Comparative study of locking neutralization plate construct versus tension band wiring with a cannulated screw for patella fractures: experimental and finite element analysis.

Autor: Kim S; Department of Orthopedic Surgery, University of Illinois at Chicago, Chicago, IL, USA., Mungalpara N; Department of Orthopedic Surgery, University of Illinois at Chicago, Chicago, IL, USA., Wangikar R; Department of Orthopedic Surgery, University of Illinois at Chicago, Chicago, IL, USA., Tarabichi M; Department of Orthopedic Surgery, University of Illinois at Chicago, Chicago, IL, USA., Karam J; Department of Orthopedic Surgery, Orthopedic and Spine Institute, Northshore University Health System, An Affiliate of the University of Chicago Pritzker School of Medicine, 9669 Kenton Avenue, Skokie, IL, 60076, USA., Bedi A; Department of Orthopedic Surgery, Orthopedic and Spine Institute, Northshore University Health System, An Affiliate of the University of Chicago Pritzker School of Medicine, 9669 Kenton Avenue, Skokie, IL, 60076, USA., Koh J; Department of Orthopedic Surgery, Orthopedic and Spine Institute, Northshore University Health System, An Affiliate of the University of Chicago Pritzker School of Medicine, 9669 Kenton Avenue, Skokie, IL, 60076, USA., Amirouche F; Department of Orthopedic Surgery, University of Illinois at Chicago, Chicago, IL, USA. famirouche@northshore.org.; Department of Orthopedic Surgery, Orthopedic and Spine Institute, Northshore University Health System, An Affiliate of the University of Chicago Pritzker School of Medicine, 9669 Kenton Avenue, Skokie, IL, 60076, USA. famirouche@northshore.org.
Jazyk: angličtina
Zdroj: Journal of orthopaedic surgery and research [J Orthop Surg Res] 2024 Jan 18; Vol. 19 (1), pp. 77. Date of Electronic Publication: 2024 Jan 18.
DOI: 10.1186/s13018-024-04538-w
Abstrakt: Transverse patella fractures, accounting for approximately 1% of Orthopedic injuries, pose intricate challenges due to their vital role in knee mechanics. This study aimed to compare the biomechanical performance of a construct, integrating cannulated screws and an anterior locking neutralization plate, with the conventional tension band wiring technique for treating these fractures. Experimental testing and Finite Element Analysis were employed to evaluate the constructs and gain profound insights into their mechanical behavior. Sixteen cadaveric knees were prepared, and transverse patella fractures were induced at the midpoints using a saw. The plate construct and tension band wire fixation were randomly assigned to the specimens. A cyclic test evaluated the implants' durability and stability, simulating knee movement during extension and flexion. Tensile testing assessed the implants' maximum failure force after cyclic testing, while Finite Element Analysis provided detailed insights into stress distribution and deformation patterns. Statistical analysis was exclusively performed for the experimental data. Results showed the plate enhanced stability with significantly lower deformation (0.09 ± 0.12 mm) compared to wire fixation (0.77 ± 0.54 mm) after 500 cycles (p = 0.004). In tensile testing, the construct also demonstrated higher failure resistance (1359 ± 21.53 N) than wire fixation (780.1 ± 22.62N) (p = 0.007). Finite Element Analysis highlighted distinct stress patterns, validating the construct's superiority. This research presents a promising treatment approach for transverse patella fractures with potential clinical impact and future research prospects. This study presents a promising advancement in addressing the intricate challenges of transverse patella fractures, with implications for refining clinical practice. The construct's improved stability and resistance to failure offer potential benefits in postoperative management and patient outcomes.
(© 2024. The Author(s).)
Databáze: MEDLINE
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