Standardized artificially created stable pertrochanteric femur fractures present more homogenous results compared to osteotomies for orthopaedic implant testing
Abstract Background With regard to biomechanical testing of orthopaedic implants, there is no consensus on whether artificial creation of standardized bone fractures or their simulation by means of osteotomies result in more realistic outcomes. Therefore, the aim of this study was to artificially cr...
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| Format: | Article |
| Language: | English |
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BMC
2021-04-01
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| Series: | BMC Musculoskeletal Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12891-021-04234-4 |
| _version_ | 1819291191566401536 |
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| author | J.F. Schader I. Zderic D. Gehweiler J. Dauwe K. Mys C. Danker Y. P. Acklin C. Sommer B. Gueorguiev K. Stoffel |
| author_facet | J.F. Schader I. Zderic D. Gehweiler J. Dauwe K. Mys C. Danker Y. P. Acklin C. Sommer B. Gueorguiev K. Stoffel |
| author_sort | J.F. Schader |
| collection | DOAJ |
| description | Abstract Background With regard to biomechanical testing of orthopaedic implants, there is no consensus on whether artificial creation of standardized bone fractures or their simulation by means of osteotomies result in more realistic outcomes. Therefore, the aim of this study was to artificially create and analyze in an appropriate setting the biomechanical behavior of standardized stable pertrochanteric fractures versus their simulation via osteotomizing. Methods Eight pairs of fresh-frozen human cadaveric femora aged 72.7 ± 14.9 years (range 48–89 years) were assigned in paired fashion to two study groups. In Group 1, stable pertrochanteric fractures AO/OTA 31-A1 were artificially created via constant force application on the anterior cortex of the femur through a blunt guillotine blade. The same fracture type was simulated in Group 2 by means of osteotomies. All femora were implanted with a dynamic hip screw and biomechanically tested in 20° adduction under progressively increasing physiologic cyclic axial loading at 2 Hz, starting at 500 N and increasing at a rate of 0.1 N/cycle. Femoral head fragment movements with respect to the shaft were monitored by means of optical motion tracking. Results Cycles/failure load at 15° varus deformation, 10 mm leg shortening and 15° femoral head rotation around neck axis were 11324 ± 848/1632.4 ± 584.8 N, 11052 ± 1573/1605.2 ± 657.3 N and 11849 ± 1120/1684.9 ± 612.0 N in Group 1, and 10971 ± 2019/1597.1 ± 701.9 N, 10681 ± 1868/1568.1 ± 686.8 N and 10017 ± 4081/1501.7 ± 908.1 N in Group 2, respectively, with no significant differences between the two groups, p ≥ 0.233. Conclusion From a biomechanical perspective, by resulting in more consistent outcomes under dynamic loading, standardized artificial stable pertrochanteric femur fracture creation may be more suitable for orthopaedic implant testing compared to osteotomizing the bone. |
| first_indexed | 2024-12-24T03:34:43Z |
| format | Article |
| id | doaj.art-7e233504cc8144dfbb76117568686941 |
| institution | Directory Open Access Journal |
| issn | 1471-2474 |
| language | English |
| last_indexed | 2024-12-24T03:34:43Z |
| publishDate | 2021-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj.art-7e233504cc8144dfbb761175686869412022-12-21T17:17:06ZengBMCBMC Musculoskeletal Disorders1471-24742021-04-0122111110.1186/s12891-021-04234-4Standardized artificially created stable pertrochanteric femur fractures present more homogenous results compared to osteotomies for orthopaedic implant testingJ.F. Schader0I. Zderic1D. Gehweiler2J. Dauwe3K. Mys4C. Danker5Y. P. Acklin6C. Sommer7B. Gueorguiev8K. Stoffel9AO Research Institute DavosAO Research Institute DavosAO Research Institute DavosAO Research Institute DavosAO Research Institute DavosAO Research Institute DavosUniversity Hospital BaselDepartment of Surgery, Cantonal Hospital GraubuendenAO Research Institute DavosUniversity of BaselAbstract Background With regard to biomechanical testing of orthopaedic implants, there is no consensus on whether artificial creation of standardized bone fractures or their simulation by means of osteotomies result in more realistic outcomes. Therefore, the aim of this study was to artificially create and analyze in an appropriate setting the biomechanical behavior of standardized stable pertrochanteric fractures versus their simulation via osteotomizing. Methods Eight pairs of fresh-frozen human cadaveric femora aged 72.7 ± 14.9 years (range 48–89 years) were assigned in paired fashion to two study groups. In Group 1, stable pertrochanteric fractures AO/OTA 31-A1 were artificially created via constant force application on the anterior cortex of the femur through a blunt guillotine blade. The same fracture type was simulated in Group 2 by means of osteotomies. All femora were implanted with a dynamic hip screw and biomechanically tested in 20° adduction under progressively increasing physiologic cyclic axial loading at 2 Hz, starting at 500 N and increasing at a rate of 0.1 N/cycle. Femoral head fragment movements with respect to the shaft were monitored by means of optical motion tracking. Results Cycles/failure load at 15° varus deformation, 10 mm leg shortening and 15° femoral head rotation around neck axis were 11324 ± 848/1632.4 ± 584.8 N, 11052 ± 1573/1605.2 ± 657.3 N and 11849 ± 1120/1684.9 ± 612.0 N in Group 1, and 10971 ± 2019/1597.1 ± 701.9 N, 10681 ± 1868/1568.1 ± 686.8 N and 10017 ± 4081/1501.7 ± 908.1 N in Group 2, respectively, with no significant differences between the two groups, p ≥ 0.233. Conclusion From a biomechanical perspective, by resulting in more consistent outcomes under dynamic loading, standardized artificial stable pertrochanteric femur fracture creation may be more suitable for orthopaedic implant testing compared to osteotomizing the bone.https://doi.org/10.1186/s12891-021-04234-4Fracture modelFracture standardizationOsteotomyStable pertrochanteric fractureFracture line analysisProximal femur fracture |
| spellingShingle | J.F. Schader I. Zderic D. Gehweiler J. Dauwe K. Mys C. Danker Y. P. Acklin C. Sommer B. Gueorguiev K. Stoffel Standardized artificially created stable pertrochanteric femur fractures present more homogenous results compared to osteotomies for orthopaedic implant testing BMC Musculoskeletal Disorders Fracture model Fracture standardization Osteotomy Stable pertrochanteric fracture Fracture line analysis Proximal femur fracture |
| title | Standardized artificially created stable pertrochanteric femur fractures present more homogenous results compared to osteotomies for orthopaedic implant testing |
| title_full | Standardized artificially created stable pertrochanteric femur fractures present more homogenous results compared to osteotomies for orthopaedic implant testing |
| title_fullStr | Standardized artificially created stable pertrochanteric femur fractures present more homogenous results compared to osteotomies for orthopaedic implant testing |
| title_full_unstemmed | Standardized artificially created stable pertrochanteric femur fractures present more homogenous results compared to osteotomies for orthopaedic implant testing |
| title_short | Standardized artificially created stable pertrochanteric femur fractures present more homogenous results compared to osteotomies for orthopaedic implant testing |
| title_sort | standardized artificially created stable pertrochanteric femur fractures present more homogenous results compared to osteotomies for orthopaedic implant testing |
| topic | Fracture model Fracture standardization Osteotomy Stable pertrochanteric fracture Fracture line analysis Proximal femur fracture |
| url | https://doi.org/10.1186/s12891-021-04234-4 |
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