Finite element analysis of Puddu and Tomofix plate fixation for open wedge high tibial osteotomy

被引:110
作者
Izaham, Raja Mohd Aizat Raja [1 ]
Kadir, Mohammed Rafiq Abdul [1 ,2 ]
Rashid, Abdul Halim Abdul [3 ]
Hossain, Md. Golam [4 ]
Kamarul, T. [4 ]
机构
[1] Univ Teknol Malaysia, Med Implant Technol Grp, Johor Baharu 81310, Johor, Malaysia
[2] Univ Teknol Malaysia, Fac Biomed Engn & Hlth Sci, Dept Biomech & Biomed Mat, Johor Baharu 81310, Johor, Malaysia
[3] Univ Kebangsaan Malaysia, Med Ctr, Dept Orthopaed & Traumatol, Kuala Lumpur 56000, Malaysia
[4] Univ Malaya, Dept Orthopaed Surg, NOCERAL, TEG, Kuala Lumpur 50603, Malaysia
来源
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED | 2012年 / 43卷 / 06期
关键词
Finite element analysis; High tibial osteotomy; Tomofix; Puddu plate; Orthopaedics; Biomechanic; BIOMECHANICAL EVALUATION; INTERNAL-FIXATION; BONE; COMPLICATIONS; STABILITY; STIFFNESS;
D O I
10.1016/j.injury.2011.12.006
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
The use of open wedge high tibial osteotomy (HTO) to correct varus deformity of the knee is well established. However, the stability of the various implants used in this procedure has not been previously demonstrated. In this study, the two most common types of plates were analysed (1) the Puddu plates that use the dynamic compression plate (DCP) concept, and (2) the Tomofix plate that uses the locking compression plate (LCP) concept. Three dimensional model of the tibia was reconstructed from computed tomography images obtained from the Medical Implant Technology Group datasets. Osteotomy and fixation models were simulated through computational processing. Simulated loading was applied at 60: 40 ratios on the medial: lateral aspect during single limb stance. The model was fixed distally in all degrees of freedom. Simulated data generated from the micromotions, displacement and, implant stress were captured. At the prescribed loads, a higher displacement of 3.25 mm was observed for the Puddu plate model (p < 0.001). Coincidentally the amount of stresses subjected to this plate, 24.7 MPa, was also significantly lower (p < 0.001). There was significant negative correlation (p < 0.001) between implant stresses to that of the amount of fracture displacement which signifies a less stable fixation using Puddu plates. In conclusion, this study demonstrates that the Tomofix plate produces superior stability for bony fixation in HTO procedures. (c) 2011 Elsevier Ltd. All rights reserved.
引用
收藏
页码:898 / 902
页数:5
相关论文
共 34 条
[1]  
ARO HT, 1993, CLIN ORTHOP RELAT R, P8
[2]   Shear movement at the fracture site delays healing in a diaphyseal fracture model [J].
Augat, P ;
Burger, J ;
Schorlemmer, S ;
Henke, T ;
Peraus, M ;
Claes, L .
JOURNAL OF ORTHOPAEDIC RESEARCH, 2003, 21 (06) :1011-1017
[3]   Evaluation of bone plate with low-stiffness material in terms of stress distribution [J].
Benli, Semih ;
Aksoy, Sami ;
Havitcioglu, Hasan ;
Kucuk, Mumin .
JOURNAL OF BIOMECHANICS, 2008, 41 (15) :3229-3235
[4]  
Blecha L. D., 2005, Computer Methods in Biomechanics and Biomedical Engineering, V8, P307, DOI 10.1080/10255840500322433
[5]   FINITE-ELEMENT ANALYSIS (FEA) FOR THE POINT-CONTACT FIXATOR - SCREW DRIVE, PLATE DESIGN, OVERCUTS [J].
BRESINA, SJ ;
TEPIC, S .
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 1995, 26 :SB20-SB23
[6]   Early complications of medial opening wedge high tibial osteotomy using autologous tricortical iliac bone graft and T-plate fixation [J].
Chae, Dong Ju ;
Shetty, Gautam M. ;
Wang, Kook Hyun ;
Montalban, Antonio Santa Cruz, Jr. ;
Kim, Jong In ;
Nha, Kyung Wook .
KNEE, 2011, 18 (04) :278-284
[7]   Biomechanical evaluation of the modified double-plating fixation for the distal radius fracture [J].
Cheng, Hsin-Yi Kathy ;
Lin, Chun-Li ;
Lin, Yu-Hao ;
Chen, Alvin Chao-Yu .
CLINICAL BIOMECHANICS, 2007, 22 (05) :510-517
[8]   Force transfer between the plate and the bone: relative importance of the bending stiffness of the screws and the friction between plate and bone [J].
Cordey, J ;
Borgeaud, M ;
Perren, SM .
INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED, 2000, 31 :21-28
[9]  
Cronier P., 2010, ORTHOP TRAUMATOL-SUR, V96, pS17, DOI DOI 10.1016/J.OTSR.2010.03.008
[10]   Mechanical boundary conditions of fracture healing: borderline indications in the treatment of unreamed tibial nailing [J].
Duda, GN ;
Mandruzzato, F ;
Heller, M ;
Goldhahn, J ;
Moser, R ;
Hehli, M ;
Claes, L ;
Haas, NP .
JOURNAL OF BIOMECHANICS, 2001, 34 (05) :639-650