An in vitro biomechanical comparison of a limited-contact dynamic compression plate fixation with a dynamic compression plate fixation of osteotomized equine third metacarpal bones

Load-bearing composite fracture-fixation devices with tailored fibre placement for toy-breed dogs

Fibre reinforced composites are attractive materials for hard tissue reconstructions, due to the high strength and low flexural modulus. However, lack of contourability in the operation theatre inhibits their clinical applications. The study presents a novel in situ contourable composite implant system for load-bearing conditions. The implant system consists of a thin bioresorbable shell with several cavities, much like bubble-wrap. The central cavity contains a semi-flexible glass fibre preform prepared using Tailored Fibre Placement method. The preform is either pre-impregnated with a light curable resin, or the resin is injected into the cavity during the surgical procedure, followed by light curing. The semi-flexible glass fibre preforms were also examined as separate devices, "miniplates". Two types of miniplates were scrutinized, a simplified pilot design and a spatially refined, "optimized" design. The optimized miniplates were implemented as biostable and bioresorbable versions. The feasibility of the in situ contourable composite implant system was demonstrated. The potential of Tailored Fibre Placement for the semi-flexible glass fibre preforms and miniplates was confirmed in a series of biomechanical tests. However, structural optimization is required. Antebrachial fractures in toy-breeds of dogs are exemplar veterinary applications of the devices; further applications in veterinary and human patients are foreseen.

An in vitro biomechanical comparison of hydroxyapatite coated and uncoated ao cortical bone screws for a limited contact: dynamic compression plate fixation of osteotomized equine 3rd metacarpal bones

OBJECTIVES

To compare the monotonic biomechanical properties of a broad 4.5 mm limited contact-dynamic compression plate (LC-DCP) fixation secured with hydroxyapatite (HA) coated cortical bone screws (HA-LC-DCP) versus uncoated cortical bone screws (AO-LC-DCP) to repair osteotomized equine 3rd metacarpal (MC3) bones.

STUDY DESIGN

Experimental.

SAMPLE POPULATION

Adult equine cadaveric MC3 bones (n = 12 pair).

METHODS

Twelve pairs of equine MC3 were divided into 3 test groups (4 pairs each) for: (1) 4 point bending single cycle to failure testing; (2) 4 point bending cyclic fatigue testing; and (3) torsional single cycle to failure testing. For the HA-LC-DCP-MC3 construct, an 8-hole broad LC-DCP (Synthes Ltd, Paoli, PA) was secured on the dorsal surface of each randomly selected MC3 bone with a combination of four 5.5 mm and four 4.5 mm HA-coated cortical screws. For the AO-LC-DCP-MC3 construct, an 8-hole 4.5 mm broad LC-DCP was secured on the dorsal surface of the contralateral MC3 bone with a combination of four 5.5 mm and four 4.5 mm uncoated cortical screws. All MC3 bones had mid-diaphyseal osteotomies. Mean test variable values for each method were compared using a paired t-test within each group. Significance was set at P < .05.

RESULTS

Mean yield load, yield bending moment, composite rigidity, failure load, and failure bending moment, under 4 point bending, single cycle to failure, of the HA-LC-DCP fixation were significantly greater than those of the AO-LC-DCP fixation. Mean ± SD values for the HA-LC-DCP and the AO-LC-DCP fixation techniques, respectively, in single cycle to failure under 4 point bending were: yield load, 26.7 ± 2.15 and 16.3 ± 1.38 kN; yield bending moment, 527.4 ± 42.4 and 322.9 ± 27.2 N-m; composite rigidity, 5306 ± 399 and 3003 ± 300 N-m/rad; failure load, 40.6 ± 3.94 and 26.5 ± 2.52 kN; and failure bending moment, 801.9 ± 77.9 and 522.9 ± 52.2 N-m. Mean cycles to failure in 4 point bending of the HA-LC-DCP fixation (116,274 ± 13,211) was significantly greater than that of the AO-LC-DCP fixation 47,619 ± 6580. Mean yield load, mean composite rigidity, and mean failure load under torsional testing, single cycle to failure was significantly greater for the broad HA-LC-DCP fixation compared with the AO-LC-DCP fixation. In single cycle to failure under torsion, mean ± SD values for the HA-LC-DCP and the AO-LC-DCP fixation techniques, respectively, were: yield load, 101.3 ± 14.68 and 70.54 ± 10.20 N-m; composite rigidity, 437.9 ± 32.9 and 220.7 ± 17.6 N-m/rad; and failure load: 105.7 ± 15.5 and 75.28 ± 10.1 N-m.

CONCLUSION

HA-LC-DCP was superior to AO-LC-DCP in resisting the static overload forces (palmarodorsal 4 point bending and torsional) and in resisting cyclic fatigue under palmarodorsal 4 point bending.

Effect of sequential removal of parts of the second metacarpal bone on the biomechanical stability of the equine carpus

OBJECTIVE

To quantify changes in biomechanical stability and stiffness within the equine carpus after removal of 50%, 80%, and 100% of the second metacarpal bone (MC2).

STUDY DESIGN

In vitro biomechanical study.

METHODS

Cadaveric equine forelimbs (n = 16) were evaluated. Intact constructs were loaded in axial compression from 0 to 5000 N and compression + torsion (5000 N ± 20°) for 5 cycles. This was repeated after removal of 50%, 80%, and 100% of MC2. The primary biomechanical outcome variables were the compressive stiffness and compressive + torsional stiffness of the carpus. Relative kinematic motion was also evaluated between the second carpal bone (C2) and the radial carpal bone (RC), C2 and the third metacarpal bone (MC3) and C2 and the third carpal bone (C3).

RESULTS

A significant decrease in compressive + torsional stiffness was found after 100% removal of MC2. Compressive stiffness of the carpus did not change after 100% MC2 removal. A significant increase in relative rotation around the z-axis (rotation around the long axis) was observed for C2 versus MC3 and C2 versus C3 when 100% of MC2 was removed as compared to 80%, 50%, and 0% removal. No significant difference in relative rotation between C2 and RC was detected.

CONCLUSIONS

The biomechanical results reported here suggest that the torsional stability of the equine carpus is significantly decreased only after complete resection of MC2.

In vitro biomechanical evaluation and comparison of a new prototype locking plate and a limited-contact self compression plate for equine fracture repair

OBJECTIVE

To determine if the mechanical properties (strength and stiffness) of a new prototype 4.5 mm broad locking plate (NP-LP) are comparable with those of a traditional 4.5 mm broad limited-contact self compression plate (LC-SCP), and to compare the bending and torsional properties of the NP-LP and LC-SCP when used in osteotomized equine third metacarpal bones (MC3).

METHODS

The plates alone were tested in four-point bending single cycle to failure. The MC3-plate constructs were created with mid-diaphyseal osteotomies with a 1 cm gap. Constructs were tested in four-point bending single cycle to failure, four-point bending cyclic fatigue, and torsion single cycle to failure.

RESULTS

There were not any significant differences in bending strength and stiffness found between the two implants. The MC3-NP-LP construct was significantly stiffer than the MC3-LC-SCP in bending. No other biomechanical differences were found in bending, yield load in torsion, or mean composite rigidity. Mean cycles to failure for bending fatigue testing were similar for both constructs.

CLINICAL SIGNIFICANCE

The NP-LP was comparable to the LC-SCP in intrinsic, as well as structural properties. The NP-LP construct was more rigid than the LC-SCP construct under four-point bending, and both constructs behaved similarly under four-point bending cyclic fatigue testing and torsion single cycle to failure. The new NP-LP implant fixation is biomechanically comparable to the LC-SCP in a simulated MC3 fracture.

In vitro biomechanical comparison of dynamic compression plates with a rough contact surface and a polished contact surface for fixation of osteotomized equine third metacarpal bones

OBJECTIVES

To compare the number of cycles to failure of 4.5 mm broad dynamic compression plates (DCP), 4.5 mm broad limited-contact dynamic compression plates (4.5-LC-DCP), and 5.5 mm broad limited-contact dynamic compression plates (5.5-LC-DCP) having a rough (denoted by a prefix R-) versus a standard smooth contact surface for the fixation of osteotomized equine 3rd metacarpal (MC3) bones.

STUDY DESIGN

Experimental.

ANIMAL POPULATION

Fifteen pairs of adult equine cadaveric MC3 bones.

METHODS

Fifteen pairs of equine MC3 were divided into 3 test groups (5 pairs each) for comparison of (1) R-DCP fixation with DCP fixation, (2) R-4.5-LC-DCP fixation with 4.5-LC-DCP fixation, and (3) R-5.5-LC-DCP fixation with 5.5-LC-DCP fixation to repair osteotomized equine MC3 bones under palmarodorsal 4-point bending cyclic fatigue testing. For each group an 8-hole plate with rough contact surface was applied to the dorsal surface of one randomly selected bone from each pair and a corresponding 8-hole plate with smooth contact surface was applied dorsally to the contralateral bone from each pair. All plates and screws were applied using standard ASIF techniques. All MC3 bones had mid-diaphyseal osteotomies. Mean number of cycles to failure for each method were compared using a paired t-test within each group. Significance was set at P < .05.

RESULTS

Mean cycles to failure ± standard deviation was significantly greater for the R-DCP fixation (230,025 ± 23,129) compared with the DCP fixation (103,451 ± 14,556), for the R-4.5-LC-DCP fixation (99,237 ± 14,390) compared with the 4.5-LC-DCP fixation (46,464 ± 6325) and for the R-5.5-LC-DCP fixation (65,113 ± 7796) compared with the 5.5-LC-DCP fixation (34,224 ± 3835).

CONCLUSION

For the fixation of osteotomized MC3 bones, the constructs with plates having rough contact surface were superior to the corresponding constructs with plates having standard smooth contact surfaces in resisting cyclic fatigue under palmarodorsal 4-point bending.

In vitro biomechanical comparison of a modified 5.5 mm locking compression plate fixation with a 5.5 mm locking compression plate fixation of osteotomized equine third metacarpal bones

OBJECTIVES

To compare number of cycles to failure for palmarodorsal 4-point bending of a modified 5.5 mm broad locking compression plate (M5.5-LCP) fixation with a 5.5 mm broad LCP (5.5-LCP) fixation used to repair osteotomized equine third metacarpal (MC3) bones.

STUDY DESIGN

In vitro biomechanical testing.

ANIMAL POPULATION

Adult equine cadaveric MC3 bones (n=6 pairs).

METHODS

An 8-hole, M5.5-LCP, obtained by having a 1.0 mm thickness removed from the bone contact portion of the 5.5-LCP, was applied to the dorsal surface of 1 randomly selected MC3 from each pair, and an 8-hole, 5.5-LCP was applied dorsally to the contralateral bone from each pair using a combination of cortical and locking screws. Plates and screws were applied using standard ASIF techniques to MC3 bones with a mid-diaphyseal osteotomy. MC3 constructs had palmarodorsal 4-point bending cyclic fatigue testing. Mean cycles to failure for each method were compared using a paired t-test within each group. Significance was set at P<.05.

RESULTS

Mean±SD cycles to failure of the M5.5-LCP fixation (188,641±17,971) was significantly greater than that of the 5.5-LCP fixation (166,497±15,539).

CONCLUSION

M5.5-LCP fixation was superior to 5.5-LCP fixation of osteotomized equine MC3 bones in resisting cyclic fatigue under palmarodorsal 4-point bending.

CLINICAL RELEVANCE

This suggests that biological plate fixation is not the ideal choice for osteotomized equine MC3 bones.

An In Vitro Biomechanical Comparison of a Prototype Equine Metacarpal Dynamic Compression Plate Fixation with Double Dynamic Compression Plate Fixation of Osteotomized Equine Third Metacarpal Bones

OBJECTIVES

To compare the monotonic biomechanical properties of a prototype equine third metacarpal dynamic compression plate (EM-DCP) fixation with a double broad dynamic compression plate (DCP) fixation to repair osteotomized equine third metacarpal (MC3) bones.

STUDY DESIGN

In vitro biomechanical testing of paired cadaveric equine MC3 with a mid-diaphyseal osteotomy, stabilized by 1 of 2 methods for fracture fixation.

POPULATION

Twelve pairs of adult equine cadaveric MC3 bones.

METHODS

Twelve pairs of equine MC3 were divided into 3 test groups (4 pairs each) for (1) 4-point bending single cycle to failure testing, (2) 4-point bending cyclic fatigue testing, and (3) torsional testing. The EM-DCP (10-hole, 4.5 mm) was applied to the dorsal surface of one randomly selected bone from each pair. Two DCPs, 1 dorsally (10-hole, 4.5 mm broad) and 1 laterally (9-hole, 4.5 mm broad) were applied to the contralateral bone from each pair. All plates and screws were applied using standard AO/ASIF techniques to MC3 bones that had mid-diaphyseal osteotomies. Mean test variable values for each method were compared using a paired t-test within each group. Significance was set at P<.05.

RESULTS

Mean 4-point bending yield load, yield bending moment, bending composite rigidity, failure load and failure bending moment of the EM-DCP fixation were significantly greater (P<.0001) than those of the double broad DCP fixation. Mean cycles to failure in 4-point bending of the EM-DCP fixation was significantly greater (P<.0008) than that of the double broad DCP fixation. Mean yield load, composite rigidity, and failure load in torsion of the EM-DCP fixation were significantly greater (P<.0035) than that of the double broad DCP fixation.

CONCLUSION

The EM-DCP provides increased stability in both static overload testing and cyclic fatigue testing.

CLINICAL RELEVANCE

Results of this in vitro study support the conclusion that the prototype EM-DCP fixation is biomechanically superior to the double broad DCP fixation for the stabilization of osteotomized equine MC3.