Biomechanical comparison of the anterior reverse PHILOS and locking compression plate extra-articular distal humerus plates for extra-articular distal humeral fractures.
IF 4.8 3区 工程技术Q1 BIOTECHNOLOGY & APPLIED MICROBIOLOGY
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引用次数: 0
Abstract
Background: The locking compression plate extra-articular distal humeral plate (EADHP) is an anatomically pre-contoured plate that is used for extra-articular distal humeral fractures. However, there is currently no standard criterion for the internal fixation of this type of fracture. Moreover, the anterior reverse proximal humeral internal locking system (PHILOS) plate (ARPP) has been clinically applied as a new internal-fixation plate without testing in biomechanical studies. We aimed to compare the biomechanical properties of ARPP and EADHP for the definitive fixation of extra-articular distal humeral fractures.
Methods: Eighteen composite humerus bones were cut at the distal humerus using an electrical saw to generate a fracture gap. Internal fixation via the ARPP or EADHP was performed following standard techniques. An Instron testing machine (Instron 8872) was used to evaluate biomechanical properties by applying bending torque, axial force, and torsional torque.
Results: Fixations with both ARPP and EADHP could withstand forces that exceeded the physiological forces (200 N). Under axial compression, ARPP constructs demonstrated greater stiffness (668.9 ± 120.7 N/mm vs 171.2 ± 45.4 N/mm) and higher maximal load-to-failure (2,092.6 ± 305.2 N vs 907.0 ± 56.5 N) compared with EADHP, although these differences were not statistically significant. During anterior bending, ARPP provided significantly higher stiffness (17.8 ± 2.0 N/mm vs 13.9 ± 1.0 N/mm, p = 0.041), whereas EADHP showed a higher but non-significant load-to-failure. Under torsional loading, ARPP tended to exhibit greater stiffness in both external and internal rotation, as well as higher load-to-failure (31.1 ± 0.8 N m vs 26.0 ± 4.4 N m), but without statistical significance.
Conclusion: ARPP demonstrated superior bending stiffness compared with the EADHP, while both constructs performed equivalently in axial compression and torsion. Therefore, ARPP can serve as an alternative internal-fixation method for extra-articular distal humeral fractures.
背景：锁定加压钢板肱骨远端关节外钢板（EADHP）是一种解剖预成形钢板，用于肱骨远端关节外骨折。然而，对于这类骨折的内固定，目前尚无标准标准。此外，肱骨近端前反向内锁定系统（PHILOS）钢板（ARPP）已被临床应用作为一种新型内固定钢板，在生物力学研究中未经试验。我们的目的是比较ARPP和EADHP在肱骨远端关节外骨折的最终固定中的生物力学性能。方法：采用电锯在肱骨远端切割18块复合肱骨，形成骨折间隙。按照标准技术通过ARPP或EADHP进行内固定。使用Instron试验机（Instron 8872）通过施加弯曲扭矩、轴向力和扭转扭矩来评估生物力学性能。结果：ARPP和EADHP固定物均能承受超过生理力（200 N）的力。与EADHP相比，ARPP结构在轴向压缩下表现出更大的刚度（668.9±120.7 N/mm vs 171.2±45.4 N/mm）和更高的最大失效载荷（2092.6±305.2 N vs 907.0±56.5 N），尽管这些差异没有统计学意义。在前弯时，ARPP提供了显著更高的刚度（17.8±2.0 N/mm vs 13.9±1.0 N/mm, p = 0.041），而EADHP显示了更高但不显著的载荷-失效。在扭转载荷下，ARPP在内外旋转中均表现出更大的刚度，以及更高的载荷-失效（31.1±0.8 N m vs 26.0±4.4 N m），但无统计学意义。结论：与EADHP相比，ARPP具有更好的弯曲刚度，而两种结构在轴向压缩和扭转方面表现相同。因此，ARPP可作为肱骨远端关节外骨折的替代内固定方法。
期刊介绍：
The translation of new discoveries in medicine to clinical routine has never been easy. During the second half of the last century, thanks to the progress in chemistry, biochemistry and pharmacology, we have seen the development and the application of a large number of drugs and devices aimed at the treatment of symptoms, blocking unwanted pathways and, in the case of infectious diseases, fighting the micro-organisms responsible. However, we are facing, today, a dramatic change in the therapeutic approach to pathologies and diseases. Indeed, the challenge of the present and the next decade is to fully restore the physiological status of the diseased organism and to completely regenerate tissue and organs when they are so seriously affected that treatments cannot be limited to the repression of symptoms or to the repair of damage. This is being made possible thanks to the major developments made in basic cell and molecular biology, including stem cell science, growth factor delivery, gene isolation and transfection, the advances in bioengineering and nanotechnology, including development of new biomaterials, biofabrication technologies and use of bioreactors, and the big improvements in diagnostic tools and imaging of cells, tissues and organs.
In today`s world, an enhancement of communication between multidisciplinary experts, together with the promotion of joint projects and close collaborations among scientists, engineers, industry people, regulatory agencies and physicians are absolute requirements for the success of any attempt to develop and clinically apply a new biological therapy or an innovative device involving the collective use of biomaterials, cells and/or bioactive molecules. “Frontiers in Bioengineering and Biotechnology” aspires to be a forum for all people involved in the process by bridging the gap too often existing between a discovery in the basic sciences and its clinical application.
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