Functional load of plates in fracture fixation in vivo and its correlate in bone healing

Stoffel, Karl; Klaue, Kaj; Perren, S. M.

doi:10.1016/s0020-1383(00)80042-x

Cited by 81 publications

(77 citation statements)

References 10 publications

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“…Our interest currently lies with using wireless sensing to observe the healing processes of fractured long bones in biomedical engineering. 3 When complicated fractures occur in humans, plates are implanted to impart stability to the fracture site during the acute postoperative period. In order to observe the healing process, wireless measurement of the strain on the plate could be utilized to indicate when healing was proceeding through a normal or aberrant pathway.…”

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confidence: 99%

Metamaterial-based wireless strain sensors

Melik

Ünal

Perkgöz

et al. 2009

Applied Physics Letters

158

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We proposed and demonstrated metamaterial-based strain sensors that are highly sensitive to mechanical deformation. Their resonance frequency shift is correlated with the surface strain of our test material and the strain data are reported telemetrically. These metamaterial sensors are better than traditional radio-frequency (rf) structures in sensing for providing resonances with high quality factors and large transmission dips. Using split ring resonators (SRRs), we achieve lower resonance frequencies per unit area compared to other rf structures, allowing for bioimplant sensing in soft tissue (e.g., fracture healing). In 5×5 SRR architecture, our wireless sensors yield high sensitivity (109 kHz/kgf, or 5.148 kHz/microstrain) with low nonlinearity error (<200 microstrain). © 2009 American Institute of Physics

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confidence: 99%

Metamaterial-based wireless strain sensors

Melik

Ünal

Perkgöz

et al. 2009

Applied Physics Letters

158

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“…In the group of segmental ostectomy treated by fixation using the six-hole 3.5 mm titanium LCP a highly significant (p < 0.01) number of titanium locking screw failures was found compared to the group of pigs treated with the five-hole 4.5 mm titanium LCP. The number of cortical screws affects the implant stability (Piermattei and Flo 1997;Stoffel et al 2000;Stoffel et al 2003;Wagner 2003;Koch 2005;Nečas et al 2007). In flexible bridging osteosynthesis using LCP, more than 3 cortical screws inserted in one bone fragment only slightly increase the axial stability (rigidity) of fixation (Stoffel et al 2003).…”

Section: Discussionmentioning

confidence: 99%

“…With the use of LCP for fixation of a critically sized diaphyseal defect, bending forces act in the absence of cortical bone on the opposed side which may lead to fixation failure in the form of bending or breaking of the bone plate (Hulse et al 1997). The cause of the described failure (breaking of the plate at the place of the empty central plate hole) of 4.5 mm LCP in the bridging fixation of segmental femoral osteotomy in the miniature pig as model animal was probably the concentration of bending forces at the place of the hollow opening (unfilled with screw) at the site of the ostectomy defect (Stoffel et al 2000;Stoffel et al 2003). With regard to time, the first weeks after segmental defect fixation present the highest risk of possible LCP implant failure, i.e.…”

Section: Discussionmentioning

confidence: 99%

“…Segmental bone defect was created with oscillating saw in the whole cross section of the bone at the height of 15 mm of the bone column. While maintaining the principles of flexible bridging osteosynthesis (Stoffel et al 2000;Stoffel et al 2003;Wagner 2003), the main femoral fragments of the miniature pigs were stabilized using one of the two dimensionally relevant (with regard to the dimensions and size of the bone of the animals used) systems of LCP. Six-hole titanium locking compression plate (LCP, Synthes ® ) in the system of 3.5 mm (n = 9) and four 3.5 mm titanium locking bicortical screws leaving two central plate holes empty at the level of the segmental bone defect was used (Plate V, Fig.…”

Section: Methodsmentioning

confidence: 99%

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Radiographic Assessment of Implant Failures of Titanium 3.5 LCP vs. 4.5 LCP Used for Flexible Bridging Osteosynthesis of Large Segmental Femoral Diaphyseal Defects in a Miniature Pig Model

et al. 2010

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The study describes types, absolute and relative numbers of implant failures in flexible bridging osteosynthesis using a six-hole 3.5 mm titanium Locking Compression Plate (n = 9) or a fivehole LCP 4.5 mm titanium (n = 40) selected for the fixation of segmental ostectomy of femoral diaphysis in the miniature pig used as an in vivo model in a study on the healing of a critically sized bone defect using transplantation of mesenchymal stem cells combined with biocompatible scaffolds within a broader research project.Occasional implant failure was evaluated based on radiographic examination of femurs of animals 2, 4, 8, 12 and 16 weeks after surgery. When bone defect was stabilized using 3.5 mm LCP, in 6 cases (66.7%) the screw was broken/lost in the proximal fragment of the femur 2 weeks after implantation (n = 4) and 4 weeks after implantation (n = 2). In 4 cases of these, the implant failure was accompanied also by loosening of the screw in position 3 in the proximal fragment of the femur. During ostectomy stabilization with 4.5 mm LCP, in 3 cases (7.5%) LCP was broken at the place of the empty central plate hole (without inserted screw) at the level of the segmental bone defect.Compared to the six-hole 3.5 mm LCP, the five-hole titanium 4.5 mm LCP is more suitable implant for flexible bridging osteosynthesis of a critically sized segmental defect of femoral diaphysis in the miniature pig. The results of this study will allow reducing implant failures in time-and cost-demanding transplantation experiments focused on bone healing.

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“…Observing the rules of flexible bridging osteosynthesis (Stoffel et al 2000;Gautier and Sommer 2003;Stoffel et al 2003;Wagner 2003) we then performed fixation and stabilisation of the main femoral fragments with the "plate and rod" technique bridging osteosynthesis with a five-hole titanium LCP (Synthes ® , Switzerland) in the 4.5 mm system and with four 4.5 mm titanium locking screws inserted bicortically (leaving central plate hole empty (without screw) at the level of the segmental bone defect) in combination of the "plate and rod" technique with 3 mm intramedullary Steinmann pin which filled 30% of the diameter of the bone cavity in its isthmus -model PR-LCP (n = 5).…”

Section: Methodsmentioning

confidence: 99%