The Mechanical Characterization and Comparions of Male and Female Calvaria Under Four-Point Bending Impacts.

The circumstances in which we mechanically test and critically assess human calvarium tissue would find relevance under conditions encompassing real-world head impacts. These conditions include, among other variables, impact velocities, and strain rates. Compared to quasi-static loading on calvaria, there is less reporting on the impact loading of the calvaria and consequently, there are relatively fewer mechanical properties on calvaria at relevant impact loading rates available in the literature. The purpose of this work was to report on the mechanical response of 23 human calvarium specimens subjected to dynamic four-point bending impacts. Impacts were performed using a custom-built four-point impact apparatus at impact velocities of 0.86-0.89 m/s resulting in surface strain rates of 2-3/s-representative of strain rates observed in vehicle collisions and blunt impacts. The study revealed comparable effective bending moduli (11-15 GPa) to the limited work reported on the impact mechanics of calvaria in the literature, however, fracture bending stress (10-47 MPa) was relatively less. As expected, surface strains at fracture (0.21-0.25%) were less compared to studies that performed quasi-static bending. Moreover, the study revealed no significant differences in mechanical response between male and female calvaria. The findings presented in this work are relevant to many areas including validating surrogate skull fracture models in silico or laboratory during impact and optimizing protective devices used by civilians to reduce the risk of a serious head injury.

Compressive mechanical properties of vitrified porcine menisci are superior to frozen and similar to fresh porcine menisci.

The common practice of freezing meniscal allograft tissue is limited due to the formation of damaging ice crystals. Vitrification, which eliminates the formation of damaging ice crystals, may allow the mechanical properties of meniscal allograft tissue to be maintained during storage and long-term preservation. The primary objective of this study was to investigate the differences between fresh, frozen, and vitrified porcine lateral menisci examining compressive mechanical properties in the axial direction. Unconfined compressive stress-relaxation testing was conducted to quantify the mechanical properties of fresh, frozen and vitrified porcine lateral menisci. The compressive mechanical properties investigated were peak and equilibrium stress, secant, instantaneous and equilibrium modulus, percent stress-relaxation, and relaxation time constants from three-term Prony series. Frozen menisci exhibited inferior compressive mechanical properties in comparison with fresh menisci (significant differences in peak and equilibrium stress, and secant, instantaneous and equilibrium modulus) and vitrified menisci (significant differences in peak stress, and secant and instantaneous modulus). Interestingly, fresh and vitrified menisci exhibited comparable compressive mechanical properties (stress, modulus and relaxation parameters). These findings are significant because (1) vitrification was successful in maintaining mechanical properties at values similar to fresh menisci, (2) compressive mechanical properties of fresh menisci were characterized providing a baseline for future research, and (3) freezing affected mechanical properties confirming that freezing should be used with caution in future investigations of meniscal mechanical properties. Vitrification was superior to freezing for preserving compressive mechanical properties of menisci which is an important advance for vitrification as a preservation option for meniscal allograft transplantation.

Quantifying Asymmetry and Performance of Lower Limb Mechanical Muscle Function in Varsity Athletes-Using Non-Countermovement Jumps.

ABSTRACT: Stadnyk, M, Sepehri, M, Cook, M, Adeeb, S, and Westover, L. Quantifying asymmetry and performance of lower limb mechanical muscle function in varsity athletes-using non-countermovement jumps. J Strength Cond Res 37(1): 98-106, 2023-The ability to automatically quantify jump performance and lower limb muscle function in athletes would be beneficial for both training and rehabilitation purposes. Countermovement jumps (CMJs) and non-CMJs (NCMJs) are simple, quick, and require relatively inexpensive equipment to effectively and reliably monitor lower limb function. In a previous study, CMJ characteristics were assessed across different varsity sports. This study is a follow-up study to incorporate NCMJs into assessing jump characteristics of the same sports and investigate the additional information provided by the complementary jump type. The main objective of this study was to look at a means of quantifying the lower limb mechanical muscle function automatically to provide information for rehabilitation and performance purposes in athletes of specific sports. Male and female varsity athletes from 4 different sports completed 5 trials of an NCMJ on dual force plates. An analysis program was developed using Wolfram Mathematica to analyze force-time jump data. Various parameters of interest were generated, including peak force, force-time curve shape classification, jump phase lengths, phase-specific kinetic impulse, asymmetry index, takeoff velocity, jump height, phase-specific center of mass displacements, and reactive strength index modified. Results obtained indicate that similar jump characteristics to the CMJ study can be quantified, which can be used for performance enhancement or injury rehabilitation. Additional data found, such as the ability of an athlete to hold a steady squat during an NCMJ, could also be meaningful in aiding trainers to design programs tailored for athletes.

A feature-based statistical shape model for geometric analysis of the human talus and development of universal talar prostheses.

Statistical data pertaining to anatomic variations of the human talus contain valuable information for advances in biological anthropology, diagnosis of the talar pathologies, and designing talar prostheses. A statistical shape model (SSM) can be a powerful data analysis tool for the anatomic variations of the talus. The main concern in constructing an SSM for the talus is establishing the true geometric correspondence between the talar geometries. The true correspondence complies with biological and/or mathematical homologies on the talar surfaces. In this study, we proposed a semi-automatic approach to establish a dense correspondence between talar surfaces discretized by triangular meshes. Through our approach, homologous salient surface features in the form of crest lines were detected on 49 talar surfaces. Then, the point-wise correspondence information of the crest lines was recruited to create posterior Gaussian process morphable models that non-rigidly registered the talar meshes and consequently established inter-mesh dense correspondence. The resultant correspondence perceptually represented the true correspondence as per our visual assessments. Having established the correspondence, we computed the mean shape using full generalized Procrustes analysis and constructed an SSM by means of principal component analysis. Anatomical variations and the mean shape of the talus were predicted by the SSM. As a clinically related application, we considered the mean shape and investigated the feasibility of designing universal talar prostheses. Our results suggest that the mean shape of (the shapes of) tali can be used as a scalable shape template for designing universal talar prostheses.

An Equivalent Constitutive Model of Cancellous Bone With Fracture Prediction.

To simulate the mechanical and fracture behaviors of cancellous bone in three anatomical directions and to develop an equivalent constitutive model. Microscale extended finite element method (XFEM) models of a cancellous specimen were developed with mechanical behaviors in three anatomical directions. An appropriate abaqus macroscale model replicated the behavior observed in the microscale models. The parameters were defined based on the intermediate bone material properties in the anatomical directions and assigned to an equivalent nonporous specimen of the same size. The equivalent model capability was analyzed by comparing the micro- and macromodels. The hysteresis graphs of the microscale model show that the modulus is the same in loading and unloading; similar to the metal plasticity models. The strength and failure strains in each anatomical direction are higher in compression than in tension. The microscale models exhibited an orthotropic behavior. Appropriate parameters of the cast iron plasticity model were chosen to generate macroscale models that are capable of replicating the observed microscale behavior of cancellous bone. Cancellous bone is an orthotropic material that can be simulated using a cast iron plasticity model. This model is capable of replicating the microscale behavior in finite element (FE) analysis simulations without the need for individual trabecula, leading to a reduction in computational resources without sacrificing model accuracy. Also, XFEM of cancellous bone compared to traditional finite element method proves to be a valuable tool to predict and model the fractures in the bone specimen.

Hip Joint Contact Pressure Distribution During Pavlik Harness Treatment of an Infant Hip: A Patient-Specific Finite Element Model.

Developmental dysplasia of the hip (DDH) in infants under 6 months of age is typically treated by the Pavlik harness (PH). During successful PH treatment, a subluxed/dislocated hip is spontaneously reduced into the acetabulum, and DDH undergoes self-correction. PH treatment may fail due to avascular necrosis (AVN) of the femoral head. An improved understanding of mechanical factors accounting for the success/failure of PH treatment may arise from investigating articular cartilage contact pressure (CCP) within a hip during treatment. In this study, CCP in a cartilaginous infant hip was investigated through patient-specific finite element (FE) modeling. We simulated CCP of the hip equilibrated at 90 deg flexion at abduction angles of 40 deg, 60 deg, and 80 deg. We found that CCP was predominantly distributed on the anterior and posterior acetabulum, leaving the superior acetabulum (mainly superolateral) unloaded. From a mechanobiological perspective, hypothesizing that excessive pressure inhibits growth, our results qualitatively predicted increased obliquity and deepening of the acetabulum under such CCP distribution. This is the desired and observed therapeutic effect in successful PH treatment. The results also demonstrated increase in CCP as abduction increased. In particular, the simulation predicted large magnitude and concentrated CCP on the posterior wall of the acetabulum and the adjacent lateral femoral head at extreme abduction (80 deg). This CCP on lateral femoral head may reduce blood flow in femoral head vessels and contribute to AVN. Hence, this study provides insight into biomechanical factors potentially responsible for PH treatment success and complications.

3D Markerless asymmetry analysis in the management of adolescent idiopathic scoliosis.

BACKGROUND: Three dimensional (3D) markerless asymmetry analysis was developed to assess and monitor the scoliotic curve. While the developed surface topography (ST) indices demonstrated a strong correlation with the Cobb angle and its change over time, it was reported that the method requires an expert for monitoring the procedure to prevent misclassification for some patients. Therefore, this study aimed at improving the user-independence level of the previously developed 3D markerless asymmetry analysis implementing a new asymmetry threshold without compromising its accuracy in identifying the progressive scoliotic curves. METHODS: A retrospective study was conducted on 128 patients with Adolescent Idiopathic Scoliosis (AIS), with baseline and follow-up radiograph and surface topography assessments. The suggested "cut point" which was used to separate the deformed surfaces of the torso from the undeformed regions, automatically generated deviation patches corresponding to scoliotic curves for all analyzed surface topography scans. RESULTS: By changing the "cut point" in the asymmetry analysis for monitoring scoliotic curves progression, the sensitivity for identifying curve progression was increased from 68 to 75%, while the specificity was decreased from 74 to 59%, compared with the original method with different "cut point". CONCLUSIONS: These results lead to a more conservative approach in monitoring of scoliotic curves in clinical applications; smaller number of radiographs would be saved, however the risk of having non-measured curves with progression would be decreased.

Geometric analysis of the talus and development of a generic talar prosthetic.

BACKGROUND: Trauma to the talus can result in fracture, avascular necrosis and structural collapse. Treatment has been limited to surgical fusion and total ankle arthroplasty. Total ankle arthroplasty may not be an appropriate treatment for avascular necrosis while surgical fusion of the joint limits mobility. Custom-made implants have recently been used to address these limitations but have lengthy delays between injury and surgery and higher associated costs. A generic talar prosthesis available in various sizes may serve as a suitable alternative. METHODS: The geometric variation between shapes of individual tali was determined using 3D geometric models of 91 tali created from CT-scan data. Comparisons were done to determine if tali are one shape. The best shape was determined for each sex, and was compared to determine if a unisex implant would be possible. A geometric template for the implant in multiple sizes was created and compared to the models. RESULTS: The average of the average deviation between tali after volume scaling was found to be less than 1mm on the main articulating surfaces. One shape group was found for the talus. The female and male tali were found to be similar and a unisex implant template was created. CONCLUSIONS: Ten generic talar implant sizes were determined to be sufficient to match the size and shape of the 91 tali examined in this study.

Leg dominance may not be a predictor of asymmetry in peak joint moments and ground reaction forces during sit-to-stand movements.

Sit-to-stand transfer is a common prerequisite for many daily tasks. Literature often assumes symmetric behavior across the left and right side. Although this assumption of bilateral symmetry is prominent, few studies have validated this supposition. This pilot study uniquely quantifies peak joint moments and ground reaction forces (GRFs), using a Euclidian norm approach, to evaluate bilateral symmetry and its relation to lower limb motor-dominance during sit to stand in ten healthy males. Peak joint moments and GRFs were determined using a motion capture system and inverse dynamics. This analysis included joint moment contributions from all three body planes (sagittal, coronal, and axial) as well as vertical and shearing GRFs. A paired, one-tailed t test was used, suggesting asymmetrical joint moment development in all three lower extremity joints as well as GRFs (P < .05). Furthermore, using an unpaired two-tailed t test, asymmetry developed during these movements does not appear to be predictable by participants' lower limb motor-dominance (P < .025). Consequently, when evaluating sit-to-stand it is suggested the effects of asymmetry be considered in the interpretation of data. The absence of a relationship between dominance and asymmetry prevents the suggestion that one side can be tested to infer behavior of the contralateral.

Development and validation of a novel ankle joint musculoskeletal model.

An improved understanding of contact mechanics in the ankle joint is paramount for implant design and ankle disorder treatment. However, existing models generally simplify the ankle joint as a revolute joint that cannot predict contact characteristics. The current study aimed to develop a novel musculoskeletal ankle joint model that can predict contact in the ankle joint, together with muscle and joint reaction forces. We modelled the ankle joint as a multi-axial joint and simulated contact mechanics between the tibia, fibula and talus bones in OpenSim. The developed model was validated with results from experimental studies through passive stiffness and contact. Through this, we found a similar ankle moment-rotation relationship and contact pattern between our study and experimental studies. Next, the musculoskeletal ankle joint model was incorporated into a lower body model to simulate gait. The ankle joint contact characteristics, kinematics, and muscle forces were predicted and compared to the literature. Our results revealed a comparable peak contact force and the same muscle activation patterns in four major muscles. Good agreement was also found in ankle dorsi/plantar-flexion and inversion/eversion. Thus, the developed model was able to accurately model the ankle joint and can be used to predict contact characteristics in gait.

Integration of Swin UNETR and statistical shape modeling for a semi-automated segmentation of the knee and biomechanical modeling of articular cartilage.

Simulation studies, such as finite element (FE) modeling, provide insight into knee joint mechanics without patient involvement. Generic FE models mimic the biomechanical behavior of the tissue, but overlook variations in geometry, loading, and material properties of a population. Conversely, subject-specific models include these factors, resulting in enhanced predictive precision, but are laborious and time intensive. The present study aimed to enhance subject-specific knee joint FE modeling by incorporating a semi-automated segmentation algorithm using a 3D Swin UNETR for an initial segmentation of the femur and tibia, followed by a statistical shape model (SSM) adjustment to improve surface roughness and continuity. For comparison, a manual FE model was developed through manual segmentation (i.e., the de-facto standard approach). Both FE models were subjected to gait loading and the predicted mechanical response was compared. The semi-automated segmentation achieved a Dice similarity coefficient (DSC) of over 98% for both the femur and tibia. Hausdorff distance (mm) between the semi-automated and manual segmentation was 1.4 mm. The mechanical results (max principal stress and strain, fluid pressure, fibril strain, and contact area) showed no significant differences between the manual and semi-automated FE models, indicating the effectiveness of the proposed semi-automated segmentation in creating accurate knee joint FE models. We have made our semi-automated models publicly accessible to support and facilitate biomechanical modeling and medical image segmentation efforts ( https://data.mendeley.com/datasets/k5hdc9cz7w/1 ).

Compositional and material properties of rat bone after bisphosphonate and/or Strontium ranelate drug treatment.

PURPOSE: We investigated elemental strontium and/or bisphosphonate drug incorporation upon the compositional and biomechanical properties of vertebral bone, in a rat model of Osteoporosis secondary to ovariectomy. METHODS: Six month old female rats were ovariectomized (OVX) and divided into untreated OVX-Vehicle, OVX-RIS (Risedronate bisphosphonate [BP] treated), OVX-SrR (Strontium Ranelate [Protos®] treated), combination OVX-RIS+SrR, and sham-operated controls. After 16 weeks of treatment, rats were euthanized and lumbar vertebra were dissected. Micro-Computed Tomography (micro-CT), Electron Probe Micro-Analysis (EPMA), mechanical testing in compression and nano-indentation testing were then undertaken to evaluate bone morphometry, elemental composition, material properties and strength. RESULTS: Bone Volume was significantly reduced in the OVX-Vehicle (133±10 mm(3)) compared with OVX-RIS (169±22 mm(3)), OVX-SrR (145±2 mm(3)), and OVX-RIS+SrR (172±8 mm(3)). EPMA mapped elemental Sr deposition to the periosteal surface of cortical bone (50-100 µm thick), endosteal trabecular surfaces (20 µm thick), as well as to both vertebral growth plates. The atomic ratios of (Ca+Sr)/P were significantly reduced with SrR treatment (2.4%-6.6%), indicating Sr incorporation into bone mineral. No significant differences were measured in vertebral bone reduced modulus by nano-indentation. Conversely, all BP-dosed groups had significantly increased structural bone strength. CONCLUSIONS: Thus, we conclude that BP drugs dominate the conservation of trabecular geometry and structural strength in OP rats, whereas Sr drugs likely influence bone volume and material composition locally.

Locking plate fixation of proximal humeral fractures with impaction of the fracture site to restore medial column support: a biomechanical study.

BACKGROUND: Despite the advent of locking plate techniques, proximal humeral fracture fixation can fail due to varus collapse, especially in osteoporotic bone with medial cortex comminution. This study investigated the effect of restoring the integrity of the medial column by fracture impaction and shaft medialization with locking plate fixation. This construct was compared with a traditional locking plate construct under conditions of varus cyclical loading. MATERIALS AND METHODS: Proximal humeral fractures with medial comminution were simulated by performing wedge-shaped osteotomies at the surgical neck in cadaveric specimens and removing 1 cm of medial cortex. For each cadaver (n = 6), 1 humeral fracture was fixed with a traditional locking plate construct. The other was fixed with the locking plate construct plus fracture impaction and shaft medialization, resulting in medial column restoration. The humeral head was immobilized, and a repetitive, varus force was applied to the humeral shaft until construct collapse or until 25,000 cycles were completed. RESULTS: None of the constructs with fracture impaction collapsed, whereas 5 of 6 of the nonaugmented constructs collapsed before reaching 25,000 cycles (P = .008). Collapse of the 5 nonimpacted constructs that failed occurred after an average of 11,470 ± 3589 cycles. CONCLUSION: Fracture impaction increased the ability of the locking plate to withstand repetitive varus loading. This technique provides a construct biomechanically superior to locking plate fixation alone.

An in vitro study on the dimensional stability of a vinyl polyether silicone impression material over a prolonged storage period.

STATEMENT OF PROBLEM: A new elastomeric impression material, a vinyl polyether silicone, has been commercially introduced. Its dimensional stability at different pouring times has not been reported. PURPOSE: The purpose of this study was to evaluate the dimensional stability of vinyl polyether silicone (VPES) impressions as a function of delayed-pouring time for up to 2 weeks after performing a recommended clinical disinfection procedure. MATERIAL AND METHODS: The 3 medium-body impression materials tested were EXA'lence 370, Imprint 3, and Impregum Penta soft. Impressions of a cylindrical metal model, which served as a control, were made and poured in a Type V stone after being disinfected in 2.5% buffered glutaraldehyde solution. Die diameter and anteroposterior and cross-arch measurements on each cast were made and compared to direct measurements of the control with a digital micrometer. The linear dimensional changes were compared and analyzed by using the Mann-Whitney U test (α=.05). RESULTS: Considering the absolute values for the mean percentage dimensional change, VPES cast measurements were below 1.0% (P<.001), with the majority being minimal (≤0.34%) at all pour times. Measurements of the casts were larger than those of the control in all but one specimen. The percentage dimensional changes of the individual die diameters were higher than those of the anteroposterior and cross-arch linear measurements. Casts produced from VPES impressions had similar dimensional changes to those of VPS at 1 week of storage and similar changes to those of PE at 2 weeks of storage. The behavior of VPES impressions varied from being the most accurate at immediate-pour to gradually exhibiting higher dimensional changes as time progressed. CONCLUSIONS: Casts produced from a disinfected regular set VPES (EXA'lence 370 monophase) demonstrated excellent dimensional stability at different pour times and were comparable to the tested VPS and PE impression materials.

Impact of bisphosphonate drug burden in alveolar bone during orthodontic tooth movement in a rat model: a pilot study.

INTRODUCTION: The aim of this pilot study was to investigate the effect of long-term bisphosphonate drug use (bone burden) on orthodontic tooth movement in a rat model. METHODS: Sprague Dawley rats were used for orthodontic protraction of the maxillary first molars with nickel-titanium coil springs and temporary anchorage devices as anchorage. Four groups of 5 rats each were included in the study; the first 2 groups were dosed with alendronate or a vehicle during concurrent orthodontic tooth movement. The third and fourth groups were pretreated for 3 months with alendronate or vehicle injections, and bisphosphonate drug treatment was discontinued before orthodontic tooth movement. Tooth movement measurements were obtained at 0, 4, and 8 weeks using high-resolution in-vivo microcomputed tomography, and the tissues were analyzed with histology and dynamic labeling of bone turnover. RESULTS: Appreciable tooth movement was achieved during the 8-week duration of this study with nickel-titanium coil springs and temporary anchorage devices. Both bisphosphonate treatment groups exhibited reduced tooth movement compared with the vehicle-dosed controls with a tendency toward more severe reduction in the bisphosphonate predosed group. Concurrent dosing of the bisphosphonate drug resulted in 56% and 65% reductions in tooth protraction at the 4-week and 8-week times, respectively. The impact of bisphosphonate bone burden in retarding tooth movement was even greater, with 77% and 86% reductions in tooth movement at 4 and 8 weeks, respectively. CONCLUSIONS: In this study, we used a robust rat model of orthodontic tooth movement with temporary anchorage devices. It has provided evidence that the bone burden of previous bisphosphonate use will significantly inhibit orthodontic tooth movement.

Comparison of wear on articular cartilage by titanium alloy, ultra-high-molecular-weight polyethylene, and carbon fibre reinforced polyether-ether-ketone: A pilot study.

Artificial implant materials may articulate against native articular cartilage in certain clinical scenarios and the selection of an implant material that results in the least wear on articular cartilage is preferred to maintain normal joint architecture and function. This project compared the wear on porcine femoral condyles induced by articulation against porcine patellae, titanium alloy (Ti6Al4V), ultra high molecular weight polyethylene (UHMWPE), and carbon fibre reinforced polyether-ether-ketone (CFR-PEEK) through an ex vivo experimental setup. A sinusoidal compressive load of 30-160 N, representing an approximate joint pressure of 0.19-1 MPa at a frequency of 3 Hz coupled with a rotational displacement of +/- 10° at 3 Hz was used to simulate physiological joint motion. Wear was characterized via gross examination and histologically using the OARSI scoring system after 43,200 cycles. CFR-PEEK resulted in the most significant wear on articular cartilage compared to titanium alloy and UHMWPE whereas titanium alloy and UHMWPE resulted in similar levels of wear. All materials caused more wear compared to cartilage-on-cartilage testing. The wear mechanism was characterized by progressive loss of proteoglycan content in cartilage in histology samples.

A Preliminary Step Towards a Physical Surrogate of the Human Calvarium to Model Fracture.

A surrogate model of the human calvarium can be used to assess skull-fracture-related head injuries without continuously requiring post-mortem human skulls. Skull simulants developed in the literature often require sophisticated manufacturing procedures and/or materials not always practical when factoring in time or expense considerations. This study's objective was to fabricate three exploratory surrogate models (1. pure epoxy prototype, 2. epoxy-chalk mix prototype, and 3. epoxy-chalk three-layered prototype) of the calvarium to mimic the calvarium's mechanical response at fracture using readily available and cost-effective materials, specifically epoxy and chalk. The surrogates and calvaria were subject to quasi-static and dynamic impact 4-point bending and their mechanical responses were compared statistically. Under quasi-static loading, all three surrogates showed a considerable number of differences in mechanical response variables to calvaria that was deemed significant (p < 0.05). Under dynamic impact loading, there was no sufficient evidence to reject that the average mechanical response variables were equal between the epoxy-chalk three-layered prototype and calvaria (p > 0.05). This included force and bending moment at fracture, tensile strain at fracture, tensile and compressive stress at fracture, tensile modulus, and tensile strain rate. Overall, our study illustrates two main remarks: (1) the three exploratory surrogate models are potential candidates for mimicking the mechanical response of the calvarium at fracture during impact loading and (2) employing epoxy and chalk, which are readily available and cost-effective has the potential to mimic the mechanical response of calvaria in impact loading.

The effect of morphometric and geometric indices of the human calvarium on mechanical response.

BACKGROUND: When developing a surrogate model of the human skull, there is a multitude of morphometric and geometric properties to consider when constructing the model. To simplify this approach, it is important to identify only the properties that have a significant influence on the mechanical response of the skull. The objective of this study was to identify which morphometric and geometric properties of the calvarium were significant predictors of mechanical response. METHODS: Calvarium specimens (N = 24) were micro-computed tomography scanned to determine morphometric and geometric properties. The specimens were assumed to be Euler-Bernoulli beams and were subject to 4-point quasi-static bending to determine mechanical response. Univariate linear regressions were performed whereby the morphometric and geometric properties were independent or predictor variables and the mechanical responses were dependent or outcome variables. FINDINGS: Nine significant linear regression models were established (p < 0.05). In the diploë, trabecular bone pattern factor was a significant predictor of force and bending moment at fracture. The inner cortical table had more significant predictors (thickness, tissue mineral density, and porosity) of mechanical response compared to the outer cortical table and diploë. INTERPRETATION: Morphometric and geometric properties had a key influence on the calvarium's biomechanics. Trabecular bone pattern factor and the morphometry and geometry of the cortical tables must be considered when evaluating the mechanical response of the calvarium. These properties can aid the design of surrogate models of the skull that seek to mimic its mechanical response for head impact simulation.

Proximal humeral fracture fixation: locking plate construct ± intramedullary fibular allograft.

BACKGROUND: Locking plate constructs for proximal humeral fractures can fail due to varus collapse, especially in osteoporotic bone with medial cortex comminution. Augmentation, using a fibular allograft as an intramedullary bone peg, may strengthen fixation preventing varus collapse. This study investigated the ability of the augmented locking plate construct to withstand repetitive varus stresses relative to the nonaugmented construct. MATERIALS AND METHODS: Proximal humeral fractures with medial comminution were simulated by performing wedge-shaped osteotomies at the surgical neck in cadaveric specimens. For each cadaver (n = 8), 1 humeral fracture was fixated with the locking plate construct alone and the other with the locking plate construct plus ipsilateral fibular autograft augmentation. The humeral head was immobilized and a repetitive, medially directed load was applied to the humeral shaft until construct collapse or until 25000 cycles were completed. RESULTS: No augmented construct collapsed. In comparison, 6 of 8 nonaugmented constructs collapsed (P < .05). Collapse in the 6 nonaugmented constructs occurred after an average ±SD of 6604 ± 1984 cycles. Screw penetration of the articular surface was found in only 1 of the nonaugmented constructs. CONCLUSION: Fibular allograft augmentation increased the ability of the locking plate to withstand repetitive varus loading. Clinically, this may assist proximal humeral fracture fixation in osteoporotic bone with medial cortex comminution.

Prediction of fracture initiation and propagation in pelvic bones.

The objective is developing an XFEM model that is capable of predicting different types of fracture in the pelvic bone under various loading conditions. Previously published mechanical and failure characteristics of cortical and cancellous tissues were implemented and assigned to an intact pelvic bone with specified cortical and cancellous tissues. Various loading conditions, including combined load directions, were applied to the acetabulum to model different types of fracture (e.g., anterior/posterior wall fracture and transverse fracture) in the pelvic bone. The predicated types of fracture and the maximum force at fracture were compared to those acquired from previously published experimental tests. Anterior/posterior wall fracture and transverse fracture were the most common types of fractures determined in the simulations. The XFEM simulations were able to predict similar fractures to those reported in the experimental tests. The maximum fracture force in the XFEM model was found to be 18.6 kN compared to 8.85 kN reported in the previous experimental tests. The results revealed that different types of fracture in the pelvic bones can be caused by the various loading conditions in unstable high-rate impact loads. Using proper mechanical and failure behaviors of cortical and cancellous tissues, XFEM modeling of pelvic bone is capable of predicting bone fracture. In future work, the XFEM models of cancellous and cortical tissues can be assigned to other bones in human body skeleton so that the failure mechanism in such bones can be investigated.