Der HEPFIEx-Simulator, eine Apparatur zur Bestimmung der Reibzahlen zwischen Hüftkopf-Prothesen und Knorpel / The HEPFlEx Simulator, a Device for Measuring the Friction between Femoral Head Prostheses and Cartilage

We describe a device designed to investigate friction between various femoral head prostheses and human acetabula. It enables not only the determination of friction and the relevance of the play between the femoral head and acetabulum, but also the evaluation of the kinematic behaviour of bipolar prostheses. In the simulator, the various femoral head prostheses are placed on a special cone and tested against a human cadaveric acetabulum. The swiveling range of the device is uniaxial, and the swiveling angle is +/- 35 degrees. The maximum force produced pneumatically is 5kN. Testing of the simulator with a TEP was successful and friction-coefficients of < 0.1 were measured, as are reported i…

Intramedullary nailing vs. palmar locked plating for unstable dorsally comminuted distal radius fractures: A biomechanical study

Abstract Background The purpose of this study was to compare the stability of a 2.4 mm palmar locking compression plate and a new intramedullary nail-plate-hybrid Targon DR for dorsally comminuted distal radius fractures. Methods An extraarticular 10 mm dorsally open wedge osteotomy was created in 8 pairs of fresh frozen human radii to simulate an AO–A3-fracture. The fractures were stabilized using one of the fixation methods. The specimens were loaded axially with 200 N and dorsal-excentrically with 80 N. 2000 cycles of dynamic loading and axial loading-to-failure were performed. Findings Axial loading revealed that intramedullary osteosynthesis (Targon DR: 369 N/mm) was significantly ( p …

Are there any differences in various polyaxial locking systems? A mechanical study of different locking screws in multidirectional angular stable distal radius plates.

Numerous angular stable plates for the distal radius exist, and technically based comparisons of the polyaxial locking interfaces are lacking. The aim of this mechanical study was to investigate three different locking interfaces of angular stable volar plates by cantilever bending: VA-LCP Two-Column Distal Radius Plates 2.4 mm (Synthes® GmbH, Oberdorf, Switzerland), IXOS® P4 (Martin, Tuttlingen, Germany) and VariAX™ (Stryker®, Duisburg, Germany). We assessed the strength of 0°, 5°, 10° and 15° screw locking angles and tested the bending strength from 10° to 5° angles by cyclic loading until breakage. The final setup repeated the above assessments by inclusion of four locking screws. The si…

Die proximale extraartikuläre Tibiafraktur

Die Stabilisierung proximaler extraartikularer Tibiafrakturen stellt unter Verwendung der gebrauchlichen Osteosyntheseverfahren unverandert ein Problem dar. Die Wahl des Operationsverfahrens hangt unter anderem von der Situation der oftmals erheblich kompromittierten frakturumgebenden Weichteile ab. An der proximalen Tibia besteht zusatzlich das Problem von Fehlstellungen der Fraktur. Neben der Gefahr einer intraoperativen Frakturdislokation durch Muskelzug und den operativen Zugang kommt es gehauft zu sekundaren Fehlstellungen durch relative Implantatinstabilitat. Es wurden verschiedene Verfahren zur Versorgung dieser Frakturen entwickelt; sie zeichnen sich durch differierende biomechanisc…

Influence of implant and screw type on local bone strain field: a preliminary study

Number and Locations of Screw Fixation for Volar Fixed-Angle Plating of Distal Radius Fractures: Biomechanical Study

Purpose To compare the biomechanical properties of different numbers and locations of screws in a multidirectional volar fixed-angle plate in a distal radius osteotomy cadaver model. Methods We created an extra-articular fracture in 16 pairs of fresh-frozen human cadaver radiuses. The 32 specimens were randomized into 4 groups. All fractures were fixated with a multidirectional volar fixed-angle plate. We tested 4 different screw-placement options in the distal fragment. The distal fragment was fixed with 4 locking screws in the distal row of the plate in group a, and with 4 locking screws alternately in the distal and proximal rows in group b. In group c, 3 locking screws were used in the …

Locking plates for corrective osteotomy of malunited dorsally tilted distal radial fractures: a biomechanical study.

The purpose of the study was to compare the biomechanical properties of five different palmar fixation plate designs in a distal radius osteotomy cadaver model. A 1 cm metaphyseal osteotomy gap was made to simulate a corrective osteotomy and the osteotomy plated. Axial load was applied to the distal end of each construct by a material testing machine under control of a motion analysis video system. The specimens were arranged into five implant groups of eight specimens each. No test group developed deformity and movement of the fracture gap greater than 2 mm with a load of 100 N. Increasing the load to 250 N revealed statistically significant differences in stiffness and failure load betwe…

The Retrograde Tibial Nail: presentation and biomechanical evaluation of a new concept in the treatment of distal tibia fractures.

Displaced distal tibia fractures require stable fixation while minimizing secondary damage to the soft tissues by the surgical approach and implants. Antegrade intramedullary nailing has become an alternative to plate osteosynthesis for the treatment of distal metaphyseal fractures over the past two decades. While retrograde intramedullary nailing is a standard procedure in other long bone fractures, only few attempts have been made on retrograde nailing of tibial fractures. The main reasons are difficulties of finding an ideal entry portal and the lack of an ideal implant for retrograde insertion. The Retrograde Tibial Nail (RTN) is a prototype intramedullary implant developed by our group…

Sind winkelstabile Plattensysteme mit elastischen Eigenschaften für die Stabilisierung der Oberarmkopffraktur vorteilhaft? / Eine in-vitro biomechanische Untersuchung

AbstractWinkelstabile Platten werden mit zunehmender Häufigkeit zur Stabilisierung von Oberarmkopfbrüchen verwendet. Rigide Implantate führen bei osteoporotischen Knochenverhältnissen u. U. aber häufiger zum Versagen. Um den Effekt der Implantatelastizität zu beurteilen wurden in einer in-vitro Studie die biomechanischen Eigenschaften eines rigiden und eines elastischen winkelstabilen Plattensystems vergleichend analysiert. An 8 Humeruspaaren wurde eine instabile subkapitale Fraktur simuliert. Die Proben wurden axial- und torsions-belastet. Analysiert wurden die Steifigkeit, das Setzverhalten unter Dauerlast und die Versagensbelastung.Das elastische Plattensystem kennzeichnete sich durch ei…

Biomechanical evaluation of a new treatment method for distal tibia fractures

Distal tibial fractures are often the result of high-energy impacts combined with excessive soft tissue injury. Treatment options include either open reduction and internal fixation usually as a mi...

Biomechanische Untersuchungen verschiedener Osteosynthesen an der proximalen Tibia - Vorstellung einer neuartigen meßgeometrischen Anordnung. Biomechanical Investigations of Various Osteosynthesis Procedures on the Proximal Tibia - Introduction of a New Measuring System

In this article a new measuring system for biomechanical studies of various osteosynthesis procedures on the tibia is described. The paired tibias are osteotomized and embedded in PMMA in accordance with a randomization protocol. Testing is then carried out under nonaxial loading at 350 N, 600 N and 900 N, uniaxial bending applying a force of 12 Nm, and torsion at a force of 5 Nm in a universal pneumatic testing machine. Ultrasonic sensors pick up movement at the fracture gap under external loading. Testing of the measuring setup has been successful, and relevant results were obtained.

Treatment of distal intraarticular tibial fractures: A biomechanical evaluation of intramedullary nailing vs. angle-stable plate osteosynthesis

In factures of the distal tibia with simple articular extension, the optimal surgical treatment remains debatable. In clinical practice, minimally invasive plate osteosynthesis and intramedullary nailing are both routinely performed. Comparative biomechanical studies of different types of osteosynthesis of intraarticular distal tibial fractures are missing due to the lack of an established model. The goal of this study was first to establish a biomechanical model and second to investigate, which are the biomechanical advantages of angle-stable plate osteosynthesis and intramedullary nailing of distal intraarticular tibial fractures. Seven 4(th) generation biomechanical composite tibiae feat…