The influence of screw omission on construction stiffness and bone surface strain in the application of bone plates to cadaveric bone.

Biological fracture repair is becoming an increasingly popular means of fracture fixation. This technique involves a reduction in the amount of surgical trauma thereby preserving vascular supply and soft-tissue integrity combined with the implantation of less hardware. The aim is the stimulation of callus formation as the means by which fracture union occurs. This paper describes the mechanical effect of the symmetrical omission of screws on construction stiffness and bone surface strain following the application of bone plates to cadaveric bone. The influence of the pattern of screw omission was evaluated in both intact and osteotomized bone specimens. The application of bone plates using certain patterns of screw omission did not significantly effect the stiffness of the final construction whilst inherent bone surface strain was increased. It was concluded that the omission of screws in certain defined patterns for a given plate-bone construction may meet the criteria for 'biological fixation'. There was no apparent deleterious effect on structural stiffness following the omission of 40% of the total screw complement from a plate-bone construction.

Semi-quantitative assessment of tibial blood flow and distribution in response to surgical intervention using first pass radionuclide angiography and intravascular vital dye.

The acute vascular response in bone to surgical trauma was investigated utilizing a sheep model. Blood flow and distribution were determined using two methods; perfusion of the vasculature with an intravascular vital dye (Disulphine blue) prior to euthanasia and by radionuclide angiography (RNA) before and after each surgical intervention. The pattern of Disulphine blue distribution provided a good indication of local perfusion and response to surgical trauma (drilling holes). Radionuclide angiography provided a dynamic image of the vascular response to surgical trauma. The generation of time activity curves of the first pass of radionuclide bolus enabled calculation of the relative blood flow through selected regions. For both techniques areas of ischaemia were apparent which were directly related to the location of screw holes. We conclude that factors other than bone plate contact influence the ischaemia that develops in bone subsequent to the application of bone plates.

Using the Unger system to classify 386 long bone fractures in dogs.

A system already described by Unger and others was used to classify long bone fractures in dogs. The present paper reports experiences using the fracture classification system regarding its ease of use and the ability to analyse the data generated. Three hundred and eighty-six canine long bone fractures were classified from radiographs. Results were assessed by reviewing the medical records or by sending questionnaires to referring veterinarians. There were a few inconsistencies, particularly in classifying proximal ulnar fractures, but the system was easy to use and data retrieval was readily accomplished. Data from the system were used to compare the results of repairs of diaphyseal fractures of the radius/ulna, femur and tibia/fibula. A chi square analysis was used to determine significant differences between the outcome scores of the three fracture types. Fractures of the femoral diaphysis had a statistically poorer outcome than did diaphyseal fractures of the radius/ulna or tibia/fibula.

Delayed unions and nonunions. Diagnosis, pathophysiology, and treatment.

This article describes the different situations that result in interference with fracture healing and discusses the possible causes of such problems. Prevention and treatment of these states are reviewed.

Use of high-speed cinematography and computer generated gait diagrams for the study of equine hindlimb kinematics.

High-speed cinematography with computer aided analysis was used to study equine hindlimb kinematics. Eight horses were filmed at the trot or the pace. Filming was done from the side (lateral) and the back (caudal). Parameters measured from the lateral filming included the heights of the tuber coxae and tailhead, protraction and retraction of the hoof and angular changes of the tarsus and stifle. Abduction and adduction of the limb and tarsal height changes were measured from the caudal filming. The maximum and minimum values plus the standard deviations and coefficients of variations are presented in tabular form. Three gait diagrams were constructed to represent stifle angle versus tarsal angle, metatarsophalangeal height versus protraction-retraction (fetlock height diagram) and tuber coxae and tailhead height versus stride (pelvic height diagram). Application of the technique to the group of horses revealed good repeatability of the gait diagrams within a limb and the diagrams appeared to be sensitive indicators of left/right asymmetries.

An experimental investigation in the dog into the mode of osseous integration of total joint implants.

An uncemented scaled down version of the Mueller SLS femoral component was inserted into 30 dogs. The material (Protasul 100), geometry, and finish were identical to those designed for clinical use. Half of the prostheses inserted were fitted out with a modular collar to improve stability. Initial stability was achieved through press fit which was made possible by the special modification of the surface area and external configuration of the prosthesis. The function of the prosthesis was assessed through clinical assessment and force plate gait analysis. This was correlated with the degree of osseous integration which was evaluated on the basis of regular radiological examinations, and at post mortem by microradiography of the serially sectioned undecalcified femurs, and histological examination of selected sections under regular and ultraviolet light. The animals were sacrificed at 4, 8, and 12 months. Force plate gait analysis revealed that all animals walked with a normal gait by the 4th post-operative month. Evaluation revealed that 29/30 femoral prostheses became successfully integrated. The prostheses without the collar were less stable and most achieved stability only by incorporation of the distal tip of the prostheses in bone and the remainder in dense fibrous tissue. The prostheses with the collar were stable and achieved without fail full bony integration. The stability was provided by appositional growth of bone which came into direct contact with the implant over the proximal 1/3 and the distal 1/3 without an intervening fibrous membrane. Despite failure of full integration of the collarless prostheses clinically and by force plate analyses the two groups were indistinguishable.(ABSTRACT TRUNCATED AT 250 WORDS)

A strain-gauge study of the effect of external fixation on the canine tibia.

Electrical resistance rosette strain gauges bonded directly to the surface of the midshaft of the normal canine tibia were utilized to study the effect of the AO external skeletal fixator on the magnitude and orientation of the peak strain values recorded during locomotion. The application of the fixator in a single lateral bar configuration resulted in a significant decrease in surface bone strain magnitude but in only minor changes in the orientation of those strains. However, in only one of three dogs tested did the addition of a second external connecting bar result in significant further decreases in bone strain.

Measurement of bending and torsion with and without an intramedullary nail implanted in sheep tibia in vivo.

This report concerns the analysis of the dynamic measurements of torque and bending on nailed tibiae, using two sheep walking at different speeds on a treadmill, both before and after nailing. The amplitude and the period of the measured values are reported and discussed in relationship to the speed and duration of the experiment.

Wagner resurfacing arthroplasty of the canine hip.

Twelve surface replacement arthroplasties were performed on the hips of ten mongrel dogs using scaled-down replicas of the Wagner prosthesis. The contralateral hips and two further animals served as nonoperated controls. Animals were killed 5 months postoperatively. Clinical, radiological, histological and fluorochrome-labelling studies were employed to assess the bony and soft tissue reaction to resurfacing arthroplasty. There was no clinical or radiographic evidence of prosthetic loosening. Histological examination disclosed a thick foreign body and chronic inflammatory membrane containing acrylic cement and polyethylene wear particles at the bone-cement interface of both components. Generally, the bone marrow and trabecula were viable. There was evidence of increased bony remodelling and new bone formation in the subchondral area. The similarity between the above findings and those of aseptic component loosening in man suggests a mechanism whereby wear debris initiate a biological foreign body reaction culminating in component loosening.

The effect of polymethylmethacrylate on bone: an experimental study.

In order to assess the response of bone to low-viscosity polymethylmethacrylate, CMW or Simplex acrylic cement was digitally packed while in a doughy state into drill holes in the proximal diaphysis in each of four long bones (humeri and tibiae) of mongrel dogs. Histological assessment was performed in areas of minimal load at the interface between the viscoelastic bone and the acrylic cement. Decalcified and undecalcified sections were evaluated and a remodeling or activity index calculated. Fluorescent labeling studies were performed in order to assess bone growth. Animals were killed at 2, 4 or 5 months. Histological analysis showed a thin connective-tissue membrane containing scattered giant cells and histiocytes at the bone-cement interface. Inflammation was not an important facet of this response. The marrow and trabecular bone were viable, except for scattered localized areas of marrow necrosis and fibrosis immediately adjacent to the cement. The bone adjacent to the cement showed a lower remodeling or activity index, fewer fluorescent bands, and smaller distances between successive bands, suggesting decreased bone formation and turnover. The etiology of these findings may include a vascular disturbance secondary to disruption of the cortical and marrow circulation, temperature effects during cement polymerization, and/or chemical effects from the acrylic monomer.

Evaluation of analytical grade of metrizamide for canine stifle arthrography.

The use of analytical grade of metrizamide as contrast material in canine stifle arthrography was evaluated in 27 stifle joints. A concentration of 280 mg of I/100 ml was prepared, and the material was injected at a rate of 0.3 ml/cm thickness of the lateral to medial measurement. Acceptable arthrograms were produced in 22 (81.5%) cases. The mediolateral radiographic view was useful in demonstrating the cranial and caudal cruciate ligaments, the infrapatellar fat pad, and the tendon of the long digital extensor muscle. The caudocranial radiographic view was useful in demonstrating the medial and lateral menisci, the articular surfaces of the femoral condyles, and the outline of the joint capsule. Radiographs made within 15 minutes after injection of the contrast medium were acceptable, thus setting this period as the limit for obtaining useful arthrograms. The double contrast technique was found to be of little value.

Treatment of nonuniting osteotomies with pulsating electromagnetic fields. A controlled animal experiment.

To evaluate treatment of nonunions or pseudarthrosis in humans by pulsating electromagnetic fields (PEMF), the authors tested the method in four- to six-year-old beagle dogs with midshaft osteotomies of both ulnae. This type of osteotomy in dogs leads to nonunion. After surgery one foreleg of each dog was stimulated for an average of 25 days; the second foreleg served as a control. Subsequently all ulnae were harvested, radiographs were obtained, and the stiffness of the callus was mechanically tested. Thus, the reputed efficiency is not confirmed by controlled experiments on dogs. The stimulated bones were neither radiologically nor mechanically superior to the controls.

Evaluation of tension and compression forces in the canine femur in vivo.

In order to verify the existence of tension and compression forces from the cortical surface of canine femora, rosette strain gauges and a radio telemetry system were used to observe the animals during normal locomotion. Surface strain measured from the lateral cortical surface was consistently in tension whereas surface strain measured from the medial cortical surface was in compression. This data supported in vitro work which showed that eccentric loading of bone results in the convex side of bone being in tension and the concave side of bone being in compression.

Effect of internal fixation on the strain environment of the canine femur.

Strain gauge technology and telemetric transmission were utilized to investigate the dynamic strain patterns along the cortical surface of bone and the response to internal fixation, in vivo. Application of a tension band plate resulted in conversion of normal tensile strain into compressive strain which verified the tension band principle of internal fixation. Creation of a transverse osteotomy did not alter this response, provided that the fragments were rigidly fixed. The plate caused an appreciable decrease in normal surface strain measured from the lateral and medial cortices, illustrating the concept of stress protection.