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Teimouri M, Akbari Aghdam H, Alipoor R, Lalehzar SS. Operative treatment results of posterior malleolar fractures in trimalleolar fractures with screw fixation and plate fixation: short-term results. Int J Burns Trauma 2024; 14:14-24. [PMID: 38505346 PMCID: PMC10944710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/05/2023] [Accepted: 01/04/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Ankle fractures are among the most common lower limb fractures. There is no agreement about the best treatment for these fractures. This study compared the short-term results of screw and plate fixation methods. METHODS In this prospective study, 32 patients that underwent screw fixation for posterior malleolar fracture and 32 patients that underwent plate fixation for posterior malleolar fracture were assessed 1, 3, and 6 months after surgery. RESULTS The mean age in group 1 (screw fixation) and group 2 (plate fixation) was 32.56, and 37.82 ± 9.99, respectively. The frequency of gender in group 1 (screw fixation) and group 2 (plate fixation) for females and males was 20%, 80%, 4%, and 18%, respectively. The mean range of motion (ROM) in month 1 in group 1 was 89.4, in group 2 was 90.22, in month 3 in group 1 was 100.6, in group 2 was 100.36, in month 6 in group 1 was 115.4, and in group 2 was 110.68. The mean visual analog scale (VAS) in month 1 in group 1 was 6.88, in group 2 was 6.09, in month 3 in group 1 was 4.14, in group 2 was 3.63, in month 6 in group 1 was 2.56, and in group 2 was 2.54. In group 1, we had 1 case of nerve injury, 1 case of deep infection, and 3 cases of superficial infection, and in group 2, we had 2 cases of nerve injury, 2 cases of deep infection, and no case of superficial infection. The mean foot and ankle outcome score (FAOS) in group 1 was 75.44, and in group 2 was 74.36. CONCLUSION In our study, we were unable to indicate a superior treatment method. More comprehensive studies with larger populations are suggested.
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Affiliation(s)
- Mehdi Teimouri
- Department of Orthopedic Surgery, Kashani University Hospital, School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
| | - Hossein Akbari Aghdam
- Department of Orthopedic Surgery, Kashani University Hospital, School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
- Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
| | - Reza Alipoor
- Department of Orthopedic Surgery, Kashani University Hospital, School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
| | - Sahar Sadat Lalehzar
- Department of Orthopedic Surgery, Kashani University Hospital, School of Medicine, Isfahan University of Medical SciencesIsfahan, Iran
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Trębacz P, Frymus J, Barteczko A, Pawlik M, Kurkowska A, Czopowicz M. A 3D Printed Anatomically Pre-Contoured Plate for the Treatment of Y-T Humeral Condylar Fractures: A Feline Cadaveric Study. Animals (Basel) 2024; 14:537. [PMID: 38396505 PMCID: PMC10885935 DOI: 10.3390/ani14040537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/01/2024] [Accepted: 02/03/2024] [Indexed: 02/25/2024] Open
Abstract
(1) Background: Anatomically pre-contoured plates usually require only minimal or even no intraoperative contouring. For complex cases, such plates also assist the surgeon as an anatomical template during fracture reduction. In this study, we present our experience of using a 3D printing technology for the treatment of bicondylar humeral fractures in feline cadavers. (2) Methods: Surgeries were performed on 15 pairs of front limbs amputated at the scapula. The limbs were obtained from 15 adult cats without obvious pathology of the skeleton. After flexion of the elbow and subperiosteal elevation of the anconeus muscle, the humeral Y-T fractures were created using a bone chisel and mallet. A custom-made anatomically pre-contoured interlocking plate was used to reduce and stabilise the medial aspect of the humeral condyle to the humeral diaphysis. After reduction of the humeral condyle, a positional locking screw was then inserted from the medial to the lateral side and a straight 2.4/2.7 interlocking bone plate was used to stabilise the lateral part of the condyle to the humeral diaphysis. (3) Results: The length of the humerus ranged from 98.2 to 107.0 mm and did not differ significantly between the left and right bone. The diameter of the isthmus of the humeral condyle ranged from 5.2 to 5.5 mm and did not differ significantly between the left and right bone. In all 30 limbs, bicondylar fracture was accompanied by epicondylar comminution. In 7/30 limbs (4 left, 3 right) the fracture of the humeral shaft was also present. In the left limbs, the postoperative articular surface defect of the humeral condyle was small (<1 mm) in 11/15 cases, moderate (1-2 mm) in 2/15 cases and large (>2 mm) in 2/15 cases in which the condylar screw was incorrectly inserted. In the right limbs, the postoperative articular surface defect of the humeral condyle was small (<1 mm) in 14/15 cases and moderate (1-2 mm) in 1 case. (4) Conclusions: 3D printing and the technology of metal powder sintering offers a wide range of possibilities for the development of new surgical implants. The anatomically pre-contoured bone plate appears to be a valuable tool in the reduction and stabilisation of Y-T humeral fractures in adult domestic cats weighing 3.0 to 4.5 kg.
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Affiliation(s)
- Piotr Trębacz
- Department of Surgery and Anaesthesiology of Small Animals, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159 C Street, 02-776 Warsaw, Poland
| | - Jan Frymus
- Department of Surgery and Anaesthesiology of Small Animals, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159 C Street, 02-776 Warsaw, Poland
| | - Anna Barteczko
- CABIOMEDE Ltd., Karola Olszewskiego 21 Street, 25-663 Kielce, Poland; (A.B.); (M.P.); (A.K.)
| | - Mateusz Pawlik
- CABIOMEDE Ltd., Karola Olszewskiego 21 Street, 25-663 Kielce, Poland; (A.B.); (M.P.); (A.K.)
- Department of Biomaterials and Medical Devices Engineering, Faculty of Biomedical Engineering, Silesian University of Technology, Roosevelta 40 Street, 41-800 Zabrze, Poland
| | - Aleksandra Kurkowska
- CABIOMEDE Ltd., Karola Olszewskiego 21 Street, 25-663 Kielce, Poland; (A.B.); (M.P.); (A.K.)
- Department of Biomaterials and Medical Devices Engineering, Faculty of Biomedical Engineering, Silesian University of Technology, Roosevelta 40 Street, 41-800 Zabrze, Poland
| | - Michał Czopowicz
- Division of Veterinary Epidemiology and Economics, Institute of Veterinary Medicine, Warsaw University of Life Sciences-SGGW, Nowoursynowska 159 C Street, 02-776 Warsaw, Poland;
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Ho TY, Hsu CE, Wang WC, Ting YN, Tsai MT, Chiu YC, Hsu JT. Biomechanical study of the fixation ability of the dorsal and volar locking plate for transverse metacarpal neck fractures. Medicine (Baltimore) 2023; 102:e34981. [PMID: 37682204 PMCID: PMC10489259 DOI: 10.1097/md.0000000000034981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/07/2023] [Indexed: 09/09/2023] Open
Abstract
Metacarpal neck fracture is one of the most common types of hand fractures; the literature suggests that applying a bone plate on the dorsal side provides higher fixation strength than that provided by other fixation methods. However, bone plate fixation on the dorsal side may result in postoperative tendon adhesion. So far, no studies have investigated the fixation of metacarpal neck fractures on the volar side by using a bone plate. The objective of this study was to investigate the differences in the fixation results between bone plate fixation on the dorsal side and bone plate fixation on the volar side of the metacarpal in the case of a metacarpal neck fracture. A saw blade was used to create a transverse metacarpal neck fracture on 14 artificial metacarpal bone specimens. The specimens were divided into 2 groups depending on the fixation method: a volar locking plate (VLP) group and a dorsal locking plate (DLP) group. All specimens were subjected to a cantilever bending test on a material testing system, and a force-displacement curve was used to measure the yield force and stiffness, which served as an indicator of the fixation ability of the 2 fracture fixation methods. For the experimental results, the Mann-Whitney U test was used to compare the fixation abilities of the 2 fixation methods. In terms of yield force, the DLP group (266.9 ± 68.3 N) scored significantly higher than the VLP group (32.6 ± 2.7 N) (P < .05); expressed in terms of median, the DLP group scored 8.2 times higher than the VLP group. Similarly, in terms of stiffness, the DLP group (69.0 ± 13.4 N/mm, median ± interquartile range) scored significantly higher than the VLP group (12.9 ± 1.4 N/mm) (P < .05); expressed in terms of median, the DLP group scored 5.3 times higher than the VLP group. The fixation strength of volar bone plates is only about one-third of that of dorsal bone plates.
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Affiliation(s)
- Tsung-Yu Ho
- School of Medicine, China Medical University, Taichung, Taiwan
- Department of Orthopedic Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Cheng-En Hsu
- Department of Orthopaedics, Taichung Veterans General Hospital, Taichung, Taiwan
- Sports Recreation and Health Management Continuing Studies-Bachelor’s Degree Completion Program, Tunghai University, Taichung, Taiwan
| | - Wei-Chih Wang
- Department of Orthopedic Surgery, China Medical University Hospital, Taichung, Taiwan
- Department of Orthopedic Surgery, China Medical University Hsinchu Hospital, Hsinchu, Taiwan
| | - Yen-Nien Ting
- 3D Printing Medical Research Center, China Medical University Hospital, Taichung, Taiwan
| | - Ming-Tzu Tsai
- Department of Biomedical Engineering, Hungkuang University, Taichung, Taiwan
| | - Yung-Cheng Chiu
- School of Medicine, China Medical University, Taichung, Taiwan
- Department of Orthopedic Surgery, China Medical University Hospital, Taichung, Taiwan
| | - Jui-Ting Hsu
- Department of Biomedical Engineering, China Medical University, Taichung, Taiwan
- School of Dentistry, China Medical University, Taichung, Taiwan
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Xu S, Ding X, Xiong M, Duan P, Zhang H, Li Z. The optimal design of 3D-printed lattice bone plate by considering fracture healing mechanism. Int J Numer Method Biomed Eng 2023; 39:e3682. [PMID: 36625630 DOI: 10.1002/cnm.3682] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 12/22/2022] [Accepted: 01/06/2023] [Indexed: 06/17/2023]
Abstract
The biomechanical stimulus is the most important factor for fracture healing and mainly determined by the structural stiffness of bone plate. Currently, the materials commonly used in bone plates are stainless steel and titanium, which often lead to stress shielding effects because of their higher elastic modulus compared with the bone. This article suggests an optimal design method of lattice bone plate based on fracture healing theory. First, the mechanical regulation model with deviatoric strain is established to simulate the tissue differentiation process during fracture healing process. The ratio of the average elastic modulus of callus at the 120th day to the elastic modulus of mature bone is used to characterize the fracture healing rate. Second, the optimal elastic modulus of the design domain is obtained by the optimization mathematical model with the maximum fracture healing rate. Then, the design domain is filled with microstructures, the porosity of which is adjusted to make it possible that the equivalent elastic modulus is equal to the optimized value. And the finite element analysis of the bone plate with microstructure is executed. Finally, the designed lattice bone plates are manufactured through 3D printing, and the mechanical test is carried out. The simulation results indicate that the fracture healing rate is maximum when the elastic modulus of material in design domain is 38 GPa under the constraints of fixation stability. And both the finite element analysis and experiment results show that the designed lattice bone plate meet the strength requirements of fracture internal fixation implants.
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Affiliation(s)
- Shipeng Xu
- School of Mechanical Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Xiaohong Ding
- School of Mechanical Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Min Xiong
- School of Mechanical Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Pengyun Duan
- School of Mechanical Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Heng Zhang
- School of Mechanical Engineering, University of Shanghai for Science and Technology, Shanghai, China
| | - Zhuoyi Li
- School of Mechanical Engineering, University of Shanghai for Science and Technology, Shanghai, China
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5
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Ma Z, Liu B, Li S, Wang X, Li J, Yang J, Tian S, Wu C, Zhao D. A novel biomimetic trabecular bone metal plate for bone repair and osseointegration. Regen Biomater 2023; 10:rbad003. [PMID: 36817973 PMCID: PMC9926947 DOI: 10.1093/rb/rbad003] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 12/28/2022] [Accepted: 01/05/2023] [Indexed: 02/09/2023] Open
Abstract
Fracture is one of the most common traumatic diseases in clinical practice, and metal plates have always been the first choice for fracture treatment because of their high strength. However, the bone plates have high elastic modulus and do not match the biomechanics of human bone, which adversely affects callus formation and fracture healing. Moreover, the complex microenvironment in the human body can induce corrosion of metallic materials and release toxic ions, which reduces the biocompatibility of the bone plate, and may necessitate surgical removal of the implant. In this study, tantalum (Ta) was deposited on porous silicon carbide (SiC) scaffolds by chemical vapor deposition technology to prepare a novel porous tantalum (pTa) trabecular bone metal plate. The function of the novel bone plate was evaluated by implantation in an animal fracture model. The results showed that the novel bone plate was effective in fracture fixation, without breakage. Both X-ray and microcomputed tomography analysis showed indirect healing by both pTa trabecular bone metal plates and titanium (Ti) plates; however, elastic fixation and obvious callus formation were observed after fixation with pTa trabecular bone metal plates, indicating better bone repair. Histology showed that pTa promoted the formation of new bone and integrated well with the host bone. Therefore, this novel pTa trabecular bone metal plate has good prospects for application in treating fractures.
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Affiliation(s)
| | | | | | - Xiaohu Wang
- Orthopaedic of Department, Affiliated ZhongShan Hospital of Dalian University, Dalian, Liaoning 116001, China
| | - Jingyu Li
- Orthopaedic of Department, Affiliated ZhongShan Hospital of Dalian University, Dalian, Liaoning 116001, China
| | - Jiahui Yang
- Orthopaedic of Department, Affiliated ZhongShan Hospital of Dalian University, Dalian, Liaoning 116001, China
| | - Simiao Tian
- Orthopaedic of Department, Affiliated ZhongShan Hospital of Dalian University, Dalian, Liaoning 116001, China
| | - Chengjun Wu
- School of Biomedical Engineering, Faculty of Electronic Information and Electrical Engineering, Dalian University of Technology, Dalian, Liaoning 116024, China
| | - Dewei Zhao
- Correspondence address. Tel: +86 0411 62893509, E-mail:
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Abstract
BACKGROUND The risk of displaced and comminuted midshaft clavicle fractures is increased in high-energy traumas such as sport injuries and traffic accidents. Open reduction and plate fixation have been widely used for midshaft clavicle fractures. Among various plates for clavicle shaft fractures, superior locking compression plates (LCPs) have been mostly used. In plate fixation, nonunion caused by implant failure is the most difficult complication. The most common reasons for metal plate failure are excessive stress and stress concentration caused by cantilever bending. These causes were easily addressed using a locking screw cap (LSC). METHODS The clavicle 3-dimensional image was made from a computed tomography scan, and the clavicle midshaft fracture model was generated with a 10-mm interval. The fracture model was fixed with a superior LCP, and finite element analysis was conducted between the presence (with LSC model) and absence (without LSC model) of an LSC on the site of the fracture. The stresses of screw holes in models with and without LSCs were measured under 3 forces: 100 N cantilever bending force, 100 N axial compression force, and 1 N·m axial torsion force. After the finite element analysis, a validation test was conducted on the cantilever bending force known as the greatest force applied to superior locking plates. RESULTS The mean greatest stress under the cantilever bending force was significantly greater than other loading forces. The highest stress site was the screw hole edge on the fracture site in both models under the cantilever bending and axial compression forces. Under the axial torsional force, the maximum stress point was the lateral first screw hole edge. The ultimate plate stress of the with LSC model is completely lower than that of the without LSC model. According to the validation test, the stiffness, ultimate load, and yield load of the with LSC model were higher than those of the without LSC model. CONCLUSIONS Therefore, inserting an LSC into an empty screw hole in the fracture area reduces the maximum stress on an LCP and improves biomechanical stability.
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Affiliation(s)
- Dae-Geun Kim
- Department of Orthopedic Surgery, College of Medicine, Soonchunhyang University Gumi Hospital, Gumi, Republic of Korea
- *Correspondence: Dae-Geun Kim, Department of Orthopedic Surgery, Soonchunhyang University Gumi Hospital, 179 1Gongda-ro, Gumi 39371, Korea (e-mail: )
| | - Soo Min Kim
- Convergence Material Research Center, Innovative Technology Research Division, Gumi Electronics & Information Technology Research Institute (GERI), Gumi, Republic of Korea
| | - Yoonkap Kim
- Convergence Material Research Center, Innovative Technology Research Division, Gumi Electronics & Information Technology Research Institute (GERI), Gumi, Republic of Korea
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Jamil K, Yahaya MY, Abd-Rasid AF, Ibrahim S, Abdul-Rashid AH. Angular Deformities of the Knee in Children Treated with Guided Growth. Malays Orthop J 2021; 15:26-35. [PMID: 34429819 PMCID: PMC8381675 DOI: 10.5704/moj.2107.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 04/05/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction: The guided growth technique is an alternative to corrective osteotomy for treating angular deformities of the extremities. It has the advantage of being minimally invasive and is effective in a growing child. This study reports on the outcome of guided growth technique using a plate in correcting knee angular deformities. Material and Methods: We conducted a retrospective study of children with angular deformity of the knee treated by the guided growth technique from January 2010 to December 2015 in a tertiary centre. The guided growth technique was done using either the flexible titanium plate (8-plate) or the 2-hole reconstruction plate. Correction of deformity was assessed on radiographs by evaluating the mechanical axis deviation and tibiofemoral angle. The implants were removed once deformity correction was achieved. Results: A total of 17 patients (27 knees) were evaluated. Twenty-two knees (81.5%) achieved complete correction of the deformity. The median age was 4.0 (interquartile range 3.0-6.0) years and the median Body Mass Index (BMI) was 26.0 (25.0-28.0). There were 7 unilateral and 10 bilateral deformities with different pathologies (14 tibia vara, 3 genu valgus). The median rate of correction was 0.71° per month. One patient (1 knee) had screw pull-out and two patients (4 knees) had broken screws in the proximal tibia. Three patients (5 knees) failed to achieve complete correction and were subsequently treated with corrective osteotomies. Out of five patients (8 knees) who were followed-up for at least 12 months after removal of hardware, two had rebound deformities. No permanent growth retardation occurred in our patients. Conclusion: Our outcome for guided growth to correct knee angular deformity was similar to other studies. Guided growth is safe to perform in children below 12 years old and has good outcome in idiopathic genu valgus and Langeskiold II for tibia vara. Patients should be observed for recurrence until skeletal maturity following implant removal.
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Affiliation(s)
- K Jamil
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - M Y Yahaya
- Department of Orthopaedics, Universiti Teknologi Mara, Batu Caves, Malaysia.,Faculty of Medicine, Universiti Teknologi Mara, Sungai Buloh, Malaysia
| | - A F Abd-Rasid
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - S Ibrahim
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - A H Abdul-Rashid
- Department of Orthopaedics and Traumatology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Ng SL, Das S, Ting YP, Wong RCW, Chanchareonsook N. Benefits and Biosafety of Use of 3D-Printing Technology for Titanium Biomedical Implants: A Pilot Study in the Rabbit Model. Int J Mol Sci 2021; 22:8480. [PMID: 34445182 DOI: 10.3390/ijms22168480] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/03/2021] [Accepted: 08/04/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Titanium has been used in osteosynthesis for decades and its compatibility and safety is unquestioned. Studies have shown that there is release and collection of titanium in the organ systems with little note of toxicity. The gold standard is considered to be titanium osteosynthesis plate produced by milling methods. The use of customized titanium plates produced with 3D printing, specifically direct metal laser sintering, have found increasing use in recent years. It is unknown how much titanium is released in these printed titanium implants, which is known to be potentially porous, depending on the heat settings of the printer. We hypothesize that the amount of titanium released in printed titanium implants may be potentially more or equal compared to the gold standard, which is the implant produced by milling. METHODS We studied the biosafety of this technology and its products by measuring serum and organ titanium levels after implantation of 3D-printed versus traditionally fabrication titanium plates and screws in a pilot study using the rabbit model. A total of nine rabbits were used, with three each in the control, milled and printed titanium group. The animals were euthanized after six months. Serum and organs of the reticuloendothelial system were harvested, digested and assayed for titanium levels. RESULTS Organ and serum titanium levels were significantly higher in rabbit subjects implanted with titanium implants (milled and printed) compared to the control group. However, there was no significant difference in organ and serum titanium levels of subjects implanted with milled and traditionally fabricated titanium implants. CONCLUSIONS The biosafety of use of 3D-printed titanium implants and traditionally fabricated titanium implants are comparable. With this in mind, 3D-printed custom implants can not only replace, but will very possibly surpass traditionally fabricated titanium implants in the mode and extent of use.
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Al-Sobayil F, Sadan MA, El-Shafaey ES, Ahmed AF. Can bone marrow aspirate improve mandibular fracture repair in camels ( Camelus dromedarius)? A preliminary study. J Vet Sci 2021; 21:e90. [PMID: 33263237 PMCID: PMC7710458 DOI: 10.4142/jvs.2020.21.e90] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 08/30/2020] [Accepted: 10/08/2020] [Indexed: 11/20/2022] Open
Abstract
Background Mandibular fractures are common in camels, leading to considerable economic losses. This study explored methods of improving mandibular fractures repair, adjuvant with interdental wire, or bone plate fixation. Autologous bone marrow (BM) injection enhances osteogenesis and rapid healing. Objectives To investigate the effect of autologous BM aspirate as an adjuvant treatment for repairing mandibular fractures in camels with interdental wire, or bone plate fixation. Methods Thirty dromedary camels aged 5–8 years and of both sexes were randomly divided into 4 treatment groups: group 1 (n = 10) treated with stainless steel wire fixation and BM injection at the fracture line, group 2 (n = 10) treated with plate fixation and BM injection at the fracture line, group 3 (n = 5) treated with stainless steel bone wire fixation and placebo saline injection at the fracture line, and group 4 (n = 5) treated with plate fixation and placebo injection at the fracture line. The mandibular fractures were followed weekly for 12 weeks postoperatively to assess improvement and healing based on clinical evaluation, radiographic union scale, and bone turnover markers (i.e., bone alkaline phosphatase, osteocalcin, pyridinoline, and deoxypyridinoline). Results Compared to other groups, elevated bone turnover markers in group 1 were demonstrated (p < 0.05) on the seventh postoperative day. Likewise, compared to other groups, both clinical findings and radiographic union scale significantly improved (p < 0.05) in group 1 on the 56th postoperative day. Conclusions BM aspirate has a promising beneficial osteogenic effect on mandibular fracture repair in camels, most notably when combined with interdental wire fixation.
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Affiliation(s)
- Fahd Al-Sobayil
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraidah 51452, Qassim, Saudi Arabia
| | - Madeh A Sadan
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraidah 51452, Qassim, Saudi Arabia.,Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, South Valley University, Qena 83523, Egypt
| | - El Sayed El-Shafaey
- Department of Veterinary Medicine, College of Agriculture and Veterinary Medicine, Qassim University, Buraidah 51452, Qassim, Saudi Arabia.,Department of Surgery, Anesthesiology and Radiology, Faculty of Veterinary Medicine, Mansoura University, Mansoura 35516, Egypt.
| | - Ahmed F Ahmed
- Department of Animal Surgery, Faculty of Veterinary Medicine, Assiut University, Assiut 71526, Egypt
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Fernández-Iglesias Á, Fuente R, Gil-Peña H, Alonso-Durán L, Santos F, López JM. The Formation of the Epiphyseal Bone Plate Occurs via Combined Endochondral and Intramembranous-Like Ossification. Int J Mol Sci 2021; 22:ijms22020900. [PMID: 33477458 PMCID: PMC7830543 DOI: 10.3390/ijms22020900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/08/2021] [Accepted: 01/15/2021] [Indexed: 11/24/2022] Open
Abstract
The formation of the epiphyseal bone plate, the flat bony structure that provides strength and firmness to the growth plate cartilage, was studied in the present study by using light, confocal, and scanning electron microscopy. Results obtained evidenced that this bone tissue is generated by the replacement of the lower portion of the epiphyseal cartilage. However, this process differs considerably from the usual bone tissue formation through endochondral ossification. Osteoblasts deposit bone matrix on remnants of mineralized cartilage matrix that serve as a scaffold, but also on non-mineralized cartilage surfaces and as well as within the perivascular space. These processes occur simultaneously at sites located close to each other, so that, a core of the sheet of bone is established very quickly. Subsequently, thickening and reshaping occurs by appositional growth to generate a dense parallel-fibered bone structurally intermediate between woven and lamellar bone. All these processes occur in close relationship with a cartilage but most of the bone tissue is generated in a manner that may be considered as intramembranous-like. Overall, the findings here reported provide for the first time an accurate description of the tissues and events involved in the formation of the epiphyseal bone plate and gives insight into the complex cellular events underlying bone formation at different sites on the skeleton.
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Affiliation(s)
- Ángela Fernández-Iglesias
- Division of Pediatrics, Department of Medicine, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Asturias, Spain; (Á.F.-I.); (R.F.); (H.G.-P.); (L.A.-D.); (F.S.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Asturias, Spain
| | - Rocío Fuente
- Division of Pediatrics, Department of Medicine, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Asturias, Spain; (Á.F.-I.); (R.F.); (H.G.-P.); (L.A.-D.); (F.S.)
| | - Helena Gil-Peña
- Division of Pediatrics, Department of Medicine, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Asturias, Spain; (Á.F.-I.); (R.F.); (H.G.-P.); (L.A.-D.); (F.S.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Asturias, Spain
- Department of Pediatrics, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Asturias, Spain
| | - Laura Alonso-Durán
- Division of Pediatrics, Department of Medicine, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Asturias, Spain; (Á.F.-I.); (R.F.); (H.G.-P.); (L.A.-D.); (F.S.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Asturias, Spain
| | - Fernando Santos
- Division of Pediatrics, Department of Medicine, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Asturias, Spain; (Á.F.-I.); (R.F.); (H.G.-P.); (L.A.-D.); (F.S.)
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), 33011 Oviedo, Asturias, Spain
- Department of Pediatrics, Hospital Universitario Central de Asturias (HUCA), 33011 Oviedo, Asturias, Spain
| | - José Manuel López
- Division of Pediatrics, Department of Medicine, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Asturias, Spain; (Á.F.-I.); (R.F.); (H.G.-P.); (L.A.-D.); (F.S.)
- Department of Morphology and Cellular Biology, Faculty of Medicine, University of Oviedo, 33006 Oviedo, Asturias, Spain
- Correspondence:
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11
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Lim YN, Park IY, Kim JC, Byun SH, Yang BE. Comparison of Changes in the Condylar Volume and Morphology in Skeletal Class III Deformities Undergoing Orthognathic Surgery Using a Customized versus Conventional Miniplate: A Retrospective Analysis. J Clin Med 2020; 9:E2794. [PMID: 32872568 DOI: 10.3390/jcm9092794] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 08/26/2020] [Accepted: 08/28/2020] [Indexed: 11/28/2022] Open
Abstract
With the great leap in the development of three-dimensional computer-assisted surgical technology, surgeons can use a variety of assistive methods to achieve better results and evaluate surgical outcomes in detail. This retrospective study aimed to evaluate the postoperative stability after bilateral sagittal split ramus osteotomy by volume rendering methods and to evaluate how postoperative stability differs depending on the type of surgical plate. Of the patients who underwent BSSRO, ten patients in each group (non-customized miniplate and customized miniplate) who met the inclusion criteria were selected. Preoperative and postoperative cone-beam computed tomography data were collected, and condylar morphological and landmark measurements were obtained using Checkpoint and OnDemand software, respectively. The postoperative condylar morphological dataset revealed no significant difference (p > 0.05) between the two groups. No significant difference (p > 0.05) was observed between the two groups in horizontal, vertical, or angular landmark measurements used to quantify operational stability. These results indicate that there is no difference in the surgical outcome between the patient-specific system and the conventional method, which will allow clinicians to take advantage of the patient-specific system for this surgical procedure, with favorable results, as with the conventional method.
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Arumugam S, Kandasamy J, Md Shah AU, Hameed Sultan MT, Safri SNA, Abdul Majid MS, Basri AA, Mustapha F. Investigations on the Mechanical Properties of Glass Fiber/Sisal Fiber/Chitosan Reinforced Hybrid Polymer Sandwich Composite Scaffolds for Bone Fracture Fixation Applications. Polymers (Basel) 2020; 12:E1501. [PMID: 32640502 DOI: 10.3390/polym12071501] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 11/25/2022] Open
Abstract
This study aims to explore the mechanical properties of hybrid glass fiber (GF)/sisal fiber (SF)/chitosan (CTS) composite material for orthopedic long bone plate applications. The GF/SF/CTS hybrid composite possesses a unique sandwich structure and comprises GF/CTS/epoxy as the external layers and SF/CTS/epoxy as the inner layers. The composite plate resembles the human bone structure (spongy internal cancellous matrix and rigid external cortical). The mechanical properties of the prepared hybrid sandwich composites samples were evaluated using tensile, flexural, micro hardness, and compression tests. The scanning electron microscopic (SEM) images were studied to analyze the failure mechanism of these composite samples. Besides, contact angle (CA) and water absorption tests were conducted using the sessile drop method to examine the wettability properties of the SF/CTS/epoxy and GF/SF/CTS/epoxy composites. Additionally, the porosity of the GF/SF/CTS composite scaffold samples were determined by using the ethanol infiltration method. The mechanical test results show that the GF/SF/CTS hybrid composites exhibit the bending strength of 343 MPa, ultimate tensile strength of 146 MPa, and compressive strength of 380 MPa with higher Young’s modulus in the bending tests (21.56 GPa) compared to the tensile (6646 MPa) and compressive modulus (2046 MPa). Wettability study results reveal that the GF/SF/CTS composite scaffolds were hydrophobic (CA = 92.41° ± 1.71°) with less water absorption of 3.436% compared to the SF/CTS composites (6.953%). The SF/CTS composites show a hydrophilic character (CA = 54.28° ± 3.06°). The experimental tests prove that the GF/SF/CTS hybrid composite can be used for orthopedic bone fracture plate applications in future.
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Zhang J, Chen L, Li Z, Nie W, Xu Z. [A comparative study of titanium elastic intramedullary nail internal fixation and bone plate internal fixation in the treatment of adult Galeazzi fracture]. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi 2018; 32:406-411. [PMID: 29806297 PMCID: PMC8414345 DOI: 10.7507/1002-1892.201705080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 03/06/2018] [Indexed: 11/03/2022]
Abstract
Objective To explore the effectiveness difference between titanium elastic intramedullary nail internal fixation and bone plate internal fixation in the treatment of adult Galeazzi fracture. Methods Ninety-seven patients of Galeazzi fracture according with the selection criteria were divided into 2 groups by prospective cohort study, who were admitted between January 2012 and November 2015. In the patients, 59 were treated with open reduction and bone plate internal fixation (plate group), and 38 with titanium elastic intramedullary nail internal fixation (minimally invasive group). There was no significant difference in the gender, age, cause of injury, fracture site, type of fracture, and time from injury to operation between 2 groups ( P>0.05). The operation time, intraoperative blood loss, fracture healing time, and complications were recorded and compared between 2 groups, and the forearm function was evaluated by Anderson score. Results All the patients were followed up 12-23 months (mean, 17 months). The operation time, intraoperative blood loss, fracture healing time of minimally invasive group were significantly less than those in plate group ( P<0.05). There were 1 case of fracture nonunion, 1 case of wound infection in plate group, and 1 case of nail tail slight infection in minimally invasive group, which were all cured after the corresponding treatment. The remaining patients had good fracture healing, and no vascular injury, internal fixation failure, deep infection, or other complications occurred. According to Anderson score at 12 months after operation, the forearm function results were excellent in 46 cases, good in 12 cases, and poor in 1 case, with an excellent and good rate of 98.3% in plate group; and the results were excellent in 26 cases, good in 11 cases, and poor in 1 case, with an excellent and good rate of 97.4% in minimally invasive group; showing no significant difference ( χ2=0.10, P=0.75). Conclusion Minimally invasive fixation with titanium elastic nail has such advantages as small damage, quick recovery, no skin scarring, etc. As long as the correct indication is selected, minimally invasive titanium intramedullary nail internal fixation of Galeazzi fractures can also get good effectiveness.
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Affiliation(s)
- Junwei Zhang
- Shandong University of Traditional Chinese Medicine, Ji'nan Shandong, 250355, P.R.China;The 1st Department of Trauma Rehabilitation, Wendeng Osteopathic Hospital in Shandong Province, Weihai Shandong, 264400, P.R.China
| | - Lingling Chen
- Orthopaedic Institute, Wendeng Osteopathic Hospital in Shandong Province, Weihai Shandong, 264400, P.R.China
| | - Zhaohui Li
- The 1st Department of Trauma Rehabilitation, Wendeng Osteopathic Hospital in Shandong Province, Weihai Shandong, 264400, P.R.China
| | - Weizhi Nie
- The 1st Department of Trauma Rehabilitation, Wendeng Osteopathic Hospital in Shandong Province, Weihai Shandong, 264400, P.R.China
| | - Zhanwang Xu
- Shandong University of Traditional Chinese Medicine, Ji'nan Shandong, 250355,
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Tan Y, Hu J, Ren L, Zhu J, Yang J, Liu D. A Passive and Wireless Sensor for Bone Plate Strain Monitoring. Sensors (Basel) 2017; 17:E2635. [PMID: 29144380 PMCID: PMC5713191 DOI: 10.3390/s17112635] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 11/11/2017] [Accepted: 11/13/2017] [Indexed: 11/17/2022]
Abstract
This paper reports on a sensor for monitoring bone plate strain in real time. The detected bone plate strain could be used for judging the healing state of fractures in patients. The sensor consists of a magnetoelastic material, which can be wirelessly connected and passively embedded. In order to verify the effectiveness of the sensor, a tibia-bone plate-screw (TBS) model was established using the finite element analysis method. A variation of the bone plate strain was obtained via this model. A goat hindquarter tibia was selected as the bone fracture model in the experiment. The tibia was fixed on a high precision load platform and an external force was applied. Bone plate strain variation during the bone fracture healing process was acquired with sensing coils. Simulation results indicated that bone plate strain decreases as the bone gradually heals, which is consistent with the finite element analysis results. This validated the soundness of the sensor reported here. This sensor has wireless connections, no in vivo battery requirement, and long-term embedding. These results can be used not only for clinical practices of bone fracture healing, but also for bone fracture treatment and rehabilitation equipment design.
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Affiliation(s)
- Yisong Tan
- School of Mechanical Engineering, Northeast Electric Power University, Jilin 132012, China.
| | - Jiale Hu
- School of Mechanical Engineering, Northeast Electric Power University, Jilin 132012, China.
| | - Limin Ren
- School of Mechanical Engineering, Northeast Electric Power University, Jilin 132012, China.
| | - Jianhua Zhu
- School of Mechanical Engineering, Northeast Electric Power University, Jilin 132012, China.
| | - Jiaqi Yang
- School of Mechanical Engineering, Northeast Electric Power University, Jilin 132012, China.
| | - Di Liu
- School of Mechanical Engineering, Northeast Electric Power University, Jilin 132012, China.
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Ribeiro-Junior PD, Vago TM, da Silva WS, Padovan LEM, Tiossi R. Mandibular angle fractures treated with a single miniplate without postoperative maxillomandibular fixation: A retrospective evaluation of 50 patients. Cranio 2017; 36:234-242. [PMID: 28553749 DOI: 10.1080/08869634.2017.1330799] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE This retrospective study evaluated the use of a single miniplate for the treatment of mandibular angle fractures (MAF). METHODS Fifty patients with 53 MAF were treated by open reduction and internal fixation with the use of a single miniplate and were analyzed in this study. RESULTS Five patients with MAF had postoperative complications that required additional procedures. Three patients had postoperative infection, one patient complained of malocclusion in the first postoperative week, and one patient had miniplate exposure three months after surgery. Every additional procedure was performed in the office under local anesthesia without disruption of the initial fracture treatment. Postoperative maxillomandibular fixation (MMF) was performed in four patients. Treatment of MAF using a single miniplate was effective, with low morbidity and with low rates of postoperative complications. MAF can be treated without MMF, and stability is improved when long miniplates are used. CONCLUSIONS The use of a single miniplate is therefore encouraged. However, postoperative MMF should be considered with the presence of little contact between bone segments, malocclusion, or extensive tooth loss.
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Affiliation(s)
| | - Thessio Miná Vago
- a Department of Oral and Maxillofacial Surgery , Sacred Heart University , Bauru , SP , Brazil
| | | | | | - Rodrigo Tiossi
- b Department of Restorative Dentistry , School of Dentistry, State University of Londrina , Londrina , PR , Brazil
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16
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Wang D, Wang Y, Wu S, Lin H, Yang Y, Fan S, Gu C, Wang J, Song C. Customized a Ti6Al4V Bone Plate for Complex Pelvic Fracture by Selective Laser Melting. Materials (Basel) 2017; 10:E35. [PMID: 28772395 DOI: 10.3390/ma10010035] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 12/16/2016] [Accepted: 12/29/2016] [Indexed: 11/17/2022]
Abstract
In pelvic fracture operations, bone plate shaping is challenging and the operation time is long. To address this issue, a customized bone plate was designed and produced using selective laser melting (SLM) technology. The key steps of this study included designing the customized bone plate, metal 3D printing, vacuum heat treatment, surface post-processing, operation rehearsal, and clinical application and evaluation. The joint surface of the bone plate was placed upwards with respect to the build platform to keep it away from the support and to improve the quality of the joint surface. Heat conduction was enhanced by adding a cone-type support beneath the bone plate to prevent low-quality fabrication due to poor heat conductivity of the Ti-6Al-4V powder. The residual stress was eliminated by exposing the SLM-fabricated titanium-alloy bone plate to a vacuum heat treatment. Results indicated that the bone plate has a hardness of HV1 360–HV1 390, an ultimate tensile strength of 1000–1100 MPa, yield strength of 900–950 MPa, and an elongation of 8%–10%. Pre-operative experiments and operation rehearsal were performed using the customized bone plate and the ABC-made pelvic model. Finally, the customized bone plate was clinically applied. The intraoperative C-arm and postoperative X-ray imaging results indicated that the customized bone plate matched well to the damaged pelvis. The customized bone plate fixed the broken bone and guides pelvis restoration while reducing operation time to about two hours. The customized bone plate eliminated the need for preoperative titanium plate pre-bending, thereby greatly reducing surgical wounds and operation time.
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17
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Smith KE, Dupont KM, Safranski DL, Blair J, Buratti D, Zeetser V, Callahan R, Lin J, Gall K. Use of 3D Printed Bone Plate in Novel Technique to Surgically Correct Hallux Valgus Deformities. Tech Orthop 2016; 31:181-9. [PMID: 28337049 DOI: 10.1097/BTO.0000000000000189] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Three-dimensional (3-D) printing offers many potential advantages in designing and manufacturing plating systems for foot and ankle procedures that involve small, geometrically complex bony anatomy. Here, we describe the design and clinical use of a Ti-6Al-4V ELI bone plate (FastForward™ Bone Tether Plate, MedShape, Inc., Atlanta, GA) manufactured through 3-D printing processes. The plate protects the second metatarsal when tethering suture tape between the first and second metatarsals and is a part of a new procedure that corrects hallux valgus (bunion) deformities without relying on doing an osteotomy or fusion procedure. The surgical technique and two clinical cases describing the use of this procedure with the 3-D printed bone plate are presented within.
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18
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Graham ME, Chikka A, Goel VK. Inherent Strength of the osteo-WEDGE(™) Bone Plate Locking System for Arthrodesis of the First Metatarsocuneiform Joint: A Biomechanical Study. J Foot Ankle Surg 2016; 55:444-9. [PMID: 26884262 DOI: 10.1053/j.jfas.2015.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2012] [Indexed: 02/03/2023]
Abstract
First metatarsocuneiform joint arthrodesis with a locking bone plate and screw system has been effectively used to correct metatarsus primus varus and instability of the first ray. The goal of the present cadaveric biomechanical study was to quantify and compare the inherent strength of the first metatarsocuneiform joint and surrounding bones fixated with the osteo-WEDGE(™) bone plate locking system (OW) with that of intact specimens. Fourteen fresh-frozen adult human cadaveric foot specimens consisting of the first metatarsal and medial cuneiform bones with intact joint capsules and ligaments were used. The OW was implanted in 7 of these specimens at the first metatarsal cuneiform joint (MCJ), and the remaining 7 specimens were left intact. Each of the specimens was then subjected to axial force to simulate dorsiflexion of the first metatarsal using a cantilever bending test setup. Load was applied on the plantar aspect of the first metatarsal head until failure of the construct. The mean load and bending moment on the first MCJ at failure for the implanted specimens were 119.98 ± 56.76 N and 5.57 ± 2.71 Nm, respectively. For the intact specimens, the mean load and bending moment on the first MCJ at failure were 107.93 ± 60.90 N and 6.07 ± 3.18 Nm, respectively. None of the specimens showed catastrophic failure within the physiologic loading limits. These results imply that the mechanical strength of the OW is comparable to that of intact specimens. Thus, the first MCJ and surrounding bones fixated with an OW should be able to effectively withstand the vertical ground reaction forces the same as intact specimens.
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Affiliation(s)
| | - Avanthi Chikka
- Research Assistant, Graham International Implant Institute, Macomb, MI
| | - Vijay K Goel
- Distinguished University Professor, Endowed Chair and McMaster-Gardner Professor of Orthopaedic Bioengineering, and Co-Director, Engineering Center for Orthopaedic Research Excellence (E-CORE), Departments of Bioengineering and Orthopaedic Surgery, Colleges of Engineering and Medicine, University of Toledo, Toledo, OH
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19
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Hammou N, Abid H, Shimi M, El Ibrahimi A, El Mrini A. [Surgical treatment of articular fractures of the calcaneus by bone plate]. Pan Afr Med J 2015; 20:291. [PMID: 26161214 PMCID: PMC4484189 DOI: 10.11604/pamj.2015.20.291.4635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 03/10/2015] [Indexed: 11/18/2022] Open
Abstract
Les fractures du calcanéum sont peu fréquentes mais le plus souvent graves. Le traitement chirurgical par plaque vissée est ardemment défendu. L'objectif de notre travail rétrospectif est d’évaluer les résultats du traitement chirurgical des fractures articulaires du calcanéum à travers une série de 12 patients opérée aux service d'orthopédie du CHU Hassan II de Fès sur une durée de 3 ans, et les comparer aux données de la littérature. L’âge moyen dans notre série était de 34 ans, le geste opératoire était réalisé au 7ème jour. Tous nos patient ont bénéficie d'une réduction à foyer ouvert avec une ostéosynthèse par plaques vissées. Le recul moyen était de 12 mois et les résultats fonctionnels ont été évaluer selon le score de Kitaoka.
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Affiliation(s)
| | - Hatim Abid
- Service de Chirurgie Ostéo-Articulaire B4, CHU Hassan II, Fès, Maroc
| | - Mohammed Shimi
- Service de Chirurgie Ostéo-Articulaire B4, CHU Hassan II, Fès, Maroc
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Cronskär M, Rasmussen J, Tinnsten M. Combined finite element and multibody musculoskeletal investigation of a fractured clavicle with reconstruction plate. Comput Methods Biomech Biomed Engin 2013; 18:740-8. [PMID: 24156391 DOI: 10.1080/10255842.2013.845175] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This paper addresses the evaluation of clavicle fixation devices, by means of computational models. The aim was to develop a method for comparison of stress distribution in various fixation devices, to determine whether the use of multibody musculoskeletal input in such model is applicable and to report the approach. The focus was on realistic loading and the motivation for the work is that the treatment can be enhanced by a better understanding of the loading of the clavicle and fixation device. The method can be used to confirm the strength of customised plates, for optimisation of new plates and to complement experimental studies. A finite element (FE) mesh of the clavicle geometry was created from computed tomography data and imported into the FE solver where the model was subjected to muscle forces and other boundary conditions from a multibody musculoskeletal model performing a typical activity of daily life. A reconstruction plate and screws were also imported into the model. The combination models returned stresses and displacements of plausible magnitudes in all included parts and the result, upon further development and validation, may serve as a design guideline for improved clavicle fixation.
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Affiliation(s)
- Marie Cronskär
- a Department of Technology and Sustainable Development , Mid Sweden University , 83125 Östersund , Sweden
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Omori S, Murase T, Kataoka T, Kawanishi Y, Oura K, Miyake J, Tanaka H, Yoshikawa H. Three-dimensional corrective osteotomy using a patient-specific osteotomy guide and bone plate based on a computer simulation system: accuracy analysis in a cadaver study. Int J Med Robot 2013; 10:196-202. [PMID: 24106094 DOI: 10.1002/rcs.1530] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2013] [Revised: 07/25/2013] [Accepted: 07/31/2013] [Indexed: 11/11/2022]
Abstract
BACKGROUND The accuracy of three-dimensional (3-D) corrective osteotomy using a patient-specific osteotomy guide and bone plate based on computer simulation was investigated. METHODS Six fresh-frozen cadaver upper limbs were used. A patient-specific osteotomy guide designed to realize a preplanned osteotomy was set on the distal humerus and distal radius, and the error in the setting location was evaluated. After the osteotomy, the surgical site was fixed using a patient-specific bone plate designed to exactly fit the anatomical shape of the postoperative bone model. The postoperative results were compared with the preoperative simulation. RESULTS The errors in the guide location on the humerus and radius were <1.5° and 1.0 mm and <1.0° and 1.0 mm, respectively. The plate fixation errors of the humerus and radius were <2.0° and 1.5 mm and <1.0° and 1.0 mm, respectively. CONCLUSIONS The system is sufficiently feasible to realize precise 3-D deformity correction of a limb.
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Affiliation(s)
- Shinsuke Omori
- Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan
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Bell AD, Lascau-Coman V, Sun J, Chen G, Lowerison MW, Hurtig MB, Hoemann CD. Bone-Induced Chondroinduction in Sheep Jamshidi Biopsy Defects with and without Treatment by Subchondral Chitosan-Blood Implant: 1-Day, 3-Week, and 3-Month Repair. Cartilage 2013; 4:131-43. [PMID: 26069656 PMCID: PMC4297102 DOI: 10.1177/1947603512463227] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Delivery of chitosan to subchondral bone is a novel approach for augmented marrow stimulation. We evaluated the effect of 3 presolidified chitosan-blood implant formulations on osteochondral repair progression compared with untreated defects. DESIGN In N = 5 adult sheep, six 2-mm diameter Jamshidi biopsy holes were created bilaterally in the medial femoral condyle and treated with presolidified chitosan-blood implant with fluorescent chitosan tracer (10 kDa, 40 kDa, or 150k Da chitosan, left knee) or left to bleed (untreated, right knee). Implant residency and osteochondral repair were assessed at 1 day (N = 1), 3 weeks (N = 2), or 3 months (N = 2) postoperative using fluorescence microscopy, histomorphometry, stereology, and micro-computed tomography. RESULTS Chitosan implants were retained in 89% of treated Jamshidi holes up to 3 weeks postoperative. At 3 weeks, biopsy sites were variably covered by cartilage flow, and most bone holes contained cartilage flow fragments and heterogeneous granulation tissues with sparse leukocytes, stromal cells, and occasional adipocytes (volume density 1% to 3%). After 3 months of repair, most Jamshidi bone holes were deeper, remodeling at the edges, filled with angiogenic granulation tissue, and lined with variably sized chondrogenic foci fused to bone trabeculae or actively repairing bone plate. The 150-kDa chitosan implant elicited more subchondral cartilage formation compared with 40-kDa chitosan-treated and control defects (P < 0.05, N = 4). Treated defects contained more mineralized repair tissue than control defects at 3 months (P < 0.05, N = 12). CONCLUSION Bone plate-induced chondroinduction is an articular cartilage repair mechanism. Jamshidi biopsy repair takes longer than 3 months and can be influenced by subchondral chitosan-blood implant.
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Affiliation(s)
- Angela D. Bell
- Department of Clinical Studies, University of Guelph, Guelph, Ontario, Canada
| | - Viorica Lascau-Coman
- Department of Chemical Engineering, École Polytechnique, Montreal, Quebec, Canada
| | - Jun Sun
- BioSyntech/Piramal Healthcare Canada, Montreal, Quebec, Canada
| | - Gaoping Chen
- Department of Chemical Engineering, École Polytechnique, Montreal, Quebec, Canada
| | - Mark W. Lowerison
- Department of Clinical Studies, University of Guelph, Guelph, Ontario, Canada
| | - Mark B. Hurtig
- Department of Clinical Studies, University of Guelph, Guelph, Ontario, Canada
| | - Caroline D. Hoemann
- Department of Chemical Engineering, École Polytechnique, Montreal, Quebec, Canada,Institute of Biomedical Engineering, École Polytechnique, Montreal, Quebec, Canada
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Ibn El Kadi K, Benabid M, Saliou S, Zizah S, Mezzani A, Lahrach K, Marzouki A, Boutayeb F. [Surgical treatment of Galeazzi fractures in adults by compression plate: about 28 cases]. Pan Afr Med J 2013; 16:61. [PMID: 24711861 PMCID: PMC3976666 DOI: 10.11604/pamj.2013.16.61.2856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Accepted: 07/04/2013] [Indexed: 11/30/2022] Open
Abstract
La fracture de Galeazzi associe une fracture diaphysaire du radius ou des deux os de l'avant bras à une luxation de l'articulation radio ulnaire distale. Décrite en 1934, sa fréquence varie chez l'adulte entre 2,7% et 6,8% de l'ensemble des fractures de l'avant bras. Le traitement admis de façon consensuel chez l'adulte est chirurgical reposant sur une ostéosynthèse stable par une plaque vissée de compression dynamique associée ou non à un embrochage de la radio ulnaire distale. Nous rapportons dans notre étude les résultats cliniques de 28 patients colligés au service de traumatologie et orthopédie A du CHU Hassan II de Fès sur une période de 06 ans. L’âge moyen de nos patients était de 30 ans avec prédominance masculine de 90%; tous nos patients ont présenté un traumatisme de poignet lors d'un accident de sport. Le côté droit était atteint dans 75% des cas. Le bilan radiologique objectiva une fracture diaphysaire du raduis associée à une luxation radio ulnaire distale; nous avons adopté la classification de de Mansat. Le traitement a consisté en une synthèse par une plaque vissée dynamique associée à un embrochage transversal chez six patients qui ont présenté une instabilité de la radio ulnaire distale. L'immobilisation par attelle plâtrée postérieure BABP était de mise. Après un recul de 36 mois, nos résultats ont été très satisfaisants suivant le score de Mestdagh, avec bonne récupération de la mobilité du poignet et reprise de toute activité sportive.
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Affiliation(s)
- Khalid Ibn El Kadi
- Service de chirurgie orthopédique et traumatologique (A), Pr F.Boutayeb, centre hospitalier universitaire Hassan II de Fès, Maroc
| | - Mounir Benabid
- Service de chirurgie orthopédique et traumatologique (A), Pr F.Boutayeb, centre hospitalier universitaire Hassan II de Fès, Maroc
| | - Sarr Saliou
- Service de chirurgie orthopédique et traumatologique (A), Pr F.Boutayeb, centre hospitalier universitaire Hassan II de Fès, Maroc
| | - Said Zizah
- Service de chirurgie orthopédique et traumatologique (A), Pr F.Boutayeb, centre hospitalier universitaire Hassan II de Fès, Maroc
| | - Amine Mezzani
- Service de chirurgie orthopédique et traumatologique (A), Pr F.Boutayeb, centre hospitalier universitaire Hassan II de Fès, Maroc
| | - Kamal Lahrach
- Service de chirurgie orthopédique et traumatologique (A), Pr F.Boutayeb, centre hospitalier universitaire Hassan II de Fès, Maroc
| | - Amine Marzouki
- Service de chirurgie orthopédique et traumatologique (A), Pr F.Boutayeb, centre hospitalier universitaire Hassan II de Fès, Maroc
| | - Fawzi Boutayeb
- Service de chirurgie orthopédique et traumatologique (A), Pr F.Boutayeb, centre hospitalier universitaire Hassan II de Fès, Maroc
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