1
|
Sisk MR, Yang LC, Paul KD, Elphingstone JW, Brabston EW, Ponce BA, Martin EC, Corriveau KM. Biomechanical Principles of Intramedullary Nails in Veterinary and Human Medicine. Vet Comp Orthop Traumatol 2024. [PMID: 38981690 DOI: 10.1055/s-0044-1788316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
Intramedullary nails are specialized metal rods inserted into the medullary cavity of a fractured bone and secured to reduce load on the fracture site, provide stability, and permit healing. The purpose of this review is to highlight the biomechanics of orthopaedic intramedullary nailing, as well as discuss the biomechanical considerations that have shaped implant design and fixation technique in veterinary and human medicine. Relevant studies were included from the PubMed database and Google Scholar for discussion on the basic science and nail design of intramedullary nails. Implant design and implementation continues to progress, with new innovative designs currently under investigation. A lack of consensus remains on the superior implant material. Recent studies, particularly in human populations, have supported the use of reaming based on reoperation rates, nonunion rates, and dynamization. Design modifications, such as the expandable intramedullary nails and angle-stable interlocking designs, have been investigated as methods of improving cortical contact and resisting torsional stress. Intramedullary nailing is a valuable stabilization technique for long bone fractures across a variety of species. The technology continues to undergo design improvements in both veterinary and human medicine.
Collapse
Affiliation(s)
- Morgan R Sisk
- Department of Orthopaedic Surgery, University of Alabama in Birmingham Heersink School of Medicine, Birmingham, Alabama, United States
| | - Lydia C Yang
- Department of Orthopaedic Surgery, University of Alabama in Birmingham Heersink School of Medicine, Birmingham, Alabama, United States
| | - Kyle D Paul
- Department of Orthopaedic Surgery, University of Alabama in Birmingham Heersink School of Medicine, Birmingham, Alabama, United States
| | - Joseph W Elphingstone
- Department of Orthopaedic Surgery, University of Alabama in Birmingham, Birmingham, Alabama, United States
| | - Eugene W Brabston
- Department of Orthopaedic Surgery, University of Alabama in Birmingham, Birmingham, Alabama, United States
| | - Brent A Ponce
- Hughston Foundation, Hughston Clinic, Columbus, Georgia, United States
| | | | - Kayla M Corriveau
- Department of Clinical Sciences, Auburn University College of Veterinary Medicine, Auburn, Alabama, United States
| |
Collapse
|
2
|
Stan E, Muresan CO, Daescu E, Dumache R, Ciocan V, Ungureanu S, Costachescu D, Enache A. A Review of Histological Techniques for Differentiating Human Bone from Animal Bone. Methods Protoc 2024; 7:51. [PMID: 39051265 PMCID: PMC11270420 DOI: 10.3390/mps7040051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2024] [Revised: 06/25/2024] [Accepted: 06/28/2024] [Indexed: 07/27/2024] Open
Abstract
The first step in anthropological study is the positive identification of human remains, which can be a challenging undertaking when bones are broken. When bone pieces from different species are mixed together, it can be crucial to distinguish between them in forensic and archaeological contexts. For years, anthropology and archaeology have employed the histomorphological analysis of bones to evaluate species-specific variations. Based on variations in the dimensions and configuration of Haversian systems between the two groups, these techniques have been devised to distinguish between non-human and human bones. All of those techniques concentrate on a very particular kind of bone, zone, and segment. Histomorphometric techniques make the assumption that there are size, form, and quantity variations between non-humans and humans. The structural components of Haversian bones are significant enough to use discriminant function analysis to separate one from the other. This review proposes a comprehensive literature analysis of the various strategies or techniques available for distinguishing human from non-human bones to demonstrate that histomorphological analysis is the most effective method to be used in the case of inadequate or compromised samples.
Collapse
Affiliation(s)
- Emanuela Stan
- Department of Neuroscience, Discipline of Forensic Medicine, Bioethics, Deontology and Medical Law, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (E.S.); (C.-O.M.); (R.D.); (V.C.); (S.U.); (A.E.)
- Institute of Legal Medicine Timisoara, 300610 Timisoara, Romania
| | - Camelia-Oana Muresan
- Department of Neuroscience, Discipline of Forensic Medicine, Bioethics, Deontology and Medical Law, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (E.S.); (C.-O.M.); (R.D.); (V.C.); (S.U.); (A.E.)
- Institute of Legal Medicine Timisoara, 300610 Timisoara, Romania
- Ethics and Human Identification Research Center, Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ecaterina Daescu
- Institute of Legal Medicine Timisoara, 300610 Timisoara, Romania
- Department I of Anatomy and Embryology, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Raluca Dumache
- Department of Neuroscience, Discipline of Forensic Medicine, Bioethics, Deontology and Medical Law, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (E.S.); (C.-O.M.); (R.D.); (V.C.); (S.U.); (A.E.)
- Institute of Legal Medicine Timisoara, 300610 Timisoara, Romania
- Ethics and Human Identification Research Center, Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Veronica Ciocan
- Department of Neuroscience, Discipline of Forensic Medicine, Bioethics, Deontology and Medical Law, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (E.S.); (C.-O.M.); (R.D.); (V.C.); (S.U.); (A.E.)
- Institute of Legal Medicine Timisoara, 300610 Timisoara, Romania
- Ethics and Human Identification Research Center, Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Stefania Ungureanu
- Department of Neuroscience, Discipline of Forensic Medicine, Bioethics, Deontology and Medical Law, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (E.S.); (C.-O.M.); (R.D.); (V.C.); (S.U.); (A.E.)
- Institute of Legal Medicine Timisoara, 300610 Timisoara, Romania
| | - Dan Costachescu
- Radiology Laboratory, Emergency Municipal Clinical Hospital Timisoara, 300254 Timisoara, Romania;
- Department of Orthopedics-Traumatology, Urology, Radiology and Medical Imaging, Discipline of Radiology and Medical Imaging, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Alexandra Enache
- Department of Neuroscience, Discipline of Forensic Medicine, Bioethics, Deontology and Medical Law, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania; (E.S.); (C.-O.M.); (R.D.); (V.C.); (S.U.); (A.E.)
- Institute of Legal Medicine Timisoara, 300610 Timisoara, Romania
- Ethics and Human Identification Research Center, Department of Neurosciences, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
| |
Collapse
|
3
|
Makar JG, Lai JYK, Simcock JO, Jerram RM, Lai A, Levien AS, Hoon QJ, Hall EJS, Basa RM. Feline radial and ulnar diaphyseal fractures: a retrospective study of 49 cases comparing single bone fixation and dual bone fixation. J Feline Med Surg 2024; 26:1098612X231214930. [PMID: 38358307 PMCID: PMC10911300 DOI: 10.1177/1098612x231214930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
OBJECTIVES The objectives of this study were to report the complications in radial and ulnar diaphyseal fractures in cats and to compare the differences in outcome between single and dual bone internal fixation. METHODS Medical records between 2004 and 2022 were searched retrospectively for cats with antebrachial diaphyseal fractures treated with internal bone-plate fixation. In total, 49 cases were included from six referral hospitals, including one teaching hospital. Patient information was collated, including fracture configuration, location, repair method and clinical outcome as assessed by veterinary physical examination, radiography and owner questionnaire. RESULTS A total of 47 cats (mean age 4.2 years) were included. Fractures were located distally (24/49, 49%), proximally (13/49, 26.5%) and mid-diaphyseally (12/49, 24.5%). Dual bone fixation was used in 13/49 (26.5%) cases, with only 1/13 (7.7%) having major complications. By comparison, 4/36 (11.1%) of single plated fractures had major complications. Single bone fixation was 14.25 times more likely (95% confidence interval [CI] 2.07-97.99) to have a successful outcome (veterinarian-assigned score of 0) compared with dual bone fixation (P = 0.007). When evaluating owner-assessed outcomes, single bone fixation was 9.4 times more likely (95% CI 1.4-61.96) to have a successful outcome (owner score of 0) compared with dual bone fixation (P = 0.019). CONCLUSIONS AND RELEVANCE Fractures that were repaired with single bone fixation had a greater chance of a better outcome. Although the difference was not significant, there was a higher major complication rate and a lower minor complication rate for cases treated with single bone fixation compared with dual bone fixation. The majority of fractures were located in the distal diaphysis. Comminution of the fracture and concurrent orthopaedic issues did not significantly affect the outcome. Further prospective studies with standardised follow-up, radiographic assessment, surgeon and implants are required to truly assess the difference between dual and single bone fixation.
Collapse
Affiliation(s)
- Jason G Makar
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, NSW, Australia
| | - Jane YK Lai
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, NSW, Australia
| | - James O Simcock
- Southpaws Specialty, Emergency and Referral Hospital, Moorabbin, VIC, Australia
| | - Richard M Jerram
- Veterinary Specialists Aotearoa, Mount Wellington, Auckland, New Zealand
| | - Alen Lai
- Northside Veterinary Specialists, Terrey Hills, Sydney, NSW, Australia
| | | | - QiCai J Hoon
- Veterinary Specialist Services, Underwood, QLD, Australia
| | - Evelyn JS Hall
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, NSW, Australia
| | - Rachel M Basa
- Sydney School of Veterinary Science, Faculty of Science, The University of Sydney, NSW, Australia
- Veterinary Specialists of Sydney, Miranda, NSW, Australia
| |
Collapse
|
4
|
Planner F, Feichtner F, Meyer-Lindenberg A. The cat as a small dog?-Comparison of trabecular and cortical bone microarchitecture of radius and ulna in cats and small dogs using microcomputed tomography. Vet Med Sci 2021; 7:2113-2119. [PMID: 34453415 PMCID: PMC8604124 DOI: 10.1002/vms3.619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
The forearms of dogs and cats do not only differ anatomically from each other, but there are also differences in prevalence of radius and ulna fractures between the two species. The prevalence of antebrachial fractures is 18.0% in dogs and 2.0–8.0% in cats. Many studies focus solely on the trabecular and cortical bone structure of dogs and the characteristics of the cat are often disregarded. The aim of this study was to evaluate the trabecular structure parameters [bone volume fraction per total volume (BV/TV), bone surface per total volume (BS/BV), trabecular number (Tb.N), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp), connectivity density (Conn. D), degree of anisotropy (DA)] and the diaphyseal cortical bone density (Mean Density) of the antebrachium in cats and small dogs to visualise their differences. For this purpose, a total of 32 forearms of cats (n = 8) and small dogs (n = 8) were evaluated using microcomputed tomography and the findings were compared. The results of the study showed that cats had higher values for BV/TV, Tb.Th, Tb.Sp, DA and Mean Density and lower values for BS/BV, Tb.N and Conn.D at radius and ulna compared to dogs. According to the results of this study, the higher bone volume fraction (BV/TV), thicker trabeculae (Tb.Th), increased anisotropy (DA) and significantly higher diaphyseal cortical density (Mean Density) could contribute to the lower fracture risk of the antebrachium in cats compared to small dogs.
Collapse
Affiliation(s)
- Franziska Planner
- Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-University, Munich, Germany
| | - Franziska Feichtner
- Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-University, Munich, Germany
| | - Andrea Meyer-Lindenberg
- Clinic for Small Animal Surgery and Reproduction, Ludwig-Maximilians-University, Munich, Germany
| |
Collapse
|