Academic literature on the topic 'Bone plates and screws'
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Journal articles on the topic "Bone plates and screws"
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Hearn, T. C., T. D. Woodside, and J. R. Field. "The influence of screw torque in the application of bone plates." Veterinary and Comparative Orthopaedics and Traumatology 14, no. 02 (2001): 78–83. http://dx.doi.org/10.1055/s-0038-1632679.
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SummaryThe applied level of screw torque has a significant impact on both the mechanical and vascular environment in bone following the application of a bone plate. The amount of torque applied dictates the resultant level of axial tension generated in the screw and the compressive forces between the plate and underlying bone. The interface contact area between the plate and underlying bone is also affected. As a consequence, screw torque can be implicated in the pathogenesis of implant induced osteopenia and other pathological occurrences that follow bone plate fixation.The work performed was designed to evaluate the effect of the applied level of screw torque. The construction stiffness (rigidity) and bone surface strain was quantitated in response to variable levels of screw torque. This was performed utilizing intact and osteotomized cadaveric bone.The current level of screw torque applied in the clinical situation, for 4.5 mm cortical screws, is approximately 5 Newton metres (Nm). It appears from the work presented herein, that lowering the level of applied screw torque does not adversely affect the rigidity of the final construction. This fact may serve to ameliorate the pathological consequences of applying screws and plates using current clinical criteria.The amount of torque applied to screws in the application of bone plates has a profound effect on a number of elements, namely the interface contact area and force. The work presented examines the effect of screw torque on the rigidity and bone strain distribution of fractured bone following bone plate reconstruction. It appears that the use of lower levels of screw torque, than currently used in clinical practice, does not adversely effect the rigidity of the final construction. These findings support the notion that the level of screw torque applied may have a role in ameliorating the pathogenic response that occur following bone plate application, namely osteopaenia.
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Bruecker, K. A., J. L. Palmer, Barbara Powers, M. B. Histand, and P. D. Schwarz. "A Mechanical and Histological Comparison of Bone Healing Using Titanium Bone Plates with Porous Surfaced Titanium Screws versus Smooth Surfaced Titanium Screws." Veterinary and Comparative Orthopaedics and Traumatology 4, no. 01 (1991): 1–10. http://dx.doi.org/10.1055/s-0038-1633242.
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SummaryBilateral midshaft femoral osteotomies were stabilized with a 3 mm fracture gap in 12 dogs using titanium bone plates and either smooth surfaced (SS) or porous surfaced (PS) titanium screws. Mechanical studies demonstrated that PS screws required a significantly greater torque to remove than the SS screws at both 8 and 16 weeks. At 16 weeks, screw removal torque increased by a factor of 1.3 over the insertion torque for PS screws and decreased by a factor of 2.9 for SS screws. Histologically, the amount of new bone formation and porosity, over the entire length of the femur, was significantly greater in the femora stabilized with PS screws; indicative of greater overall fixation rigidity. At both time periods, there was an increase in torsional stiffness in the osteotomies stabilized with SS screws. Radiographically, there was no difference in the osteotomy callus area for either screw type. From this study, there appears to be advantages to using PS bone screws instead of SS screws when subjected to dynamic loading such as gap fixation.
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Conzemius, Mike, and Scott Swainson. "Fracture Fixation with Screws and Bone Plates." Veterinary Clinics of North America: Small Animal Practice 29, no. 5 (September 1999): 1117–33. http://dx.doi.org/10.1016/s0195-5616(99)50105-8.
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Wang, Cheng-Chi, Cheng-Hung Lee, Ning-Chien Chin, Kun-Hui Chen, Chien-Chou Pan, and Kuo-Chih Su. "Biomechanical analysis of the treatment of intertrochanteric hip fracture with different lengths of dynamic hip screw side plates." Technology and Health Care 28, no. 6 (November 17, 2020): 593–602. http://dx.doi.org/10.3233/thc-202248.
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BACKGROUND: Dynamic hip screw (DHS) is a common implant used to treat stable-type intertrochanteric hip fractures. There are many factors that can affect the success rate of the surgery, including the length of side plates. It is therefore important to investigate the biomechanical effect of different DHS side plates on bones. OBJECTIVE: In order to reduce the likelihood of an implant failure, the aim of this study was to use finite element analysis (FEA) to investigate and understand the effect of side plates with different lengths in DHS. METHODS: In this FEA study, a 3D model with cortical bone, cancellous bone, side plate, lag screw, and cortical screws to simulate the implantation of DHS with different lengths of side plate (2-hole, 4-hole, and 6-hole) for intertrochanteric hip fractures was constructed. The loading condition was used to simulate the force (400 N) on the femoral head and the stress distribution on the lag screw, side plate, cortical screws, and femur was measured. RESULTS: The highest stress points occured around the region of contact between the screw and the cortical bones. The stress on the femur at the most distal cortical screw was the greatest. The shorter the length of the side plate, the greater the stress on the cortical screws, resulting in an increased stress on the femur surrounding the cortical screws. CONCLUSIONS: The use of DHS with 2-hole side plate may increase the risk of side plate pull-out. The results of this study provide a biomechanical analysis for selection of DHS implant lengths that can be useful for orthopaedic surgeons.
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Wang, Wen Teng, and Yu Chen Lin. "Study on the Optimization of Process Parameters for Absorbable Bone Plate with In-Mold Heat Treatment." Solid State Phenomena 294 (July 2019): 71–76. http://dx.doi.org/10.4028/www.scientific.net/ssp.294.71.
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Titanium alloy & stainless steel are major materials for bone fracture fixation such as bone screws and plates in today's medical devices. However, the fixation devices made of metal not only have the risk of metal ion release to cause human allergies, but they also need to be removed by a second surgical operation making pain and the risk of the patient’s wound infection after the bone fracture healing. The biodegradable Polylactic Acid (PLA) bone screws & bone plates have the great advantage of not needing a second operation, but their insufficient strengths make them not be widely used in the current bone fracture fixation. In the study, we use PLA as the matrix and in-mod heat treatment with induction coils to increase the strength of bone screw & plate by improving crystallinity of material. Regarding ASTM F2502 “Standard Specification and Test Methods for Absorbable Plates and Screws for Internal Fixation Implants”, we measure bending loads of test pieces before and after in-mold heat treatment, and obtain the optimized process parameters by Taguchi method that will increase the bend load of PLA bone plates by 34.82%. These optimal parameters are the injection speed of 80 mm/s, the melt temperature of 205 °C, the heat treatment temperature of 110 °C and heat treatment time of 20 min.
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Barranco, Guilherme Henrique Fernandes, Maria Stella Fernandes Villela, Gracila Heitor De Oliveira, Stephanie Fernandez, Nathália Gonçalves De Santana, Tatiana Morosini de Andrade Cruvinel, and Victor José Vieira Rossetto. "Femoral Osteosynthesis in Black Capuchin Monkey (Sapajus nigritus) using Locking Plate." Acta Scientiae Veterinariae 46 (February 5, 2018): 5. http://dx.doi.org/10.22456/1679-9216.85154.
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Background: Locking bone plates for internal fixation are characterized by plates with a locknut by screwing in a threaded chamber. The increased stability associated with less vascular lesion contribute to the lower risk of complications and makes the locking bone plates especially interesting in fracture management of wild animals to be reintroduced into nature.The aim of this report is to describe the case of a black capuchin monkey with a femoral fracture, submitted to internal fixation using locking plate, with a satisfactory postoperative evolution, characterized by the bone consolidation and full recovery of the function of the member.Case: An exemplar of an adult male black capuchin monkey (Sapajus nigritus) with 4.2 kg of body weight was presented due to a comminuted, diaphyseal fracture of the left femur. The animal was then submitted to internal fixation of the femoral fracture using a 2.0 mm locking plate with 11 holes. For the internal fixation, the plate was contoured and positioned on the lateral surface of the bone. In addition, four locking screws were inserted through both cortices in the proximal bone segment, while other three locking screws were inserted in the distal bone segment. Two of the distal locking screws were inserted through both bone cortices, while one of them were inserted through only one bone cortical. The animal showedcomplete functional recovery of the left hind limb at 30 days postoperatively. Despite this, it was visualized at the radiographic examination a partial release of the plate from the distal bone segment. Due to this, the animal was submitted to another surgical intervention to replace the distal locking screws by bicortical locking screws. The animal showed hind limb weight support at the second day postoperatively. The complete functional recovery of the left hind limb, however, was verified at 26 days postoperatively. In this moment, it was performed a new radiographic examination, which allowed the visualization of bone consolidation, and the animal was reintroduced into its natural habitat.Discussion: The choice of the bone plate may play a fundamental role in the bone healing process. Among many bone plates configuration, locking plates are highlighted, as they offer greater angular stability to the fracture and result in less injuring periosteum and blood vessels. In addition, other methods for internal fixation are related to numerous postoperative complications. Despite the low rate of complications of the locking system, in the present case, it was visualized the partial release of the plate from the distal bone segment, which is probably related to the higher concentration of load near the sniffle joint, and the early release of one monocortical screw. The use of monocortical screws is permissible whenproperly locked in the threaded chambers of the plate. In the present case, however, it is believed that the early release of the distal monocortical screw is probably related to the incompletely screw head locked in the threaded chamber of the plate. Therefore, the use of bicortical screws should be preferred even using locking systems, especially in anatomical regions subjected to a higher concentration of load, as near the sniffle joint. In addition, it is concluded that the locking plate maybe a viable option for the treatment of long bone fractures in wild animals, in particular femoral fractures of specimens of black capuchin monkey (Sapajus nigritus).Keywords: wild animals, internal fixation, fracture.
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Garg, Bhavuk, Tarun Goyal, Vijay Kumar, Rajesh Malhotra, and Prakash P. Kotwal. "Removal of locking plates: new implant, new challenges and new solutions." Surgical Techniques Development 1, no. 2 (November 3, 2011): 25. http://dx.doi.org/10.4081/std.2011.e25.
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Removal of locking plates in many ways poses novel challenges compared to conventional plates. None of the techniques described for the removal of locking plates are adequate for all situations. We report our experience of 27 patients from whom a total of 33 locking plates were removed. We also describe a novel technique for the removal of locking plates which in our experience could be used in most of these patients because it is appropriate for all situations and, from a technical point of view, is easy to use. Our new technique consists of removing the problematic locking screw by cutting the plate on both sides of the screw hole and using the screw head-plate hole unit for removal. We analyzed all these patients for the location of the plate, number of locking screws, time of implant removal since the initial surgery, reason for removal of the plate, nature of the difficulties encountered during surgery, and any perioperative complications. A total of 43 (17.34%) screws were difficult to remove. Twenty screws were found to be stripped, 15 were jammed and 8 were broken. Fourteen of the 20 stripped screws and all 15 jammed screws were removed using our technique. We found this technique of locking plate removal to be very versatile and useful in most of the cases in which removal was difficult. At the same time, it also causes less damage to the bone compared to other techniques.
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Putri, Trixie Brevi, Erwin Ramawan, Mohammad Zaim Chilmi, Kukuh Dwiputra Hernugrahanto, Jifaldi AMD Sedar, and Fundhy S. I. Prihatanto. "Choosing between the Conventional Plates, Locking Plates, or Iliosacral Screws for Sacroiliac Joint Dislocation: A Biomechanical Comparison Study." Hip and Knee Journal 2, no. 1 (February 20, 2021): 28–33. http://dx.doi.org/10.46355/hipknee.v2i1.38.
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Background: This study examines the comparison of biomechanical strengths of three kinds of the most familiar implants available in Indonesia: conventional and locking sacroiliac plates and screws, also iliosacral screws. Despite the common thought that iliosacral screws are preferred compared to conventional plates and screws due to its biomechanic superiority, this study tested whether the locking plates and screws could offer an alternative.Materials and Methods: This study was an in vitro experimental study with a Randomized Post Test - Only Control Group Design using pelvic bones from male cadavers aged 20-50 y.o. Twelve samples were divided into three treatment groups and one control group. Group P1 was fixed with two conventional plates, P2 was fixed with two locking plates, P3 was fixed with two iliosacral screws, and control group K with sacroiliac joint was intact. Each group was given an increasing load until a vertical shift of the sacroiliac joint ≥ 2.0 mm was obtained.Results: The average force load for 2 mm displacement among the fixation systems being tested shows a statistically significant difference (p0.05). Load failure force for 2 mm displacement in the locking plate and screw group has the highest average (591.33 ± 56.08 N) compared to the iliosacral screw group (583.67 ± 73.56 N) and conventional plate and screw group (574 ± 106.05 N).Conclusions: Biomechanically, the fixation system using two locking anterior sacroiliac plates and screws is more stable than the iliosacral screws and conventional sacroiliac plates and screws.
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Cho, Ji Hyun, Byeong Uk Song, Keum Hee Seo, Kyung Tak Min, and Tae Il Seo. "Optimal Design of Bone Plate System Using Finite Element Method." Advanced Materials Research 433-440 (January 2012): 3045–51. http://dx.doi.org/10.4028/www.scientific.net/amr.433-440.3045.
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This paper investigates a design optimization for "Bone Plate System" which can directly fix human bones fractured. The active trauma system consists of several shaped bone plates and implant screws for fixation of fractured human bones with various manual instruments allowing to handle them. The material corresponds to titanium because it was well known as harmless material when being inserted into human body. This system has to be suitably rigid as well as manually bended in orthopedic surgery operations. Then bone plates have to be designed with suitable shapes. In order to verify whether bone plates were well designed, a series of bending tests. However optimized shapes of bone plates have to be determined before unnecessary a number of bending tests. For this purpose FEM(Finite Elements Method) was applied during design process which allows us to investigate the bending strengths of bone plates. Based on FEM results, dimensions of bone plates were optimized in order to be suitably rigid without actual bending tests.
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Ortiz-Romero, Mercedes, Luke D. Cicchinelli, Álvaro Fernández-Garzón, and Luis M. Gordillo-Fernández. "Surgical Reconstruction of Nonunion after Iatrogenic Scarf Osteotomy." International Journal of Environmental Research and Public Health 18, no. 11 (May 25, 2021): 5620. http://dx.doi.org/10.3390/ijerph18115620.
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We present the case of a young patient, 32 years old, with nonunion in the diaphysis of the first metatarsal after scarf osteotomy for correction of hallux valgus. After removal of the failed osteosynthesis material and preparation of the bone fragments, a calcaneal bone autograft, previously extracted from the patient, was placed in the nonunion area. The new physiological position of the first metatarsal in the three planes was checked intraoperatively, and autograft and fragment fixation was performed using a combination of a low-profile plate with six screws and two interfragmentary screws. The advantage of using an autogenous graft is that it provides corticocancellous bone and great osteogenic capacity with little antigenic capacity. This makes it an excellent option in many situations in foot and ankle surgery. Regarding the fixation method, we used the two most commonly used techniques for osteosynthesis of bone grafts in cases of bone nonunion, combining plates with locking screws and two interfragmentary screws. This provides greater stability of the bone fragments in the three planes and makes it possible to bring forward when the patient starts postsurgical loading.
Dissertations / Theses on the topic "Bone plates and screws"
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Cavalieri-Pereira, Lucas 1982. "Resistência de três tipos de fixação utilizados no tratamento das fraturas do ângulo mandibular." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/287857.
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Orientadores: Alexandre Elias Trivellato, Marcio de MoraesTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: Fraturas do ângulo mandibular são muito freqüentes dentre as fraturas mandibulares e um das formas de tratamento é a utilização de fixação interna com placas e parafusos. Neste estudo o objetivo foi avaliar comparativamente a resistência de três tipos de fixação em réplicas de mandíbula de poliuretano, empregando-se a técnica de Champy. Foram utilizadas 63 mandíbulas dentadas, submetidas aa seccionamento simulando uma fratura linear e favorável de ângulo mandibular esquerdo. As fixações foram realizadas com placas retas do sistema 2,0 mm, dispostas da seguinte forma: uma placa com quatro furos, uma com cinco furos e uma com quatro furos e extensão (ponte). A estabilização e fixação foram realizadas com adaptação da placa e quatro parafusos de 6,0 mm de comprimento, sobre a linha oblíqua da mandíbula. Foram elaborados 9 grupos, com 7 mandíbulas cada um, sendo 3 grupos fixados com placa de 5 furos, 3 com placa reta de 4 furos com extensão e 3 com placa reta de 4 furos. Cada conjunto foi submetido ao teste de carregamento linear com aplicação de carga no sentido súpero-inferior em três pontos distintos da mandíbula, de modo não simultâneo (região de molar ipsilateral à secção, incisivos centrais e molar contralateral) em máquina de ensaio universal EMIC DL 2000. Foram mensurados valores de carga no deslocamento de 1 mm, 2 mm e final e anotado o deslocamento final. Os resultados obtidos foram submetidos à análise estatística, utilizando a análise de variância (ANOVA), seguido do teste de Tukey, nível de significância de 5%. Nos valores de cargas obtidos, tanto quando aplicada no molar ipsilateral ao seccionamento, no molar contralateral ao seccionamento e entre incisivos centrais, foi verificada diferença estatística somente no momento do deslocamento final, na qual a placa com 5 furos e com 4 com extensão foi superior a placa com quatro furos. Não houve diferença entre placa com 5 furos e com 4 com extensão
Abstract: Mandibular angle fractures are very frequent among the mandibular fractures and a form of treatment is the use of internal fixation with plates and screws. In this study, the objective was to evaluate the resistance of three types of fixation in mandibular replicas of polyurethane, using the technique of Champy. Sixty three toothed mandibles were used, subject to sectioning simulating a linear and favorable fracture of left mandibular angle. The fixations were performed with straight plates system 2.0 mm, prepared as follows: one plate with 4-holes, one with 5-holes and one 4-holes and extension (bridge). Stabilization and adjustment were performed with locking plate and four screws of 6.0 mm in length, about the oblique line of the mandible. Nine groups were elaborated, with 7 each, which 3 groups being fixed with 5-holes plates, 3 groups with 4-holes plates with extension and 3 groups with 4-holes plates. Each set was submitted for loading test with load application towards in three distinct points of the mandible, so do not simultaneously (molar region on the side ipsilateral of section, the central incisors and contralateral molar) in universal testing machine EMIC DL 2000. Load values were measured at offset 1 mm, 2 mm and final and was noted the final dislocation. The results were submitted to statistical analysis, using analysis of variance (ANOVA) followed by Tukey test, a significance level of 5%. The values obtained, when loads were applied in the ipsilateral molar, contralateral molar and incisors, was verified statistically only at the final dislocation, in which the 5-holes plates and 4-holes with extension was more resistant than 4-holes plates. There was no difference between plate with 5-holes and 4-holes with extension
Doutorado
Cirurgia e Traumatologia Buco-Maxilo-Faciais
Doutor em Clínica Odontológica
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Rozema, Frederik Reinder. "Resorbable poly(L-lactide) bone plates and screws tests and applications /." [S.l. : [Groningen : s.n.] ; University Library Groningen] [Host], 1991. http://irs.ub.rug.nl/ppn/29129460X.
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Tams, Jan. "Suitability of polylactide bone plates and screws for fixation of mandibular fractures." [S.l. : [Groningen : s.n.] ; University Library Groningen] [Host], 1998. http://irs.ub.rug.nl/ppn/292801297.
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Brasileiro, Bernardo Ferreira. "Avaliação biomecanica in vitro de tecnicas de fixação rigida metalica para osteotomia sagital do ramo mandibular em movimentos de avanço e recuo." [s.n.], 2007. http://repositorio.unicamp.br/jspui/handle/REPOSIP/289676.
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Orientador: Luis Augusto PasseriTese doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: Um melhor entendimento biomecânico da fixação interna rígida (FIR) na osteotomia sagital dos ramos mandibulares (OSRM) pode ser baseado em pesquisas com o intuito de investigar sua função in vitro antes da aplicação clínica. Assim, este trabalho teve como objetivo avaliar comparativamente a resistência de três diferentes técnicas de FIR em réplicas de hemimandíbulas humanas de poliuretano simulando a OSRM para movimentos de 5 mm em avanço e recuo. As técnicas de FIR incluíram uma miniplaca ponte com 4 furos e 4 parafusos monocorticais (grupo miniplaca), uma miniplaca com 4 furos e 4 parafusos monocorticais mais um parafuso bicortical posicional (grupo híbrido) e 3 parafusos bicortical posicionais em configuração em ¿L¿ invertido (grupo ¿L¿ invertido). Os parafusos e as miniplacas utilizados eram de titânio e pertencentes ao sistema de 2,0 mm. Estes foram avaliados quanto à padronização dimensional por meio do coeficiente de variação, que evidenciou alta semelhança macroscópica. As hemimandíbulas foram submetidas a testes de carregamento linear vertical e lateral por uma unidade de testes mecânicos Instron 4411 para registro da carga de pico aos deslocamentos de 1 mm, 3 mm, 5 mm e 10 mm. Médias e desvio padrão foram avaliados aplicando-se a Análise de Variância e o teste de Tukey em nível de significância de 5%. O grupo miniplaca apresentou menores valores de carga de pico ao deslocamento (p<0,01) quando comparada com as outras técnicas de fixação considerando-se igual tipo de movimento e direção de carga. O grupo ¿L¿ invertido foi ainda superior em resistência (p<0,01) ao grupo híbrido em movimento de avanço e com aplicação de carga verticalmente. Concluiu-se que a utilização da técnica de FIR para a OSRM baseada em 3 parafusos bicorticais em ¿L¿ invertido foi a mais estável, e que a colocação de um parafuso bicortical pode otimizar significativamente a resistência da fixação com miniplacas e parafusos monocorticais
Abstract: A better understanding of the biomechanics of sagittal split ramus osteotomy (SSRO) rigid internal fixation (RIF) can be based on research aiming to evaluate its function in vitro before clinical application. Thus, the goal of this investigation was to evaluate comparatively the resistance of three different RIF techniques applied to polyurethane synthetic hemi-mandible replicas simulating the SSRO for 5 mm advancement and setback. RIF techniques included a 4-hole miniplate and 4 monocortical screws (miniplate group), a 4-hole plate and 4 monocortical screws with one additional bicortical positional screw (hybrid group), and 3 bicortical positional screws in a traditional inverted-L pattern (inverted-L group). Screws and miniplates were made of titanium and from 2.0 mm system. These were analyzed according to dimensional standardization by a coefficient of variation, which revealed high macroscopic similarity. The hemi-mandibles were submitted lateral and vertical loading tests in an Instron 4411 mechanical testing unit for recording of peak loading at 1 mm, 3 mm, 5 mm and 10 mm of displacement. Means and standard deviation were analyzed using Analysis of Variance and Tukey test with a 5% level of significance. Miniplate group showed lower load peak scores (p<.01) when compared to the others fixation techniques regarding equal type of movement and force direction. Inverted-L group demonstrated higher resistance (p<.01) than hybrid group during advancement and with application of vertical load. It was concluded the RIF technique for SSRO based on 3 bicortical screws in the inverted-L pattern was the most stable, and the installation of a bicortical screw may significantly optimize the resistance of the miniplate and monocortical screws fixation
Doutorado
Cirurgia e Traumatologia Buco-Maxilo-Faciais
Doutor em Clínica Odontológica
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Iamashita, Heric Yukio. "Estudo biomecanico de tres tecnicas diferentes de fixações metalicas utilizadas em osteotomia sagital do ramo mandibular." [s.n.], 2009. http://repositorio.unicamp.br/jspui/handle/REPOSIP/290201.
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Orientadores: Valfrido Antonio Pereira Filho, Luis Augusto PasseriDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: Estudos têm proposto diversas técnicas e métodos de fixação interna rígida (FIR) no sentido de se obter maior estabilidade dos segmentos ósseos e mínimo deslocamento condilar após osteotomia sagital do ramo mandibular (OSRM). Desta forma, o presente estudo teve por objetivo avaliar por meio de ensaio mecânico de compressão em hemimandíbulas sintéticas, três diferentes tipos de fixações utilizadas na OSRM em movimento de avanço de 5 mm. Foram utilizadas 30 hemimandíbulas, divididas em 3 grupos com 10 hemimandíbulas em cada. O grupo 1 foi fixado com três parafusos posicionais de 15 mm do sistema 2,0 mm dispostos bicorticalmente na posição de L invertido e com angulação de inserção de 90°; no Grupo 2 a fixação foi realizada com placa de 4 furos do sistema 2,0 mm e 4 parafusos monocorticais de 6 mm de comprimento disposto sobre a região do canal mandibular, e o Grupo 3 a fixação consistiu de uma placa sagital ajustável do sistema 2,0 mm e 8 parafusos de 6,0 mm de comprimento também localizada sobre o canal mandibular. Sendo avaliados quanto à padronização, o sistema de fixação demonstrou semelhança dimensional. As hemimandíbulas foram submetidas a cargas compressivas verticais, por meio de ponta de aplicação de carga em máquina de ensaio universal MTS®, na velocidade de 1 mm/min com deslocamento máximo de 10 mm. Médias e desvios padrão foram obtidos e submetidos à análise de variância a um fator e teste HSD de Tukey com nível de significância de 5%. O Grupo 1 apresentou maiores valores de resistência à força de carga compressiva (p<0,001) sendo superior aos demais grupos. O Grupo 3 demonstrou a menor resistência às forças (p<0,001). Concluiuse que o uso de parafusos bicorticais posicionais em L invertido promove a maior capacidade de resistência às cargas compressivas, sendo que as placas sagitais ajustáveis apresentam-se cerca de 60% menos resistentes do que o Grupo 1.
Abstract: Studies have considered many techniques and methods of rigid internal fixation (RIF) leads to obtain greater stability to the bone segments and minimum displacement of the condyles after performed the sagittal split ramus osteotomy (SSRO). In this way, the purpose of this study was to evaluate by means of mechanical compression testing model with synthetic hemimandibles, three different fixation types used in the SSRO in movement of advance of 5 mm. Thirty hemimandibles, divided in 3 groups with 10 hemimandibles in each group. Group 1 was fixed with three 15 mm positional screws (2.0 mm diameter) bicortically in an inverted-L pattern and with insertion angle of 90°; in Group 2 the fixation was carried through with four-hole straight plate and four 6 mm monocortical screws made located on the region of the mandibular canal, and Group 3 the fixation is consisted of an adjustable sagittal plate and eight 6 mm screws also placed on the mandibular canal. Evaluated for dimensional standardization, the fixation system had demonstrated dimensional similarity. Hemimandibles had been exposed to the vertical compressive loads, by means of tip of load application in a MTS® mechanical testing unit, in the speed of 1 mm/min with maximum displacement of 10 mm. Averages and standard deviations had been obtained and submitted to the analysis of variance to a factor and have tested for HSD of Tukey test with a 5% level of significance. Group 1 presented greaters values of resistance to the compressive loads (p< 0.001) showed superior to the other groups. Group 3 demonstrated the lesser resistance to the loading forces (p< 0.001). It was concluded that the use of positional bicortical screws in inverted-L pattern promotes the higher capacities of resistance to compressive loads, moreover, the adjustable sagittal plates are presented about less resistant 60% that the Group 1.
Mestrado
Cirurgia e Traumatologia Buco-Maxilo-Faciais
Mestre em Clínica Odontológica
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Chow, Lop-keung Raymond. "Clinical morbidity of resorbable plates and screws for internal fixation in orthognathic surgery." Click to view the E-thesis via HKUTO, 2003. http://sunzi.lib.hku.hk/hkuto/record/B31954285.
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González, Diana Maritza Contreras. "Avaliação in vitro da resistência de três tipos de fixação para tratamento de fraturas de ângulo mandibular." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/58/58136/tde-13042015-093719/.
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As fraturas do ângulo mandibular são muito frequentes dentre as fraturas mandibulares e um das formas de tratamento é a utilização de fixação interna com placas e parafusos. Neste estudo o objetivo foi avaliar comparativamente a resistência de três tipos de fixação em réplicas de mandíbula de poliuretano. Foram utilizadas 63 mandíbulas dentadas, submetidas a seccionamento simulando uma fratura linear e desfavorável de ângulo mandibular esquerdo. As fixações foram realizadas com placas do sistema 2,0 mm, dispostas da seguinte forma: uma placa reta de quatro furos, uma placa reta de quatro furos com extensão (ponte) e uma placa 3D 4 furos. Cada grupo (n = 21) foi submetido ao teste de resistência linear com aplicação de carga no sentido súpero-inferior em três pontos distintos da mandíbula, de modo não simultâneo (região do primeiro molar ipsilateral à secção, primeiro molar contralateral e incisivos centrais) em máquina de ensaio universal EMIC DL 2000. Foram mensurados valores de carga no deslocamento de 1 mm, 2 mm e 5mm. Os resultados obtidos foram submetidos à análise estatística, utilizando a análise de variância (ANOVA), nível de significância de 5%. Os valores obtidos, não apresentaram diferença estatisticamente significante entre as placas. Os resultados mostraram que as placas 3D produzem escores similares às placas usadas convencionalmente. Com base nos resultados obtidos, pode-se concluir que os três tipos de fixação se comportam de forma similar.Mandibular angle fractures are very frequent among the mandibular fractures and a form of treatment is the use of internal fixation with plates and screws. In this study, the objective was to evaluate the resistance of three types of fixation in mandibular replicas of polyurethane. Sixty three toothed mandibles were used, subject to sectioning simulating a linear and unfavorable fracture of left mandibular angle. The fixations were performed with straight plates system 2.0 mm, prepared as follows: one plate with 4-holes, one 4-holes and extension (bridge) and one plate 3D 4-holes .Each set was submitted for loading test with load application towards in three distinct points of the mandible, so do not simultaneously (molar region on the side ipsilateral of section, the central incisors and contralateral molar) in universal testing machine EMIC DL 2000. Load values were measured at offset 1 mm, 2 mm and 5mm and was noted the final dislocation. The results were submitted to statistical analysis, using analysis of variance (ANOVA), a significance level of 5%. the values obtained showed no statistically significant difference between the plates. The results show that the 3D plate can reproduce similar mechanical scores to the plates used conventionally. It can be concluded that the three types of fasteners behaved similarly.
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Chow, Lop-keung Raymond, and 周立強. "Clinical morbidity of resorbable plates and screws for internal fixation in orthognathic surgery." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2003. http://hub.hku.hk/bib/B31954285.
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Assis, Adriano Freitas de 1977. "Análise mecânica e fotoelástica de sistemas de fixação interna estável utilizados para o tratamento de fraturas subcondilares da mandíbula." [s.n.], 2012. http://repositorio.unicamp.br/jspui/handle/REPOSIP/287892.
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Orientador: Márcio de MoraesTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: As fraturas do côndilo mandibular apresentam-se como as injúrias mais comuns ao complexo maxilo-mandibular, contudo ainda existe controvérsia quanto ao seu tratamento. O objetivo neste estudo foi avaliar comparativamente, in vitro, por meio de testes mecânicos e fotoelásticos a fixação de fraturas condilares com diferentes sistemas. Para os testes mecânicos foram utilizadas 60 hemimandíbulas de poliuretano, que foram divididas em 12 grupos com 5 hemimandíbulas cada, sendo dois grupos controle com hemimandíbulas íntegras e mais dois grupos de cada tipo de fixação: duas placas retas do sistema 2,0mm, uma placa trapezoidal do sistema 2,0mm, uma placa trapezoidal com extensão do sistema 2,0mm, uma placa trapezoidal do sistema 1,5mm e uma placa trapezoidal com extensão do sistema 1,5mm. Foram realizados testes de carregamento linear no sentido ântero-posterior e médio-lateral. As médias foram comparados pelo teste de Tukey. As diferenças foram consideradas estatisticamente significantes para p ? 0,05. Para os testes fotoelásticos, foi utilizada uma amostra de 10 hemimandíbulas de resina fotoelástica, sendo duas para cada grupo, na mesma distribuição dos testes mecânicos, submetidas ao carregamento linear nos mesmos sentidos para análise do comportamento e distribuição das tensões. Os resultados indicaram que a fixação com duas placas apresenta maior resistência no sentido ântero-posterior e a fixação com uma placa trapezoidal com extensão apresenta maior resistência no sentido médio-lateral. A análise fotoelástica demonstrou que as tensões são melhores distribuídas nas fixações com placas trapezoidais. De acordo com os resultados foi possível concluir que a extensão posterior das placas trapezoidais aumentou a resistência do sistema de fixação e que a utilização de placa trapezoidal com ou sem extensão posterior foi favorável à distribuição de tensão de maneira mais uniforme
Abstract: Fractures of the mandibular condyle are presented as the most common injuries to the maxillo-mandibular complex, however there is still great controversy regarding treatment. The aim of this study was to assess comparatively, in vitro, by mechanical and photoelastic testing, fixation for condylar fractures with different systems. For the mechanical tests 60 polyurethane mandible models were used. They were divided into 12 groups of 5 mandibles, two control groups with intact mandibles and two groups of each type of fixation: two 2.0mm straight plates, a 2.0mm trapezoidal plate, a 2.0mm trapezoidal plate with extension, a 1.5mm trapezoidal plate and a 1.5mm trapezoidal plate with extension. Linear loading tests were carried out in anterior-posterior and medial-lateral directions. Mean and standard deviations were compared by Tukey test. Differences were considered statistically significant at p ? 0.05. For the photoelastic tests, 10 photoelastic mandibles were used, 2 for each group, in the same distribution as the mechanical tests, submitted to linear loading in the same directions to analyze the behavior and distribution of tensile strain lines. The results indicated that the fixation with two plates presented a higher resistance in the anteroposterior direction and fixation with a plate with trapezoidal extension is more resistant towards mediolateral. The photoelastic analysis showed that the strain lines were best distributed when trapezoidal plates were used. According to the results we concluded that the posterior extension of the trapezoidal plates increased the strength of the fixation system, and the use of trapezoidal plate with or without posterior extension was favorable to a more balanced stress distribution
Doutorado
Cirurgia e Traumatologia Buco-Maxilo-Faciais
Doutor em Clínica Odontológica
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Cavalieri-Pereira, Lucas 1982. "Resistência de quatro técnicas de fixação utilizadas no tratamento das fraturas subcondilares = estudo in vitro em mandíbulas de poliuretano." [s.n.], 2011. http://repositorio.unicamp.br/jspui/handle/REPOSIP/287846.
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Orientador: Alexandre Elias TrivellatoDissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Odontologia de Piracicaba
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Resumo: A fratura do côndilo mandibular usualmente requer tratamento cirúrgico com emprego de fixação interna estável. O objetivo neste estudo foi avaliar comparativamente a resistência de quatro técnicas de fixação utilizadas no tratamento de fraturas subcondilares. Foram empregadas 84 mandíbulas sintéticas, 147 placas retas e 546 parafusos. As mandíbulas foram submetidas a um seccionamento simulando uma fratura subcondilar esquerda e fixadas com quatro técnicas utilizando-se das placas de 2,0 e 1,5 mm, que deram origem a doze grupos experimentais, cada um com 7 mandíbulas. Chamou-se de grupos G1, G5 e G9, aqueles fixados com uma placa reta de 4 furos do sistema 2,0 mm. Os grupos G2, G6 e G10, foram fixados com uma placa de 4 furos dos sistema 2,0 mm e uma placa de 3 furos do sistema 1,5 mm. Grupos G3, G7 e G11, aqueles fixados com duas placas 2,0 mm, sendo a anterior de 3 furos; Grupos G4, G8 e G12, aqueles fixados com duas placas 2,0 mm de 4 furos. Cada sistema foi submetido ao teste de resistência com aplicação de carga no sentido súpero-inferior em máquina de ensaio EMIC, modelo DL2000. Em G1, G2, G3 e G4 a aplicação de carga foi no primeiro molar do lado da fratura simulada (MF). Em G5, G6, G7 e G8, no primeiro molar contralateral à fratura simulada (MC). Em G9, G10, G11 e G12, entre os incisivos centrais (I). Foram mensurados valores de carga para os deslocamentos de 1 mm, 2 mm e 5 mm. Os resultados obtidos no teste de resistência foram comparados utilizando análise de variância (ANOVA), seguido do teste de Tukey com nível de significância de 5%. Verificou-se valores de carga menores no grupo tratado com uma placa de 4 furos do sistema 2,0 mm, nos deslocamentos de 1 e 2 mm, com aplicação de carga em MF. Pode-se concluir que a utilização do sistema de fixação com duas placas proporciona maior resistência
Abstract: Fractures of mandibular condyles usually require surgical treatment with steady employment internal fixation. The aim in this study was to evaluate the resistance of four fixation technique used in the treatment of subcondylar fractures. Were employed 84 synthetic jaws, 147 straight plates and 546 screws. The jaws underwent a sectioning simulating a left subcondylar fracture and fixed with four techniques using 2.0 mm and 1.5 mm plates, which gave rise to twelve experimental groups, each with 7 mandibles. Drew G1, G5 and G9, those set with single straight plate 4-holes. Groups G2, G6 and G10, were fixed with one 2.0 mm system plate 4-holes and one 1.5 mm system plate 3-hole. Groups G3, G7 and G11, were fixed with two plates 2.0 mm, which more anterior had 3-hole. Groups G4, G8 and G12, those fixed with two plates 2.0 mm with 4-hole. Each system was subjected to the test of resistance with load application superior-inferior on testing machine EMIC model DL2000. In G1, G2, G3 and G4 the implementation of load was the first molar side fracture simulated (MF). In G5, G6, G7 and G8 were in the first molar contralateral to the simulated fracture (MC). In G9, G10, G11 and G12 was between the central incisors (I). Load values were measured for displacement from 1 mm, 2 mm and 5 mm. Results obtained in the test of resistance were compared using analysis of variance (ANOVA), followed by Tukey test with a significance level off 5%. There was minor loads value in the group treated with a plate of 4-hole system 2.0 mm, in displacements of 1 and 2 mm, with application in MF. Can conclude that the use of the fixation system with two plates provide greater resistance
Mestrado
Cirurgia e Traumatologia Buco-Maxilo-Faciais
Mestre em Clínica Odontológica
Books on the topic "Bone plates and screws"
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Harvey, JP, and RF Games, eds. Clinical and Laboratory Performance of Bone Plates. 100 Barr Harbor Drive, PO Box C700, West Conshohocken, PA 19428-2959: ASTM International, 1994. http://dx.doi.org/10.1520/stp1217-eb.
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(Matthias), Rapp M., and SpringerLink (Online service), eds. The Double Dynamic Martin Screw (DMS): Adjustable Implant System for Proximal and Distal Femur Fractures. Heidelberg: Steinkopff, 2008.
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Oh, Sooyoung. Autologous bone plugs fusion: Treatment for lumbar instability : 3E criteria, technical operative notes, the functioning of the Oh's screw. Basel: Karger, 2009.
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Oh, Sooyoung. Autologous bone plugs fusion: Treatment for lumbar instability : 3E criteria, technical operative notes, the functioning of the Oh's screw. Basel: Karger, 2009.
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1922-, Harvey J. Paul, and Games Robert F, eds. Clinical and laboratory performance of bone plates. Philadelphia, PA: ASTM, 1994.
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Harle, Franz. Atlas Of Craniomaxillofacial Osteosynthesis: Miniplates, Microplates, and Screws. THIEME, 1999.
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Harle, Franz. Atlas of Craniomaxillofacial Osteosynthesis: Microplates, Miniplates, and Screws. Georg Thieme Verlag, 1999.
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Atlas of craniomaxillofacial osteosynthesis: Microplates, miniplates, and screws. 2nd ed. Stuttgart: Thieme, 2009.
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Parker, Philip M. The 2007-2012 World Outlook for Medical and Surgical Bone Nails, Plates, and Screws and Other Internal Fixation Devices. ICON Group International, Inc., 2006.
Find full textBook chapters on the topic "Bone plates and screws"
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Liporace, Frank A., and Nirmal Tejwani. "Intertrochanteric Femur Fractures: Plates and Screws." In Proximal Femur Fractures, 77–84. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-64904-7_7.
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Schatzker, J. "Screws and Plates and Their Application." In Manual of INTERNAL FIXATION, 179–290. Berlin, Heidelberg: Springer Berlin Heidelberg, 1992. http://dx.doi.org/10.1007/978-3-642-77380-8_3.
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Schatzker, J. "Screws and Plates and Their Application." In Manual of INTERNAL FIXATION, 179–290. Berlin, Heidelberg: Springer Berlin Heidelberg, 1991. http://dx.doi.org/10.1007/978-3-662-02695-3_3.
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Ernberg, Jens J., and Stanley E. Asnis. "Materials and Manufacturing of Orthopaedic Bone Screws." In Cannulated Screw Fixation, 1–14. New York, NY: Springer New York, 1996. http://dx.doi.org/10.1007/978-1-4612-2326-9_1.
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Disegi, J. A., B. Shultzabarger, and Michael Roach. "Torsional Properties of Nanostructured Titanium Cortical Bone Screws." In Ceramic Transactions Series, 55–61. Hoboken, NJ, USA: John Wiley & Sons, Inc., 2015. http://dx.doi.org/10.1002/9781119190134.ch6.
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Yuan, Qiang, Nan Li, Jie Yu, and Wei Tian. "Cortical Bone Trajectory for Lumbar Pedicle Screws Placement." In Navigation Assisted Robotics in Spine and Trauma Surgery, 129–39. Singapore: Springer Singapore, 2020. http://dx.doi.org/10.1007/978-981-15-1846-1_16.
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Eschbach, Lukas, Andreas Marti, and Beat Gasser. "Fretting Corrosion Testing of Internal Fixation Plates and Screws." In Materials for Medical Engineering, 199–204. Weinheim, FRG: Wiley-VCH Verlag GmbH & Co. KGaA, 2005. http://dx.doi.org/10.1002/3527606149.ch27.
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Evans, M., S. H. White, and J. L. Cunningham. "Improvement in the Design of Bone Screws for External Fixation." In Interfaces in Medicine and Mechanics—2, 249–56. Dordrecht: Springer Netherlands, 1991. http://dx.doi.org/10.1007/978-94-011-3852-9_25.
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Yadav, Abhilasha. "Principles of Internal Fixation in Maxillofacial Surgery." In Oral and Maxillofacial Surgery for the Clinician, 1039–51. Singapore: Springer Singapore, 2021. http://dx.doi.org/10.1007/978-981-15-1346-6_51.
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AbstractSince past many years management of facial trauma has evolved greatly. To provide stable fixation various plating system have been developed. To reconstruct the chin and mandibles, craniofacial skeleton surgery and midface fractures, the maxillofacial plating system is designed. There are various forms of plates and screws for fixation of maxilla, mandible and midface including fractures of orbit and zygoma. They also involve plates for mandibular reconstruction after tumor resection. Different sizes and shapes of plates are available as per the needs.
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Matsukawa, Keitaro. "New Techniques and MIS: The Cortical Bone Trajectory Screws—Indications and Limits." In Modern Thoraco-Lumbar Implants for Spinal Fusion, 113–26. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-60143-4_10.
Full textConference papers on the topic "Bone plates and screws"
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Hussain, M., R. N. Natarajan, G. S. Deol, G. B. J. Andersson, and H. A. An. "Stability of Corpectomy With Anterior Cervical Plating Depends on the Angular Placement of the Screws: An FE Model Study." In ASME 2004 International Mechanical Engineering Congress and Exposition. ASMEDC, 2004. http://dx.doi.org/10.1115/imece2004-59410.
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The stability of the plate-screw constructs as well as the stresses and strains in the implant and bone graft depend on many factors including the angular positioning of the screws with respect to the end plate attached to the vertebra. It is hypothesized that the placement of the screw parallel to the endplates provide greater stability and reduced stresses in the implant and bone graft as compared to constructs in which the screws are placed oblique with respect to the end plates.
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Hildebrand, Lucas, D. Gordon Allan, and Manish Paliwal. "PMMA in Bone Allograft Fixation Utilizing Unicortical Versus Bicortical Screws: A Finite Element Analysis." In ASME 2015 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2015. http://dx.doi.org/10.1115/imece2015-51836.
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Bone grafts are widely used in skeletal reconstruction subsequent to tumor surgery, traumatic injuries, or in conjunction with a total joint procedure. As the graft site may be subjected to destabilizing mechanical forces, any motion at the interface between graft and the host tissue may impede or prevent healing. The application and the maintenance of the compression between screw threads and the bone is the most important factor in attaining rigid internal fixation by means of screws or screws & plates. This study is designed to assess various allograft fixation options with the intent of finding an option that is secure yet does minimal damage to the allograft. Utilizing computational modeling and analysis (SolidWorks), we compared the bending stiffness for diaphyseal bone constructs with a gap and stabilized with a dynamic compression plate, with screws placed in a unicortical or bicortical manner, with and without intramedullary PMMA. The model was validated by comparing the simulation results with the experimental results from literature for two unicortical screws application with PMMA in bending test. The study was then exteneded by looking at the stress distribution across the plates with the use of bicortical and unicortical screws with and without PMMA. For unicortical screws the use of PMMA reduces the displacement by 4:65% and reduces the stress by 5:69%. For bicortical screws, the use of PMMA reduces the displacement by 1:78% and reduces the stress by 9:45%. The bicortical screws with PMMA has a displacement which is 0:74% smaller but a stress which is 0:73% higher when compared to the unicortical screws with PMMA. From the results of total displacement and maximum stress on the plate, conclusion can be drawn that the two best arrangements are the use of unicortical screws with PMMA and bicortical screws with PMMA, thus allowing the use of fewer screws.
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Dharia, Mehul A., Micah A. Forstein, Rick C. Compton, and Danny L. Levine. "Screw/Plate Stability in Universal Locking Plate: A Novel Internal Fixator." In ASME 2007 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2007. http://dx.doi.org/10.1115/sbc2007-176232.
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The recent trend in internal fixation of fractures puts a greater emphasis on biological fixation, which involves the use of locking plates and screws [1]. While conventional plates rely on frictional forces between the plate and the bone, locking plates utilize a threaded connection between screw and plate for fixation and stability [2]. Surgeons choose either type of fixation device in treatments for specific fractures and injuries.
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Chung, Chen-Yuan, Jiing-Yih Lai, He-Kai Young, and Han-Yuan Gao. "Pre-Surgical Planning of Screw-Position Arrangement for the Femur Fractures With a Custom APP." In ASME 2018 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2018. http://dx.doi.org/10.1115/imece2018-86013.
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Several types of implants, plates, and screws have been developed for corresponding bone fractures at different sites. To understand the mechanical behavior of a bone plate and to provide surgeons with suggestions for selecting screw positions, this study aimed to create an APP to provide pre-surgical planning using a computed tomography (CT)-based finite element model. This model was validated using a compression test of synthetic sawbones. Furthermore, the specific APP was established using the COMSOL application builder to calculate the stress and strain of the implant under different screw positions. This APP reveals how the number and location of screws affect the stress distribution of the implant. It can provide clinicians with preliminary reference information before surgery.
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Christakis, Alexander, John Dieselman, Jonathan Ahn, Andrew Sandefer, Charles Psoinos, Ronald Ignotz, Janice Lalikos, Raymond Dunn, and Kristen Billiar. "Comparison of Cortical and Cancellous Screws for Sternal Fixation." In ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-206368.
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The goal of this study is to compare the performance of currently available screw types and configurations for rigid sternal fixation. Bone fixation plates were attached to osteoporotic human sternum with cortical or cancellous screws in either a unicortical or bicortical manner. The plates were cyclically loaded transversely (0–50N at 2Hz) for 15,000 cycles; the resulting lateral screw displacement was measured continuously. Bicortical attachment allowed significantly lower initial displacement than unicortical (p = 0.015), whereas cortical screws allowed significantly lower displacement than cancellous screws after long term cycling (p = 0.039). These initial findings indicate that both screw type and cortical purchase are important parameters in the design of a rigid plating system for sternal closure. Cortical screws appear to be more applicable to the osteoporotic sternum, as the cortical shell regions support more screw purchase than the degenerated cancellous part, and bicortical screw purchase appears to decrease screw loosening.
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Ponnusamy, Karthik, Sravisht Iyer, Alex Hui, Gaurav Gupta, Kartik Trehan, Christopher Yu, and A. Jay Khanna. "A Pull-Out Resistant Pedicle Screw for the Osteoporotic Spine." In ASME 2007 2nd Frontiers in Biomedical Devices Conference. ASMEDC, 2007. http://dx.doi.org/10.1115/biomed2007-38050.
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Pedicle screws are commonly used in spine surgery to implant and affix metal devices to the spine. These screws are most commonly associated with cases that require rod or plate implantation. Use of pedicle screws in osteoporotic patients, however, is limited because they suffer from low bone mass density (BMD). The low BMD is harmful to patients in two ways — it leads to increased incidence of spinal trauma and also prevents surgeons from instrumenting osteoporotic patients because screws do not achieve the required fixation in osteoporotic patients [1]. The risk of trauma is increased due to the brittle bone and vertebral compression fractures, resulting in spinal misalignment and increased risk of future trauma. Instrumenting these cases with rods or plates, however, is impossible because osteoporotic bone is not strong enough to “hold” pedicle screws in, i.e., prevent screws from pulling out [2, 3].
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James, Thomas P., Benjamin J. Dobson, and Anil Saigal. "Novel Technique for Measurement of Screw Bending in Bone Fixation Constructs." In ASME 2010 International Mechanical Engineering Congress and Exposition. ASMEDC, 2010. http://dx.doi.org/10.1115/imece2010-38779.
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The focus of the present research was to develop a reliable test method and apparatus to measure bending deflection of individual surgical screws during quasi-static loading of a plate construct. It was preferable to measure screw deflection in a non-invasive manner, thus promoting clinical relevance. Significant research has been conducted in the area of axial pullout strength and failure of screws due to torsion, but little exists related to bending deflection of surgical screws and the resultant bending stress. Current test methods to predict screw failure typically require cyclical loading of plate constructs to failure. This is both costly and time consuming. The desire to develop a new method for screw deflection measurement was instigated from observed screw failures postoperative open wedge high tibial osteotomy. Screw failures have been observed prior to healing of the open wedge, resulting in partial collapse and recurring misalignment. It was hypothesized that these failures were due to high bending loads. Engineers continue to design new plate and screw systems to strengthen the tibial plate construct. Most relevant design parameters include materials, plate geometry, number and alignment of screws, and most recently various retention methods of screw heads against the plate. With such a proliferation of designs, there exists a need to develop experimental methods for measurement of screw deflections as a precursor to ultimate cyclic failure. An open wedge, medial, high tibial osteotomy was performed on a composite replica tibia. A servo hydraulic machine was used to cyclically load the tibia in compression, while a Puddu plate construct supported the open wedge osteotomy. Deflection of individual screws was determined by means of laser projection and dial indicators affixed to exposed screw heads and reference points on the bone. During the period of elastic deformation, screw deflection measurements confirmed that each screw in the plate carried a different load. The laser projection method allows engineers to test newly designed plate constructs under relatively few cycles to determine the bending load carried by each screw. This non-invasive method of measuring screw deflection was repeatable with minimal error.
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Lee, JuEun, O. Burak Ozdoganlar, and Yoed Rabin. "Analysis of Heat Transfer in Bone Drilling." In ASME 2011 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2011. http://dx.doi.org/10.1115/sbc2011-53331.
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Bone drilling is widely used to mount screws for anchoring plates and attaching exoskeleton devices to assist healing of bone fractures. The heat generated during drilling can cause significant thermal damage to the bone tissue. Hence, prediction of the developing temperature field as a function of the drilling parameters is of an important clinical value.
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Shepherd, Duncan E. T., and Alan J. Johnstone. "How Extreme Locking of Intramedullary Nails Affects the Overall Biomechanics of Intramedullary Nail Systems." In ASME 7th Biennial Conference on Engineering Systems Design and Analysis. ASMEDC, 2004. http://dx.doi.org/10.1115/esda2004-58162.
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Intramedullary nails are tube-like implantable medical devices that are commonly used to treat long bone fractures. Interlocking screws, that pass from one side of the bone to the other, through holes at either end of the nail, provide additional stability. Newer designs of intramedullary nails have screws placed more extremely. The aim of this study was to use mechanics to analytically investigate how extreme locking of intramedullary nails affects the overall biomechanics of intramedullary nail systems. The nail was modelled as a tube of various sizes. The deflection of the nail from axial compression, bending and torsion was determined as the working length of the nail was varied. The screw was modelled as a simple beam, built-in at both ends. The deflection of the screw was determined as the medullary width was varied. Placing interlocking screws more extremely in intramedullary nails increases the working length of the nail and leads to the use of longer screws, since at the bone extremities, the width of the medullary cavity increases. An increased working length leads to increased rotation of the nail. The use of longer screws leads to increased deflection of the screw and an increased bending moment that has to be resisted by the bone cortex. Extreme locking of intramedullary nails changes the biomechanics of the nail system, and may well have clinical implications in terms of fracture healing.
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Amerinatanzi, Amirhesam, Narges Shayesteh Moghaddam, Ahmadreza Jahadakbar, David Dean, and Mohammad Elahinia. "On the Effect of Screw Preload on the Stress Distribution of Mandibles During Segmental Defect Treatment Using an Additively Manufactured Hardware." In ASME 2016 11th International Manufacturing Science and Engineering Conference. American Society of Mechanical Engineers, 2016. http://dx.doi.org/10.1115/msec2016-8840.
Full textAbstract:
The most common method for mandibular reconstructive surgery is the use of a Ti-6Al-4V fixation device and a fibular double barrel graft. This highly stiff fixation hardware (E = 112 GPa) often shields the bone graft (E = 20 GPa) from carrying the load, which may result in bone resorption. Highly stiff Ti-6Al-4V fixation hardware is also likely to concentrate stress in the fixation plate or at screw threads, possibly leading to hardware cracking or screw pull-out. As a solution for that, we have proposed and studied the effect of using a low stiffness, porous NiTi fixation device [1–4]. Although the stress in the fixation device is increased, using such low stiffness fixation hardware, is preferable to have an even higher stress on the graft in order to minimize the risk of resorption or hardware failure. We assume that preloading screws allows them to better engage the fixation hardware with the plate and the surrounding bone and causes an increased von Mises stress. The fixation device can be patient-specific and additively manufactured, such that the shape would match the outer surface of the cortical bone. In this study, we modeled a healthy cadaver mandible via CT-derived 3D surface data. The mandible was virtually resected in the molar region (M1−3). The model simulated the result of reconstructive surgery under the highest chewing loading regime (i.e., 526 N on first right molar tooth [5, 6]) where reconstruction was done with either Ti-6Al-4V fixation hardware or patient specific, stiffness-matched, porous NiTi fixation hardware. The calibration of the material properties for this simulation was done using experimentally obtained data (DSC and compression tests) of Ni-rich NiTi bulk samples. The analyzed term in the finite element analysis was stress distribution in the cortical and cancellous bone. Porous NiTi fixation devices were also produced using Selective Laser Melting (SLM) using the geometry of the aforementioned cadaver mandible. In this paper we have studied the effect of additional torque or preload on the performance of the fixation plates. The finite element analysis demonstrated that applying a preload to the screws increased the stress on the bone. Under similar levels of applied preload, the porous NiTi fixation device showed an increased level of von Mises stress in the bone, particularly in the graft. Additionally, the analysis indicated the higher level of stress on the bone surrounding the screws for the case of using NiTi, which could contribute to increasing screw stability. The fabricated patient-specific fixation hardware not only matched the shape of cortical bone but also contained the level of porosity that defines the appropriate modulus of elasticity.