3D Optical Investigation of 2 Nail Systems Used in Tibiotalocalcaneal Arthrodesis: A Biomechanical Study

Evers, Julia; Lakemeier, Martin; Wähnert, Dirk; Schulze, Martin; Richter, Martinus; Raschke, Michael J.; Ochman, Sabine

doi:10.1177/1071100717690805

Cited by 5 publications

(7 citation statements)

References 27 publications

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“…The tibia and fibula were shortened to a length of 30 cm measured from the ankle joint [ 19 , 20 ]. Disarticulation of the Chopart joint was performed [ 19 , 20 ].…”

Section: Mehodsmentioning

confidence: 99%

“…The tibia and fibula were shortened to a length of 30 cm measured from the ankle joint [ 19 , 20 ]. Disarticulation of the Chopart joint was performed [ 19 , 20 ]. Soft tissues were removed except for the membrana interossea, the syndesmosis, and the ankle ligaments [ 19 , 20 ].…”

Section: Mehodsmentioning

confidence: 99%

“…Disarticulation of the Chopart joint was performed [ 19 , 20 ]. Soft tissues were removed except for the membrana interossea, the syndesmosis, and the ankle ligaments [ 19 , 20 ]. The joint surfaces were left intact [ 19 , 20 ].…”

Section: Mehodsmentioning

confidence: 99%

“…Soft tissues were removed except for the membrana interossea, the syndesmosis, and the ankle ligaments [ 19 , 20 ]. The joint surfaces were left intact [ 19 , 20 ]. The specimens were wrapped in saline-soaked compresses and stored at − 20 °C between experiments.…”

Section: Mehodsmentioning

confidence: 99%

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Biomechanical comparison of different fixation methods in tibiotalocalcaneal arthrodesis: a cadaver study

Trost,

Yarkin,

Knieps

et al. 2023

J Orthop Surg Res

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Background Various fixation methods are available for tibiotalocalcaneal arthrodesis: nail, plate, or screws. An intramedullary bone stabilization system within a balloon catheter has not previously been used in tibiotalocalcaneal arthrodesis. The aim of this study was to compare the stability of these techniques. Methods Twenty-four lower legs from fresh-frozen human cadavers were used. Tibiotalocalcaneal arthrodesis was performed with a retrograde nail, a lateral locking plate, three cancellous screws, or an intramedullary bone stabilization system. The ankles were loaded cyclically in plantarflexion and dorsiflexion. Results For cyclic loading at 125 N, the mean range of motion was 1.7 mm for nail, 2.2 mm for plate, 6.0 mm for screws, and 9.0 mm for the bone stabilization system (P < .01). For cyclic loading at 250 N, the mean range of motion was 4.4 mm for nail, 7.5 mm for plate, 12.1 mm for screws, and 14.6 mm for the bone stabilization system (P < .01). The mean cycle of failure was 4191 for nail, 3553 for plate, 3725 for screws, and 2132 for the bone stabilization system (P = .10). Conclusions The stability of the tibiotalocalcaneal arthrodesis differs depending on the fixation method, with nail or plate showing the greatest stability and the bone stabilization system the least. When three screws are used for tibiotalocalcaneal arthrodesis, the stability is intermediate. As the biomechanical stability of the bone stabilization system is low, it cannot be recommended for tibiotalocalcaneal arthrodesis.

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“…The tibia and fibula were shortened to a length of 30 cm measured from the ankle joint [ 19 , 20 ]. Disarticulation of the Chopart joint was performed [ 19 , 20 ].…”

Section: Mehodsmentioning

confidence: 99%

Section: Mehodsmentioning

confidence: 99%

Section: Mehodsmentioning

confidence: 99%

Section: Mehodsmentioning

confidence: 99%

See 2 more Smart Citations

Biomechanical comparison of different fixation methods in tibiotalocalcaneal arthrodesis: a cadaver study

Trost,

Yarkin,

Knieps

et al. 2023

J Orthop Surg Res

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show abstract

“…Charnley noted that compression helped eliminate shearing strains and gaps between the cut bone surfaces. Several mechanical factors have been associated with successful arthrodesis [1,29,[31][32][33]; these include bony apposition with high contact area, primary stiffness and stability by rigid immobilization (limits micromotion between surfaces and promotes direct or primary bone healing with minimal callus/fibrous tissue formation), sufficient compression at desired fusion site (contributes to rigidity by neutralizing shear and bending forces and maintaining apposition), and load sharing between hardware and native bone (contributes to bone modeling once weight-bearing begins, and prevents fatigue failure of hardware in cases of non-union).…”

Section: Evolution Of Compressive Technologymentioning

confidence: 99%

Untitled

2019

GJOR

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In many cases, tibiotalocalcaneal arthrodesis (TTCA) acts as a salvage procedure and alternative to amputation in nonbraceable neuropathic deformities, failed ankle arthrodesis, failed total ankle arthroplasty, talar osteonecrosis, and severe ankle and subtalar arthritis [1,2]. The goal of this procedure is to fuse the ankle and subtalar joints simultaneously leading to pain relief, stability, and a functional limb [3]. The purpose of this review is to examine the mechanobiological foundations of TTCA and the technological evolution of intramedullary (IM) nails used to provide fixation in TTCA procedures. Discussion Mechanobiological backgroundMechanobiology is the study of how mechanical or physical stimuli regulate biological processes [4]. Julius Wolff was among the first to recognize the influence of mechanical forces on bone morphology and architecture, and in 1866 observed that trabecular trajectories within the proximal femur roughly align with directions of maximum stresses [5,6]. Wolff's Law states that mechanical inputs, creating functional and morphological changes in a bone, are followed by alterations of the bone's architecture and mechanical strength. Animal and cell culture models and their associated techniques (histology, radiography, mechanical testing, etc.) have been used to study the effects of mechanical inputs on biological responses, including bone repair, at multiple biological scales.Mechanobiological principles are relevant to TTCA with IM nails, because knowledge of micromovements and mechanical stresses, and how they stimulate bone cells leading to tissue adaptation, can be incorporated into development of new nail designs, leading to improved joint fixation and superior local healing conditions [7,8].

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Pseudoelastic NiTiNOL in Orthopaedic Applications

Safranski

Dupont

Gall

2020

Shap. Mem. Superelasticity

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3D Optical Investigation of 2 Nail Systems Used in Tibiotalocalcaneal Arthrodesis: A Biomechanical Study

Abstract: The better stability of the locking-only HAN nail in this osteoporotic test setup could lead to more favorable results in comparison to the A3 nail in clinical use.

Cited by 5 publications

References 27 publications

Biomechanical comparison of different fixation methods in tibiotalocalcaneal arthrodesis: a cadaver study

Biomechanical comparison of different fixation methods in tibiotalocalcaneal arthrodesis: a cadaver study

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Pseudoelastic NiTiNOL in Orthopaedic Applications

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