Plate and Bone Stresses for Single- and Double-Plated Femoral Fractures. D.R. Carter and R. Vasu
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1 Plate and Bone Stresses for Single- and Double-Plated Femoral Fractures D.R. Carter and R. Vasu J. Biomech 14: 55-62, 1981
2 Loading Koch Conditions
3 Intact Trans-cortical stress
4 Composite Beam Representation
5 Strain Distribution
6 Gap Contact Healed Single Plate Stresses
7 Gap Contact Healed Double Plate Stresses
8 Stress Fields in Unplated and Plated Canine Femora, from In-Vivo Strain Measurements D.R. Carter, R. Vasu, D. Spengler, R. Dueland J. Biomech 14: 63-70, 1981
9 Gage Placements In-Plane FEA
10 t* Strains (Recorded) Loads (Solved)
11 Intact Bone Stresses
12 Composite Beam Theory Stresses for Plated Bone
13 Changes in Stress
14 16 Week Histology
15 Discussion Site-specific agreement/disagreement Single loading instant Toward quantifying Wolff s Law?
16 Role of Interfragmentary Strain in Fracture Healing: Ovine Model of an Healing Osteotomy E.J. Cheal, K.A. Mansmann, A.M. DiGioia, W.C. Hayes, S.M. Perren J. Orthop. Res. 9: , 1991
17 Hydraulic Actuator Experimental Preparation
18 FEA Zoning of Gap
19 Osteogenic Index I = (σ s + k σ d ) / (1 + k) k = 0.5, 2.0
20 Strain Evolution
21 Global Healing Histology
22 3 wk 4 wk 1 wk 2 wk
23 Gap Deformations Poisson Effect
24 193% Gap Principal Strains 144%?
25 Gap Stress Distributions
26 Osteogenic Index Distribution
27 Resorption vs. Octahedral Stress
28 Resorption vs. Hydrostatic Stress
29 Examples of Local Healing Histology
30 Local Healing Histology
31 Locations of Resorption
32 Discussion Resorption for tolerable gage length? Experimental apparatus failure: Strain control early Load control late FEA: nonuniform strain in gap No consistent numerical relation with histology
33 Mechanical and Morphological Properties of Bone Beneath Internal Fixation Plates of Differing Rigidity Lutz Claes J. Orthop. Res. 7: , 1989.
34 Post-Op
35 24 weeks
36 Specimen Harvest
37 Stress-strain comparison
38 Cross-sectional Microradiographs
39 Elastic Modulus
40 Cross-sectional Morphology
41 Femoral Diameter
42 Porosity & Modulus Distribution
43 Discussion 7% net area decrease for steel vs. CFC Modulus differential: 27% More severe change under plates Newer osteons are less mineralized More new osteons where turnover is high Argued that CFC had sufficient rigidity to stabilize the fracture and minimized stress protection.
44 Quantitative Measures for Fracture Healing: An In Vitro Biomechanical Study A. Foux, R.C. Black, H.K. Uhtoff J. Biomech. Engr. 112: , 1990
45 Variable-Direction Flexure Set-up
46 Idealized Model EI = k (P / y)
47 Contralateral Symmetry Rigidity Profiles
48 Best-fit Ellipse Semi-Axes Reproducibility
49 Healed Rigidity Profiles
50 Healed Rigidity Profiles
51 Healing Efficiency
52 A Retrospective Analysis of Plate Contouring in Using Conventional 4.5 Narrow Dynamic Compression Plates M.A. Frankel, J. Cordey, M.D. Frankle, F. Baumgart, S. Perren J. Orthop. Trauma 8: 59-63, 1994
53 Plate Length vs. Curvature Radius
54 Distribution of Plate Lengths
55 Distribution of Plate Curvature Radii
56 Distribution of Plate Bends
57 Strain, based on Flexural Elongation
58 Screw-Hole Influence on Bending LC-DCP DCP
59 Strain (%) Yield Behavior
60 Internal Fixation of the Distal Humerus: A Biomechanical Comparison of Methods D.L. Helfet, R.N. Hotchkiss J. Orthop. Trauma 4: , 1990
61 Fracture Model
62 Crossed 4.5 mm Malleolar Screws
63 3.5 mm Y Plate
64 3.5 mm Reconstruction Plates at Right Angles
65 1/3 Tubular Plates at Right Angles
66 1/3 Tubular Plate Medially and 3.5 mm Reconstruction Plate Posterio-Laterally
67 Fixation # of Specimens Malleolar 3 Y-Plate 3 Reconstruction 3 Plate Tubular Plate 3 Mixed Plates 2
68 Specimen Loading
69 Fatigue Cycling in Extension
70 Results of fatigue and rigidity testing Rigidity (N/mm) Fatigue failure(# cycles) a Flexion Extension Malleolar screws 113( ) 111(+-16.3) 75.5 (+-15) Y-plates 124(+-15.1) 167(+-13) 223 (+-124) Reconstruction plate 313(+-18) 447(+-164) 4,148 (+-315) 1/3 tubular plate 206(+-63) 229(+-39) 3,559 (+-471) Mixed plates b 215(+-71) 282(+-81) 3,471 (+-365) a Number of cycles before permanent deformation > 1mm b Two specimens (+-) represents two SD s Construct Comparisons
71 Ultimate Properties of Intramedullary Nails M. Martens, V.H. Frankel, A.H. Burstein Injury 4: 18-24, 1973
72 IM Nail Loading Complications: Infection Migration: 2-7% Plastic Bending: 4-5% Fatigue Fx: 1-2% Fx Mal-Union: 4-5%
73 Nail Designs
74 Femur 13 mm A,D: Kuntscher B,E: Schneider C,F: Diamond mm Load-Deformation Comparisons
75 Permanent Deformation
76 Four-Point Bending
77 Deflection vs. Diameter Deformation
78 Yield Points
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