Biomechanical analysis of a novel Y-plate designed for the treatment of extraarticular distal humerus fractures |
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| Institution: | 1. Experimental Mechanics Laboratory, Faculty of Mechanical Engineering and Naval Architecture, University of Zagreb, Ivana Lu?i?a 5, 10000 Zagreb, Croatia;2. Department of Diagnostic and Interventional Radiology, Sestre Milosrdnice University Hospital Center, Vinogradska Cesta 29, 10000 Zagreb, Croatia;3. Probotica d.o.o., Slavonska avenija 6A, 10000 Zagreb, Croatia;4. Department of Traumatology, Sestre milosrdnice University Hospital Center, Dra?kovi?eva 19, 10000 Zagreb, Croatia;5. School of Medicine, University of Split, ?oltanska 2, 21000 Split, Croatia;1. Orthopedic Surgery and Traumatology, Servicio de Cirugía Ortopédica y Traumatología, Hospital Miguel Servet, Paseo Isabel la Católica, 1-3, Zaragoza 50.009, Spain;2. Institute for Health Research Aragón, Zaragoza, Spain;3. Universidad de Zaragoza, Spain;1. University of Kansas Medical Center;2. University Hospitals Cleveland Medical Center;3. University of Kansas School of Medicine;1. Mahircan Demir Eskisehir Osmangazi University Department of Orthopaedics and Traumatology, Turkey;2. Muhammed Cuneyd Gunay Eskisehir Osmangazi University Department of Orthopaedics and Traumatology, Turkey;1. Spine Clinic & Traumatology, Private Hospital Bethanien, Swiss Medical Network, Zurich, Switzerland;2. Department of Traumatology, University Hospital Zurich, Switzerland;3. Department of Orthopedics & Traumatology, Landeskrankenhaus Bludenz/Feldkirch, Austria;1. Resident in Orthopedic Surgery, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA;2. Resident in Orthopedic Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, USA;3. Assistant Professor of Orthopedic Surgery, University Hospitals Cleveland Medical Center, 11100 Euclid Ave, Cleveland, OH 44106, USA;4. Assistant Professor of Orthopedic Surgery, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA;1. Department of Orthopedics and Trauma, Yaoundé General Hospital, Yaoundé, Cameroon;2. Department of surgery and specialties, University of Yaoundé 1, Yaoundé PO Box 5408, Cameroon;3. Department of Orthopedics and Trauma, Yaoundé Emergency Center, Yaoundé, Cameroon;4. Royal National Orthopedic Hospital NHS TRUST, United Kingdom of Great Britain and Northern Ireland. United Kingdom;5. King''s Global Health Partnerships, School of Life Course and Population Sciences, King''s College London, United Kingdom of Great Britain and Northern Ireland, London, United Kingdom;6. Department of Orthopedics and Trauma, Cliniques Universitaires Saint-Luc, Brussels, Belgium;7. Bone Infection Unit, Nuffield Orthopaedic Centre, Oxford University Hospitals, United Kingdom of Great Britain and Northern Ireland, Oxford, United Kingdom |
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| Abstract: | Adult distal humerus fractures are infrequent, yet they account for one-third of all humerus fractures. For the treatment of comminuted and osteoporotic fractures, locking plates are claimed to be biomechanically superior to alternative internal fixing techniques. Treatment remains difficult despite recent advancements and the use of locking plates due to frequent comminution, low bone quality, and limited healing ability in osteoporotic bone. An optimal design of the newly constructed plate and the control model were selected. The biomechanical characteristics of non-osteoporotic and osteoporotic synthetic bone were compared on six models. The biomechanical properties of the new plate were tested and compared on 54 osteoporotic synthetic humerus models. The control models were reconstructive and parallel LCPs. The tests were carried out under static and dynamic axial, lateral and bending loads. Fracture displacements were measured by optical measuring system Aramis. The test model is significantly stiffer for lateral load (p = 0.0007) and for bending load at the moment of model failure (p = 0.0002), while for axial load the LCP model showed greater stiffness (p = 0.0017). During lateral dynamic loading, all three LCP models broke and there was a significant difference compared to the test model (p = 0.0125). The LCP model is dynamically significantly more durable under axial load, while the largest displacements were recorded with the test model (p = 0.029). The displacements induced by all three loads are within the limits that fulfil the parameters of appropriate biomechanical stability. A novel locking plate for extra-articular distal humerus fractures may provide an alternative to the traditional two-plate. |
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