Straining of the intact and fractured proximal humerus under physiological-like loading

Maldonado, Zully; Seebeck, J.; Heller, Markus O.; Brandt, Doris; Hepp, Pierre; Lill, Helmut; Duda, Georg N.

doi:10.1016/s0021-9290(03)00212-4

Cited by 57 publications

(36 citation statements)

References 25 publications

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“…Clinically, in rare cases augmentation is considered a final chance to achieve a somewhat stable reconstruction in complex fractures with weak bone stock and significant voids [60,61]. The potential effect of Hepp P, Josten C. Biology and Biomechanics in Osteosynthesis of Proximal Humerus Fractures bone augmentation on the remaining bone stock as well as on the bone cement used remains unclear.…”

Section: Locking Plate and Augmentation In Finite Element Analysismentioning

confidence: 99%

“…The potential effect of Hepp P, Josten C. Biology and Biomechanics in Osteosynthesis of Proximal Humerus Fractures bone augmentation on the remaining bone stock as well as on the bone cement used remains unclear. Maldonado et al [60] in a finite element analysis determined the straining of the intact and fractured proximal humerus under physiological-like loading conditions. Furthermore, they evaluated the impact of augmentation on tissue straining.…”

Section: Locking Plate and Augmentation In Finite Element Analysismentioning

confidence: 99%

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Biology and Biomechanics in Osteosynthesis of Proximal Humerus Fractures

Hepp

Josten

2007

Eur J Trauma Emerg Surg

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Surgical treatment of proximal humeral fractures still remains a challenge. This is primarily due to the fact that sufficient implant fixation in humeral head fractures is often not achieved due to substantial bone tissue loss with increasing age. In the last few years the locking plates and locking nails have been introduced into clinical practice with varying results. The biomechanical studies have focused on locking plate osteosynthesis as well. The following paper focuses on bone quality, biomechanical studies and biology of proper osteosynthesis and reviews the most recent literature.

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Section: Locking Plate and Augmentation In Finite Element Analysismentioning

confidence: 99%

Section: Locking Plate and Augmentation In Finite Element Analysismentioning

confidence: 99%

Biology and Biomechanics in Osteosynthesis of Proximal Humerus Fractures

Hepp

Josten

2007

Eur J Trauma Emerg Surg

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“…A biomechanical study has shown that in patients with osteoporosis higher strain forces occur at the implant/bone interface compared to patients with healthy bone [18]. This may lead to early failure of relatively stiff constructs like angular stable plates or nails [18], especially in patients with reduced bone quality.…”

Section: Introductionmentioning

confidence: 99%

“…This may lead to early failure of relatively stiff constructs like angular stable plates or nails [18], especially in patients with reduced bone quality. In addition, too stiff constructs may reduce micromotion at the fracture site below the threshold required for callus formation [19].…”

Section: Introductionmentioning

confidence: 99%

The Humerusblock NG: a new concept for stabilization of proximal humeral fractures and its biomechanical evaluation

Brunner

Resch

Babst

et al. 2012

Arch Orthop Trauma Surg

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“…Existing Finite Element Analysis (FEA) considered the reconstruction of the proximal humerus by osteosynthesis plates and screws in comparison to a nailing system [30,39]. Some studies investigated the glenohumeral load transfer and the appearance of contact stresses in the articulating surface during abduction for the healthy joint [11,20].…”

Section: Introductionmentioning

confidence: 99%

Refixation stability in shoulder hemiarthroplasty in case of four-part proximal humeral fracture

Baumgartner

Lorenzetti

Mathys

et al. 2009

Med Biol Eng Comput

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Primary stability of refixated fractures in case of shoulder hemiarthroplasty is a prerequisite to restore physiological glenohumeral joint function. Clinical observations often show a secondary dislocation and subsequent resorption of the bony anchor points like the greater and lesser tuberosity at the rotator cuff tendons. This failed integration leads to impaired glenohumeral load transmission and subsequent reduction of mobility. As a consequence, the optimisation of refixation methods is crucial for a better clinical outcome. To prove the stability of refixation techniques, a Finite Element fracture model was built. Resulting stresses at the bone surface and fragment migration relative to the prosthesis shaft were studied. The results of the calculations show that the isolated tuberosities show unstressed bone regions compared to the intact model. This circumstance may explain the clinically detected bone resorption due to the absence of mechanical stimuli. Furthermore, a cable guidance through lateral holes in the middle part of the proximal prosthesis results in a lower fragment displacement than a circumferential fixation method surrounding the entire proximal bone.

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Straining of the intact and fractured proximal humerus under physiological-like loading

Cited by 57 publications

References 25 publications

Biology and Biomechanics in Osteosynthesis of Proximal Humerus Fractures

Biology and Biomechanics in Osteosynthesis of Proximal Humerus Fractures

The Humerusblock NG: a new concept for stabilization of proximal humeral fractures and its biomechanical evaluation

Refixation stability in shoulder hemiarthroplasty in case of four-part proximal humeral fracture

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