Torsional strength estimates of femoral diaphyses with endosteal lytic lesions: Dual‐energy x‐ray absorptiometry study

Robertson, Douglas D.; Beck, Thomas; Chan, Barry; Scott, William W.; Sharma, Gulshan B.; Maloney, William J.

doi:10.1002/jor.20419

Cited by 7 publications

(3 citation statements)

References 58 publications

(82 reference statements)

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“…We also tested our hypothesis in different defect sizes (25% versus 50% of bone diameter) and locations (proximal versus distal) across a long bone, indicating that CTRA is location independent, since linear regressions from all sites correlate better with failure torque than aBMD. We did not observe any significant difference among different size holes, a finding also confirmed by Robertson et al (2007), who also showed that lesion size did not correlate with bone strength.…”

Section: Discussionsupporting

confidence: 88%

Non-invasive assessment of failure torque in rat bones with simulated lytic lesions using computed tomography based structural rigidity analysis

Entezari

Basto

Vartanians

et al. 2011

Journal of Biomechanics

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This study applies CT-based structural rigidity analysis (CTRA) to assess failure torque of rat femurs with simulated lytic defects at different locations (proximal and distal femur) and diameters (25% and 50% of the cross-section at the site), and compared the results to those obtained from mechanical testing. Moreover, it aims to compare the correlation coefficients between CTRA-based failure torque and DXA-based aBMD versus actual failure torque. Twenty rats were randomly assigned to four equal groups of different simulated lesions based on size and location. Femurs from each animal underwent micro-computed tomography to assess three-dimensional micro-structural data, torsional rigidity using structural rigidity analysis and dual energy X-ray absorptiometry to assess bone mineral density. Following imaging, all specimens were subjected to torsion. Failure torque predicted from CT-derived structural rigidity measurements was better correlated with mechanically derived failure torque [R2 = 0.85] than was aBMD from DXA [R2 = 0.32]. In summary, the results of this study suggest that computed tomography based structural rigidity analysis can be used to accurately and quantitatively measure the mechanical failure torque of bones with osteolytic lesions in an experimental rat model. Structural rigidity analysis can provide more accurate predictions on maximal torque to mechanical failure than dual energy X-ray absorptiometry based on bone mineral density.

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Section: Discussionsupporting

confidence: 88%

Non-invasive assessment of failure torque in rat bones with simulated lytic lesions using computed tomography based structural rigidity analysis

Entezari

Basto

Vartanians

et al. 2011

Journal of Biomechanics

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“…Callus stiffness is the most typical biomechanical indicator of fracture healing. Currently, the in vivo evaluation of callus stiffness involves performing tests for bending [ 11 , 12 ], torsion [ 13 , 14 ], and axial compression [ 15 – 17 ]. The axial stiffness is a direct measure of the limb’s weight-bearing capacity.…”

Section: Introductionmentioning

confidence: 99%

In vivo axial load-share ratio measurement using a novel hexapod system for safe external fixator removal

Liu,

Lu,

Chen

et al. 2024

BMC Musculoskelet Disord

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Background External fixation is widely used in the treatment of traumatic fractures; however, orthopedic surgeons encounter challenges in deciding the optimal time for fixator removal. The axial load-share ratio (LS) of the fixator is a quantitative index to evaluate the stiffness of callus healing. This paper introduces an innovative method for measuring the LS and assesses the method’s feasibility and efficacy. Based on a novel hexapod LS-measurement system, the proposed method is to improve the convenience and precision of measuring LS in vivo, hence facilitating the safe removal of external fixators. Methods A novel hexapod system is introduced, including its composition, theoretical model, and method for LS measurement. We conducted a retrospective study on 82 patients with tibial fractures treated by the Taylor Spatial Frame in our hospital from September 2018 to June 2020, of which 35 took LS measurements with our novel method (Group I), and 47 were with the traditional method (Group II). The external fixator was removed when the measurement outcome (LS < 10%) was consistent with the surgeon’s diagnosis based on the clinical and radiological assessment (bone union achieved). Results No significant difference was found in the fracture healing time (mean 25.3 weeks vs. 24.9 weeks, P > 0.05), frame-wearing duration (mean 25.5 weeks vs. 25.8 weeks, P > 0.05), or LS measurement frequency (mean 1.1 times vs. 1.2 times, P > 0.05). The measurement system installation time in Group I was significantly shorter compared to Group II (mean 14.8 min vs. 81.3 min, P < 0.001). The LS value of the first measurement in Group I was lower than that of Group II (mean 5.1% vs. 6.9%, P = 0.011). In Group I, the refracture rate was 0, but in Group II it was 4.3% (2/47, P > 0.05). Conclusion The novel hexapod LS-measurement system and involved method demonstrated enhanced convenience and precision in measuring the LS of the external fixator in vivo. The LS measurement indicates the callus stiffness of fracture healing, and is applicable to evaluate the safety of removing the fixator. Consequently, it is highly recommended for widespread adoption in clinical practice.

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“…Radiologically, metastatic defects also appear as transcortical holes in long bones. These defects decrease the capacity of 4,17 .…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the Effects of Holes of Various Sizes on Fracture Rates in Sheep Femurs

Olcay¹,

Allahverdi²,

Gülmez³

et al. 2013

Kafkas Univ Vet Fak Derg

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SummaryDefects in long bones are known to lead to increased risk of pathologic fracture. Holes weaken bones and increase the risk of fracture during bending, especially on exposure to torsional forces. Here, we investigated the effect of holes of varying numbers and sizes drilled into sheep femur bones on the resistance of the bone to torsional forces. Ninety-six fresh sheep femur bones were allocated to 8 groups, which were further subdivided into 4 groups of 3 bones each. In each group, 1 to 4 holes ranging from 2 to 5.5 mm were drilled into the femurs, and the bones were subjected to a rotation test. Forces that caused fractures and the force curves were measured and recorded. The effect of the number and size of the holes drilled in the femurs on the occurrence of fractures was compared using two-way analysis of variance, and Tukey's multiple comparison test was used for multiple comparisons. P<0.05 was considered statistically significant. We found that the resistance of a bone to torsional forces decreased significantly with increase in the number and size of the drilled holes (P<0.001). The rate of fractures increased as the number and sizes of the holes increased. The resistance of the bones to torsional forces decreased as the number of holes increased. We showed that the size of a defect in a bone is extremely important for torsional resistance and is, in fact, more important than the number of defects. Keywords: Fracture, Rotational forces, Bone, Femur, Sheep Koyun Femurlarında Çeşitli Boyutlardaki Deliklerin Kırık Oranları Üzerine Etkilerinin Değerlendirilmesi ÖzetUzun kemiklerdeki defektlerin patololojik kırığa neden olduğu bilinmektedir. Delikler özellikle torsiyonel güçlere maruz kalınca bükülme esnasında kemiği zayıflatır ve kırık riskini artırır. Buradaki çalışmamızda biz koyun femur kemiklerinde drille delinmiş çeşitli sayı ve boyutlardaki deliklerin etkilerini araştırdık. 96 tane taze koyun kemiği her biri ilaveten 3 kemiği içeren 4'lü alt gruplara bölünerek 8 gruba ayrıldı. Her bir grubta 2 mm'den 5.5 mm'ye kadar değişen 1'den 4'e kadar delikler femurlar delinerek açıldı ve kemikler rotasyon testine tabi tutuldular. Kırığa neden olan kuvvetler ve kuvvet eğrileri ölçüldü ve kayıt edildi. Delik açılan femurlarda kırık oluşturan deliklerin boyutları ve sayısının etkisi iki yönlü varyans analizi ve Tukey'in çoklu karşılaştırma testi ile mukayese edildi. P<0.05 istatistiksel olarak anlamlı bulundu. Dril ile delinmiş deliklerin boyut ve sayısında artma ile birlikte kemiğin torsiyonel kuvvetlere karşı direncinin önemli derecede azaldığını bulduk (P<0.001). Kırık oranı deliklerin sayısı ve boyutu arttıkça artmaktadır. Torsiyonel kuvvetlere karşı kemiğin direnci deliklerin sayısı arttıkça azalmaktadır. Biz bir kemik defektinin boyutunun torsiyonel direnç için oldukça önemli olduğunu ve gerçekte de defektlerin sayısının boyutuna göre daha etkili olduğunu gösterdik.

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Torsional strength estimates of femoral diaphyses with endosteal lytic lesions: Dual‐energy x‐ray absorptiometry study

Cited by 7 publications

References 58 publications

Non-invasive assessment of failure torque in rat bones with simulated lytic lesions using computed tomography based structural rigidity analysis

Non-invasive assessment of failure torque in rat bones with simulated lytic lesions using computed tomography based structural rigidity analysis

In vivo axial load-share ratio measurement using a novel hexapod system for safe external fixator removal

Evaluation of the Effects of Holes of Various Sizes on Fracture Rates in Sheep Femurs

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