Evaluation of a Feline Bone Surrogate and In Vitro Mechanical Comparison of Small Interlocking Nail Systems in Mediolateral Bending

Marturello, Danielle M.; Pfeil, Dirsko J F von; Déjardin, Loïc M.

doi:10.1055/s-0040-1721708

Cited by 5 publications

(9 citation statements)

References 40 publications

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“…There are benefits and limitations of ILN or LCP use (20)(21)(22). Although the LCP counteracted bending and torsion to a similar degree as the ILN-10, some intricacies of LCP placement require consideration and might make them less suitable implants for a particular situation.…”

Section: Discussionmentioning

confidence: 99%

Biomechanical evaluation of interlocking nail and locking compression plating for stabilization of ovine critical-sized segmental tibia defects

Koch¹,

Johnson²,

Smith³

et al. 2023

Ann Transl Med

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Background: Segmental large volume bone loss resulting from fracture or osseous neoplasia is a major challenge to orthopedic surgeons and there is an ongoing quest to identify treatments that optimize healing.To advance treatment, large animal translational models-such as the ovine critical-sized tibia defect modelare instrumental for testing of novel scaffolds for bone regeneration. However, little standardization in the implants utilized for defect stabilization has been determined and current commercially available implants may be inadequate to replicate the strength of the native tibia. We hypothesize that a 10-mm interlocking nail (ILN) would be stiffer in axial, bending, and torsional loading than its 8-mm counterpart and would be stiffer in axial and torsional loading compared to a 4.5-mm broad locking compression plate (LCP).Methods: Tibias were harvested from 24 ovine hind limbs from skeletally mature ewes euthanized for reasons unrelated to this study and were randomized to treatment group. An ex vivo comparison of a novel 10-mm angle-stable non-tapered ILN was compared to a commercially available 8-mm angle-stable tapered ILN and a broad LCP in an ovine critical-sized (5-cm) tibia defect model. Axial stiffness, torsional stiffness, and bending stiffness were determined in control intact tibia and tibial constructs in the three treatment groups. Following implantation, radiography was performed in all limbs and tibia length and cortical and medullary cavity diameter were measured. Comparisons between groups were assessed with a one-way analysis of variance. Significance was set at P<0.05. Results:The 10-mm ILN in tibia containing a 5-cm ostectomy gap most closely replicated the structural properties of intact tibia compared with other constructs. The 10-mm ILN had significantly stronger torsional (P<0.001) and bending (P=0.002) stiffness than the 8-mm ILN, and was significantly stronger than the LCP in axial (P=0.04) and torsional (P=0.01) stiffness.Conclusions: A 10-mm ILN used to stabilize an ovine critically-sized tibia defect most closely mimicked the structural properties of the intact tibia when compared to a 8-mm ILN or broad LCP. Further in vivo testing will aid in determining which stabilization method is best suited for testing of novel tissue engineering and bone healing studies.

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Section: Discussionmentioning

confidence: 99%

Biomechanical evaluation of interlocking nail and locking compression plating for stabilization of ovine critical-sized segmental tibia defects

Koch¹,

Johnson²,

Smith³

et al. 2023

Ann Transl Med

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“…Sample size (n = 5 printed models humerus/printer type) was based on previous studies using 3D printed or machined bone models. 32,[36][37][38][39] Normality of data distribution was evaluated using the Shapiro-Wilk test. Mean dimension differences between groups were compared using a two-factor (bone size and printer type) repeated measures ANOVA followed by Tukey post-hoc tests when significant differences were identified.…”

Section: Discussionmentioning

confidence: 99%

“…Sample size ( n = 5 printed models humerus/printer type) was based on previous studies using 3D printed or machined bone models 32,36–39 . Normality of data distribution was evaluated using the Shapiro–Wilk test.…”

Section: Methodsmentioning

confidence: 99%

Accuracy of anatomic 3‐dimensionally printed canine humeral models

et al. 2022

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Objective: To evaluate the accuracy of various three-dimensional print (3DP) technologies using morphometric measurements.Study design: Experimental. Sample population: Cadaveric canine humeri and size-matched 3DP models.Methods: Fiduciary radiopaque markers were affixed to canine humeri of three different sizes (4, 13, 29 kg) at predetermined anatomical landmarks. 3DP models were created using one of three printers; desktop printers Form 3L and Ultimaker 5S, and industrial printer Objet Connex (n = 5/group/ printer). Marker based morphometric dimensions between cadavers and 3DP models were statistically compared using 2-factor repeated measures ANOVA followed by Tukey's post-hoc test (p < .05).Results: Bone size and printer type both significantly affected 3DP accuracy, with size having the larger effect (p < .0001 and p < .02, respectively). Regardless of printing technology, model size was smaller than native bone in most cases. At the humeral condylar level, the best accuracy was seen in the medium-sized humerus with the Ultimaker printer ([0.09 mm], p < .03).Accuracy was reduced in the proximal humerus in all groups. Conclusion: Desktop printers were overall more accurate than the industrial printer. Although significant differences were identified between models of different sizes, the submillimetric magnitude of these differences is unlikely to be clinically relevant.Clinical significance: While preoperative planning using 3DP models is becoming mainstream, accurate representation of the actual bone is critical. This study demonstrates that common desktop printers are suitable for this purpose.

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“…By comparison, the I-Loc system does not allow correction of alignment after placement of the locking bolts but may be mechanically superior and is appropriate for use in metaphyseal fractures. Ex vivo studies of the I-Loc system provide evidence that the I-Loc 3 and I-Loc 4 nails have greater torsional stability compared with size-matched TVS nails and small (2.0 mm and 2.4 mm) LCPs, 89 that the I-Loc 4 provides more bending stability than the sizematched TVS nail 91 and that the I-Loc system may be associated with a lower risk of post-explantation refracture than TVS nails. 89,91 In addition, clinical studies have reported the use of the I-Loc system in a wide variety of feline fracture configurations with good outcomes.…”

Section: Jfms Clinical Practice 453mentioning

confidence: 99%

“…Ex vivo studies of the I-Loc system provide evidence that the I-Loc 3 and I-Loc 4 nails have greater torsional stability compared with size-matched TVS nails and small (2.0 mm and 2.4 mm) LCPs, 89 that the I-Loc 4 provides more bending stability than the sizematched TVS nail 91 and that the I-Loc system may be associated with a lower risk of post-explantation refracture than TVS nails. 89,91 In addition, clinical studies have reported the use of the I-Loc system in a wide variety of feline fracture configurations with good outcomes. 81,92 It should be noted that interlocking nails can be placed without the need for fluoroscopy as palpation of anatomical landmarks while flexing and extending the leg has been shown to be accurate for limb alignment; 22 Although external skeletal fixators are particularly well suited to non-reconstructable fractures, they can be applied to all fracture types.…”

Section: Jfms Clinical Practice 453mentioning

confidence: 99%

Feline Femoral Fracture Fixation: What are the options?

Roberts

Meeson

2022

Journal of Feline Medicine and Surgery

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Practical relevance: The femur is the most commonly fractured bone in cats. Femoral fractures usually result from high-velocity trauma such as a road traffic accident or fall from a height and, as such, are associated with a wide variety of concurrent injuries. The initial focus of treatment should always be on assessment and stabilisation of the major body systems. Once any concurrent injuries have been addressed, all femoral fractures need surgical stabilisation, with the notable exception of greenstick fractures in very young cats, which can heal with cage rest alone. A number of different surgical options are available depending on the fracture type, location, equipment, surgeon experience and owner finances. Clinical challenges: Femoral fractures can vary hugely in complexity and the small size of feline bones can limit the choice of implants. Furthermore, cats can present unique challenges in the postoperative period due to their active nature and the limited means to control their exercise level. Audience: This review is aimed at general and feline-specific practitioners who have some experience of feline orthopaedics, as well as those simply wishing to expand their knowledge. Aims: The aim of this review is to help clinicians assess, plan and manage feline femoral fractures. It provides an overview of diagnostic imaging and a discussion of a range of suitable surgical options, including the principles of different types of fixation. It also highlights cat-specific issues, approaches and implants pertinent to the management of these cases. Evidence base: A number of original articles and textbook chapters covering many aspects of femoral fractures in cats and dogs have been published. Where possible, this review draws on information from key feline research and, where necessary, extrapolates from relevant canine literature. The authors also offer practical guidance based on their own clinical experience.

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Evaluation of a Feline Bone Surrogate and In Vitro Mechanical Comparison of Small Interlocking Nail Systems in Mediolateral Bending

Cited by 5 publications

References 40 publications

Biomechanical evaluation of interlocking nail and locking compression plating for stabilization of ovine critical-sized segmental tibia defects

Biomechanical evaluation of interlocking nail and locking compression plating for stabilization of ovine critical-sized segmental tibia defects

Accuracy of anatomic 3‐dimensionally printed canine humeral models

Feline Femoral Fracture Fixation: What are the options?

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