Academic literature on the topic 'Orthopedic fixation devices'

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Journal articles on the topic "Orthopedic fixation devices"

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Slone, R. M., M. M. Heare, R. A. Vander Griend, and W. J. Montgomery. "Orthopedic fixation devices." RadioGraphics 11, no. 5 (September 1991): 823–47. http://dx.doi.org/10.1148/radiographics.11.5.1947319.

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Richardson, M. L., R. F. Kilcoyne, K. A. Mayo, J. G. Lamont, and W. Hastrup. "Radiographic evaluation of modern orthopedic fixation devices." RadioGraphics 7, no. 4 (July 1987): 685–701. http://dx.doi.org/10.1148/radiographics.7.4.3329363.

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Filip, Nina, Iulian Radu, Bogdan Veliceasa, Cristiana Filip, Mihaela Pertea, Andreea Clim, Alin Constantin Pinzariu, Ilie Cristian Drochioi, Remus Lucian Hilitanu, and Ionela Lacramioara Serban. "Biomaterials in Orthopedic Devices: Current Issues and Future Perspectives." Coatings 12, no. 10 (October 14, 2022): 1544. http://dx.doi.org/10.3390/coatings12101544.

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In orthopedics, bone fixation imposes the use of implants in almost all cases. Over time, the materials used for the implant have evolved from inert materials to those that mimic the morphology of the bone. Therefore, bioabsorbable, biocompatible, and bioactive materials have emerged. Our study aimed to review the main types of implant materials used in orthopedics and present their advantages and drawbacks. We have searched for the pros and cons of the various types of material in the literature from over the last twenty years. The studied data show that consecrated metal alloys, still widely used, can be successfully replaced by new types of polymers. The data from the literature show that, by manipulating their composition, the polymeric compounds can simulate the structure of the different layers of human bone, while preserving its mechanical characteristics. In addition, manipulation of the polymer composition can provide the initiation of desired cellular responses. Among the implanting materials, polyurethane is distinguished as the most versatile polymeric material for use both as orthopedic implants and as material for biomechanical testing of various bone reduction and fixation techniques.
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Yan, Lamei, Meiling Zhang, Mihang Wang, Yuhui Guo, Xiangquan Zhang, Junhua Xi, Youwei Yuan, and Alireza Mirzasadeghi. "Bioresorbable Mg-Based Metastable Nano-Alloys for Orthopedic Fixation Devices." Journal of Nanoscience and Nanotechnology 20, no. 3 (March 1, 2020): 1504–10. http://dx.doi.org/10.1166/jnn.2020.17350.

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This research has been accomplished using the advanced selective laser melting (SLM) technique as well as HIP post-treatment in order to improve mechanical properties and biocompatibility of Mg– Ca–Sr alloy. Through this research it becomes clearly noticeable that the Mg–1.5Ca–xSr (x = 0.6, 2.1, 2.5) alloys with Sr exhibited better mechanical properties and corrosion potentials. This is more particular with the Mg–1.5Ca–2.5Sr alloy after HIP post-treatment allowing it to provide a desired combination of degradation and mechanical behavior for orthopedic fracture fixation during a desired treatment period. In vivo trials, there was a clear indication and exhibition that this Mg–1.5Ca–2.5Sr alloy screw can completely dissolve in miniature pig’s body which leads to an acceleration in growth of bone tissues. Mg–Ca–Sr alloy proved potential candidate for use in orthopedic fixation devices through Our results concluded that Mg–Ca–Sr alloy are potential candidate for use in orthopedic fixation devices through mechanical strength and biocompatibility evaluations (in vitro or In vivo).
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Stevenson, M. E., M. E. Barkey, and R. C. Bradt. "Fatigue failures of austenitic stainless steel orthopedic fixation devices." Practical Failure Analysis 2, no. 3 (June 2002): 57–64. http://dx.doi.org/10.1007/bf02719191.

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Vilensky, Viktor Aleksandrovich, Aleksander Pavlovich Pozdeev, Edgar Valentinovich Bukharev, Andrey Aleksandrovich Pozdeev, Timur Faizovich Zubairov, and Leonid Nikolaevich Solomin. "Orthopedic hexapods: history, present and prospects." Pediatric Traumatology, Orthopaedics and Reconstructive Surgery 3, no. 1 (March 15, 2015): 61–69. http://dx.doi.org/10.17816/ptors3161-69.

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The article is dedicated to computer-assisted external fixation devices, so-called hexapods. The main advantage of these frames is capability to make mathematically precise correction of bone fragments in three planes and six degrees of freedom on the base of calculations made in special software application. Recently these devices are mostly applied in long bone deformity correction but the sphere of its effective useis not limited by only this direction. The article presents the history of investigation of these devices, their development, implemented comparative analysis of the basic hexapods: TSF (Taylor Spatial Frame), IHA (Ilizarov Hexapod Apparatus) and Ortho-SUV Frame.
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Bartolomei, Jonathan, Shanthan C. Challa, Kenneth J. Hunt, and Daniel K. Moon. "Current Practices in the Treatment of Syndesmotic Injuries: A Global Perspective." Foot & Ankle Orthopaedics 5, no. 4 (October 1, 2020): 2473011420S0011. http://dx.doi.org/10.1177/2473011420s00113.

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Category: Ankle; Sports Introduction/Purpose: There exists little consensus regarding optimal treatment protocols for syndesmotic injuries. Orthopedic clinicians have implemented a variety of treatment strategies, ranging from immobilization to screw fixation to new flexible fixation devices. While the body of literature is growing with regard to both the biomechanics and clinical outcomes for various constructs and rehabilitation protocols, there is little consensus on the optimal treatment and return to sport strategy for these injuries. We endeavored to assess current approaches to syndesmotic injuries by orthopedic foot and ankle specialists around the world in six athlete scenarios with increasing degrees of injury. Commensurate with the lack of available data to guide treatments, we hypothesize that there will be great variability in the treatment and management of syndesmotic injuries. Methods: A REDcap survey was created with 27 questions, including respondent demographics, indications for treatment of syndesmotic injuries, preferred treatment, preferred technique for repairing the syndesmosis, and post-operative management. Respondents were asked to choose their preferred fixation device and post-operative return to play protocols in six different athlete scenarios (moderate impact, high impact, and very high impact and each with/without complete deltoid injury). The survey was disseminated among the memberships of 18 North American and International medical societies. Society members were surveyed via three emails distributed two weeks apart. Frequencies and percentages were calculated for all categorical responses. Results: A total of 596 providers responded to the survey, including 337 American surgeons and 259 members of various international societies. There was a 70% survey completion rate with a wide geographic distribution among respondents. Flexible devices were the preferred fixation construct (48%), followed by screws (27%), hybrid fixation (19%) and other (6%). There was a higher preference for flexible devices among sports medicine trained providers (58%) relative to non-sports medicine trained providers (44%). 62% of respondents noted that their rehabilitation protocols would not change for each athlete scenario. Considerable variability was present in anticipated full return to sport, ranging from immediately following injury to six months post-op. 33% stated that they would repair the deltoid ‘greater than 50%’ of the time if injured. Conclusion: There is a wide variety of indications and treatment constructs employed by orthopedic surgeons for athletes with ligamentous syndesmotic injuries requiring fixation. Although flexible fixation devices are the preferred choice among all respondents, there was considerable variability in device choices. Fellowship training also appears to affect the preferred fixation method. There was no overall difference between device preference between North American and International respondents (Fig1). There also exists substantial variability in expected return to play for every athlete scenario. The diversity in approaches and post-operative recommendations underscores the need for evidence-based guidelines regarding the management of syndesmotic injuries.
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Boydstun, Seth, Lisa Nash, and Ghazi M. Rayan. "Distal Radius Fracture Fixation Devices and Their Radiographs." Journal of Hand Surgery (Asian-Pacific Volume) 24, no. 04 (November 5, 2019): 412–20. http://dx.doi.org/10.1142/s2424835519500528.

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Background: Distal radius fractures are among the most common fractures encountered in orthopedic practices. If treated operatively, most implants are retained after the fracture heals unless there is hardware failure, limitation of wrist motion, pain, infection, tendon rupture, or tenosynovitis. Complications have been reported during hardware removal, including not knowing the exact implant prior to its removal. If a patient presents for plate removal to a surgeon who did not perform the initial fracture fixation, having a preoperative visual aid can help the treating surgeon choose the right instruments for their removal. Methods: To identify many of the available distal radius fixation devices, we searched the Internet and contacted local industry representatives. We also approached industry personnel at the commercial exhibit of a national hand society meeting to provide us with implants they manufacture. The implants were placed on the volar and dorsal aspects of sawbone models of the distal radius and in one case the radial styloid, using the screws, screwdrivers and accessories in the standard implant set and then posteroanterior and lateral x-rays of the implants were obtained. We created an atlas and a list of the screwdriver(s) used for each. Results: We obtained radiographs and photographs for 28 implants that were manufactured by 14 different companies. Two companies sent us radiographs and photographs placed on either a sawbone or cadaveric model. We found that 7 of the implants were outliers and could be identified easily on the x-rays, whereas 21 implants had similar design of shaft and distal components. Conclusions: To aid the orthopedic surgeon in their removal, we compiled a comprehensive list of most distal radius fixation devices on the market including plates and their corresponding screws and screwdrivers. The goal was to help the surgeon when removing the plate to identify the implant on radiographs.
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Zahaf, Samir, and Said Kebdani. "Study and Analysis of Mechanical Behavior between Rigid and Dynamic Fixation Systems Analyzed by the Finite Element Method." Journal of Biomimetics, Biomaterials and Biomedical Engineering 33 (July 2017): 12–31. http://dx.doi.org/10.4028/www.scientific.net/jbbbe.33.12.

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Orthopedic fixation devices are widely used in treatment of spinal diseases. It is expected that application of dynamic stabilization confers valuable movement possibility besides its main role of load bearing. Comparative investigation between pedicle screw model rigid fixation and (B Dyne, Elaspine, Bioflex, Coflexe rivet) models dynamic fixation systems may elucidate the efficacy of each design. The goal of the present study is to evaluate the efficacy of five fixation systems mounted on L4-L5 motion segment. In this numerical study, a 3D precious model of L4, L5 and their intervertebral disc has been employed based on CT images. five fixation devices have been also implanted internally to the motion segment. Finite element method was used to evaluate stress distribution in the disc and determine the overall displacement of the segment as a measure of movement possibility. The results show that The Coflex rivet implantation can provide stability in all motions and reduce disc annulus stress at the surgical segment (L4-L5), on the other hand, Maximum stress in the disc has been observed in dynamic systems but within the safe range. The greater movement of the motion segment has been also appeared in dynamic fixations. Existence of the fixation systems reduced the stress on the intervertebral disc which might be exerted in intact cases. Use of the fixation devices can considerably reduce the load on the discs and prepare conditions for healing of the injured ones. Furthermore, dynamic modes of fixation confer possibility of movement to the motion segments in order to facilitate the spinal activities.
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Honda Saito, Guilherme, Marcelo Pires Prado, Alberto Abussamra Moreira Mendes, Danilo Ryuko Nishikawa, Beatriz Devito, and Leticia Devito. "PO 18198 - Treatment of distal tibiofibular syndesmosis injury in ankle fractures with suture button." Scientific Journal of the Foot & Ankle 13, Supl 1 (November 11, 2019): 43S. http://dx.doi.org/10.30795/scijfootankle.2019.v13.1031.

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Introduction: Distal tibiofibular syndesmosis (DTFS) injuries in ankle fractures are conventionally treated by DTFS fixation with stabilizing screws. However, screws may cause problems due to their inherent rigidity. Therefore, the popularity of fixation devices that allow DTFS mobility has increased. The objective of the present study is to describe the outcomes of the surgical treatment of ankle fractures with DTFS injury using suture button syndesmosis fixation. Methods: Forty-four patients surgically treated with a suture button for ankle fractures associated with DTFS injury were retrospectively analyzed. The mean follow-up time was 14.7 months. Patient functioning was assessed using the American Orthopedic Foot and Ankle Society (AOFAS) score, the visual analog scale (VAS), the rate of complications and the need for reoperation. Results: The mean AOFAS score at the last follow-up visit was 92 (35-100). The mean VAS was 0.8 (0-7). Eight patients (18%) developed complications, the most common of which were posttraumatic osteoarthrosis and peroneal tendinopathy. Reoperations were performed in 6 patients (13.5%) and included orthopedic hardware removal, peroneal tenoplasty, neurolysis or distal tibiofibular arthrodesis. Only one patient was unable to resume previous activities. Conclusion: Suture button is a reliable alternative for DTFS fixation in ankle fractures, providing excellent functional outcomes with a low rate of complications. This device has the theoretical advantage of allowing physiological mobility of the distal tibiofibular joint and generally requires no subsequent orthopedic hardware removal.
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Dissertations / Theses on the topic "Orthopedic fixation devices"

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Devlin, Sean M. "Improving Degradable Biomaterials for Orthopedic Fixation Devices." Diss., Temple University Libraries, 2016. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/394989.

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Bioengineering
Ph.D.
Current degradable orthopedic fixation devices do not typically facilitate tissue integration during healing. Proposed here is a novel combination of processing methods to enhance the tissue integration capability of degradable thermoplastics used in temporary orthopedic fixation devices. The provision of open pores in devices used to affix reconstructed hard tissues would allow for local cells to infiltrate during the healing process. Any openly porous structure is inherently weakened in comparison to its monolithic peers (i.e. decreased relative bulk modulus), such that the matrix materials must be made more resilient in keep the device from becoming friable. These processing methods aim to improve degradable surgical fixation devices at multiple levels of design: both through the inclusion of porous morphology, processing changes, and additives to regain mechanical integrity. Biomimetic pores are added for cellular infiltration by dissolving a porogen’s interpenetrating polymer network. The addition of open pores significantly reduces the bulk stiffness. More uniform phase separation has led to better pores, but the objects still need more resilience. Carbon nanomaterials are used to improve on the mechanics and surface chemistry of the polymer matrix material, composites of polylactide/nanodiamond are produced through cryogenic milling and solid state polycondensation. The addition of minute amounts of functionalized nanodiamond has remedied the brittle failure of the material, by cryogenic milling and solid state polycondensation of poly((D,L)lactide-co-glycolide) and hydroxyl functionalized detonation nanodiamonds. This composite has also demonstrated increased cytocompatability with 7F2 osteoblasts, as analyzed by cellular adhesion through fluorescence microscopy and alamar blue assay.
Temple University--Theses
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Gianforcaro, Anthony L. "Improvement Of Biodegradable Biomaterials For Use In Orthopedic Fixation Devices." Master's thesis, Temple University Libraries, 2019. http://cdm16002.contentdm.oclc.org/cdm/ref/collection/p245801coll10/id/599834.

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Bioengineering
M.S.
Current orthopedic internal fixation devices, such as pins and screws, are typically made from metals and have a long list of complications associated with them. Most notably, complications such as infection or decreased wound healing arise from revisional surgeries needed to remove the used hardware. A new class of fixation devices is being produced from biodegradable biomaterials to eliminate the need for revisional surgery by being naturally broken down in the body. While currently available polymers lack the necessary mechanical properties to match bone strength, the incorporation of small amounts of hydroxylated nanodiamonds has been proven to increase the mechanical properties of the native polymer to better resemble native bone. Additionally, modern polymers used in biodegradable fixation devices have degradation rates that are too slow to match the growth of new bone. Poly-(D, L)-lactic-co-glycolic acid (PDLG) incorporated with hydroxylated nanodiamonds has not only been proven to start out stronger, but then also helps the polymer degrade faster when compared to the pure polymer in vivo and prevents effusion of the polymer into the surrounding environment. Nanodiamond incorporation is accomplished via solid state polycondensation of PDLG to create a uniform material with increased mechanical properties, faster degradation rates, and enhanced calcification when tested in simulated body fluid.
Temple University--Theses
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Röhrl, Stephan Maximilian. "Wear and fixation of the acetabular component : In vivo evaluation of different polyethylenes and modes of fixation in total hip arthroplasty /." Umeå : Univ, 2004. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-230.

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Ciocanel, Despina E. "Atlantoaxial instability : biomechanical evaluation of T-Plate versus transarticular screw fixation." Connect to full-text via OhioLINK ETD Center, 2005. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=mco1116798081.

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Thesis (M.S.)--Medical College of Ohio, 2005.
"In partial fulfillment of the requirements for the degree of Master of Science in Biomedical Sciences." Major advisor: Nabil Ebraheim. Includes abstract. Document formatted into pages: iii, 57 p. Title from title page of PDF document. Bibliography: pages 35-42,49-56.
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Sawaia, Rogerio Naim 1970. "Estudo das complicações no tratamento das fraturas transtrocanterianas do fêmur utilizando pino deslizante extramedular com técnica minimamente invasiva, Sistema Minus." [s.n.], 2011. http://repositorio.unicamp.br/jspui/handle/REPOSIP/309913.

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Orientador: William Dias Belangero
Tese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciências Médicas
Made available in DSpace on 2018-08-19T13:05:04Z (GMT). No. of bitstreams: 1 Sawaia_RogerioNaim_D.pdf: 9806060 bytes, checksum: d75ddfca6472ebb85dbfad46a0daa1a4 (MD5) Previous issue date: 2011
Resumo: INTRODUÇÃO: O tratamento cirúrgico das fraturas intertrocanterianas do fêmur ainda é motivo de estudo e controvérsias. As vantagens da utilização de técnicas minimamente invasivas para essas fraturas já despontam na literatura. O objetivo deste estudo foi avaliar as complicações da técnica minimamente invasiva que utiliza um implante e um instrumental desenvolvidos especificamente (Sistema Minus) para o tratamento dessas fraturas. CASUÍSTICA E MÉTODO: Foram estudados 172 pacientes com fratura intertrocanteriana do fêmur, tratados com o Sistema Minus, dos quais 52 pacientes foram excluídos do estudo por não terem preenchido os critérios de inclusão. No protocolo inicial foram registrados o gênero, a idade, detalhes operatórios como tempo cirúrgico, tempo de uso da fluoroscopia, qualidade da redução e da fixação da fratura. Como parâmetros clínicos foram incluídos a capacidade de marcha, dor, classificação da fratura segundo os critérios de Tronzo e o risco anestésico segundo a classificação de ASA. Dividimos as complicações em dois grupos. As complicações gerais, subdivididas em infecção e mortalidade e as complicações específicas, subdivididas em migração do implante, a perda da redução e a falta de união. Embora a migração do pino deslizante não seja considerada na literatura como uma complicação do DHS (Hrubna e Skotak, 2010)1, no presente estudo ela foi incluída. Cabendo salientar que foi considerada como migração, a impacção lateral da fratura sem a ocorrência de perda de redução. RESULTADOS: O gênero feminino ocorreu em 93 casos e obteve percentual de 77,5%, foi prevalente em relação ao masculino com 27 casos e 22,5%. A idade variou de 52 a 95 anos, com a média de 80,06 anos e desvio padrão de 7,87 anos. A média de idade do gênero masculino foi de 76,19 anos e desvio padrão de 8,321. O gênero feminino obteve a média de 81,18 anos com desvio padrão de 7,407. O tempo cirúrgico médio foi de 39,35 minutos, variando de 25 a 65 minutos. O tempo médio de radioscopia foi 1min7s, variando de 0,6 a 2 minutos e 3s. A redução foi considerada adequada em 92 casos (76,6%), quando obteve-se o alinhamento do eixo de carga, como valgo em 20 casos (16,6%) e como varo em oito casos (6,6%). O somatório médio do TAD (Tip Apex Distance) na incidência Ântero-posterior (AP) foi de 1,19cm, variando de 0,2 a 2,8cm; e no Perfil (P), de 1,14cm, variando de 0,3 a 2,52cm. Dos pacientes, 112 (93,3%) voltaram a andar e a dor pós-operatória em uma escala de 0 a 10, teve a média de 4,44. Dos 120 pacientes, 11 foram classificados como Tronzo I (9,1%), 24 como Tronzo II (20%), 58 como Tronzo III (48,3%), sete Tronzo III variante (5,8%) e 20 Tronzo IV (16,7%). As fraturas instáveis ocorreram em 85 (70,8%) pacientes, os quais 74 (61,6%) tinham idade superior a 75 anos. Já as fraturas estáveis em 35 (29,1%) pacientes, os quais 17 (14,1%) possuíam idade superior a 75 anos. Em relação ao risco anestésico, oito (6,6%) foram classificados como ASA I, 33 (27,5%) ASA II, 74 (61,6%) ASA III e cinco ASA IV (4,16%). Houve um caso de infecção (0,83%). Ocorreram 13 óbitos (10,8%) dentro do primeiro ano de pós-operatório. Desses, um (0,83%) foi classificado como Asa II, cinco (4,16%) como Asa III e sete (5,83%) Asa IV. Dos 85 pacientes com fraturas instáveis, 36 (30%) apresentaram complicações, como perda de redução em 7(5,88%) e migração do pino deslizante em 29 (24,1%). No grupo das 35 fraturas estáveis, as complicações ocorreram em 4 casos (3,33 %), sendo que a perda de redução ocorreu em um caso (0,83%) e a migração em 3 casos (2,5%). No total, a migração ocorreu em 33 casos (27,6%), sendo que desses, todos evoluíram para consolidação. A perda de redução ocorreu em oito (6,7%) e a falta de união, em um caso (0,83%). CONCLUSÃO: Concluímos que a técnica minimamente invasiva, Sistema Minus, é uma técnica segura, que permite a realização da cirurgia com baixa incidência de complicações, quando comparada aos demais métodos existentes
Abstract: INTRODUCTION: The surgical treatment of intertrochanteric fractures is still controversial, resulting in further studies. Many papers have appeared in reference to the advantages of minimal invasive procedures for these fractures. The aim of this study was to evaluate the complications of a minimal invasive procedure using a specific implant and instruments developed for the treatment of intertrochanteric fractures (Minus System). MATERIAL AND METHOD: One hundred and seventy two patients with intertrochanteric fractures of the femur were studied, and submitted to treatment with the Minus System. Fifty two patients were excluded from the study as they did not fulfil all criteria for inclusion. The initial protocol registered gender, age, operative details such as length of operation, length of fluoroscopy use, quality of reduction and fixation of the fracture. The clinical parameters considered included deambulatory ability, pain, Tronzo fracture classification and anesthesia risk according to ASA classification. Complications were divided into two groups: general complications (infection and mortality rate) and specific complications (implant migration, loss of reduction and non-union). Although the migration of a sliding nail has not been considered in the literature as a DHS complication (Hrubna e Skotak, 2010)1 RESULTS: There were 93 feminine cases (77.5%) prevailing on 27 masculine cases (22.5%). Age span was 52 to 95 years, with an average of 80.06 years (standard deviation of 7.87 years). The average age for men was 76.19 years with a standard deviation of 8.321. The average age for women was 81.18 years with a standard deviation of 7.407. The average operative length of time was 39.35 minutes (25 to 65 minutes). The average time of fluoroscopy was 1min 7sec (0.6 to 2min 3sec). Fracture reduction was considered adequate in 92 cases (76.6%), , in the present study it was taken into account. It is important to mention that migration here is the lateral impaction of the fracture without loss of reduction. when alignment with weight-bearing axis was obtained, valgus in 20 cases (16.6%) and varus in eight cases (6.6%). The average Tip Apex Distance (TAD) on an anteroposterior view was 1.19cm (variation of 0.2 to 2.52 cm) and lateral view was 1.14cm (variaton of 0.3 to 2.52cm). One hundred and twelve patients (93,3%) were able to walk with postoperative pain (average of 4.4 on a pain scale of 0 to 10). The classification of the 120 patients is as follows: 11 patients with Tronzo I (9,1%), 24 cases of Tronzo II (20%), 58 Tronzo III (48.3%), seven Tronzo III variant (5.8%) and 20 Tronzo IV (16.7%). Unstable fractures occured in 85 (70.8%) patients, and 74 (61.6%) were over 75 years of age. There were 35 stable fractures (29.1%), with 17 patients (14.1%) over 75 years of age. As to the anesthesia risk eight (6.6%) were classified as ASA I, 33 (27.5%) ASA II, 74 (61.6%) ASA III and five patients as ASA IV (4.16%). There was one case of infection (0.83%). During the first postoperative year there were 13 deaths (10.8%). Of these, one patient (0.83%) had been classified as ASA II, five (4.16%) as ASA III and seven (5.83%) as ASA IV. There were 36 patients (30%) with complications out of 85 patients with unstable fractures, with loss of reduction in seven (5.88%) and migration of the sliding nail in 29 (24.1%). In the group of 35 stable fractures there were complications in four cases (3.3 %), with loss of reduction in one case (0.83%) and migration in three (2.5%). The total number of migrations was 33 (27.5%), but resulted in union in all patients. The loss in reduction occurred in eight patients (6.7%) and non-union in one case (0.83%). CONCLUSION: The minimal invasive procedure, the Minus System, is a safe procedure, that provides adequate surgery with a low incidence of complications, when compared to other existing techniques
Doutorado
Fisiopatologia Cirúrgica
Doutor em Ciências
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Baker, Sean Travis. "Mechanical Assessment of Veterinary Orthopedic Implant Technologies: Comparative Studies of Canine Fracture Fixation and Equine Arthrodesis Devices and Techniques." Thesis, 2013. http://hdl.handle.net/1969.1/149599.

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The Clamp-Rod Internal Fixator (CRIF) is a fracture fixation implant with growing popularity among veterinarian’s for its versatility and ease of use. Although the CRIF is currently in clinical use, relatively few reports exist describing the biomechanical properties and clinical results of this system. The objective of this study was to determine the in vitro biomechanical properties of a 5mm CRIF/rod construct to a 3.5mm Limited Contact-Dynamic Compression Plate (LC-DCP/rod) construct using a canine femoral gap model. Paired canine femora were treated with 40mm mid-diaphyseal ostectomies and randomly assigned to CRIF/rod or LC-DCP/rod. Five pairs of constructs were tested in bending and five pairs were evaluated in torsion. Single ramp to failure tests were conducted to evaluate construct stiffness, yield load, and failure mode. While CRIF/rod and LC-DCP/rod were not significantly different when evaluated in bending, LC-DCP/rod constructs are significantly more rigid than CRIF/rod constructs at higher torsional loads. Below 10degrees of twist, or 4.92Nm torque, the LC-DCP/rod and CRIF/rod were not statistically different in torsion. Catastrophic injuries of the metacarpophalangeal joint resulting in the disruption of the suspensory apparatus are the most common fatal injuries in thoroughbred racehorses. Fetlock arthrodesis is a procedure designed to mitigate suffering from injury as well as degenerative diseases affecting articulation. The objective of this study is to assess the in vitro biomechanical behavior of techniques for fetlock arthrodesis. Twelve forelimb pairs were collected from adult horses euthanized for reasons unrelated to disease of the metacarpophalangeal joint (MCP). A 14-16-hole broad 4.5mm Locking Compression Plate (LCP) was compared to a 14-16 hole broad Dynamic Compression Plate (DCP). Both constructs used a two “figure-eight” 1.25mm stainless steel wire tension band. Fatigue tests and to failure tests were conducted. There were no significant differences in stiffness between groups for fatigue tests. Stiffness increased after the first fatigue cycle for the LCP/wire (80.56+/-52.22%) and DCP/wire (56.58+/-14.85%). Above 3.5mm of axial deformation there was a statistical difference between the stiffness of the LCP/wire (3824.12+/-751.84 N/mm) and the DCP/wire (3009.65+/-718.25 N/mm) (P=0.038). The LCP/wire showed increased stiffness above 3.5mm compression compared to the DCP/wire. Under fatigue testing conditions the constructs are not statistically different.
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Books on the topic "Orthopedic fixation devices"

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1945-, Berquist Thomas H., ed. Imaging of orthopaedic fixation devices and prostheses. Philadelphia, PA: Lippincott Williams & Wilkins, 2009.

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7th Proceeding of the International Congress on Cotrel-Dubousset Instrumentation: 1990. Monpellier: Sauramps Medical, 1990.

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V, Mummaneni Praveen, Lenke Lawrence 1960-, and Haid Regis W, eds. Spinal deformity: A guide to surgical planning and management. St. Louis, Mo: Quality Medical Pub., 2007.

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D, Hsu John, Michael John W, Fisk John R. 1943-, and American Academy of Orthopaedic Surgeons., eds. AAOS atlas of orthoses and assistive devices. 4th ed. Philadelphia: Mosby/Elsevier, 2008.

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Transfixation: Atlas of anatomical sections for the external fixation of limbs. Berlin: Springer-Verlag, 1987.

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G, Fessler Richard, and Haid Regis W, eds. Current techniques in spinal stabilization. New York: McGraw-Hill, Health Professions Division, 1996.

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S, An Howard, and Cotler Jerome M, eds. Spinal instrumentation. Baltimore: Williams & Wilkins, 1992.

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C, Benzel Edward, and AANS Publications Committee., eds. Spinal instrumentation. [Park Ridge, Ill.]: American Association of Neurological Surgeons, 1994.

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H, Kim Daniel, Vaccaro Alexander R, and Fessler Richard G, eds. Spinal instrumentation: Surgical techniques. New York: Thieme, 2005.

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Biomechanics of spine stabilization: Principles and clinical practice. New York: McGraw-Hill, Health Professions Division, 1995.

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Book chapters on the topic "Orthopedic fixation devices"

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Heimbach, Bryant, and Mei Wei. "Composite Orthopedic Fixation Devices." In Orthopedic Biomaterials, 399–425. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-73664-8_15.

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Korunovic, Nikola, and Jovan Arandjelovic. "Structural Analysis and Optimization of Fixation Devices Used in Treatment of Proximal Femoral Fractures." In Personalized Orthopedics, 503–33. Cham: Springer International Publishing, 2022. http://dx.doi.org/10.1007/978-3-030-98279-9_17.

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Solomin, Leonid Nikolaevich. "External Fixation at the Vreden Russian Research Institute of Traumatology and Orthopedics." In The Basic Principles of External Skeletal Fixation Using the Ilizarov and Other Devices, 257–300. Milano: Springer Milan, 2012. http://dx.doi.org/10.1007/978-88-470-2619-3_9.

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Kawalec, Jill. "Orthopedic Fixation Devices." In Encyclopedia of Biomaterials and Biomedical Engineering, Second Edition - Four Volume Set, 2073–80. CRC Press, 2008. http://dx.doi.org/10.1201/b18990-199.

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"Orthopedic Fixation Devices." In Encyclopedia of Biomaterials and Biomedical Engineering, Second Edition, 2073–80. CRC Press, 2008. http://dx.doi.org/10.1081/e-ebbe2-120013946.

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"Orthopedic Fixation Devices / Jill S. Kawalec." In Encyclopedia of Biomaterials and Biomedical Engineering, 2105–12. CRC Press, 2008. http://dx.doi.org/10.1201/9780429154065-199.

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Porrino, Jack, and Alvin R. Wyatt. "Fracture Fixation." In Musculoskeletal Imaging Volume 1, edited by Mihra S. Taljanovic and Tyson S. Chadaz, 130–33. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190938161.003.0027.

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Chapter 27 discusses fracture fixation. Although many fractures are managed nonoperatively, others require various forms of surgical intervention. Fracture fixation can be conservative or surgical. The goal is to stabilize the fractured bone, enable fast healing, and return early mobility and function of the injured extremity. Orthopedic hardware permits stabilization of the fractured bone, expediting healing and early mobility. Percutaneous pins and wires can be used to apply traction to a fracture. External and internal fixation are used when more advanced operative intervention is required and encompass external fixator devices, pins/wires, screws, plates, and intramedullary nails/rods. Hardware is unfortunately susceptible to complication, including loosening, migration, fracture, and infection.
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"Fatigue Failures of Austenitic Stainless Steel Orthopedic Fixation Devices." In ASM Failure Analysis Case Histories: Medical and Biomedical Devices. ASM International, 2019. http://dx.doi.org/10.31399/asm.fach.med.c9001606.

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"Biotribology." In Tribomaterials, 363–90. ASM International, 2021. http://dx.doi.org/10.31399/asm.tb.tpsfwea.t59300363.

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Abstract The chapter covers various aspects of biotribology in the context of dental care, orthopedic implants, haptics, eyewear, and stents and fixation devices. It also addresses the issue of biocompatibility and the effects of friction and contact pressure on skin.
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Conference papers on the topic "Orthopedic fixation devices"

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Zhang, Qingwei, Wei Zhang, Donggang Yao, David M. Wootton, Peter I. Lelkes, and Jack G. Zhou. "Micro-Porous PLLA Scaffolds for Orthopedic Surgical Fixation Devices." In ASME 2010 First Global Congress on NanoEngineering for Medicine and Biology. ASMEDC, 2010. http://dx.doi.org/10.1115/nemb2010-13166.

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Anterior cruciate ligament (ACL) reconstructive surgery is a major health concern world-wide because of a large aging population and increased occurrence of sport-related injuries. Tissue engineering is a rapidly growing interdisciplinary field that offers a promising new approach for ACL repair. The aim of this project is to explore novel “smart” surgical fixation devices that not only secure a graft in place without strength failure, but also incorporate and release bioactive materials, intended to promote bone tissue growth. In order to facilitate bioactive reagent release, biopolymeric scaffolds with continuous micro-porous structure were developed. The morphology of the porous structures in the poly-L-lactic acid (PLLA) matrix reflects the differential influence of the concentration of sacrificial material (PS-polystyrene), phase separation levels of the immiscible polymers (PLLA and PS), and melt-blending conditions (Fig. 1) [1]. During removal of the sacrificial material, the chemical solvent might introduce some chemical reactant into the scaffolds. In order to assess the feasibility of using the micro-porous structures for medical applications, 7F2 osteoblasts were cultured on these scaffolds for 7 days. The attachment and proliferation of 7F2 cells on all scaffolds were assessed by fluorescent nuclear staining with Hoechst 33258 and phalloidin. The morphology of 7F2 osteoblasts on solid PLLA and PLLA/HA with 40% porous structure scaffolds till the 7 days pos-seeding was observed under confocal microscopy (Fig. 2A and B). The results showed that removal of the sacrificial material does not influence cell growth and the composites are biocompatible. Besides in vitro cytotoxicity test, in vivo test of all the micro-porous structural scaffolds was performed through rat subcutaneous surgery. Histological analysis (H&E staining) of the porous PLLA/HA with 40% pores retrieved from rat subcutaneous tissue 4 weeks postimplantation show that cells start to grow inside the porous scaffold (Fig. 3A). The morphology of surrounding extracellular matrix (ECM) growing on the scaffolds was observed under SEM. Figure 3B shows soft tissue attached onto PLLA/HA porous scaffold after 1 month post implantation time point, which indicates the good biocompatibility of the scaffolds. Based on these data we predict that these scaffolds will be suitable for inducing and sustaining bone tissue regeneration, and will be feasible for ACL repair.
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Ruhala, Laura, Dennis Beck, Richard Ruhala, Aaron Megal, and Megan Perry. "Development and Testing of an External Fixation Coupling for a Damage Control Orthopedic System." In 2017 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/dmd2017-3530.

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Seligson [1] describes how Hoffmann and Jaquet, a medical doctor and an engineer, respectively, developed the original Hoffmann fixator as a tool to stabilize human fractures with minimal invasiveness. Whether being utilized in mass trauma injury situations such as the 2010 Haitian earthquake, within our emerging geriatric population, or in veterinary applications, external fixation is widely used [1–4]. In this investigation, a rod-to-wire coupling, shown in Figure 1, and hereafter referred to as the R2W clamp, has been designed and validation tested for Stryker Orthopaedic’s Hoffmann II (HII) External Fixation System. As the name implies, this clamp has the purpose of connecting 8mm rods to 1.5mm or 2mm Kirschner (k-) wires or olive wires to stabilize bony fragments in the lower extremity, thus expediting healing in a trauma case. This paper summarizes the results of the validation tests conducted on prototype clamps. This clamp effectively allows placement of a wire to further stabilize a frame [3] by allowing wire placement without the addition of an intermediate ring, as shown in Figure 2. The wire could be added to any configuration with two parallel rods extending in plane with the bone. As shown in Figure 3, the R2W clamp can be positioned “outboard” with the rod between it and the bone, or “inboard” between the rod and the bone, allowing the surgeon geometric flexibility. The use of two k-wires is recommended to stabilize each bone fragment [5]. One of the goals of the validation testing was to determine the effectiveness and functional safety of the clamp as related to surgically applied k-wire tensions of either 50 kg or 100 kg. Since it is feasible that surgeons may tighten, loosen, then retighten the clamp while positioning it during surgery, the effects of clamp retightenings on the performance of the R2W clamp were also evaluated [4].
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van der Burg, Erik. "Soft Tissue Fixation and Implant Development: Session Summary." In ASME 2009 4th Frontiers in Biomedical Devices Conference. ASMEDC, 2009. http://dx.doi.org/10.1115/biomed2009-83071.

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Sports medicine/joint preservation represents one of the fastest growing segments of orthopedic markets. It is estimated that the frequency of rotator cuff repair alone is increasing between 10 and 20% per year. Similar to the ongoing evolution in other medical specialties (cardiology, general surgery), an increasing number of joint preservation procedures are transitioning to less invasive techniques. However, there are significant unmet needs as soft tissue repair transitions from invasive open surgical techniques to less invasive arthroscopic methods.
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Modica, F., C. Pagano, V. Marrocco, and I. Fassi. "Micro-EDM Studies of the Fabrication of Customized Internal Fixation Devices for Orthopedic Surgery." In ASME 2015 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. American Society of Mechanical Engineers, 2015. http://dx.doi.org/10.1115/detc2015-46489.

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The fabrication of personalized implants, tailored on patient needs, is a key issue for the future of several surgical fields. The presence of a prototyping service inside the hospital would be an added value for improving clinical activity. In this context, micro-Electro Discharge Machining is exploited to customize fixation devices in orthopedic surgery. An overview of the main devices is carried out in order to identify the main characteristics and to define the common fixation system specifications. The experimentation includes a technological evaluation of the proper micro-EDM technology, chosen according to the final design of the components. Two materials are investigated for the device fabrication: titanium and Si3N4-TiN ceramic composite. An optimization of the main technological parameters is performed in order to maximize the material removal rate ensuring the accuracy of the micro-features required. Finally, a test case is selected in order to evaluate the entire fabrication process chain.
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Norton, Evan. "Soft Tissue Fixation and Implant Development: Venture Capital." In ASME 2009 4th Frontiers in Biomedical Devices Conference. ASMEDC, 2009. http://dx.doi.org/10.1115/biomed2009-83072.

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This talk will discuss venture capital trends globally and specifically how these trends are impacting the orthopedic market. The discussion will include: a. Current areas of interest in the venture community — i. Spin, ii. Knee/Hip, iii. Extremities/Small Bone; b. Choosing a financial partner; c. How to approach venture firms — i. Stage focus and how it impacts the entrepreneur, ii. General investment criteria; d. Making the pitch — i. How to make contact, ii. Key content/format, iii. Who is going to read what?, iv. Preparing for success, v. Market size, vi. Team, vii. Cap table, viii. All about milestones; e. Alternative funding sources; f. The costs associated with other people’s money.
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Zhang, Qingwei, Vadym Mochalin, Ioannis Neitzel, Yury Gogotsi, Peter I. Lelkes, and Jack Zhou. "The Study on PLLA-Nanodiamond Composites for Surgical Fixation Devices." In ASME 2010 International Mechanical Engineering Congress and Exposition. ASMEDC, 2010. http://dx.doi.org/10.1115/imece2010-38287.

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Biopolymers have a great potential in biomedical engineering, having been used as scaffolds for hard and soft tissues, such as bone and blood vessels for many years. More recently biopolymers have also found applications in surgical fixation devices. Compared with conventional metal fixation devices, bone grafts and organ substitutes, biopolymer products have advantages of no long-term implant palpability or temperature sensitivity, predictable degradation to provide progressive bone loading and no stress shielding, all of which leads to a better bone healing, reduced patient trauma and cost, elimination of second surgery for implant removal, and fewer complications from infections. However lack of initial fixation strength and bioactivity are two major concerns which limited more widespread applications of biopolymers in orthopedic surgery. Nanodiamond is attractive for its use in reinforcement of composite materials due to their outstanding mechanical, chemical and biological properties. Nanotechnology shows us many innovations and it is generally accepted view that many could be further developed and applied in tissue engineering. In this work, we conduct poly(L-lactic acid) (PLLA) and octadecylamine functionalized nanodiamond (ND-ODA) composite research to optimize the polymer/ND interface, thus to reinforce the mechanical strength. Composites comprising PLLA matrix with embedded ND-ODA were prepared by mixing PLLA/chloroform solution with chloroform suspension of nanodiamonds at concentrations of 0–10 by weight percent. The dispersion of ND-ODA was observed by transmission electron microscopy (TEM). TEM micrographs show that ND-ODA can disperse uniformly in PLLA till 10% wt. Nanoindentation result shows the mechanical strength of ND-ODA/PLLA composites improving following increasing the concentration of ND-ODA in composites. The noncytotoxicity of ND-ODA was demonstrated on 7F2 Osteoblasts. To test the usefulness of ND-ODA/PLLA composites as scaffolds for supporting cell growth, 7F2 Osteoblasts were cultured on scaffolds for 6 days. The attachment and proliferation of 7F2 on all scaffolds were assessed by fluorescent nuclear staining with Hoechst 33258 and Alamar BlueTM assay. The results showed that the adding ND-ODA does small influence cell growth, which indicates the composites have good biocompatibility. The morphology of 7F2 cells growing on all ND-ODA/PLLA composite scaffolds was determined by SEM, which confirms the Osteoblasts spread on the scaffolds. All these results combined suggest that ND-ODA/PLLA might provide a novel composite suitable for surgical fixation devices.
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Arnone, Joshua C., Carol V. Ward, Gregory J. Della Rocca, Brett D. Crist, and A. Sherif El-Gizawy. "Simulation-Based Design of Orthopedic Trauma Implants." In ASME 2010 International Mechanical Engineering Congress and Exposition. ASMEDC, 2010. http://dx.doi.org/10.1115/imece2010-40936.

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A computer-aided simulation model is developed to aid in the design and optimization of orthopaedic trauma implants. The developed model uses digital imaging, computer-aided solid modeling, and finite element methods in order to study the effects of various geometric parameters of fixation devices in orthopedic surgery practice. The results of the present simulation model would lead to the determination of the optimum implant design that provides the best match with the geometry of the human femur — reducing the risk of over-stressing bone tissue during implant insertion. The effectiveness of the presented simulation model is demonstrated through the design of intramedullary (IM) nails used in treating femoral shaft fractures. CT scans were taken of forty intact human femora. A technique was developed in order to digitally reconstruct the scans into 3D solid models using image segmentation, surface simplification, and smoothing methods while maintaining accurate representation of the original scans. Each resulting surface model is characterized by a network of nearly equilateral triangles of approximately the same size allowing for quality finite element meshing. Femoral lengths, curvature, shaft diameters, and location of maximum curvature were then quantified. An average geometric model was then generated for the investigated sample by averaging corresponding nodal coordinates in each femur model. Using the average model, a length-standardized function representing the curvature of the medullary canal was derived to create a geometrically optimized IM nail for the entire sample. “Virtual surgery” simulating the insertion process was then performed using finite element methods in order to validate the proposed optimal IM nail design. The results of both the optimum nail and a current nail were compared using the femur having the highest curvature in the sample. The present study shows that the developed simulation model leads to a nail design that reduces the insertion-induced stress within the femur to an acceptable level compared to current nails.
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Bahgat, Ahmed, Paul Okonkwo, Gupta Manoj, Noora Alqahtani, Rana Shakoor, and Aboubakr Abdullah. "Study of the In Vitro Biodegradation Behavior of Mg–2.5Zn–xES Composite for Orthopedic Application." In Qatar University Annual Research Forum & Exhibition. Qatar University Press, 2021. http://dx.doi.org/10.29117/quarfe.2021.0097.

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Non-degradable steel and titanium implants used to replace defects of the locomotor system or fabricate vascular stents provide maximum stability but have too many drawbacks. However; the defects in oxide layer and the corrosive nature of physiological environment, the thermodynamic tendencies make the alloys susceptible to release of cationic species in the form of corrosion, which result in triggering various biological factors and compromises the mechanical integrity of the implanted materials. Currently, biodegradable magnesium alloys are considered as promising materials for creation of fixation devices in orthopedics and cardiovascular surgery. In this work, zinc (Zn) and eggshell (ES) reinforced biodegradable magnesium alloy (Mg–2.5Zn), and environment concise (eco) composite (Mg–2.5Zn–xES) was fabricated using disintegrated melt deposition (DMD) technique. In vitro experiments were conducted to explore the effect variable concentration of ES ( 3 and 7 wt%) on the biodegradation behavior of Mg–Zn alloy using simulated body fluid (SBF) at 37 ℃. The corrosion behavior of the Mg–2.5Zn–xES alloys was explored in SBF solution using different techniques such as weight loss measurement, hydrogen evolution, potentiodynamic polarization, electrochemical Impedance Spectroscopy (EIS). EIS revealed increased in vitro degradation of the biodegradable magnesium alloy, and ecofriendly composite as the percentage of ES reinforcement was increased. X-ray diffraction (XRD) was performed to observe the chemical composition of elements and reaction products present in the degraded samples after the corrosion process.
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Shao, Huifeng, Zhuoluo Jing, Rougang Zhou, Zhiheng Nian, Haiqiang Liu, Youping Gong, and Yong He. "Manufacturing of Biodegradable Intramedullary Nail With High Strength." In ASME 2021 16th International Manufacturing Science and Engineering Conference. American Society of Mechanical Engineers, 2021. http://dx.doi.org/10.1115/msec2021-63654.

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Abstract Intramedullary nails (INs) have significant advantages in rigid fracture fixation. Conventional metal INs for long bone fracture fixation often lead to delay union or even nonunion healing due to their stress shielding effect and lack of biological activity. Besides, undegradable metals require a second surgery to remove them, which will not only impose a potential risk to the patient but also cause additional costs. Manufacturing high-strength biodegradable INs (BINs) is still a challenge. Here, an entirely new type of high-strength bioactive magnesium-containing silicate (CSi-Mg) BIN is manufactured by using casting, freeze drying and sintering technique. It has extremely high bending strength (> 41 MPa) and stable internal and external structure. We have systematically studied the influence of parameters such as the paste component, freeze drying process, and sintering process on the mechanical strength involved in the manufacturing process. According to our manufacturing method, a wide range of inorganic ceramic implants and BINs with different sizes can also be fabricated. The CSi-Mg BIN also has good bioactivity and biodegradation property. This bioceramic BIN and manufacturing process are expected to be applied to a variety of orthopedic medical devices. This novel bioactive BIN is expected to replace the traditional metal IN and become a more effective way of treating fracture.
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Ibrahim, Hamdy, Andrew D. Klarner, Behrang Poorganji, David Dean, Alan A. Luo, and Mohammad Elahinia. "The Effect of Heat-Treatment on Mechanical, Microstructural, and Corrosion Characteristics of a Magnesium Alloy With Potential Application in Resorbable Bone Fixation Hardware." In ASME 2016 11th International Manufacturing Science and Engineering Conference. American Society of Mechanical Engineers, 2016. http://dx.doi.org/10.1115/msec2016-8822.

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Mg alloys are promising materials for bone implant applications mainly due to their low specific density, desirable stiffness and bioresorbability in the human body. Mg-Zn-Ca alloys are among the most promising materials for resorbable orthopedic fixation devices due to their superior biocompatibility. However, the mechanical and corrosion properties of the as-cast Mg-Zn-Ca alloys are insufficient. Heat treatment is a practical approach for strengthening Mg alloys especially after the fabrication of porous structures and 3D-printed components. We have investigated heat treatment of these devices and have studied the resulting microstructure of Mg-1.6Zn-0.5Ca (wt. %) alloys by hardness, compression, scanning electron microscopy (SEM), and electrochemical and immersion corrosion tests. Mg-1.6Zn-0.5Ca alloy was prepared with high purity Mg, Zn and Ca by casting. The cast ingots were solution-treated at 510 °C for 3 h then quenched in water. The quenched ingots were age hardened in an oil bath at 200 °C for 2 h. Pure Mg, as-cast and heat-treated Mg-1.6Zn-0.5Ca alloy ingots were cut into coupons to characterize their mechanical and corrosion properties. In vitro corrosion tests were conducted in modified simulated body fluid (m-SBF) at pH 7.4 and 37 °C. The hardness of the Mg-Zn-Ca alloy was significantly increased from 52.6 to be 66.8 HV after heat treatment. Also, the compression test results revealed that the heat-treated alloy has the highest compressive yield and ultimate strengths without significant change in stiffness and maximum strain. The mass loss of the Mg-Zn-Ca alloy by week 4 of the in vitro immersion test reduced from 174.6 mg/cm2 for the as-cast alloy to 101.7 mg/cm2 after the heat-treatment process. Heat-treatment was found to be a powerful post-shaping process not only to enhance the mechanical properties of the Mg-1.6Zn-0.5Ca (wt. %) alloy, but also to significantly improve its biocorrosion properties. Such heat-treated alloys can also be coated with biocompatible ceramics that provide additional protection from corrosion during the bone healing period (3–4 months).
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