A comparison of conventional compression plates and locking compression plates using cantilever bending in an ilial fracture model.

OBJECTIVES: The purpose of this study was to compare the stiffness, yield load, ultimate load at failure, displacement at failure, and mode of failure in cantilever bending of locking compression plates (LCP) and dynamic compression plates (DCP) in an acute failure ilial fracture model. Our hypothesis was that the LCP would be superior to the DCP for all of these biomechanical properties. METHODS: Ten pelves were harvested from healthy dogs euthanatized for reasons unrelated to this study and divided into two groups. A transverse osteotomy was performed and stabilized with either a 6-hole DCP applied in compression or a 6-hole LCP. Pelves were tested in cantilever bending at 20 mm/min to failure and construct stiffness, yield load, ultimate load at failure, displacement at failure, and mode of failure were compared. RESULTS: The mean stiffness of DCP constructs (193 N/mm [95% CI 121 - 264]) and of LCP constructs (224 N/mm [95% CI 152 - 295]) was not significantly different. Mean yield load of DCP constructs (900 N [95% CI 649 -1151]) and of LCP constructs (984 N [95% CI 733 -1235]) was not significantly different. No significant differences were found between the DCP and LCP constructs with respect to mode of failure, displacement at failure, or ultimate load at failure. CLINICAL SIGNIFICANCE: Our study did not demonstrate any differences between DCP and LCP construct performance in acute failure testing in vitro.

Effect of the length of the superficial plate on bending stiffness, bending strength and strain distribution in stacked 2.0-2.7 veterinary cuttable plate constructs. An in vitro study.

OBJECTIVES: Use of stacked veterinary cuttable plates (VCP) increases the construct stiffness, but it also increases the stress protection and concentrates the stress at the extremities of the implants. We hypothesized that by shortening the superficial plate, it would not reduce the stiffness of the construct, but that it would reduce the stress concentration at the plate ends. METHODS: A 3 mm fracture gap model was created with copolymer acetal rods, stacked 2.0-2.7 VCP and 2.7 screws. The constructs consisted of an 11-hole VCP bottom plate and a 5-, 7-, 9- or 11-hole VCP superficial plate. Five of each construct were randomly tested for failure in four-point bending and axial loading. Stiffness, load at yield, and area under the curve until contact (AUC) were measured. Strains were recorded during elastic deformation for each configuration. RESULTS: During both testing methods, stiffness, load at yield and AUC progressively decreased when decreasing the length of the superficial plate. No statistically significant differences were obtained for load at yield in four-point bending and AUC in axial loading. The strain within the implant over the gap increased as the length of the superficial plate decreased. CLINICAL SIGNIFICANCE: Shortening the superficial plate reduces the stiffness and strength of the construct, and decreases stress concentration at the implants ends. As the cross section of the implant covering the gap remained constant, friction between the plates may play a role in the mechanical properties of stacked VCP.

Finite element analysis of wall stress in the equine pulmonary artery.

REASONS FOR PERFORMING STUDY: Arterial calcification is found frequently in the pulmonary artery of racehorses, but the aetiology is unknown. Calcification might be associated with increased wall stress due to arterial geometry (shape) and exercise-induced hypertension. HYPOTHESIS: High wall stress levels are found in the regions associated with calcified lesion formation, exacerbated as transluminal pressure increases to levels associated with exercise. METHODS: The pulmonary arteries of 5 horses, unaffected by calcification, were dissected and pressurised to resting and exercising physiological transluminal pressures and scanned with MRI. Arterial geometries were reconstructed to form 3D computer models and finite element analyses performed. Wall stress levels were measured in 4 regions of interest: the arterial trunk and bifurcation, the wall ipsilateral and contralateral to the bifurcation. Measurements were made for arterial transluminal pressures of 25, 50 and 100 mmHg. RESULTS: High wall stress levels were consistently found at the pulmonary artery bifurcation and wall ipsilateral to the bifurcation, where calcified lesions typically form. Lower wall stress levels were found along the trunk and the wall contralateral to the bifurcation where lesions are less frequently found. Wall stress levels increased 5-fold over a 4-fold increase in pressure. The wall stress levels ranged 10 kPa in the wall of the branch contralateral to the bifurcation at 25 mmHg to 400 kPa in the bifurcation at 100 mmHg. CONCLUSIONS: Wall stress from arterial geometry and increased pulmonary artery transluminal pressure are factors that may be associated with calcification of the equine pulmonary artery. POTENTIAL RELEVANCE: Arterial calcification may increase the risk of arterial wall failure in racing horses.

The biomechanical properties of the feline femur.

The purpose of this study was to determine the biomechanical properties of feline long bone by testing cadaver bone from mature cats in compression, three-point bending, notch sensitivity and screw pull-out strength. The determination of these properties is of clinical relevance with regard to the forces resulting in long bone fractures in cats as well as the behaviour and failure mode of surgical implants utilized for fracture stabilization and repair in the cat. Cadaveric cat femurs were tested in compression, three-point bending and in three-point bending after the addition of a 2.0 mm screw hole. Cortical screws, 2.7 mm in diameter, were inserted in cadaveric cat femur samples for screw pull-out testing. The mean maximum load to failure of mid diaphyseal feline femurs tested in compression was 4201+/-1218 N. Statistical analysis of the parameter of maximum load tested in compression revealed a statistical difference between sides (p=0.02), but not location (p=0.07), or location by side (p=0.12). The maximum strength of mid diaphyseal feline femurs tested in compression was 110.6+/-26.6 MPa. The modulus of elasticity of mid-diaphyseal cat femurs tested in compression was determined to be 5.004+/-0.970 GPa. The mean maximum load to failure of feline femurs tested in three-point bending was 443+/-98 N. The mean maximum load to failure of feline femurs tested in three-point bending after a 2.0 mm diameter hole was drilled in the mid-diaphyseal region of each sample through both cortices was 471+/-52 N. The mean maximum load required for screw pull-out of 2.7 mm cortical screws placed in feline femurs tested in tension was 886+/-221 N. This data should be suitable for investigating fracture biomechanics and the testing of orthopaedic constructs commonly used for fracture stabilization in the feline patient.

Evaluation of a short glass fibre-reinforced tube as a model for cat femur for biomechanical testing of orthopaedic implants.

The biomechanical testing of tubes made of third generation short glass fibre-reinforced (SGFR) material approximating cat femurs was performed in order to determine their suitability as cat femur surrogates for the biomechanical testing of orthopaedic implants. The tubes were tested in compression, three-point bending, notch testing, and screw pullout. Thin walled (B1-tubes) had a 13% lower maximum load to failure, a 19% higher maximum strength and a 13% lower elastic modulus compared to cat femurs tested in compression. B1-tubes maximum load to failure in three-point bending and screw pullout strength were considerably lower compared to cat femurs (29% and 63%, respectively). Notch testing was not performed on B1-tubes due to low bending strength. Thicker walled (B2-tubes) had a 23% higher maximum load to failure, a 10% higher maximum strength and a 21% lower elastic modulus compared to cat femurs tested in compression. The comparison of B2-tubes and cat femurs in three-point bending revealed a 7% increase in maximum load to failure for the B2-tubes. Drilled B2-tubes (notch testing) were weaker with a 30% lower load to failure compared to cat femurs. A screw pullout comparison of B2-tubes and cat femurs revealed a 2% increase in maximum load to failure for the B2-tubes. These tubes were intended to provide a model as a suitable surrogate for cat femurs for testing the bending strength of various orthopaedic constructs involving plates and screws. Testing revealed that third generation SGFR tubes were not suitable for these purposes and emphasizes the need to carefully evaluate the suitability of any model.

Mapping of donor and recipient site properties for osteochondral graft reconstruction of subchondral cystic lesions in the equine stifle joint.

REASONS FOR PERFORMING STUDY: To improve osteochondral graft reconstruction of subchondral cystic lesions in the medial and lateral femoral condyles by matching the material properties of donor and recipient sites. OBJECTIVES: To measure biomechanical and biochemical parameters that influence the function and healing of osteochondral grafts used to reconstruct subchondral cystic lesions. HYPOTHESIS: Suitable donor sites are available within the stifle joint for reconstructing the femoral condyles, despite considerable regional property variation. METHODS: Fifty-six osteochondral cores were harvested from 6 distal femurs for initial studies that determined subchondral bone modulus of elasticity and ultimate stress. In a second study, 28 osteochondral cores were harvested from 6 distal femurs to measure cartilage aggregate modulus, thickness and sulphated glycosaminoglycan (sGAG) content. Using micro-CT imaging, subchondral bone mineral density and bone volume fraction were also measured. In both studies 2-dimensional contour plots using a bicubic interpolation method and normalised data were generated to allow visual comparison of joint surface characteristics. Statistical comparisons between donor and recipient site raw data were made using an ANOVA for repeated measures with a post hoc Tukey test. RESULTS: Material properties of cartilage and bone vary considerably over the surface of the stifle joint but the central region of the medial condyle, where subchondral cystic lesions freqdently occur, typically demonstrated bone strength and modulus values of the highest observed. Cartilage thickness and aggregate modulus were highest in the medial femoral condyle and axial aspect of the lateral condyle. CONCLUSIONS: Material properties of the grafts from the trochlear groove and axial aspect of the lateral trochlear ridge were the closest match for those found in the medial condyle, whereas properties of the lateral condyle were most similar to those found in the trochlear groove and axial aspect of the medial trochlear ridge.

Modelling the bioelectric behaviour of halo pin-patient structures during magnetic resonance imaging.

Bioelectric compatibility of electrically conductive halo fixation devices and magnetic resonance (MR) imaging has been largely based on resulting image quality. Previous studies have focused primarily on improving image quality and, although the electrical characteristics of the system during imaging may have been noted, they have not been studied in depth. Utilizing both a theoretical and experimental approximation, this study focuses on the bioelectric characteristics of the pin-patient structures typically enountered in clinical halo fixation systems. Results indicate that the halo pin-patient system can be modelled using a resistor-inductor-capacitor circuit and that simple attempts at improving compatibility through increasing interface resistance by the use of insulated pins may not be an effective approach to improving halo instrumentation compatibility with new, stronger magnetic and higher-frequency resonance imaging systems.

Biomechanical evaluation of two halo pin designs, with, and without, intact periosteum.

The presence of periosteum has been hypothesized to adversely affect halo pin penetration and performance (Voor, 1992. Ph.D. Dissertation, Tulane University, New Orleans, LA). However, biomechanical testing of halo pins has historically been conducted on bone specimens with periosteum removed. This may have lead to an unrealistic measure of biomechanical pin performance. Our study compares the biomechanical performance of two halo pin designs on bovine bone specimens with, and without, intact periosteum. The two pin designs included in this study were the conventional pin (Bremer Medical) with conical tip, and a newly released trochar-style pin (DePuy AcroMed). Results showed the mean peak load before failure of the trochar-style pin (mean +/- 95% confidence interval: 656+/-29 N) to be significantly higher than the conventional pin (517+/-53 N) on bone with intact periosteum (p = 0.001). With the periosteum removed, the mean peak load of the trochar-style pin (655+/-99 N) remained statistically the same (p = 0.987), while the mean peak load of the conventional pin (634+/-65 N) increased significantly (p = 0.026). Variation of the data of the conventional pin significantly decreased from 32 to 19% on removal of periosteum (sigma = 165-103 N, respectively, p = 0.0967), while variation of the trochar-style remained statistically the same at 30-29% (sigma = 193-188 N, respectively, p = 0.954). These results show that the trochar-style pin may be biomechanically superior to the conventional pin for vertical forces experienced during immobilization. The performance of this new pin style may also not be significantly affected by overlying soft tissue. Use of this new pin style may, therefore, improve overall stability and fixation of the halo apparatus.

Shoulder and forelimb orientations and loading in sitting cats: implications for head and shoulder movement.

A three-dimensional static analysis was carried out to characterize the effects of ground reaction forces propagated through different joints in the forelimb and shoulder of quietly sitting cats. Stereofluoroscopy, used to identify the orientations of bones, showed that the scapula is held in a parasagittal plane, with its vertebral border located dorsally to the spines of thoracic vertebrae. The forelimb is held with the elbow flexed. Loading on the elbow tended to flex and adduct the ulna, whereas loading on the glenohumeral joint tended to extend, adduct and internally rotate the humerus. Loading on the scapula was confined primarily to the sagittal plane and tended to rotate the vertebral border of the scapula caudally around the head of the humerus. This caudally-directed moment suggests that the static equilibrium of the feline scapula depends upon muscular forces directed cranially, presumably by way of attachments on the skull and cervical column. The differing arrangement of the shoulder-to-neck transition in cats and humans suggests caution in the use of feline models to represent some aspects of human head movement.

Stereoradiogrammetric technique for estimating alignment of the joints in the hand and wrist.

A method and apparatus for quantitative measurement of the alignment and motion of the joints of the hand in three dimensions has been developed using stereoradiogrammetric principles. Alignment in planes of flexion-extension and radial-ulnar deviation can be determined to within 2.5 degrees; rotation about the long axis of the metacarpals or phalanges is more difficult to determine, and can be measured to within 7 degrees. Stereo views subtending angles in the range of 40 degrees were found to optimize the total system accuracy.

Strain gauged six-component load transducer for use in upper limb biomechanics.

A six-channel instrumented load transducer has been developed for measuring hand and upper limb loading (maximum design load, 2 kN). Modular in design, the transducer can be adapted to a variety of formats, thereby increasing the range of activities to which it can be applied. When used with a motion analysis system, hand loading can be determined with respect to a laboratory coordinate system irrespective of transducer orientation and position. Measurement accuracy of approximately +/- 1 per cent of applied loading has been determined through a system calibration.