A comparative biomechanical study of the Distal Tibia Nail against compression plating for the osteosynthesis of supramalleolar corrective osteotomies.

The Distal Tibia Nail (DTN; Mizuho, Japan) has demonstrated higher biomechanical stiffness to locking plates in previous research for A3 distal tibia fractures. It is here investigated as a fixation option for supramalleolar corrective osteotomies (SMOT). Sixteen Sawbones tibiae were implanted with either a DTN (n = 8) or Medial Distal Tibia Plate (MDTP; n = 8) and a SMOT simulated. Two surgical outcome scenarios were envisaged: "best-case" representing an intact lateral cortex, and "worst-case" representing a fractured lateral cortex. All samples were subjected to compressive (350 N, 700 N) and torsional (± 4 Nm, ± 8 Nm) testing. Samples were evaluated using calculated construct stiffness from force-displacement data, interfragmentary movement and Von Mises' strain distribution. The DTN demonstrated a greater compressive stiffness for the best-case surgical scenario, whereas the MDTP showed higher stiffness (p < 0.05) for the worst-case surgical scenario. In torsional testing, the DTN proved more resistant to torsion in the worst-case surgical setup (p < 0.05) for both ± 4 Nm and ± 8 Nm. The equivalent stiffness of the DTN against the MDTP supports the use of this implant for SMOT fixation and should be considered as a treatment option particularly in patients presenting vascularisation problems where the MDTP is an inappropriate choice.

Corrigendum: Strain Assessment of Deep Fascia of the Thigh During Leg Movement: An in situ Study.

[This corrects the article DOI: 10.3389/fbioe.2020.00750.].

Strain Assessment of Deep Fascia of the Thigh During Leg Movement: An in situ Study.

Fascia is a fibrous connective tissue present all over the body. At the lower limb level, the deep fascia that is overlying muscles of the outer thigh and sheathing them (fascia lata) is involved in various pathologies. However, the understanding and quantification of the mechanisms involved in these sheathing effects are still unclear. The aim of this study is to observe and quantify the strain field of the fascia lata, including the iliotibial tract (ITT), during a passive movement of the knee. Three fresh postmortem human subjects were studied. To measure hip and knee angles during knee flexion-extension, passive movements from 0° to around 120° were recorded with a motion analysis system and strain fields of the fascia were acquired using digital image correlation. Strains were computed for three areas of the fascia lata: anterior fascia, lateral fascia, and ITT. Mean principal strains showed different strain mechanisms depending on location on the fascia and knee angle. For anterior and lateral fascia, a tension mechanism was mainly observed with major strain greater than minor strain in absolute value. While for the ITT, two strain mechanisms were observed depending on knee movement: tension is observed when the knee is extended relatively to reference position of 47°, however, pure shear can be observed when the knee is flexed. In some cases, minor strain can also be higher than major strain in absolute value, suggesting high tissue compression probably due to microstructural fiber rearrangements. This in situ study is the first attempt to quantify the superficial strain field of fascia lata during passive leg movement. The study presents some limitations but provides a step in understanding strain mechanism of the fascia lata during passive knee movement.

Non-destructive assessment of human ribs mechanical properties using quantitative ultrasound.

Advanced finite element models of the thorax have been developed to study, for example, the effects of car crashes. While there is a need for material properties to parameterize such models, specific properties are largely missing. Non-destructive techniques applicable in vivo would, therefore, be of interest to support further development of thorax models. The only non-destructive technique available today to derive rib bone properties would be based on quantitative computed tomography that measures bone mineral density. However, this approach is limited by the radiation dose. Bidirectional ultrasound axial transmission was developed on long bones ex vivo and used to assess in vivo health status of the radius. However, it is currently unknown if the ribs are good candidates for such a measurement. Therefore, the goal of this study is to evaluate the relationship between ex vivo ultrasonic measurements (axial transmission) and the mechanical properties of human ribs to determine if the mechanical properties of the ribs can be quantified non-destructively. The results show statistically significant relationships between the ultrasonic measurements and mechanical properties of the ribs. These results are promising with respect to a non-destructive and non-ionizing assessment of rib mechanical properties. This ex vivo study is a first step toward in vivo studies to derive subject-specific rib properties.

Mechanical behaviour of the in vivo paediatric and adult trunk during respiratory physiotherapy.

The load-deflection response of the human trunk has been studied using various methods. The different shapes observed may be due to the methodology and the population. The purpose of this study is to quantify and explain the in vivo mechanical response of paediatric and adult trunks during respiratory physiotherapy. Eight children aged 5-15 months and eight healthy adult volunteers aged 30-87 years participated in this study. The force applied by the physiotherapist and the displacement of the targets on his hands were recorded. Parameters were also measured and calculated to compare against other studies. Time lags between force time histories and displacement time histories were observed on both children and adults. Different time lags resulted in different shapes of the force-displacement curves. Factors including respiration, muscle contraction and loading pattern are part of the assumptions used to explain this phenomenon. The maximum displacements of the paediatric and adult trunks were 18 and 44 mm, respectively, with a maximum load of 208 and 250 N, respectively. This study provides a better explanation of the peculiar force-displacement characteristics of both living and active children and adults under a non-injurious, low-rate compression condition. Complementary data (e.g. muscle activity and breathing) should be collected in the future to go towards in vivo human trunk modelling.

Finite element modeling of the head skeleton with a new local quantitative assessment approach.

The present study was undertaken to build a finite element model of the head skeleton and to perform a new assessment approach in order to validate it. The application fields for such an improved model are injury risk prediction as well as surgical planning. The geometrical reconstruction was performed using computed tomography scans and a total of 4680 shell elements were meshed on the median surface of the head skeleton with the particular characteristic of adapted mesh density and real element thickness. The assessment protocol of the finite element model was achieved using a quasi-static experimental compression test performed on the zygomatic bone area of a defleshed isolated head. Mechanical behavior of the finite element model was compared to the real one and the assessment approach was divided into two steps. First, the mechanical properties of the anatomical structure were identified using the simulation and then the simulated displacement field was compared to local displacement measurement performed during test using a digital correlation method. The assessment showed that the head skeleton model behaved qualitatively like the real structure. Quantitatively, the local relative error varied from 8% up to 70%.

Comparison of Hybrid III, Thor-alpha and PMHS Response in Frontal Sled Tests.

Two series of nine frontal sled tests were conducted to evaluate the behavior of the Hybrid III and Thor-alpha dummies. The first series was conducted at 50 kph with airbag and 4 kN force-limited shoulder belt and the second series at 30 kph and only a 4 kN force-limited shoulder belt. In each series, three replicate tests were conducted with each dummy and compared with three PMHS. The data provided by the same instrumentation located at the same position were compared to assess the biofidelity of both dummies. The results were mass scaled in order to account for the differences between the anthropometry of the cadaver. The good test-to-test repeatability for each dummy permitted to compare the mean value of each recorded parameter. Based on the cadaver response, the results show that the Thor-alpha provides responses that are more similar to those of PMHS than the Hybrid III. The flexible joints in the thoracic spine, the sternum design and the more humanlike ribcage give more similar accelerations than the Hybrid III as compared to those of the PMHS. Nevertheless, some parts have to be improved in order to better follow the behavior of the human subject. The head-neck complex, the chest, the shoulder and the pelvis of the Thor-alpha have a more humanlike behavior but some differences remain. The distribution of the deceleration between the components is sometimes different compared to those of the cadaver, even if the resultants are similar. The dummies and most particularly the Hybrid III are less sensitive to the change in restraint systems and tests conditions than a cadaver.