Angle Stable Nails Provide Improved Healing for a Complex Fracture Model in the Femur

Kubacki, Meghan R; Verioti, Christopher A; Patel, Savan; Garlock, Adam N; Fernandez, David; Atkinson, Patrick

doi:10.1007/s11999-013-3288-9

Cited by 4 publications

(2 citation statements)

References 3 publications

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“…The main difference of the ceramic material was a higher stiffness. This might influence the dynamics of bone healing 12,13,31 . Intramedullar stabilization was shown to allow some movement of the bone fragments due to implant material properties that stimulated fracture healing 13 .…”

Section: Discussionmentioning

confidence: 99%

A novel MRI compatible mouse fracture model to characterize and monitor bone regeneration and tissue composition

Schmitz

Timmen²,

Kostka³

et al. 2020

Sci Rep

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Over the last years, murine in vivo magnetic resonance imaging (MRI) contributed to a new understanding of tissue composition, regeneration and diseases. Due to artefacts generated by the currently used metal implants, MRI is limited in fracture healing research so far. In this study, we investigated a novel MRI-compatible, ceramic intramedullary fracture implant during bone regeneration in mice. Three-point-bending revealed a higher stiffness of the ceramic material compared to the metal implants. Electron microscopy displayed a rough surface of the ceramic implant that was comparable to standard metal devices and allowed cell attachment and growth of osteoblastic cells. MicroCT-imaging illustrated the development of the callus around the fracture site indicating a regular progressing healing process when using the novel implant. In MRI, different callus tissues and the implant could clearly be distinguished from each other without any artefacts. Monitoring fracture healing using MRI-compatible implants will improve our knowledge of callus tissue regeneration by 3D insights longitudinal in the same living organism, which might also help to reduce the consumption of animals for future fracture healing studies, significantly. Finally, this study may be translated into clinical application to improve our knowledge about human bone regeneration.

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Section: Discussionmentioning

confidence: 99%

A novel MRI compatible mouse fracture model to characterize and monitor bone regeneration and tissue composition

Schmitz

Timmen²,

Kostka³

et al. 2020

Sci Rep

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“…This investigation utilized tissues and implants from a companion study of 10 canine subjects treated with an interlocked TiVA nail; Kubacki et al 6 provide complete details regarding the operative procedure. Briefly, all subjects were cared for in compliance with the US Department of Agriculture’s Animal Welfare Act (9 Code of Federal Regulations (CFR) Parts 1, 2, and 3), the Guide for the Care and Use of Laboratory Animals, and the National Institutes of Health’s Office of Laboratory Animal Welfare.…”

Section: Methodsmentioning

confidence: 99%

Removal torque of nail interlocking screws is related to screw proximity to the fracture and screw breakage

White

Kubacki

Samona

et al. 2016

Proc Inst Mech Eng H

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Studies have shown that titanium implants can be challenging to explant due to the material's excellent biocompatibility and resulting osseointegration. Clinically, titanium alloy nail interlocking screws may require removal to dynamize a construct or revise the nail due to nonunion, infection, pain, or periprosthetic fracture. This study was designed to determine what variables influence the removal torque for titanium alloy interlocking screws. An intramedullary nail with four interlocking screws was used to stabilize a 1-cm segmental femoral defect in a canine model for 16 weeks. The animals were observed to be active following a several-day recovery after surgery. In six animals, the femora and implanted nail/screws were first tested to failure in torsion to simulate periprosthetic fracture of an implant after which the screws were then removed. In four additional animals, the screws were removed without mechanical testing. Both intraoperative insertional and extraction torques were recorded for all screws. Mechanical testing to failure broke 10/24 screws. On average, the intact screws required 70% of the insertional torque during removal while broken screws only required 16% of the insertional torque (p < 0.001). In addition, intact screws closer to the fracture required 2.8 times more removal torque than the outboard distal screw (p < 0.005). On average, the angle of rotation to peak torque was ∼80°. The peak axial load did not significantly correlate with the torque required to remove the screws. On average, the removal torque was lower than at the time of insertion, and less torque was required to remove broken screws and screws remote to the fracture. However, broken screws will require additional time to retrieve the remaining screw fragment. This study suggests that broken screws and screws in prematurely active patients will require less torque to remove.

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Methodology for Bone–Implant Stiffness Evaluation

et al. 2020

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Angle Stable Nails Provide Improved Healing for a Complex Fracture Model in the Femur

Abstract: Care should be taken in tailoring the nail design features to the characteristics of the fracture and the patient.

Cited by 4 publications

References 3 publications

A novel MRI compatible mouse fracture model to characterize and monitor bone regeneration and tissue composition

A novel MRI compatible mouse fracture model to characterize and monitor bone regeneration and tissue composition

Removal torque of nail interlocking screws is related to screw proximity to the fracture and screw breakage

Methodology for Bone–Implant Stiffness Evaluation

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