Biomechanical characteristics of rib fracture fixation systems.


Journal

Clinical biomechanics (Bristol, Avon)
ISSN: 1879-1271
Titre abrégé: Clin Biomech (Bristol, Avon)
Pays: England
ID NLM: 8611877

Informations de publication

Date de publication:
02 2023
Historique:
received: 13 10 2022
revised: 20 12 2022
accepted: 02 01 2023
pubmed: 10 1 2023
medline: 3 3 2023
entrez: 9 1 2023
Statut: ppublish

Résumé

The primary aim of this study was to determine and compare the biomechanical properties of a fractured or intact rib after implant fixation on an embalmed thorax. Five systems were fixated on the bilateral fractured or intact (randomly allocated) 6th to 10th rib of five post-mortem embalmed human specimens. Each rib underwent a four-point bending test to determine the bending structural stiffness (Newton per m As compared to a non-fixated intact rib, the relative difference in stiffness of a fixated intact rib ranged from -0.14 (standard deviation [SD], 0.10) to 0.53 (SD 0.35) and for a fixated fractured rib from -0.88 (SD 0.08) to 0.17 (SD 0.50). The most common failure mode was a new fracture at the most anterior drill hole for the plate and screw systems and a new fracture within the anterior portion of the implant for the clamping systems. The current fixation systems differ in their design, mode of action, and biomechanical properties. Differences in biomechanical properties such as stiffness and load to failure especially apply to fractured ribs. Insight in the differences between the systems might guide more specific implant selection and increase the surgeon's awareness for localizing hardware complaints or failure.

Sections du résumé

BACKGROUND
The primary aim of this study was to determine and compare the biomechanical properties of a fractured or intact rib after implant fixation on an embalmed thorax.
METHODS
Five systems were fixated on the bilateral fractured or intact (randomly allocated) 6th to 10th rib of five post-mortem embalmed human specimens. Each rib underwent a four-point bending test to determine the bending structural stiffness (Newton per m
FINDINGS
As compared to a non-fixated intact rib, the relative difference in stiffness of a fixated intact rib ranged from -0.14 (standard deviation [SD], 0.10) to 0.53 (SD 0.35) and for a fixated fractured rib from -0.88 (SD 0.08) to 0.17 (SD 0.50). The most common failure mode was a new fracture at the most anterior drill hole for the plate and screw systems and a new fracture within the anterior portion of the implant for the clamping systems.
INTERPRETATION
The current fixation systems differ in their design, mode of action, and biomechanical properties. Differences in biomechanical properties such as stiffness and load to failure especially apply to fractured ribs. Insight in the differences between the systems might guide more specific implant selection and increase the surgeon's awareness for localizing hardware complaints or failure.

Identifiants

pubmed: 36623327
pii: S0268-0033(23)00001-3
doi: 10.1016/j.clinbiomech.2023.105870
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

105870

Informations de copyright

Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: EMM Van Lieshout reports a relationship with Netherlands Organisation for Health Research and Development that includes: funding grants. MME Wijffels reports a relationship with Netherlands Organisation for Health Research and Development that includes: funding grants. EMM Van Lieshout reports a relationship with DePuy Synthes that includes: funding grants. MME Wijffels reports a relationship with DePuy Synthes that includes: funding grants. EMM Van Lieshout reports a relationship with Coolsingel Foundation that includes: funding grants. MME Wijffels reports a relationship with Coolsingel Foundation that includes: funding grants. EMM Van Lieshout reports a relationship with Osteosynthesis and Trauma Care Foundation that includes: funding grants. MME Wijffels reports a relationship with Osteosynthesis and Trauma Care Foundation that includes: funding grants.

Auteurs

Jonne T H Prins (JTH)

Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands. Electronic address: j.prins@erasmusmc.nl.

Suzanne F M Van Wijck (SFM)

Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands. Electronic address: s.vanwijck@erasmusmc.nl.

Sander A Leeflang (SA)

Department of Biomechanical Engineering, Delft University of Technology, 2628 CD Delft, the Netherlands. Electronic address: m.a.leeflang@tudelft.nl.

Gert-Jan Kleinrensink (GJ)

Department of Neuroscience and Anatomy, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands. Electronic address: g.kleinrensink@erasmusmc.nl.

Lawrence Lottenberg (L)

Department of Surgery, St. Mary's Medical Center, Florida Atlantic University, West Palm Beach, FL, USA.

Pablo Moreno de la Santa Barajas (PM)

Department of Thoracic Surgery, Ribera-Povisa Hospital, Vigo, Spain. Electronic address: pmoreno@povisa.es.

Pieter J Van Huijstee (PJ)

Department of Surgery, Haga Hospital, 2504 LN The Hague, the Netherlands. Electronic address: p.vanhuijstee@hagaziekenhuis.nl.

Jefrey Vermeulen (J)

Department of Surgery, Maasstad Hospital, 3007 AC Rotterdam, the Netherlands. Electronic address: vermeulenj@maasstadziekenhuis.nl.

Michael H J Verhofstad (MHJ)

Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands. Electronic address: m.verhofstad@erasmusmc.nl.

Amir A Zadpoor (AA)

Department of Biomechanical Engineering, Delft University of Technology, 2628 CD Delft, the Netherlands. Electronic address: A.A.Zadpoor@tudelft.nl.

Mathieu M E Wijffels (MME)

Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands. Electronic address: m.wijffels@erasmusmc.nl.

Esther M M Van Lieshout (EMM)

Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, 3000 CA Rotterdam, the Netherlands. Electronic address: e.vanlieshout@erasmusmc.nl.

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