Effects of low-modulus coatings on pin-bone contact stresses in external fixation

The intent of this study was to investigate the stress distribution in cortical bone around fracture fixation pins and around pins coated with various polymeric and elastomeric materials. Since these interface stresses cannot be measured directly, a photoelastic technique was employed and stresses were measured in two-dimensional bone models fabricated from sheets of epoxy resin. Our results showed that when a fixation pin was loaded in compression, the compressive stress measured in the model was greatest at the pin-model interface. The magnitude of the compressive stress was found to diminish steeply away from the hole in a log decrement distribution which was asymptotic to the value of the average stress in the model. When polymeric and elastomeric materials were applied as pin coatings and the performance of the coated pins was compared to that of uncoated pins of the same overall diameter, a reduction of the maximum stress in the bone model was demonstrated. Among the coatings tested, we found that of the polymeric materials ultrahigh molecular weight polyethylene (UHMWPE) was most effective at reducing the peak cortical stress magnitude. The most effective coating material overall was found to be silicon elastomer. Computation of stress values in models loaded through stainless-steel pins and through pins coated with 1-mm silicon elastomer showed that the presence of the elastomer layer caused a reduction of about 50% in the maximum compressive stress in the model.

An unusual first branchial cleft cyst

First branchial cleft anomalies have been documented with increasing frequency within the past decade, with more than 200 cases reported to date. A case of a first branchial cleft cyst with some unusual features is presented. The literature of such anomalies is reviewed, with some distinct clinical differences being noted between cysts and other branchial cleft anomalies.