Value of coining on the improvement of endurance in slotted intramedullary nails.

Cracking of intramedullary nails, starting at the proximal end of the partial slot and propagating in a circumferential direction, has been observed. These partial cracks are relatively frequent, although full failures are very rare and do not disturb fracture healing. Coining is a cold-working process used to improve the endurance of structures with residual compressive stresses generated by plastic deformation. The influence of coining was investigated to evaluate its practical value in controlling these fatigue cracks. Bending and torsional tests were performed on high frequency machines. Coined zones of different shapes and depths were examined, comparing the elapsed number of load cycles with crack initiation. The results showed that the endurance of coined nails was improved by factors of approximately 10 and 5 in bending and torsion, respectively. This increase in fatigue life corresponds to a more than 50% larger dynamic load after a million cycles. Variations in coining shape and depth did not yield any significant differences.

Stiffness characteristics of the circular Ilizarov device as opposed to conventional external fixators.

Ilizarov proposes the use of a special circular fixation device for treatment of bone defects and nonunions or for limb lengthening. Supposition was that the success of this method has to do with the specific mechanical behavior of the device. This behavior is a result of the configuration of the fixation elements. Therefore, a mechanical study of the sensitivity of the circular compression and distraction device (CDD) to configuration parameters was performed. The CDD was found to exhibit a nonlinear stiffness behavior, in particular under axial load. This may be favorable for the induction and tolerance of bone formation. Among the different parameters tested the ring radius was the most important with respect to stiffness. In general, the stiffness of the CDD allows adjustment during postoperative management. In magnitude, it is equal or lower when compared to other fixator types.

A comparative study of the initial stability of cementless hip prostheses.

In the process of prosthetic loosening, the initial motion of the implant relative to the bone is a key element. In order to provide quantitative information, three straight and one curved cementless hip stems were submitted to in vitro tests in autopsy specimens of the femur under dynamic axial and torsional loads with the displacements measured in several directions. The results were compared to those of an additional group of cemented straight stem prostheses providing reference values. Subsidence of cementless implants on the average was significantly higher than the cemented reference, but single implants were comparable to the reference. Rotational motion was distinctly higher than the reference values, with considerable differences between designs. When comparing displacements perpendicular to the main load direction, the sagittal plane motion was found to be at least double the motion in the frontal plane. Micromotions at the prosthesis/bone interfaces under the load case selected were smallest for the curved and highest for one of the straight prostheses.

Experimental method for the in vitro testing of the initial stability of cementless hip prostheses.

Micromotions at the interface between bone and prosthesis are believed to induce bone resorption and ultimately lead to loosening of the implant. Thus the initial stability achieved by a hip prosthesis is an important factor for the long-term function of the implant. Knowing the biological consequences of the mechanical conditions, it appears to be mandatory to measure the extent of these three-dimensional movements. An in vitro dynamic method for measurement of the micromotion of the femoral component of hip prostheses has been developed. Tests in cemented prostheses have confirmed that the use of cement reduces sinkage and rotation manyfold and have yielded reference values for stability. Comparison with two types of cementless prostheses has shown that certain cementless implants may achieve stability comparable to cemented ones in some load directions.