A parametric design evaluation of lateral prophylactic knee braces.

Six major mechanical design variables characterizing single-upright lateral prophylactic knee braces were studied experimentally, using a generic modular brace (GMB). Impulsive valgus loading tests were conducted with the GMB applied to a surrogate leg model. The surrogate involved anatomically realistic aluminum-reinforced acrylic components to model bone, and expendable polymeric blanks to mimic the major knee ligaments. Behavior of the surrogate system reasonably reproduced that of human cadaveric knees under similar loading conditions. Load at failure of the medial collateral ligament (MCL) analog, gross knee stiffness, and MCL relative strain relief were measured for each of twelve parametric brace design permutations. Compared to the unbraced condition, bracing provided statistically significant increases in valgus load uptake at failure and in MCL strain relief. Increasing the dimensions of individual brace components (hinge length and offset; upright length, breadth, and thickness; cuff area), relative to those of a GMB baseline configuration deemed representative of current commercial products, failed to achieve statistically significant improvements in brace performance. However, most below-baseline dimensioning of individual components did significantly compromise GMB performance. These surrogate test data indicate that geometric modifications of current single-upright lateral brace designs are unlikely to substantially improve upon the fairly modest valgus load protection afforded by this class of devices.

Stresses at the dentinoenamel junction of human teeth--a finite element investigation.

A three-dimensional, linear, elastic finite element model of a maxillary first premolar from longitudinal ground sections was developed to investigate stress variation in the enamel and dentin adjacent to the dentinoenamel junction (DEJ). The effect of regional variation in the contour of the DEJ on the stress patterns for enamel and dentin was also analyzed. The normal (compressive or tensile) and shear stresses in the dentin and enamel surfaces of the DEJ were computed for a vertical load of 170 N acting on the entire occlusal surface of the model. The normal stresses in dentin and enamel were maximum on the occlusal surface of the model and diminished along the buccal and lingual surfaces of the DEJ. However, the magnitude of the normal stresses increased at the cervical enamel, which also showed increased values for shear stress distribution. The normal and shear stresses were markedly affected by the contour of the DEJ and the thickness of enamel in the occlusal third on the buccal and lingual surfaces. The results suggested that because the mechanical interlocking between enamel and dentin in the cervical region is weaker than in other regions of the DEJ, enamel in this region may be susceptible to belated cracking that could eventually contribute to the development of cervical caries.

Mechanical analysis of the factors affecting dynamization of the Orthofix Dynamic Axial Fixator.

Loading trials were conducted to identify mechanical factors affecting dynamization of a commercially available external fixator (Orthofix) that is designed to undergo free telescopic motion when axially loaded. Angular variations between the proximal and distal screw clamps and the telescoping fixator body failed to produce fixator binding (failure to dynamize) in any of the loading trials. However, binding was produced by applying external torques in magnitudes that occasionally occur during routine ambulation. The specific torque necessary to induce binding (typically 3-4 Nm) was only a weak function of axial load magnitude, axial loading frequency, or simulated fracture stiffness. Among several geometrical variables of fixator application, only the pre-extension of the telescoping body and circumferential misalignment between proximal and distal pin clusters had an appreciable influence on the threshold binding torque. Axial fixator motions were also monitored in a small adjunct clinical series of 22 dynamized tibial fractures. The fixator dynamized appropriately in 15 cases (68%). Three patients (14%) showed evidence of fixator binding, and another four (18%) had less than predicted slider excursions. The role of several design factors implicated in torque-induced fixator binding is discussed in light of the benchtop and clinical observations.