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Herterich V, Hofmann L, Synek A, Böcker W, Polzer H, Baumbach SF. Fracture pattern analysis of fractures to the diaphysis of the fifth metatarsal. Orthop Traumatol Surg Res 2024; 110:103594. [PMID: 36921758 DOI: 10.1016/j.otsr.2023.103594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/10/2023] [Accepted: 02/21/2023] [Indexed: 03/15/2023]
Abstract
BACKGROUND Fractures to the fifth's metatarsal (MT-V) diaphysis are common. These are inconsistently referred to as diaphyseal-, shaft-, or Dancer's fractures. A comprehensive analysis of the MT-V fracture morphology is missing. The aim was to qualitatively and quantitatively analyze fracture patterns of MT-V diaphyseal fractures. HYPOTHESIS Fractures to the shaft of the fifth metatarsal feature specific fracture morphologies. MATERIALS AND METHODS Retrospective, radiologic database study. Included were all acute, isolated MT-V shaft fractures (including the proximal [Lawrence and Botte (L&B) III] and distal meta-diaphysis). Demographics and fracture characteristics were assessed. Each proximal fracture line was drawn, scaled, and a qualitative and quantitative fracture line analysis was conducted. The quantitative fracture line analysis aimed at identifying dens clusters with arbitrary shape using the DBSCAN algorithm. Data are presented as mean±standard deviation. RESULTS Out of 704 eligible MT-V fractures, 156 met the inclusion criteria. Patient's mean age was 46±19 years and 94% suffered a low energy trauma. Qualitative and quantitative fracture line analysis revealed three distinct fracture patterns. The proximal (30%) and distal (5%) meta-diaphyseal clusters showed a predominant transverse fracture pattern. The vast majority of diaphyseal fractures (56%) were spiral/oblique fractures, progressing from the proximal lateral meta-diaphyseal region in an oblique course at 61±9° to the medial distal diaphyseal cortex. Seven percent of diaphyseal fractures showed a transverse fracture pattern. DISCUSSION Based on a qualitative and quantitative analysis of all MT-V shaft fractures, three distinct fracture clusters were identified with homogeneous fracture patterns. MT-V shaft fractures should therefore be classified as proximal meta-diaphyseal (L&B Type III), diaphyseal (oblique or transverse) and distal meta-diaphyseal. LEVEL OF PROOF IV; retrospective database study.
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Affiliation(s)
- Viktoria Herterich
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, 20, Nussbaumstr, 80336 Munich, Germany
| | - Luzie Hofmann
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, 20, Nussbaumstr, 80336 Munich, Germany
| | - Alexander Synek
- Institute of Lightweight Design and Structural Biomechanics, TU Wien, Gumpendorfer Straße 7/Objekt 8, 1060 Vienna, Austria
| | - Wolfgang Böcker
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, 20, Nussbaumstr, 80336 Munich, Germany
| | - Hans Polzer
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, 20, Nussbaumstr, 80336 Munich, Germany.
| | - Sebastian Felix Baumbach
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, 20, Nussbaumstr, 80336 Munich, Germany
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Harry JR, James CR, Dufek JS. Weighted vest effects on impact forces and joint work during vertical jump landings in men and women. Hum Mov Sci 2018; 63:156-163. [PMID: 30553141 DOI: 10.1016/j.humov.2018.12.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 12/03/2018] [Accepted: 12/08/2018] [Indexed: 10/27/2022]
Abstract
Weighted vest (WV) use during vertical jump landings (VJL) does not appear to alter peak vertical ground reaction forces (GRF) or peak joint torques. However, WV effects on joint work and sex differences during VJL are not well understood. This study assessed WV effects on vertical GRF and sagittal joint work during VJL in men and women. Twelve men and 12 women performed VJL wearing a WV with zero added mass (unloaded) and with 10% body mass (loaded) while GRF and kinematic data were obtained. Mixed-model analyses of variance (α = 0.05) and effect sizes (ES) were used to assess differences between sexes and/or load conditions. Regardless of sex, greater landing height (p < 0.001; ES = 0.37) and peak vertical GRF (p = 0.001; ES 0.51) occurred when unloaded, while greater landing time (p = 0.001; ES = 0.46) and negative lower extremity work (p < 0.001; ES = 0.41) occurred when loaded through greater negative work about the hip (p = 0.001; ES = 0.27) and ankle (p = 0.020; ES = 0.27). No differences in hip (p = 0.753; ES = 0.03), knee (p = 0.588; ES = 0.07), or ankle (p = 0.580; ES = 0.09) joint displacement were detected between loaded and unloaded conditions. Men exhibited greater landing heights (p < 0.001; ES = 2.49) and greater peak vertical GRF than women (p = 0.007; ES = 1.18), though women exhibited greater negative lower extremity work (p < 0.001; ES = 1.98) than men through greater negative knee (p < 0.001; ES = 1.98) and ankle (p = 0.032; ES = 0.94) work. No sex differences were detected for joint angular displacement about the hip (p = 0.475; ES = 0.30), knee (p = 0.666; ES = 0.18), or ankle (p = 0.084; ES = 0.71). These data revealed a unique load accommodation strategy during VJL with a WV characterized by greater lower extremity joint work performed via increased joint torque despite lesser landing height and peak vertical GRF. Women appear to perform greater lower extremity joint work than men during VJL despite lesser landing height and peak vertical GRF. Current and prospective WV users should be aware of their load accommodation strategy during VJL with an external load. Women may consider developing more refined load accommodation strategies for VJL regardless of whether external loading is applied to avoid performing excessive amounts of lower extremity work.
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Affiliation(s)
- John R Harry
- Department of Kinesiology & Sport Management, Texas Tech University, 3204 Main Street, Lubbock, TX 79409, USA.
| | - C Roger James
- Center for Rehabilitation Research, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX 79430, USA
| | - Janet S Dufek
- Department of Kinesiology & Nutrition Sciences, University of Nevada, Las Vegas, 4505 S. Maryland Parkway, Box 3034, Las Vegas, NV 89154, USA
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Zapata-Cornelio FY, Jin Z, Barton DC, Jones AC, Wilcox RK. A methodology for the generation and non-destructive characterisation of transverse fractures in long bones. Bone Rep 2018; 8:221-228. [PMID: 29955641 PMCID: PMC6020270 DOI: 10.1016/j.bonr.2018.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 04/12/2018] [Accepted: 04/23/2018] [Indexed: 11/27/2022] Open
Abstract
Long bone fractures are common and although treatments are highly effective in most cases, it is challenging to achieve successful repair for groups such as open and periprosthetic fractures. Previous biomechanical studies of fracture repair, including computer and experimental models, have simplified the fracture with a flat geometry or a gap, and there is a need for a more accurate fracture representation to mimic the situation in-vivo. The aims of this study were to develop a methodology for generating repeatable transverse fractures in long bones in-vitro and to characterise the fracture surface using non-invasive computer tomography (CT) methods. Ten porcine femora were fractured in a custom-built rig under high-rate loading conditions to generate consistent transverse fractures (angle to femoral axis < 30 degrees). The bones were imaged using high resolution peripheral quantitative CT (HR-pQCT). A method was developed to extract the roughness and form profiles of the fracture surface from the image data using custom code and Guassian filters. The method was tested and validated using artificially generated waveforms. The results revealed that the smoothing algorithm used in the script was robust but the optimum kernel size has to be considered. A new method to generate and quantify long bone fracture surface geometry is proposed. Reliable transverse fractures were generated and imaged using microCT. A non-destructive method to characterise the surface from the images was developed Validation of the method using benchmark waveforms showed the method to be robust By tuning the filtering conditions, specific characteristics of the surface can be extracted.
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Pramudita JA, Kamiya S, Ujihashi S, Choi HY, Ito M, Watanabe R, Crandall JR, Kent RW. Estimation of conditions evoking fracture in finger bones under pinch loading based on finite element analysis. Comput Methods Biomech Biomed Engin 2016; 20:35-44. [PMID: 27269518 DOI: 10.1080/10255842.2016.1196197] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A finger finite element (FE) model was created from CT images of a Japanese male in order to obtain a shape-biofidelic model. Material properties and articulation characteristics of the model were taken from the literature. To predict bone fracture and realistically represent the fracture pattern under various loading conditions, the ESI-Wilkins-Kamoulakos rupture model in PAM-CRASH (ESI Group S.A., Paris, France) was utilized in this study with parameter values of the rupture model determined by compression testing and simulation of porcine fibula. A finger pinch simulation was then conducted to validate the finger FE model. The force-displacement curve and fracture load from the pinch simulation was compared to the result of finger pinch test using cadavers. Simulation results are coincident with the test result, indicating that the finger FE model can be used in an analysis of finger bone fracture during pinch accident. With this model, several pinch simulations were conducted with different pinching object's stiffness and pinching energy. Conditions for evoking finger bone fracture under pinch loading were then estimated based on these results. This study offers a novel method to predict possible hazards of manufactured goods during the design process, thus finger injury due to pinch loading can be avoided.
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Affiliation(s)
- Jonas A Pramudita
- a Department of Mechanical and Production Engineering , Niigata University , Niigata , Japan
| | - Seiji Kamiya
- b Department of Mechanical and Environmental Informatics , Tokyo Institute of Technology , Tokyo , Japan
| | - Sadayuki Ujihashi
- b Department of Mechanical and Environmental Informatics , Tokyo Institute of Technology , Tokyo , Japan.,c Nippon Bunri University , Oita , Japan
| | - Hyung-Yun Choi
- d Department of Mechanical System Design Engineering , HongIk University , Seoul , Korea
| | - Masato Ito
- e Analysis Center , Panasonic Corporation , Osaka , Japan
| | - Ryoji Watanabe
- e Analysis Center , Panasonic Corporation , Osaka , Japan
| | - Jeff R Crandall
- f Center for Applied Biomechanics , University of Virginia , Charlottesville , VA , USA
| | - Richard W Kent
- f Center for Applied Biomechanics , University of Virginia , Charlottesville , VA , USA
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Wong DWC, Niu W, Wang Y, Zhang M. Finite Element Analysis of Foot and Ankle Impact Injury: Risk Evaluation of Calcaneus and Talus Fracture. PLoS One 2016; 11:e0154435. [PMID: 27119740 PMCID: PMC4847902 DOI: 10.1371/journal.pone.0154435] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 04/13/2016] [Indexed: 12/04/2022] Open
Abstract
Introduction Foot and ankle impact injury is common in geriatric trauma and often leads to fracture of rearfoot, including calcaneus and talus. The objective of this study was to assess the influence of foot impact on the risk of calcaneus and talus fracture via finite element analysis. Methods A three-dimensional finite element model of foot and ankle was constructed based on magnetic resonance images of a female aged 28. The foot sustained a 7-kg passive impact through a foot plate. The simulated impact velocities were from 2.0 to 7.0 m/s with 1.0 m/s interval. Results At 5.0 m/s impact velocity, the maximum von Mises stress of the trabecular calcaneus and talus were 3.21MPa and 2.41MPa respectively, while that of the Tresca stress were 3.46MPa and 2.55MPa. About 94% and 84% of the trabecular calcaneus and talus exceeded the shear yielding stress, while 21.7% and 18.3% yielded the compressive stress. The peak stresses were distributed around the talocalcaneal articulation and the calcaneal tuberosity inferiorly, which corresponded to the common fracture sites. Conclusions The prediction in this study showed that axial compressive impact at 5.0 m/s could produce considerable yielding of trabecular bone in both calcaneus and talus, dominantly by shear and compounded with compression that predispose the rearfoot in the risk of fracture. This study suggested the injury pattern and fracture mode of high energy trauma that provides insights in injury prevention and fracture management.
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Affiliation(s)
- Duo Wai-Chi Wong
- Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Wenxin Niu
- Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Shanghai Yang Zhi Rehabilitation Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yan Wang
- Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Ming Zhang
- Interdisciplinary Division of Biomedical Engineering, The Hong Kong Polytechnic University, Hong Kong SAR, China
- * E-mail:
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Bone Micro-Fracture Observations From Direct Impact of Slow Velocity Projectiles. ACTA ACUST UNITED AC 2014. [DOI: 10.5812/jamm.15614] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Fouad H. Assessment of function-graded materials as fracture fixation bone-plates under combined loading conditions using finite element modelling. Med Eng Phys 2010; 33:456-63. [PMID: 21146439 DOI: 10.1016/j.medengphy.2010.11.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2010] [Revised: 11/15/2010] [Accepted: 11/16/2010] [Indexed: 11/25/2022]
Abstract
In previous work by Fouad (Medical Engineering and Physics 2010 [23]), 3D finite element (FE) models for fractured bones with function-graded (FG) bone-plates and traditional bone-plates made of stainless steel (SS) and titanium (Ti) alloy were examined under compressive loading conditions using the ABAQUS Code. In this study, the effects of the presence of the torsional load in addition to the compressive load on the predicted stresses of the fracture fixation bone-plate system are examined at different healing stages. The effects on the stress on the fracture site when using contacted and non-contacted bone-plate systems are also studied. The FE modelling results indicate that the torsional load has significant effects on the resultant stress on the fracture fixation bone-plate system, which should be taken into consideration during the design and the analysis. The results also show that the stress shielding at the fracture site decreases significantly when using FG bone-plates compared to Ti alloy or SS bone-plates. The presence of a gap between the bone and the plate results in a remarkable reduction in bone stress shielding at the fracture site. Therefore, the significant effects of using an FG bone-plate with a gap and the presence of torsional load on the resultant stress on the fracture fixation bone-plate system should be taken into consideration.
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Affiliation(s)
- H Fouad
- Department of Applied Medical Science, RCC, King Saud University, PO Box: 28095, 11437 Riyadh, Saudi Arabia.
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Vervust B, Van Dongen S, Grbac I, Van Damme R. The mystery of the missing toes: extreme levels of natural mutilation in island lizard populations. Funct Ecol 2009. [DOI: 10.1111/j.1365-2435.2009.01580.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Marturano JE, Cleveland BC, Byrne MA, O'Connell SL, Wixted JJ, Billiar KL. An improved murine femur fracture device for bone healing studies. J Biomech 2008; 41:1222-8. [PMID: 18384794 DOI: 10.1016/j.jbiomech.2008.01.029] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2007] [Revised: 01/12/2008] [Accepted: 01/24/2008] [Indexed: 10/22/2022]
Abstract
Murine models are commonly used to investigate bone healing and test new treatments before human trials. Our objective was to design an improved murine femur fracture device and determine optimal mass and velocity settings for maximal likelihood of transverse fracture. Fracture reproducibility was maximized using an adjustable kinetic energy level, a novel mouse positioning system and an electromagnet striker release assembly. Sixty wild-type mice of 8-12-week-old male and female with a weight of 26.4+/-6.1g were subjected to an experimental postmortem fracture in the left and right femur (n=120) using variable kinetic energy inputs. A best-fit prediction equation for transverse fracture was developed using multivariate linear regression. Transverse fracture was shown to correlate most highly with kinetic energy with a maximum likelihood at mv2=292 where m is mass (g) and v is velocity (m/s). Model validation with a group of 134 anesthetized C57BL/6 mice resulted in a favorable transverse fracture rate of 85.8%. Simple modifications to existing fracture devices can improve accuracy and reproducibility. The results may assist researchers studying the effects of genetic modifications and novel treatments on boney healing in murine femur fracture models. Maintaining kinetic energy parameters within suggested ranges may also aid in ensuring accuracy and reproducibility.
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Affiliation(s)
- Joseph E Marturano
- Department of Biomedical Engineering, Worcester Polytechnic Institute, 100 Institute Road, Worcester, MA 01609, USA
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