Clinical Biomechanics最新文献

{"title":"Biomechanical comparison between three intramedullary nails and percutaneous compression plate in stable and unstable trochanteric fractures.","authors":"Luigi La Barbera, Atsuki Tanaka, Francesca Berti, Guido Antonini, Tomaso Villa","doi":"10.1016/j.clinbiomech.2025.106507","DOIUrl":"https://doi.org/10.1016/j.clinbiomech.2025.106507","url":null,"abstract":"<p><strong>Background: </strong>The best surgical treatment of trochanteric fractures remains controversial and biomechanical literature lacks a comprehensive study. The study compares the behavior of fixation implants for the treatment trochanteric fractures, namely: intramedullary gamma nail, proximal femoral nail, veronail, and extramedullary percutaneous compression plate.</p><p><strong>Methods: </strong>The implants were virtually inserted into 3D femur digital twins characterized by stable and unstable trochanteric fractures. Loadings simulated walking condition without and with crutches, respectively, for stable and unstable fractures. Stresses below the yield point quantified implant safety. Constructs' stiffness, principal strains, and the load-sharing on the fracture rims demonstrated the biomechanical advantages of fixation implant in restoring a physiological condition by comparison with the intact femur.</p><p><strong>Findings: </strong>All implants are safe. Extramedullary plate and proximal femoral nail allowed to better recover the stiffness of the intact femur in the unstable fracture model, and the load acting along the fracture decreased respectively between 17 % and 44 % compared to stable fracture model. The minimum and maximum strain distribution was qualitatively similar for all devices, with extramedullary plate and gamma nail showing strains in the posteromedial area getting closer to the intact condition in stable fracture model. The compressive strains in the unstable fracture model treated with extramedullary plate were closer to the intact condition.</p><p><strong>Interpretation: </strong>All investigated devices could be safely used for stable and unstable intertrochanteric fractures. The extramedullary plate may present some biomechanical advantage with unstable fractures.</p>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":" ","pages":"106507"},"PeriodicalIF":1.4,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Drop landing between subjects post anterior cruciate ligament reconstruction and uninjured controls: A biomechanical and neuromuscular analysis","authors":"Chris Murphy ,&nbsp;Scott Landry ,&nbsp;Nathan Urquhart ,&nbsp;Catherine Coady ,&nbsp;Derek Rutherford","doi":"10.1016/j.clinbiomech.2025.106504","DOIUrl":"10.1016/j.clinbiomech.2025.106504","url":null,"abstract":"<div><h3>Background</h3><div>The capacity of functional testing to identify ‘at-risk’ landing strategies in return to sport evaluation has been questioned. The purpose was to evaluate if biomechanical and muscle activation patterns differ during a drop landing task in subjects post anterior cruciate ligament reconstruction against uninjured controls.</div></div><div><h3>Methods</h3><div>22 subjects within two years of anterior cruciate ligament reconstruction who had returned to sport and 25 activity matched controls were recruited. Sagittal plane knee and hip biomechanics and muscle activation amplitudes were recorded during a single leg drop landing task. Discrete measures derived from waveforms were analysed using <em>t</em>-tests and Analysis of Variance models (<span><math><mi>α</mi></math></span>=0.05).</div></div><div><h3>Findings</h3><div>Subjects post anterior cruciate ligament reconstruction displayed reduced knee (Effect Size = 1.2) and hip (Effect Size = 0.995) range of motion as well as reduced knee extension moments (Effect Size = 0.955) but exhibited no differences in quadriceps or hamstrings activation amplitudes versus uninjured controls.</div></div><div><h3>Interpretation</h3><div>Adoption of reduced knee and hip excursion or “stiffened” landing pattern despite similarities in muscle activation suggests the presence of adaptive strategies reflecting incomplete recovery despite receiving clearance for returned to sport. This suggests presence of altered patterns of movement which may place at increased risk for reinjury.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106504"},"PeriodicalIF":1.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143705592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Individual postoperative and preoperative workflow for patients with fractures of the lower extremities.","authors":"Annchristin Andres, Michael Roland, Kerstin Wickert, Bergita Ganse, Tim Pohlemann, Marcel Orth, Stefan Diebels","doi":"10.1016/j.clinbiomech.2025.106503","DOIUrl":"https://doi.org/10.1016/j.clinbiomech.2025.106503","url":null,"abstract":"<p><strong>Background: </strong>The individual assessment of the postoperative healing situation contributes significantly to detecting healing disorders, ensuring the mechanical stability of implants, and planning revision surgeries.</p><p><strong>Methods: </strong>Our established workflow consists of the following steps: (1) Monitoring of the patients during their treatment course with a motion capturing system as kinematic and sensor insoles for the kinetic gait analysis, (2) transfer of the motion data into the musculoskeletal simulation system AnyBody™ to achieve the corresponding individual muscle and joint forces. (3) Clinical imaging of the patients via postoperative computed tomography scans, ideally combined with a six-rod bone density calibration phantom. (4) Segmentation of the CT images and generation of the corresponding adaptive finite element meshes of the bone-implant systems, including the material parameters based on Hounsfield units and calibration phantom via the software ScanIP™. (5) Based on the patient-specific model, all information from the musculoskeletal simulation and gait analysis is transferred to our biomechanical simulation process as patient-specific constraints.</p><p><strong>Findings: </strong>This workflow allows us to simulate individual patient models based on their respective actual motion data over their treatment course. Thus, pathological processes that may lead to non-healing fractures can be detected early after surgery and prevented by adapting the postoperative treatment protocol. Furthermore, it is possible to understand the forces that affect the fracture and its healing process permanently in more detail.</p><p><strong>Interpretation: </strong>The findings demonstrate that the individual motion parameters and fracture morphology influence the local healing parameters and create individual weight-bearing recommendations.</p>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":" ","pages":"106503"},"PeriodicalIF":1.4,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"External fixators in austere environments under surge capacity conditions: A systematic review","authors":"David Bull ,&nbsp;Mark Sykes ,&nbsp;Mehdi Saeidi ,&nbsp;Anthony Bull","doi":"10.1016/j.clinbiomech.2025.106500","DOIUrl":"10.1016/j.clinbiomech.2025.106500","url":null,"abstract":"<div><h3>Background</h3><div>High-energy trauma causing open fractures can take place in low-resource settings (“austere” environment) and mainly affects the lower limbs. In these environments, external fixators often provide definitive surgical treatment. This systematic review identifies those external fixators for use on lower limbs as a definitive treatment that are most clinically effective in the austere environment.</div></div><div><h3>Methods</h3><div>Multiple databases were searched to identify studies investigating outcomes of external fixators used in austere environments. Case reports were excluded. Hand searching and expert input identified additional references.</div></div><div><h3>Findings</h3><div>33 publications met the inclusion criteria. These were used worldwide. Commercially available fixators were used in 18 publications, and non-commercial ones including Balkan-designed devices in 6. The remaining non-commercial devices had 1 or 2 publications each. Union rates, where reported, varied from 47 to 100 % with no discernible difference between devices or location of use. Clinical complications varied from infection (0–79 %) through to nonunion and delayed union (0–22 %), loosening (0–36 %), osteomyelitis (0–19 %), construct stability (27–100 %), and amputation (0–50 %).</div></div><div><h3>Interpretation</h3><div>The variability in union and complication rates highlights the variability in severity of injuries, type of austere environment, and variability in fixator device efficacy. The non-commercial or “one-off” devices show promise, with comparable or better outcomes to the commercial devices, whereas others did not work well, with poor outcomes. The need for surge capacity availability in these austere environments would enable locally manufactured devices to be quickly made which are fit for purpose, yet regulation and quality control of these remains a challenge in their rollout.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106500"},"PeriodicalIF":1.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143734916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis wave speed of optic nerve and optic nerve head for assessing normal tension glaucoma by using vibro-elastography technique","authors":"Ngoc Thang Bui ,&nbsp;Arash Kazemi ,&nbsp;John J. Chen ,&nbsp;Nicholas B. Larson ,&nbsp;Arthur J. Sit ,&nbsp;Xiaoming Zhang","doi":"10.1016/j.clinbiomech.2025.106493","DOIUrl":"10.1016/j.clinbiomech.2025.106493","url":null,"abstract":"<div><h3>Background</h3><div>This research aims to evaluate wave speed and viscoelasticity of ocular tissues including the optic nerve and optic nerve head of human eyes between normal tension glaucoma patients and healthy controls by using vibro-elastography techniques.</div></div><div><h3>Methods</h3><div>Participants included 12 patients and 12 controls. Wave speed was measured at the optic nerve and optic nerve head in each subject and viscoelasticity was estimated by using Voigt model. Wave speed and viscoelasticity of the optic nerve and optic nerve head were compared between patients and controls by linear mixed models via a restricted maximum likelihood method. The correlation between intraocular pressure and wave speed, elasticity, and viscosity of patients was performed using the Pearson correlation coefficient.</div></div><div><h3>Findings</h3><div>Significant differences in wave speed (<em>p</em> &lt; 0.0005), elasticity (<em>p</em> = 0.0001) and viscosity <em>p</em> &lt; 0.0001) between patients and controls at the optic nerve head. There was a moderate negative correlation (<em>r</em> = −0.50, <em>p</em> &lt; 0.05) between wave speed and elasticity and intraocular pressure at the optic nerve of patients but no correlation (<em>p</em> &gt; 0.05) between wave speed, elasticity, and viscosity and intraocular pressure at the optic nerve head of patients. No significant difference and correlation among wave speed, elasticity, and viscosity vs. intraocular pressure of the control group at the optic nerve and optic nerve head.</div></div><div><h3>Interpretation</h3><div>Ultrasound vibro-elastography is useful for noninvasive measurement of viscoelasticity of ocular structures. The glaucoma patient is associated with biomechanical property changes in the optic nerve and optic nerve head, suggesting another way to assess glaucoma focusing on the optic nerve and optic nerve head.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106493"},"PeriodicalIF":1.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical and energetic effects of knee flexion control during incline walking for users of the Power Knee","authors":"Sixu Zhou ,&nbsp;Hanjun Kim ,&nbsp;Jairo Maldonado-Contreras ,&nbsp;Atli Örn Sverrisson ,&nbsp;David Langlois ,&nbsp;Kinsey Herrin ,&nbsp;Aaron Young","doi":"10.1016/j.clinbiomech.2025.106499","DOIUrl":"10.1016/j.clinbiomech.2025.106499","url":null,"abstract":"<div><h3>Background</h3><div>Individuals with transfemoral amputation often report difficulty with ambulating on inclined surfaces. Conventional prosthetic control strategies typically apply a level walking controller in incline walking modes, which may not be biomechanically optimal. Able-bodied individuals modulate knee stance pre-flexion substantially during incline walking, which is absent in most prosthetic level walking controllers. However, the biomechanical effects of stance pre-flexion for users with robotic microprocessor-controlled knees are not well-explored during inclines.</div></div><div><h3>Methods</h3><div>In this study (<em>n</em> = 10), we investigated the joint kinematics/kinetics/power, biological joint level work and metabolic energy cost to evaluate the biomechanical effects of stance pre-flexion on a 7.5^o incline walking using a commercially available robotic prosthetic knee, the Össur Power Knee, and a passive foot, the Össur Pro-Flex LP. We ran a Bradley-Terry model to rank user preferences on stance pre-flexion conditions.</div></div><div><h3>Findings</h3><div>We found that a 16.7 % reduction on the contralateral biological ankle joint positive work during stance phase when stance pre-flexion increased (<em>p</em> &lt; 0.01). However, there was no significant difference in metabolic energy cost. Survey data revealed participants preferred higher stance pre-flexion angles (12^o -18^o) compared to lower angles (0^o - 6^o), indicating consistent preference towards increased stance pre-flexion on inclines.</div></div><div><h3>Interpretation</h3><div>Our results indicate that reduction in biological joint work associated with stance pre-flexion emphasizes the need to implement stance pre-flexion adjustments in prosthesis controllers, as opposed to using a level-walking controller.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106499"},"PeriodicalIF":1.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143704030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulley reparation with direct suture technique: A mechanical study","authors":"Emile Balandier ,&nbsp;Laurent Vigouroux ,&nbsp;Jean-Louis Milan ,&nbsp;Thibault Poujade ,&nbsp;André Gay","doi":"10.1016/j.clinbiomech.2025.106497","DOIUrl":"10.1016/j.clinbiomech.2025.106497","url":null,"abstract":"<div><h3>Background</h3><div>One of the most common climbing injuries is finger pulley ruptures. Depending on the grade of injury, surgery may be required. Conventional techniques are tried and tested, but they all use autograft to reconstruct the pulley and some side effects have been observed. The present technique, direct suture of injured pulleys, not using autograft, has a minimal footprint and a normal tendon-bone distance after healing. This study aimed to verify the post-operative stability of the pulley repaired with direct suture.</div></div><div><h3>Methods</h3><div>We performed rupture tests on the pulleys of 17 cadaver fingers via traction on the flexor tendons. Tests were carried out first on the native pulley and then on the sutured pulley. We measured the total tensile force and fingertip force and calculated the force of the A2 and A4 pulleys in each test.</div></div><div><h3>Findings</h3><div>We found a significant difference in force between native (334.9 N) and sutured (59.0 N) A2 pulleys and in all other parameters.</div></div><div><h3>Interpretation</h3><div>These results showed that direct suturing is a technique that allows the injured pulley to be properly positioned for regeneration with good stability but does not provide immediate resistance.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106497"},"PeriodicalIF":1.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of knee loading in subjects 12 weeks post-anterior cruciate ligament reconstruction versus repair when performing a double-limb squat","authors":"Olivia Panchal ,&nbsp;Shiho Goto ,&nbsp;Nicole L. Dietrich ,&nbsp;J. Craig Garrison ,&nbsp;Joseph P. Hannon ,&nbsp;Steven B. Singleton","doi":"10.1016/j.clinbiomech.2025.106498","DOIUrl":"10.1016/j.clinbiomech.2025.106498","url":null,"abstract":"<div><h3>Background</h3><div>Despite postoperative complications, anterior cruciate ligament reconstruction remains the gold standard treatment after a tear. Recent advancements in anterior cruciate ligament repair techniques have led to improved outcomes and renewed interest in repair as a less invasive alternative. The purpose of this study was to compare knee biomechanics and quadriceps strength during double-leg squat at 12 weeks between individuals who underwent anterior cruciate ligament reconstruction or repair.</div></div><div><h3>Methods</h3><div>A total of 43 participants (21 repair, 23 reconstruction) were included. A 10-camera Motion Capture System was used to capture joint motions during double-leg squat, and two force plates collected ground reaction forces. Peak knee extension moment, knee flexion angle, knee flexion angle displacement, and quadriceps strength were measured. Independent <em>t</em>-tests were performed for participant demographics (age, height, mass), International Knee Documentation Committee Subjective Knee Evaluation Form scores, and isokinetic quadriceps strength. A univariate ANCOVA was performed on each dependent variable and Cohen's d effect size was calculated.</div></div><div><h3>Findings</h3><div>The repair group demonstrated significantly greater knee extension moment compared to the reconstruction group after accounting for age (<em>P</em> = .033, effect size = 1.00). No statistically significant differences were observed between groups for quadriceps strength (<em>P</em> = .138), peak knee flexion angle (<em>P</em> = .330), or knee flexion angle displacement (<em>P</em> = .372).</div></div><div><h3>Interpretation</h3><div>This study adds to the growing body of literature demonstrating favorable outcomes of repair compared to reconstruction. In addition to previously identified advantages of repair, there appears to be some biomechanical advantage of repair compared to reconstruction at 12 weeks.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106498"},"PeriodicalIF":1.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term effect of unicompartmental knee arthroplasty on muscle coordination in patients with knee osteoarthritis","authors":"Zhixin Jin ,&nbsp;Jingnan Shi ,&nbsp;Haohua Zhang ,&nbsp;Kuan Zhang ,&nbsp;Xinglong Zhou ,&nbsp;Songhua Yan","doi":"10.1016/j.clinbiomech.2025.106496","DOIUrl":"10.1016/j.clinbiomech.2025.106496","url":null,"abstract":"<div><h3>Backgrouds</h3><div>Over 60 % of knee osteoarthritis patients report experiencing the “giving way” phenomenon. This study aims to investigate the alterations in coordinated muscle contraction around the knee joint when the knee joint suddenly buckles under force, similar to “giving way”, in the patients before and after unicompartmental knee arthroplasty.</div></div><div><h3>Methods</h3><div>Twenty-five patients and 20 healthy adults were recruited to test the difference of muscle coordination between the patients before and about three months after surgery and healthy individuals. The self-designed force application equipment and a wireless surface electromyography system were used to collect the data on muscles activation when the legs were hit. The standard of significant difference was set as <em>P</em> &lt; 0.05.</div></div><div><h3>Findings</h3><div>There were significant differences between the test and control groups in the directed co-contraction ratios of the hamstring/quadriceps(<em>P</em> = 0.016) and the co-contraction index of the quadriceps-hamstring(<em>P</em> &lt; 0.001) on the affected side, as well as in the directed co-contraction ratios of the biceps femoris/vastus lateralis(<em>P</em> = 0.020) on the unaffected side. Compared with data before the surgery, in directed co-contraction ratios and co-contraction index there was only a significant difference in directed co-contraction ratios of vastus lateralis/vastus medialis on the affected side(<em>P</em> &lt; 0.001) but there were significant differences in the co-contraction index of quadriceps-hamstring(<em>P</em> = 0.004) and vastus medialis-semitendinosus(<em>P</em> = 0.001) on the unaffected side after the surgery.</div></div><div><h3>Interpretation</h3><div>knee osteoarthritis affected the pattern of muscle co-contraction. In the short-term after the surgery, the co-contraction level in the affected side of patients did not have an obvious recovery but the activation level was improved, approaching healthy individuals.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106496"},"PeriodicalIF":1.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143683523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anterior variable-angle locked plating of complex patella fractures – Does the type of polar screw matter?","authors":"Karl Stoffel ,&nbsp;Ivan Zderic ,&nbsp;Torsten Pastor ,&nbsp;William Woodburn ,&nbsp;Richard Castle ,&nbsp;Jessica Penman ,&nbsp;Eladio Saura-Sanchez ,&nbsp;Boyko Gueorguiev ,&nbsp;Christoph Sommer","doi":"10.1016/j.clinbiomech.2025.106492","DOIUrl":"10.1016/j.clinbiomech.2025.106492","url":null,"abstract":"<div><h3>Background</h3><div>Treatment of complex patella fractures represents a challenging clinical problem. Whereas controversy exists regarding the most appropriate fixation method, anterior plating is an emerging treatment option. A novel design of anterior variable-angle locking plates features radiating legs with integrated screw holes aiming at capturing fragments of the distal comminuted zone via either a locking or a cortical polar screw.</div><div>The aim of this study was to compare the biomechanical performance of the novel anterior variable-angle locking plates used for fixation of complex patella fractures with either a locking or a cortical polar screw.</div></div><div><h3>Methods</h3><div>Complex five-part AO/OTA 34-C3 patella fractures mimicking comminution around the distal pole were simulated in twelve human cadaveric knees. Specimens were randomized to two groups for treatment with an anterior variable-angle locking plate fixing the patella with either one locking or one cortical caudo-cranial bicortical polar screw. Biomechanical testing was performed over 5000 cycles by pulling on the quadriceps tendon, simulating active knee extension and passive flexion within the range from 90° flexion to full extension. Interfragmentary movements were captured by motion tracking.</div></div><div><h3>Findings</h3><div>No significant differences between the two fixation techniques were detected in terms of longitudinal and shear articular displacements, and relative rotations around the mediolateral axis measured between the proximal and distal fragments at the central patella aspect between 1000 and 5000 cycles, <em>P</em> ≥ 0.116.</div></div><div><h3>Interpretation</h3><div>From a biomechanical perspective, anterior locked plating of complex patella fractures provides comparable fixation stability when using either a locking or a cortical polar screw.</div></div>","PeriodicalId":50992,"journal":{"name":"Clinical Biomechanics","volume":"124 ","pages":"Article 106492"},"PeriodicalIF":1.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143643677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}