Biomechanical evaluation of parallel versus orthogonal plate fixation of intra-articular distal humerus fractures

Zalavras, Charalampos G.; Vercillo, Michael T.; Jun, Bong-Jae; Otarodifard, Karimdad; Itamura, John M.; Lee, Thay Q.

doi:10.1016/j.jse.2010.08.005

Cited by 95 publications

(68 citation statements)

References 33 publications

(66 reference statements)

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“…Under physiological conditions, most pronounced are the flexion 15 and lateral 12,18 load, while the axial load is considerably smaller. Significantly smaller displacements under axial load obtained in this study as well suggest a substantially lesser importance of that load in the overall evaluation of the construction's biomechanical stability, which is in line with previous studies 17 , although they were not conducted on the same level of the distal humerus.…”

Section: Discussionmentioning

confidence: 94%

“…11,[13][14][15][16][17][18] No study to date has addressed the issue of biomechanical stability on the transition of the distal humeral diaphysis into the distal segment of the humerus.…”

Section: Discussionmentioning

confidence: 99%

“…Those studies are very uneven: with regard to the number and types of models, methods and load directions, methods and precision of displacements measurements, and thus the conclusions derived from them are hardly mutually comparable. 11,[13][14][15][16][17][18] Using the finite element method, attempts were made to find the optimal plate configuration which would improve its biomechanical properties, taking into account the specific anatomy of the distal humerus.…”

Section: Discussionmentioning

confidence: 99%

“…Computational simulations were performed with loads on the specific part of the articular segment of the distal humerus, distally from the gap, following the principles from the latest biomechanical studies dealing with distal humerus fractures 14,[16][17][18] , with the radial column being loaded with 60%, and the ulnar column with 40% of the total load. The load and humerus positions were as follows: Axial load or anterior deflection in which the upper arm was placed at a flexion angle of about 5° in relation to the longitudinal axis of the humeral diaphysis ( Figure 2a); Bending or posterior deflection with the upper arm flexed at a 75° angle in relation to the longitudinal axis of the humeral diaphysis ( Figure 2b); Lateral or varus load in which the load is applied laterally on the radial condylar, with the humerus placed horizontally (Figure 2c).…”

Section: Methodsmentioning

confidence: 99%

“…9 No prospective randomized studies have been published on their outcomes, and the majority of the studies carried out were retrospective and involved a small number of patients. [10][11][12][13][14][15][16][17][18][19][20][21][22][23] Hence it is not possible to draw conclusions from them on the ideal configuration of the implant for stabilization of distal humerus fractures. …”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Comparative study of three models of extra-articular distal humerus fracture osteosynthesis using the finite element method on an osteoporotic computational model

Sabalić¹,

Kodvanj

Pavić

2013

Injury

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Section: Discussionmentioning

confidence: 94%

“…11,[13][14][15][16][17][18] No study to date has addressed the issue of biomechanical stability on the transition of the distal humeral diaphysis into the distal segment of the humerus.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Comparative study of three models of extra-articular distal humerus fracture osteosynthesis using the finite element method on an osteoporotic computational model

Sabalić¹,

Kodvanj

Pavić

2013

Injury

View full text Add to dashboard Cite

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Dynamics analysis for flexion and extension of elbow joint motion based on musculoskeletal model of Anybody

Peng

et al. 2021

Robotics Computer Surgery

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Purpose:Little is known about how biomechanics governs the biological nature for humeral motion dynamically. Elbow motion ought to be investigated based on a musculoskeletal model and evidence the physiologic principle of upper limbs.Method: A humeral model was reconstructed by MIMICS after CT images input in *. dicom format, it was processed by Geomagic Studio for Surfaces, then gridded mesh and assigned materials by Hypermesh. On the other hand, a musculoskeletal model was built by AnyBody, physical motions were then simulated to export boundary condition and myodynamia during flexion and extension. Finally, all the humeral model and boundary were imported to Abaqus for finite element analysis.Result: During the simulative motion of flexion, the primary muscles are brachii biceps, brachialis anticus and teretipronator, their myodynamia increased and then decreased gradually, and reached its peak value at 30°; During extension, the main muscles are triceps brachii and brachialis anticus, their myodynamia increased and then decreased gradually too, and reached peak at 50°; In these two cases, their strain and displacement distributed at the middle of humerus. Conclusion:AnyBody is a novel modelling system to simulate physical motion, for example flexion and extension. Biceps brachii and brachialis anticus are functional for flexion, and triceps brachii plays a key role in extension critically. This simulation confirms the physiologic rule for sport event, humeral fixation and postoperative healing with clinical significance that minimizing joint forces from injury onset may promote pain-free ways.

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Dynamic effect of three locking plates fixated to humeral fracture based on multibody musculoskeletal model

Peng

Chen

et al. 2021

Robotics Computer Surgery

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Objective: This study attempts to analyse the biomechanical effect of internal fixation (plated in parallel or plated vertically) on the basis of distal humeral fractures on musculoskeletal multibody dynamics using AnyBody in Finite Element Method.Method: Humeral 3D models were reconstructed by MIMICS after volunteers' CT image input in *.dicom format, and processed by Geomagic Studio for surfaces, while locking plates and screws were then designed by Pro-E. A humeral model of T-type fracture was created and assembled in Hypermesh, to integrate fixtures (e.g., MPL/ PML/ML), to grid the mesh and then assign materials. A musculoskeletal model of the upper limb was established by AnyBody to simulate elbow flexion and extension.They were finally imported to Abaqus for boundary conditions and dynamic analysis. Result:In terms of Von Mises stress, its maximum increased and then decreased gradually during the joint motion, but p > 0.05 in SPSS suggests no significant difference for all three fixtures. In terms of displacement, when the elbow was at 90°, each motional pattern reached its peak as follows: ML180°= 0.28 mm, MPL90°= 0.49 mm & PML90°= 0.54 mm during flexion; ML180°= 0.073 mm, MPL90°= 0.10 mm & PML90°= 0.12 mm during extension. p < 0.05 suggests a significant difference for the displacements of all three fixations. p = 0.007 < 0.01667 suggests the significant difference between the two fixations, for example, PML90°and ML180°, indicating that the peak displacement of ML180°i s less than that of PML90°. Conclusion:After generally analysed in musculoskeletal dynamics, the biomechanical property of the fixtures was presented as follows: the displacement of the parallel plate was less than that of the vertical, and the parallel plate may optimise the clinical reduction anatomically.

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Biomechanical evaluation of parallel versus orthogonal plate fixation of intra-articular distal humerus fractures

Cited by 95 publications

References 33 publications

Comparative study of three models of extra-articular distal humerus fracture osteosynthesis using the finite element method on an osteoporotic computational model

Comparative study of three models of extra-articular distal humerus fracture osteosynthesis using the finite element method on an osteoporotic computational model

Dynamics analysis for flexion and extension of elbow joint motion based on musculoskeletal model of Anybody

Dynamic effect of three locking plates fixated to humeral fracture based on multibody musculoskeletal model

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