Single lag screw and reverse distal femur locking compression plate for concurrent cervicotrochanteric and shaft fractures of the femur: biomechanical study validated with a clinical series

Jitprapaikulsarn, Surasak; Chantarapanich, Nattapon; Gromprasit, Arthit; Mahaisavariya, Chantas; Patamamongkonchai, Chawanan

doi:10.1007/s00590-020-02868-z

Cited by 10 publications

(13 citation statements)

References 31 publications

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“…The equivalent elastic strain at the fracture site indicated the stability of the fracture site after osteotomy. 15 NM-Low Z approach yielded an elastic strain of 380–400 µε, whereas the HE approach yielded an elastic strain of 100–120 µε, at 1 week post-operation. This is consistent with the literature review that the optimal strain in the initial stage of bone healing should be in the 100–2000 µε range.…”

Section: Discussionmentioning

confidence: 95%

“…However, the highest EQV stress level in the HE model was observed during 1 week post-operation; it did not exceed the yield point of the titanium material. 15,32,33,34 The pattern of the stress distribution in the higheststress region for the NM-Low Z approach was concentrated in the middle of the miniplate over the fracture site, while the high stress for the HE approach occurred around the screw site. These FE results agreed with those of previous studies on the BSSO surgery.…”

Section: Discussionmentioning

confidence: 99%

“…However, the highest EQV stress level in the HE model was observed during 1 week post-operation; it did not exceed the yield point of the titanium material. 15,32,33,34…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies had emphasized this issue by performing biomechanical analysis using advanced tools of the finite element (FE) analysis, 10,11,12,13 which had been proven to be adequate for biomechanical problems. 14,15 The studies of BSSO that utilize the FE analysis tools include the comparison of fixation 16,17 and the analysis of osteotomy technique. 10,11 The applications of finite element method in the analysis of osteotomy techniques by Puricelli et al 10 evaluated the mechanical stabilities of Obwegeser-Dal Pont technique comparison to the Puricelli technique, and Takahashi et al 11 who evaluated the mechanical behavior of three different osteotomy techniques.…”

Section: Introductionmentioning

confidence: 99%

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Finite element analysis between Hunsuck/Epker and novel modification of Low Z plasty technique of mandibular sagittal split osteotomy

Dumrongwanich

Chantarapanich

Patchanee

et al. 2022

Proc Inst Mech Eng H

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A novel modification of the Low Z plasty (NM-Low Z) technique for bilateral sagittal split osteotomy was recently proposed. The osteotomy line was modified more inferiorly than in the conventional Hunsuck–Epker (HE) approach. The NM-Low Z technique enhances the mandibular setback distance and degree of rotation in severe skeletal discrepancies. This study aimed to investigate the biomechanical behavior under simulated forces, and to compare the NM-Low Z and HE techniques on the mandible with Class III skeletal deformity at 1 week, 3 weeks, and 6 weeks post-operation. Physiological muscular and occlusal loads were simulated using the finite element (FE) method. Stresses on the miniplate, screws, and bone were observed and compared between the two models. The elastic strain at the fracture site was observed for the optimal bone-healing capacity. The NM-Low Z model exhibited a lower stress than the HE model at every stage post-operation. Both models demonstrated elastic strains within the normal range for bone healing. In summary, the biomechanical behavior of the NM-Low Z technique is comparable to that of the conventional EH technique. NM-Low Z could facilitate post-operation skeletal stability by reducing the stress on fixation materials during bone healing.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 99%

“…However, the highest EQV stress level in the HE model was observed during 1 week post-operation; it did not exceed the yield point of the titanium material. 15,32,33,34…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Finite element analysis between Hunsuck/Epker and novel modification of Low Z plasty technique of mandibular sagittal split osteotomy

Dumrongwanich

Chantarapanich

Patchanee

et al. 2022

Proc Inst Mech Eng H

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“…After the intervertebral space was formed, the stiffness of the 95° hip screw at 25° adduction was significantly lower than that of the IMHS (25). This suggests that 95° hip screws and IMHS provide the same stable structure when anatomic reduction can be achieved, and IMHS may provide a more stable structure if the fracture construction and the talus breaks (26). IMHS is the hardest implant at 90° flexion.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical study of extramedullary and intramedullary fixation in the treatment of unstable intertrochanteric reversed-tilt fractures of the femur

Li¹,

Li²

2022

Ann Transl Med

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Background: To investigate the efficacy of the 135° hip screw, 95° intramedullary hip screw (IMHS) and 95° hip screw in the treatment of intertrochanteric reverse dip fracture of the femur. Methods:We retrospectively analyzed 125 matched pairs of human femurs (median age 64 years) which were osteotomized at a 33° angle in the left femur and extended downward from the minor trochanter to simulate a reverse oblique intertrochanteric fracture. The right femur served as a control. The left femur (n=4) was implanted with a 135° hip screw, 95° hip screw, or IMHS. A strain detector was placed distal to the fracture site to monitor fragment strain. The lateral displacement of the proximal femur was measured by a linear variable differential transformer. An Instron tester measured stiffness, strain, and lateral displacement at 25° adduction, and 90° adduction with vertical loads on the femoral head. A 2 cm gap was then formed at the fracture site to simulate comminution and the mechanical test was repeated.Results: Before the formation of the gap, there was no significant difference in stiffness among different bone structures (P>0.05), but after the formation of the gap, the stiffness of all the adduction structures decreased (P=0.03), and the difference in adduction was statistically significant (135° hip screw: 46.6%±3%; 95° hip screw: 22.9%±2%; IMHS: 53.7%±7.8%; P<0.05). Similar results were found for the abduction and buckling positions. There was no significant difference in the lateral displacement of the gap before (P=0.92) and after (P=0.26), but a significant difference in the failure load was found (135° hip screw: 1,222±560 N; 95° hip screw: 2,566±283 N; IMHS: 4,644±518 N; P=0.02).Conclusions: There was no statistically significant difference in stiffness among different structures (P>0.05). However, in the presence of gaps, IMHS bone implant structures are much stiffer than 135° and 95° structures and have a greater destructive load.

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The comparison of stress and strain between custom-designed bone plates (CDBP) and locking compression plate (LCP) for distal femur fracture

Shams

Mehdizadeh

Movahedi

et al. 2022

Eur J Orthop Surg Traumatol

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Single lag screw and reverse distal femur locking compression plate for concurrent cervicotrochanteric and shaft fractures of the femur: biomechanical study validated with a clinical series

Cited by 10 publications

References 31 publications

Finite element analysis between Hunsuck/Epker and novel modification of Low Z plasty technique of mandibular sagittal split osteotomy

Finite element analysis between Hunsuck/Epker and novel modification of Low Z plasty technique of mandibular sagittal split osteotomy

Biomechanical study of extramedullary and intramedullary fixation in the treatment of unstable intertrochanteric reversed-tilt fractures of the femur

The comparison of stress and strain between custom-designed bone plates (CDBP) and locking compression plate (LCP) for distal femur fracture

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