Biomechanical Performance of BoneHelix® Compared with Elastic Stable Intramedullary Nailing (ESIN) in a Pediatric Tibia Fracture Model

Abstract

Tibial shaft fractures are common injuries in the pediatric and adolescent populations. Elastic stable intramedullary nailing (ESIN) is the treatment of choice for cases that require surgical stabilization. A new intramedullary device, BoneHelix® (BH), may be an alternative for use with fractures that cannot be satisfactorily stabilized with ESIN. This study aimed to assess the biomechanical performance of BH compared with ESIN in a porcine tibia fracture model, observing cyclic fatigue and load to failure. Computed tomography was used to monitor the implant position and to rule out unintended damage. No implant or bone failure occurred during the fatigue testing. An increase in the cumulative plastic displacement was observed in both test groups over the loading cycles applied. Both implant–bone constructs displayed a trend toward closure of the osteotomy gap. During the load-to-failure test, the average loads at failure in specimens instrumented with ESIN and BH were 5364 N (±723) and 4350 N (±893), respectively, which were not statistically significant (p = 0.11). The values of both groups were two to three times higher than the estimated maximal load (2000 N) during physiological weight bearing. The biomechanical results thus indicate equivalent performance and stability by the implants tested.

Mechanical Fatigue Performance of Patient-Specific Polymer Plates in Oncologic Mandible Reconstruction

“…Testing was stopped in case of plate or screw failure or significant deformation of osteosynthesis materials; cycles were then recorded up to the point of failure. If 250,000 cycles of fatigue loading were completed without failure, the bone–implant construct was exposed to axial load to failure compression testing with a testing speed of 1 mm/s [ 19 ].…”

Healing after Trauma—New Knowledge and Procedures for the Benefit of Our Patients

“…In the publication of Brandes et al, a biomechanical study was performed to compare for the first time the Elastic Stable Intramedullary Nailing (ESIN) with a helical steel coil spring with limited bending flexibility (BoneHelix ® , BH) for the surgical treatment of tibial shaft fractures in children and adolescents [ 12 ]. Porcine tibiae have been instrumented with the ESIN or BH device, and an unstable transversal bone fracture was created.…”