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The identification of risk factors associated with overuse injuries, specifically Medial Tibial Stress Syndrome (MTSS) and Tibial Stress Fractures (TSF), may help professionals with management and prevention of these injuries. The purpose of this study was to identify risk factors associated with MTSS and TSF in female intercollegiate athletes. This study used a mulitifactorial, prospective design for 13-26 weeks. Thirty-nine Division I intercollegiate female student-athletes in volleyball, soccer, and track were examined. Anatomical, physiological (eating disorder and menstrual history), and training (duration and recovery time) characteristics were examined as possible risk factors. Only two injuries were reported during the study; therefore, analysis for risk factors was not possible. Descriptive statistics for the dependent variables were calculated, and comparisons across sport were performed. Differences in leg length values and dorsiflexion ROM were observed across sports. No conclusions could be drawn regarding possible risk factors for MTSS and TSF in this population.

京都大学 / 新制・課程博士 / 博士(工学) / 甲第23491号 / 工博第4903号 / 新制||工||1766(附属図書館) / 京都大学大学院工学研究科都市社会工学専攻 / (主査)教授 小池 克明, 教授 岸田 潔, 准教授 奈良 禎太 / 学位規則第4条第1項該当 / Doctor of Philosophy (Engineering) / Kyoto University / DFAM

This thesis contains several distinct studies aimed at better understanding fracturing in compressional fault-cored folds. At outcrops of growth strata in the Oliana anticline in the Spanish Pyrenees, the relationship of two joint sets may reflect changing mechanical properties (i.e. via diagenesis) during the folding process. Using a Schmidt hammer, I assess the rigidity contrast between the individual units and suggest that late-stage, throughgoing joints formed in strata with conditions similar to those of the present day and that early, bed-contained joints formed when the rigidity contrast between beds was significantly greater than the present day contrast. Modeling algorithms that are used for fracture prediction assume plane strain to construct, model and restore fault-cored folds. Using mechanical models that allow heterogeneous transport in three dimensions, I explore the distribution and magnitude of out-of-plane transport in plunging fault-cored anticlines and provide guidelines of where plane strain should and should not be applied. I show that out-of-plane transport is significant in the simplest non-cylindrical folds, and suggest that complex non-cylindrical structures should not be modeled using plane strain. I mapped five bed-orthogonal fracture sets associated with folding and faulting events at Sant Corneli anticline, a non-cylindrical, fault related anticline in the Spanish Pyrenees. Fold axis perpendicular, calcite healed joint sets associated with similarly oriented normal faulting both pre-date, and are cross cut by calcite healed, N-NW striking joints. Later bed strike oblique joint sets are distinguished by the presence of iron oxide mineralization that probably occurred during Paleocene-Oligocene time. This study directly links fold-related fracturing to fold evolution because fracture sets can be dated relative to the structural evolution of the anticline. I use three-dimensional restorations of Sant Corneli anticline in the Spanish Pyrenees to test the fracture prediction capability of a fully three-dimensional finite element geomechanical restoration algorithm. Reconstruction of the three-dimensional architecture of the syn-tectonic strata provides a template for incrementally unfolding the anticline. Strains predicted by the restorations are compared to the fracture sets that formed over the corresponding time intervals, which are consistent with the observed fracture patterns at Sant Corneli anticline.

Introduction Caput radii fractures vary from non-dislocated to complex comminuted fractures and are oftenclassified by the Mason Classifications system from 1954. Most caput radii-fractures aresuccessfully treated non-surgical although some need surgery. Several surgical methods havebeen developed and surgical treatment is increasing. Aim Primary aim is to assess the Mason classification correlation to choice of treatment.Secondary aims are to describe the epidemiology, treatment frequency including surgical andnon-surgical as well as reoperation rate. Results Correlation between Mason classification and surgical/non-surgical treatment showed asignificant positive correlation (rs=0.403, p<0.001). Of 315 patients 95.2% were treated nonsurgical,4,8% received acute surgery. The estimated incidence was 3.25 per 10 000 per year,for women 4.09 and men 2.41 per 10 000 per year. Median age was 49 years (IQR 33-60), 54for women and 36 years for men respectively. Of the patients with Mason I did 0.4% receiveacute surgery, Mason II 3.4%, Mason III 66.7% and Mason IV 36.4%. Multiple surgicalmethods were used, Open reduction and internal fixation with plate and screw was mostfrequent. Four patients in the surgical treatment-group (23.5%) were reoperated. Two patients(0.7%) had late surgery due to complications. Conclusions Surgical treatment was more often used in more advanced fractures according to the Masonclassification although the correlation was fair and there were patients in each class that weresurgery treated. Surgical methods varied and reoperation rate was high. Women had higherincidence and a higher median age then men at time of injury.

Intimate partner violence (IPV) is a global human rights issue that affects approximately 25% of women and 10% of men and is the leading cause of homicides of women worldwide. Multiple studies have been conducted by medical and dental practitioners to screen for indicators of IPV so that victims can be directed toward resources for help. However, despite its prevalence, injury patterns indicative of intimate partner homicide (IPH) have not previously been studied. Given that blunt force injuries are the primary type of trauma associated with IPV and the second leading trauma associated with IPH (after gunshot trauma), craniofacial fracture patterns from blunt force trauma associated with IPH served as the focus of this study. Using computed tomography (CT) scans obtained from the New Mexico Office of the Medical Investigator of identified victims of IPH, the fracture location and quantity of fractures were compared a compilation of results from previously published studies on IPV. In addition, data on fracture type were collected on the IPH sample, as this can provide information about the fracture-causing blow. This study aimed to determine whether there are differences in fracture patterns associated with IPH versus incidence of IPV that were survived. It was found that some trends present in IPV cases were maintained in IPH cases--such as a concentration of fractures to the mid-face-- fractures in IPH cases were more distributed over the skull and presented with an more frequently on the upper face and cranial vault, as well as fractures to the right side of the body.

Vertebral fractures affect at least 12-20% of men and women over the age of 50, and the risk of fracture increases exponentially with age. Despite their high prevalence, the failure mechanisms leading to these fractures are not well understood. For example, clinical observations of fractured vertebra often note that one or both vertebral endplates have collapsed, but the precise involvement of the endplates in the initiation and progression of failure has not yet been defined. The mechanisms of failure may also relate to spatial variations in the density and microstructure of the porous trabecular bone within the vertebra as well as to the health of the adjacent intervertebral discs (IVDs) which transfer loads directly to the vertebral endplates. Delineating the contributions of these factors would shed light on the etiology of vertebral fractures and would aid in development of clinically feasible, patient-specific finite element (FE) models of the vertebra. These models are built from a patient's quantitative computed tomography (QCT) scan and have shown tremendous promise for accurate, patient-specific estimates of bone strength and fracture risk. Further validation studies are required to assess the impact of the choices of material properties and boundary conditions, as a prerequisite for broad implementation of these FE models in clinical care. The overall goal of this work was to define the failure processes involved in vertebral fractures and to evaluate the accuracy of patient-specific FE models in simulating these processes. Mechanical testing of human spine segments, in conjunction with micro-computed tomography, enabled the assessment of deformation at the vertebral endplate and deformation throughout the entire bone, as the vertebra was loaded to failure under both axial compression and anterior flexion. These data were compared against predictions of vertebral deformation obtained from QCT-based FE models. The impact of the choice of boundary conditions was specifically examined by comparing the accuracy of the FE predictions between models that simulated applied loads based on measured distributions of pressure within IVDs and models that used highly idealized boundary conditions. The results of these studies demonstrated that sudden and non-recoverable endplate deflection is a defining feature of biomechanical failure of the vertebra, for both compression and flexion loading. The locations of endplate collapse as vertebral failure progressed were associated with the porosity of the endplate and the microstructure of the underlying trabecular bone. FE analyses incorporating the experimentally observed endplate deflections as boundary conditions provided more accurate predictions of displacements throughout the rest of the vertebra when compared to FE models with highly idealized boundary conditions. Under anterior flexion, the use of boundary conditions informed by measurements of IVD pressure mitigated, but did not eliminate, the inaccuracy of the idealized boundary conditions. No further improvement in accuracy was found when using boundary conditions based on pressure measurements corresponding only to IVDs whose level of degeneration matched that observed in the IVDs adjacent to the vertebra being modeled. Overall, the accuracy of the FE predictions of vertebral deformation was only moderate, particularly near the locations of endplate collapse. The outcomes of this work indicate that the vertebral endplate is principally involved in vertebral fractures and that current methods for QCT-based FE models do not adequately capture this failure mechanism. These outcomes provide a biomechanical rationale for clinical diagnoses of vertebral fracture based on endplate collapse. These outcomes also emphasize that future studies of patient-specific FE models should incorporate physiologically relevant loading conditions and also material properties that more accurately represent the vertebral endplate in order to obtain higher fidelity predictions of vertebral failure.

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