Fracture Fixation Biomechanics and Biomaterials

Tucker, Stewart; Reid, J. Spence; Lewis, Gregory S.

doi:10.1007/978-3-319-89542-0_16

Cited by 4 publications

(5 citation statements)

References 72 publications

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“…Metals are the most commonly used biomaterials and are currently the gold-standard biomaterials for many commercial medical implants in different orthopaedic applications such as osteosynthesis, arthroplasty, and dentistry. The most commonly used metal biomaterials are titanium-based alloys, cobalt-based alloys, and stainless steel [5]. Among these materials, titaniumbased materials present the most relevant properties for bone applications [33][34][35][36][37].…”

Section: Metallic Biomaterialsmentioning

confidence: 99%

“…Internal fixations are classified according to design parameters (number, type and location of screws, geometry, etc. ), injury location, material type, or type and site of fracture [5].…”

Section: Introductionmentioning

confidence: 99%

“…Fig.10 5. Optical metallographic images comparing acicular α-plates in the top section (∼1 cm) of EBM fabricated samples (a) and the bottom section (∼1 cm) (b)[60] …”

mentioning

confidence: 99%

See 2 more Smart Citations

A Review on Powder Bed Fusion Additive Manufacturing for Metallic Fixation Implants

Al-Tamimi

Alqahtani

Liu

et al. 2020

Virtual Prototyping &Amp; Bio Manufacturing in Medical Applications

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Section: Metallic Biomaterialsmentioning

confidence: 99%

“…Internal fixations are classified according to design parameters (number, type and location of screws, geometry, etc. ), injury location, material type, or type and site of fracture [5].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

A Review on Powder Bed Fusion Additive Manufacturing for Metallic Fixation Implants

Al-Tamimi

Alqahtani

Liu

et al. 2020

Virtual Prototyping &Amp; Bio Manufacturing in Medical Applications

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“…14,15 These biomechanical parameters are a direct result of the construct design decisions made by the surgeon, including implant type, material, length, size, and screw configuration. [15][16][17][18][19][20] Fracture site strain is highly dependent on fracture geometry, working length between screws, and certain other factors under the surgeon's control. Stresses are primarily dependent on plate cross-sectional geometry, and a somewhat misconception is that shorter working length directly acts to concentrate plate stresses.…”

mentioning

confidence: 99%

Virtual Simulation for Interactive Visualization of 3D Fracture Fixation Biomechanics

Lewis

Wee

Vicory

et al. 2021

J Am Acad Orthop Surg

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Introduction: In the surgical fixation of fractures, proper biomechanical stability is key in preventing clinical complications including poor fracture healing, residual deformity, loss of fixation, or implant failure. Stability is largely influenced by treatment decisions made by the surgeon. The interplay of surgeon-controlled variables and their effect on the three-dimensional (3D) biomechanics of a fracture fixation construct are often not intuitive, and current training methods do not facilitate a deep understanding of these interactions.Methods: A simulation software interface, FracSim, was developed. FracSim is built on a large precomputed library of finite element simulations. The software allows a surgeon to make adjustments to a virtual fracture fixation construct/weight-bearing plan and immediately visualize how these changes affect 3D biomechanics, including implant stress and fracture gap strain, important for clinical success. Twenty-one orthopaedic residents completed an instructor-led educational session with FracSim focused on bridge plating. Subjects completed pretests and posttests of knowledge of biomechanical concepts and a questionnaire.Results: Subjects scored a mean of 5.6/10 on the pretest of biomechanical knowledge. Senior residents scored better than junior residents (P = 0.04). After the educational session with FracSim, residents improved their test scores to a mean of 8.0/10, with a significant improvement (P , 0.001). Questionnaire scores indicated that subjects believed that FracSim had realistic implants, constructs, and motions and that training with FracSim was purposeful, desirable, efficient, fun, and useful for enhancing the understanding of fracture fixation biomechanics.Discussion: This new type of simulation software enables interactive visualization of 3D fracture fixation biomechanics. Limitations of this study include lack of a control group undergoing traditional education and lack of a delayed posttest to assess retention. FracSim may provide an effective and engaging way to promote a deeper understanding of biomechanical concepts in the orthopaedic learner.

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“…3 Despite a general understanding that fracture geometry and fixation construct influence the biomechanics essential for proper and timely healing, fracture fixation construct selection remains a largely subjective topic among surgeons and is often linked to surgical training experience. 4 At present, most hip fractures are surgically stabilized using an intramedullary (IM) nail. The surgeon selects nail type, length, and diameter, as well as whether or not to use distal locking screw fixation.…”

mentioning

confidence: 99%

Parametric Finite Element Analysis of Intramedullary Nail Fixation of Proximal Femur Fractures

Tucker

Wee

Fox

et al. 2019

Journal Orthopaedic Research

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Proximal femur fracture fixation with intramedullary nailing relies on stability at the fracture site and integrity of the fixation construct to achieve union. The biomechanics that dictate fracture site stability and implant stress depend on fracture type as well as implant features such as nail length, nail diameter, presence of distal fixation screws, and material composition of the implant. When deciding how to fix a fracture, surgeons have choices in these implant‐related design variables. This study models all combinations of a range of implant variables for nine standard AO/OTA proximal femur fractures using finite element analysis. Under simulated maximum load during gait, the maximum stress in the implant and screws as well as interfragmentary motions at the fracture site in the axial and shear directions were computed. The results were separated by fracture type to show the influence of each design variable on measured biomechanical outcomes. Filling the reamed canal with the largest fitting nail diameter reduced axial and shear interfragmentary motion for all fracture types. Nail length was less predictive of shear interfragmentary motion for most simulated fracture types than other construct variables. Furthermore, gapping at the fracture site predisposed the construct to higher implant stresses and larger interfragmentary motions. Clinical significance: Biomechanical outcomes from this computational study can aid in surgical decision‐making for optimizing hip fracture fixation with IM nailing. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2358–2366, 2019

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Fracture Fixation Biomechanics and Biomaterials

Cited by 4 publications

References 72 publications

A Review on Powder Bed Fusion Additive Manufacturing for Metallic Fixation Implants

A Review on Powder Bed Fusion Additive Manufacturing for Metallic Fixation Implants

Virtual Simulation for Interactive Visualization of 3D Fracture Fixation Biomechanics

Parametric Finite Element Analysis of Intramedullary Nail Fixation of Proximal Femur Fractures

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