Research Update on Stress Riser Fractures

Yoo, Je-Hyun; Ma, Xinfang; Lee, Jong-Hwa; Hwang, Jihyo

doi:10.1007/s43465-020-00291-4

Cited by 9 publications

(5 citation statements)

References 37 publications

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“…This increased stress concentration, often termed a stress riser, helps explain why periprosthetic fractures can result from minor trauma. 13,68 A study of forearm plate retention in the pediatric population reports a periprosthetic fracture incidence of 7.3%, 69 again similar to our reported refracture rate of 4.7%-10.4% following IR. In addition, Becker et al 29 report a periprosthetic fracture rate of 4.9% with retained femoral LCPs, which is lower than their reported fracture rate of 8.6% following IR.…”

Section: Discussionsupporting

confidence: 84%

Pediatric fractures following implant removal: A systematic review

Padgett

Howie

Sanchez

et al. 2022

Journal of Children's Orthopaedics

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Objectives: To evaluate the available literature for postoperative fracture rates following implant removal in the pediatric population. Methods: A systematic review of articles in the PubMed and Embase computerized literature databases from January 2000 to June 2022 was performed using PRISMA guidelines. Randomized controlled trials, case-control studies, cohort studies (retrospective and prospective), and case series involving pediatric patients that included data on fracture rate following removal of orthopedic implants were eligible for review. Two authors independently extracted data from selected studies for predefined data fields for implant type, anatomic location of the implant, indication for implantation, fracture or refracture rate following implant removal, mean time to implant removal, and mean follow-up time. Results: Fifteen studies were included for qualitative synthesis. Reported fracture rates following implant removal vary based on several factors, with an overall reported incidence of 0%–14.9%. The available literature did not offer sufficient data for conduction of a meta-analysis. Conclusion: Our systematic review demonstrates that fracture following implant removal in pediatric patients is a relatively frequent complication. In children, the forearm and femur are the most commonly reported sites of fracture following removal of implants. Traumatic fractures treated definitively with external fixation have the highest reported aggregate rate of refracture. Knowledge of the incidence of this risk is important for orthopedic surgeons. There remains a need for well-designed studies and trials to further clarify the roles of the variables that contribute to this complication.

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Section: Discussionsupporting

confidence: 84%

Pediatric fractures following implant removal: A systematic review

Padgett

Howie

Sanchez

et al. 2022

Journal of Children's Orthopaedics

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“…Such a defect is known to function as a stress riser and potentially increases the risk of fracture. 34 35 Nevertheless, in our study, no fracture lines were observed associated with this additional hole in the groups in which a tension device was employed (GUL and GBL). Yet, this hypothesis cannot be dismissed for other loading scenarios.…”

Section: Discussioncontrasting

confidence: 57%

Mechanical Properties and Failure Mode of Proximal Screw Fixation Technique Using Locking Compression Plate for Proximal Interphalangeal Arthrodesis in Horses: An Ex Vivo Study

de Souza,

Pereira,

Costa

et al. 2024

Vet Comp Orthop Traumatol

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Objective The aim of this study was to measure the mechanical properties and failure mode of an ex vivo model of proximal interphalangeal arthrodesis in horses with different methods of proximal screw fixation using a locking compression plate. Study Design Pastern joint arthrodesis with a 3-hole 4.5-mm narrow locking compression plate was performed on 20 forelimbs of equine cadavers, randomized into four groups based on the fixation method and type of proximal screw used: unicortical cortex, bicortical cortex, unicortical locking, bicortical locking. Single-cycle axial compression testing was conducted until failure. The frequency of implant plastic deformation was recorded. Bone failure analysis was performed through computed tomography examinations and fractal analysis. Results There were no differences in the analysed mechanical variables and fractal dimension among the groups. Transarticular screws showed a higher frequency of deformation (75%) regardless of the group. Both unicortical locking and bicortical locking groups deformed the plate more frequently. Conclusion The type of screw used in the proximal hole of the locking compression plate and its method of anchoring in the proximal phalanx do not affect the mechanical properties of pastern arthrodesis in equine cadavers subjected to single-cycle axial compression tests until failure.

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“…Placing drill holes in bone can produce areas of increased localized stress. In their review of stress-riser fractures, Yoo et al 9 described bone failure and stress-riser fractures due to increased stress in localized areas of cortical bone, which could occur due to low bone strength or high chronic mechanical stress. 10 The drill holes in our patient, placed prior to implantation of the staples, may have increased the intensity of stress on the bone at the distal staple tine.…”

Section: Discussionmentioning

confidence: 99%

Capitate Fracture Subsequent to Capitolunate Staple Fusion: A Case Report

Zakusylo

Escobar

Toci

et al. 2024

Journal of Hand and Microsurgery

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We report a case of a 71-year-old man who underwent capitolunate fusion for scapholunate advanced collapse. At the patient's 4-month follow-up, there was evidence of a fracture at the distal staple tine. He subsequently underwent removal of staple hardware with revision open reduction internal fixation using headless compression screw fixation and bone grafting. The literature review aimed to identify possible mechanisms and analyze similar cases of this complication. We presume that the fracture resulted from increased stress on the bone from both drill holes and the orientation of the staples. Placing the tines in different planes may decrease the risk of this complication.

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Research Update on Stress Riser Fractures

Cited by 9 publications

References 37 publications

Pediatric fractures following implant removal: A systematic review

Pediatric fractures following implant removal: A systematic review

Mechanical Properties and Failure Mode of Proximal Screw Fixation Technique Using Locking Compression Plate for Proximal Interphalangeal Arthrodesis in Horses: An Ex Vivo Study

Capitate Fracture Subsequent to Capitolunate Staple Fusion: A Case Report

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