2020, Cao, H., Wu, M.H., Zhou, F., McMeeking, R.M., Ritchie, R.O.

One of the contentious issues associated with the high-cycle fatigue of Nitinol, a nominally equiatomic alloy of nickel and titanium, is the claim that increasing the applied mean strain can increase, or at least have no negative impact, on the fatigue lifetime, in conflict with reported behavior for the vast majority of other metallic materials. To investigate this in further detail, cyclic fatigue tests in bending were carried out on electropolished medical grade Nitinol at 37 °C for lives of up to 400 million cycles of strain involving various levels of the mean strain. A constant life model was developed through statistical analysis of the fatigue data, with 90% reliability at a confidence level of 95% on the effective fatigue strain. Our results show that the constant life diagram, a plot of strain amplitude versus mean strain, is monotonic yet nonlinear for lives of 400 million cycles of fatigue loading. Specifically, we find that in contradiction to the aforementioned claim, the strain amplitude limit at zero mean strain is 0.55% to achieve a 400 million cycle lifetime, at 90% reliability with 95% confidence; however, to achieve the same lifetime, reliability and confidence level in the presence of a 3% or more mean strain, the required strain amplitude limit is decreased by over a factor of three to 0.16%. Moreover, for mean strains from 3% to 7%, the strain amplitude limit that allows a 400 million cycle lifetime, at 90% reliability with 95% confidence, is ~ 0.16%, and essentially independent of mean strain. We conclude that the debatable claim that an increase in the applied mean strain can increase the fatigue life of Nitinol components is not supported by the current data.

2021, Kim, S., Goelz, L., Münn, F., Kim, D., Millrose, M., Eisenschenk, A., Thelen, S., Lautenbach, M.

Background: We examined the visibility of fractures of hand and forearm in whole-body CT and its influence on delayed diagnosis. This study is based on a prior study on delayed diagnosis of fractures of hand and forearm in patients with suspected polytrauma. Methods: Two blinded radiologists examined CT-scans of patients with fractures of hand or forearm that were diagnosed later than 24 h after admission and control cases with unremarkable imaging of those areas. They were provided with clinical information that was documented in the admission report and were asked to examine forearm and hands. After unblinding, the visibility of fractures was determined. We examined if time of admission or slice thickness was a factor for late or missed diagnoses. Results: We included 72 known fractures in 36 cases. Of those 65 were visible. Sixteen visible fractures were diagnosed late during hospital stay. Eight more fractures were detected on revision by the radiologists. Both radiologists missed known fractures and found new fractures that were not reported by the other. Missed and late diagnoses of fractures occurred more often around 5 pm and 1 am. Slice thickness was not significantly different between fractures and cases with fractures found within 24 h and those found later. Conclusions: The number of late diagnosis or completely missed fractures of the hand and forearm may be reduced by a repeated survey of WBCT with focus on the extremities in patients with suspected polytrauma who are not conscious. Level of evidence: III © 2021, The Author(s).