Application Of Bone Plate Research Articles

A metamaterial bone plate for biofixation based on 3D printing technology

Bone plate design and production methods are critical for producing metamaterial bone plates. This study investigated the design and development process of porous structures and metamaterial bone plates for biofixation applications. We designed the porous structures for bone plates using parametric modeling and fused them via the implicit surface fusion method. Likewise, we designed the metamaterial bone plate structure using reverse reconstruction and topological optimization. Thereafter, we utilized three-dimensional (3D) printing for producing and post-processing the metamaterial bone plate. We observed a reduced stress-shielding effect after topological optimization. Additionally, the resultant diamond porous structure maintained a high porosity under pressure. The 3D-printed bone plates and fillers had a bright porous surface, with clear pore structures and good connectivity. The assembly of the 3D-printed femur, bone plate, filler, and standardized screw indicated a good fitting, and the filler could be fixed by the inclined surface. Taken together, the findings of this study established the foundation for the prospective application of metamaterial bone plates in biofixation.

Pectoralis major pedicle bone grafting vs. tricortical iliac grafting for Neer 4-part proximal humerus fractures: a randomized controlled trial

The risk of avascular necrosis, nonunion, or malunion is high in osteoporosis-related 4-part fractures. We tried to evaluate the results of patients who underwent plate osteosynthesis with vascularized pectoralis major graft comparing with tricortical iliac grafting to treat 4-part proximal humerus fractures. Thirty-four patients aged 50-75 with Neer 4-part proximal humerus fractures were studied. Group A (n=17) underwent osteotomy of a 2.5cm±1cm pectoralis major pedicle bone graft and plate application, while Group B (n=17) underwent plate osteosynthesis using iliac autogenous grafts. Final follow-up assessments included evaluation using Constant and American Shoulder and Elbow Surgeons scoring systems, Humeral Neck-Shaft Angle (HNSA), humeral head height (Humeral Head Height) and humeral head avascular necrosis. Although reduction loss was observed in 3 patients (17.6%) in Group A patients, reduction loss was observed in 10 patients (58.8%) in Group B., p= 0.013. Humeral head avascular necrosis was 1 (5.8%) in Group A, while it was 5 (29.4%) in the other group (p= 0.071). The HNSA was normal in 12 (70.5%) of Group A patients, while it was normal in 6 (35.2%) of Group B patients. The HNSA was weak or bad (<1200) in 29.4% of Group A patients, while this rate was 64.7% in Group B patients. HHH was 2.64±1.45 mm in Group A and 3.66±1.65 mm in Group B. There were no statistically significant differences between the two groups in terms of Constant and American Shoulder and Elbow Surgeons scoring systems. Pectoralis major bone pedicle graft in Neer 4-part proximal humerus fractures reduces the risk of avascular necrosis and nonunion rates. Our technique yielded excellent clinical and radiological results. We achieved recovery without creating additional donor site morbidity.

Novel Claw-shaped Bone Plate in Complex Unstable Scapular Neck and Body Fractures: Comparison with Reconstruction Locking Plate.

For complex and unstable scapular fractures requiring simultaneous fixation of the glenoid neck, the lateral margin of the body, and/or the scapular diaphysis, reconstruction locking plate is difficult to achieve satisfactory fixation. In order to optimize the fixation effect, the newly designed claw-shaped bone plate was designed for fixing such fractures. We also evaluate the clinical effects and follow-up at an average of 1 year after treatment in scapular internal fixation by using reconstruction locking plate and claw-shaped bone plate in complex unstable scapular body and glenoid neck fracture. A retrospective study was conducted from 2018 to 2021, thirty-three patients (27 males and six females) who were defined unstable scapular fractures by Ada-Miller. Fifteen patients (52.86 ± 8.26 years) received claw-shaped bone plate and 18 cases (51.61 ± 11.31 years) received reconstruction locking plate with the intermuscular approach. The clinical effect was evaluated based on the operation time, intraoperative blood loss, surgical complications, clinical healing time and Constant-Murley score (CMS). The data analysis by Student t, Mann-Whitney U test and Pearson's chi squared test. Compared with reconstruction locking plate, the claw-shaped bone plate showed shorter operation time (102.73 ± 18.43 min vs. 156 ± 37.53, P < 0.0001), higher CMS (94.00 ± 4.07 vs. 89.88 ± 5.42, P = 0.02) and no differences between the two groups regarding intraoperative blood loss (208.00 ± 96.45 mL vs. 269.44 ± 120.21, P = 0.12) and clinical healing times (9.96 ± 1.52 vs. 10.05 ± 1.67, P = 0.87). Follow-up were conducted at first, third, 6 and 12 months after surgery. The operation was successful in all patients with no intraoperative complications. For the treatment of complex and unstable scapular neck body fractures, the application of claw-shaped bone plate demonstrated short operation time, better stability of the fracture block, and higher CMS. In the intraoperative and postoperative follow-up showed better clinical results and rehabilitation effects.

Corrigendum to Development of silk/polycaprolactone biocomposite for internal bone plate application

Corrigendum to Development of silk/polycaprolactone biocomposite for internal bone plate application

Langerhans cell histiocytosis of the left tibia bone: A case report

Langerhans cell histiocytosis (LCH) is a rare group of disorders including single lesion to widespread disseminated disease. The incidence of this disorder is around 5–6 cases per million children per year with more than 50% of cases are diagnosed between 1 and 15 years old and peaks between 1 and 4 years old. This case report describes a rare case of a 2-year-old boy patient with a single lesion LCH in the left tibia. The diagnosis was challenging as the presenting symptom was not specific and the radiograph examination mimicked osteomyelitis. The diagnosis was then confirmed with immunohistochemistry (IHC) S-100 staining. The patient had a surgical curettage, application of bone graft and plate, and screw fixation. At 9 months follow-up, the patient was able to walk without gait disturbance and there was no new lesion reported. This case report pointed out that in the diagnosis of LCH, physical, and radiological examination mimicked other more common diseases and IHC S-100 staining had confirmed the diagnosis of LCH. It also showed that for a small single lesion of LCH, minimal intervention leads to a good outcome.

Theoretical modelling and experimental characterization of composite material for ulna bone plate application

In the procedure, isolated fractures in the ulna bone shaft are normally handled with metal bone plates, which may result in “stress shielding” contributing to bone re fracture and bone mass decrease. For bone plate applications, fiber-reinforced composites with lower stiffness have been introduced to mitigate the above disadvantages. A new glass/jute/polyester hybrid composite material for bone plate whose structure is engineered to ensure lower rigidity than traditional metal plate is being established in the current investigation. In this research, many design guidelines were followed to take account of the strength of composite systems and to optimize the advantages of the properties of both fibers. Classical lamination theory (CLT) and rule of mixture models are used to test the composite elastic properties before processing. The determined elastic properties were used to determine the viability for further processing and characterization of developed composite material models. In this analysis, three separate laminates were manufactured by hand layup process. The impact of various stacking and orientation of fibers on different mechanical properties of composite has been studied through experimental studies. In order to simulate the major loads of bone plates, the composite was evaluated directly under tensile, flexural and compressive tests. The findings of experimental tests found that the composite material introduced showed greater flexural strength (95.37–161.48 Mpa) relative to axial tension (59.81–70.17 Mpa) and compression (72.06–95.28 Mpa). The proposed composite material is ideal for bone fracture plates that need sufficient bending rigidity with lower axial rigidity.

Fretting wear and mechanical properties of surface-nanostructural titanium alloy bone plate

Surface-nanostructural TiO2 coatings on titanium alloy prepared by electrochemical anodic oxidation have shown immense potential on medical implants because of their special nanotube structure and excellent biocompatibility. Great attention has been drawn on the formation mechanism, morphology, wettability, ossification, anti-bacteria, drug delivery, and corrosion-resistance properties of the coatings in the application of bone plate. However, the relationships among microscope morphology, mechanical and tribological performances of the TiO2 nanotube coatings were not fully studied. In the present paper, TiO2 nanotube coatings were fabricated on Ti6Al4V substrate by anodic oxidation with voltage of 60 V and different oxidation times. The fretting wear behavior of the bone plate covered with TiO2 nanotubes was investigated under the condition of simulated body fluid. The mechanical properties of the coatings and their influence on the wear resistance of bone plate were analyzed. Results showed that nanotubes with orderly arrangement and large nanotube size were formed, which are beneficial to the ossification and drug delivery. Prolonging oxidation time from 2 h to 6 h increased the diameter and thickness of nanotubes, and decreased the microhardness and elasticity modulus of the coatings gradually, improving the biomechanical compatibility and wear-resistance. The TiO2 nanotube coatings on the bone plate surface reduced the friction coefficient and wear volume, because the lower elasticity and higher hydrophilicity of the coatings improve the lubrication state.

Development of silk/polycaprolactone biocomposite for internal bone plate application

In this work, the stacking of different layers of silk fabric reinforced polycaprolactone biocomposites were prepared by compression moulding technique. The mechanical and biodegradation behaviour were investigated. The mechanical properties of the different layers of silk/polycaprolactone composite were observed. The 14 layers of silk/polycaprolactone composites showed higher mechanical properties when compared to other composites. This was due to its sufficient mechanical interlocking between the fabric and the matrix. Further, scanning electron microscopy analysis confirmed the good interfacial bonding between silk and polycaprolactone. The in-vitro degradation study revealed that silk/polycaprolactone composite uptakes more water due to hydrophilic nature of silk while polycaprolactone showed higher amount of weight loss. Though there was a decrease in trend in the tensile properties of composite, still they can be used as a biodegradable plate due to its adequate mechanical strength. The changes in pH of the composite were also noticed and found negligible. Thus, the biodegradable silk/polycaprolactone composites are a promising alternative implant for patients, as they provide temporary mechanical support and controlled rate of biodegradation for the bone plate application.

Management of Bilateral Mandibular Fractures Using Intraoral Unilateral Application of Bone Plates in the Dromedary Camel

Management of Bilateral Mandibular Fractures Using Intraoral Unilateral Application of Bone Plates in the Dromedary Camel

Clinical application of locking bone plates in treatment of nonunion

Clinical application of locking bone plates in treatment of nonunion

Feasibility of knitted carbon/PEEK composites for orthopedic bone plates

This paper focuses on fabrication and characterization of knitted carbon/PEEK fabric composites for orthopedic bone plate application. Bending performance of the knitted carbon/PEEK composite bone plates was investigated with respect to two principal knitting directions (wale- and course-directions). As a result, the wale-direction knitted composite bone plates had much scattering in bending stiffness and maximum bending moment although they exhibited the same bending behavior as that of the course-direction specimens. In comparison with our previously developed braided composite bone plates, the knitted composite bone plates had 55–59% bending stiffness, 40–63% yield bending moment, and 54–77% maximum bending moment. However, the knitted composite bone plates showed higher deformability. Based on the results of the braided composite bone plates, it is considered that the knitted composite plate with 3.2 mm thickness can be suitable for forearm or humerus treatment especially when damaged bones need higher deformation to encourage bone ossification.

Strain distribution analysis of braided composite bone plates

Bone plates made of braided composites have low elastic modulus compared to conventional metal bone plates. This low elastic modulus of ensures only a part of load is transferred through bone plate and the remaining load is borne by the bone itself, thus creating a small movement at fracture. The movement induced by external loading gives stimulus to the damaged bone tissue and encourages callus formation. It is necessary to calculate magnitudes of strains induced in bone plate system subjected to loading. The results from stress–strain curves of the composite indicate that at 1% strain, there is no danger of fibre and matrix separation. The suitability of a braided carbon–epoxy composite for bone plate application is studied.

Bone blood flow response to surgical trauma

The evolution of bone plate design has been with a view to reducing the interface contact between the plate and the underlying bone thereby limiting the perfusion deficiency that develops. Little consequence, however, has been attributed to the drilling of holes in the steps prior to bone plate application; the work present herein attempts to define the vascular response of bone to the trauma of drilling holes. Anaesthetized sheep underwent the creation of drill holes in both tibiae and metatarsi. Animals were then heparinized and euthanatized. Utilizing femoral cannula, perfusion of the vasculature ensued; spalteholz (India ink), disulphine blue and radiocontrast material (barium sulfate). Decalcified histology was performed and correlated with the perfusion studies. Regions of perfusion deficiency were observed immediately adjacent to, and removed from, the drill hole site. Radiographic images showed substantial haematoma formation and vascular disruption in the vicinity of the drill hole site. Histologically, blood vessels immediately adjacent and distal to the drill hole site, contained a proteinaceous/cellular material occluding the vascular space. Our findings support the proposal of a short-term obstruction in cortical blood flow which may contribute to later adaptational osteopaenia following bone plate application. We have observed an acute vascular insufficiency in cortical bone directly related to the trauma of drilling screw holes.

The influence of screw torque in the application of bone plates

SummaryThe applied level of screw torque has a significant impact on both the mechanical and vascular environment in bone following the application of a bone plate. The amount of torque applied dictates the resultant level of axial tension generated in the screw and the compressive forces between the plate and underlying bone. The interface contact area between the plate and underlying bone is also affected. As a consequence, screw torque can be implicated in the pathogenesis of implant induced osteopenia and other pathological occurrences that follow bone plate fixation.The work performed was designed to evaluate the effect of the applied level of screw torque. The construction stiffness (rigidity) and bone surface strain was quantitated in response to variable levels of screw torque. This was performed utilizing intact and osteotomized cadaveric bone.The current level of screw torque applied in the clinical situation, for 4.5 mm cortical screws, is approximately 5 Newton metres (Nm). It appears from the work presented herein, that lowering the level of applied screw torque does not adversely affect the rigidity of the final construction. This fact may serve to ameliorate the pathological consequences of applying screws and plates using current clinical criteria.The amount of torque applied to screws in the application of bone plates has a profound effect on a number of elements, namely the interface contact area and force. The work presented examines the effect of screw torque on the rigidity and bone strain distribution of fractured bone following bone plate reconstruction. It appears that the use of lower levels of screw torque, than currently used in clinical practice, does not adversely effect the rigidity of the final construction. These findings support the notion that the level of screw torque applied may have a role in ameliorating the pathogenic response that occur following bone plate application, namely osteopaenia.

Pseudoaneurysm after a routine transbuccal approach for bone screw placement

The transbuccal approach is a routine method for inserting screws for the application of bone plates. Like many other approaches in the oral and maxillofacial region, it is a blind method that carries some degree of morbidity. Transection of the facial artery is a possibility with this approach. We report a case of pseudoaneurysm after transbuccal insertion of a screw used in the fixation of a mandibular fracture.

Pseudoaneurysm after a routine transbuccal approach for bone screw placement

The transbuccal approach is a routine method for inserting screws for the application of bone plates. Like many other approaches in the oral and maxillofacial region, it is a blind method that carries some degree of morbidity. Transection of the facial artery is a possibility with this approach. We report a case of pseudoaneurysm after transbuccal insertion of a screw used in the fixation of a mandibular fracture.

Arthrodesis of the elbow in three cats

SummarySevere disorders of the elbow in three cats were treated with arthrodesis. Fusion for two cats was achieved with bone plate application on the caudal aspect of the elbow. A modified trans-articular external skeletal fixator was used for arthrodesis of one elbow. All three elbows progressed to arthrodesis. One cat fractured the radius and ulna distal to the plate following arthrodesis; the forelimb was eventually amputated following additional complications. The remaining two cats were intermittently weight-bearing on the involved forelimb with marked circumduction of the limb during the swing phase of the stride, but the owners perceived their cats to be free of pain. Arthrodesis of the elbow is an alternative to amputation in order to achieve pain relief and limb salvage following severe elbow disorders in cats. However, limb function in these three cats was severely compromised.Arthrodesis has been described as a salvage procedure for orthopaedic disorders of the elbow in dogs. This report describes the indications, surgical techniques, and clinical results of elbow arthrodesis in three cats.

Semi-quantitative assessment of tibial blood flow and distribution in response to surgical intervention using first pass radionuclide angiography and intravascular vital dye

The acute vascular response in bone to surgical trauma was investigated utilizing a sheep model. Blood flow and distribution were determined using two methods; perfusion of the vasculature with an intravascular vital dye (Disulphine blue) prior to euthanasia and by radionuclide angiography (RNA) before and after each surgical intervention. The pattern of Disulphine blue distribution provided a good indication of local perfuslon and response to surgical trauma (drilling holes). Radionuclide angiography provided a dynamic image of the vascular response to surgical trauma. The generation of time activity curves of the first pass of radionuclide bolus enabled calculation of the relative blood flow through selected regions. For both techniques areas of ischaemia were apparent which were directly related to the location of screw holes. We conclude that factors other than bone plate contact influence the ischaemia that develops in bone subsequent to the application of bone plates.

The influence of screw omission on construction stiffness and bone surface strain in the application of bone plates to cadaveric bone

Biological fracture repair is becoming an increasingly popular means of fracture fixation. This technique involves a reduction in the amount of surgical trauma thereby preserving vascular supply and soft-tissue integrity combined with the implantation of less hardware. The aim is the stimulation of callus formation as the means by which fracture union occurs. This paper describes the mechanical effect of the symmetrical omission of screws on construction stiffness and bone surface strain following the application of bone plates to cadaveric bone. The influence of the pattern of screw omission was evaluated in both intact and osteotomized bone specimens. The application of bone plates using certain patterns of screw omission did not significantly effect the stiffness of the final construction whilst inherent bone surface strain was increased. It was concluded that the omission of screws in certain defined patterns for a given plate–bone construction may meet the criteria for ‘biological fixation’. There was no apparent deleterious effect on structural stiffness following the omission of 40% of the total screw complement from a plate–bone construction.

Fragment reconstruction and bone plate fixation versus bridging plate fixation for treating highly comminuted femoral fractures in dogs: 35 cases (1987-1997)

Objective To compare fragment reconstruction and bone plate fixation versus bridging plate fixation for treating highly comminuted (&gt; 4 fragments) femoral fractures in dogs. Design Retrospective study. Animals 35 dogs with highly comminuted fractures of the femur. Procedure Medical records of all dogs included in this study were reviewed. Dogs had been treated with fragment reconstruction and bone plate application (n = 20) or major fragment alignment and bridging plate fixation (15). Postoperative and follow-up radiographs were evaluated. Operating and hospitalization times, bone alignment, bone healing, and complications were considered. Results There were no differences in hospitalization times, limb alignment, and complications between dogs with fractures treated with fragment reconstruction and dogs with fractures treated with bridging plate fixation. Dogs with fractures treated with bridging plate fixation had shorter operative times and faster times to radiographic evidence of bone healing. Clinical Implications Bridging plate fixation is quicker to perform and results in faster healing than fragment reconstruction and bone plate fixation when used to treat comminuted femoral fractures. (J Am Vet Med Assoc 1998;213:1157-1161)