling identification method are established. In the model, the fracture morphology is fitted by the bottom-hole flowing pressure constraint. The bottom-hole flowing pressure (pwp) calculated by the construction pump pressure and the fluid wellbore flow is mainly considered as the real solution. The bottom-hole flowing pressure (pwf) calculated by the construction displacement and the fracture morphology is used as the constraint variable, and the fracture parameters are changed using the SPSA optimization algorithm to realize the dynamic fitting of the fracture morphology. In order to accurately describe the position of fracture channeling, the seepage radius of the fracture boundary is introduced to calculate the volume of fracture reconstruction. The volume coefficient of repeated reconstruction is used as the quantitative evaluation index of fracture channeling. This approach enables an accurate depiction of the position of fracture channeling. Finally, the model method is applied to the actual fracture channeling well. The study shows that the fracture length of the well inversion is greater than the well spacing, and there is a possibility of inter-well fracture channeling. The volume coefficient of repeated reconstruction is 8%, similar to the critical fracture channeling index. There are nine fracturing sections with fracture channeling, and the maximum fracture channeling coefficient is 14.2%. This paper successfully explains the reason for cross-well fracture channeling, and its conclusion aligns with the actual monitoring results. The proposed method in this paper effectively identifies the location of fracture channeling and offers guidance for optimizing channeling prevention in subsequent designs. [ABSTRACT FROM AUTHOR]

Background: There are clear standards for when to operate on both distal epiphyseal and diaphyseal forearm fractures in children. However, paediatric surgeons are often faced with fractures in the transition zone between metaphysis and diaphysis. This aim of the study is to compare different treatment approaches for diametaphyseal forearm fractures, to classify different types of these fractures, and to define further assessment parameters and treatment recommendations. Methods: This retrospective study included all patients with diametaphyseal radial fractures who were seen at a paediatric surgery clinic between 01.01.2010 and 31.12.2013. Patients were treated either non-surgically (C) or surgically using bicortical Kirschner wire (BC-KW), intramedullary K-wire (IM-KW), elastic stable intramedullary nailing (ESIN), or combined bicortical and intramedullary K-wire (BCIM-KW). Results: During the study period, 547 patients presented with forearm fractures of which 88 patients (16%) had a fracture in the diametaphyseal region. The majority of diametaphyseal fractures were greenstick fractures (54.4%) followed by transverse fractures (44.3%). Distal fractures were predominantly treated with bicortical K-wiring (BC-KW, 40.5%) or non-surgically (C, 26.2%). Proximal fractures were treated by ESIN osteosynthesis (50%), followed by IM-KW (30%). Intermediate fractures were just as likely to be treated with one out of the 5 above-mentioned techniques. The ulna was involved in 64 of 88 cases. Depending on the type of fracture, it was treated either by ESIN osteosynthesis or non-surgically. No superior operative technique was identified. Conclusions: The description of diametaphyseal fractures as a separate entity is important, because the therapy of these fractures is heterogeneous and challenging. A classification into proximal, intermediate, and distal may be useful in clinical decision-making. Despite the retrospective nature of this study, our data suggest that the use of a K-wire or combined technique BCIM-KW-technique, whenever technically feasible, achieves better radiological results without secondary dislocation. Further prospective studies are needed to provide better guidance to trauma surgeons. [ABSTRACT FROM AUTHOR]

Surface-enhanced Raman scattering spectroscopy was used to monitor changes in calcium hydroxyapatite and other biochemical components during the healing of fractures managed with and without small splints. Common factors evaluated using Raman scattering include the amount of calcium hydroxyapatite deposits, carbonate-to-phosphate ratio, and mineral-to-matrix ratio. The rabbits with complete radial bone fracture models were randomly divided into a model control group and a small splint treatment group. At 15, 30, and 45 days after surgery, rabbits were killed, and the bone calluses at the fracture site were extracted for surface-enhanced Raman scattering spectroscopy. Compared with normal Raman scattering spectroscopy, higher quality Raman spectra of the bone callus tissues were obtained, which were then analyzed to derive rich biochemical composition information. The results suggest that small splints are effective in accelerating fracture healing considering the sustained deposition of calcium hydroxyapatite, high carbonate-to-phosphate ratio, and mineral-to-matrix ratios as detected by Raman spectroscopy. Therefore, Surface-enhanced Raman scattering spectroscopy can be an excellent tool to assess fracture healing. [ABSTRACT FROM AUTHOR]