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Determination of the internal loads experienced by proximal phalanx fracture fixations during rehabilitation exercises
AO Research Institute Davos, Davos, Switzerland.
Department of Orthopedic Surgery, Hvidovre University Hospital, Copenhagen, Denmark; Department of Orthopedic Surgery, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark, Copenhagen,Rigshospitalet.
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Fibre- and Polymer Technology, Coating Technology.ORCID iD: 0000-0003-0028-1204
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Fibre- and Polymer Technology, Coating Technology.ORCID iD: 0000-0002-6501-6359
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2024 (English)In: Frontiers in Bioengineering and Biotechnology, E-ISSN 2296-4185, Vol. 12, article id 1388399Article in journal (Refereed) Published
Abstract [en]

Phalangeal fractures are common, particularly in younger patients, leading to a large economic burden due to higher incident rates among patients of working age. In traumatic cases where the fracture may be unstable, plate fixation has grown in popularity due to its greater construct rigidity. However, these metal plates have increased reoperation rates due to inflammation of the surrounding soft tissue. To overcome these challenges, a novel osteosynthesis platform, AdhFix, has been developed. This method uses a light-curable polymer that can be shaped in situ around traditional metal screws to create a plate-like structure that has been shown to not induce soft tissue adhesions. However, to effectively evaluate any novel osteosynthesis device, the biomechanical environment must first be understood. In this study, the internal loads in a phalangeal plate osteosynthesis were measured under simulated rehabilitation exercises. In a human hand cadaver study, a plastic plate with known biomechanical properties was used to fix a 3 mm osteotomy and each finger was fully flexed to mimic traditional rehabilitation exercises. The displacements of the bone fragments were tracked with a stereographic camera system and coupled with specimen specific finite element (FE) models to calculate the internal loads in the osteosynthesis. Following this, AdhFix patches were created and monotonically tested under similar conditions to determine survival of the novel technique. The internal bending moment in the osteosynthesis was 6.78 ± 1.62 Nmm and none of the AdhFix patches failed under the monotonic rehabilitation exercises. This study demonstrates a method to calculate the internal loads on an osteosynthesis device during non-load bearing exercises and that the novel AdhFix solution did not fail under traditional rehabilitation protocols in this controlled setting. Further studies are required prior to clinical application.

Place, publisher, year, edition, pages
Frontiers Media SA , 2024. Vol. 12, article id 1388399
Keywords [en]
CT derived models, customizable osteosythesis, finite element modeling, non-contact measurement, patient-specific treatment
National Category
Orthopaedics Pharmaceutical and Medical Biotechnology
Identifiers
URN: urn:nbn:se:kth:diva-353921DOI: 10.3389/fbioe.2024.1388399ISI: 001321505100001Scopus ID: 2-s2.0-85203878492OAI: oai:DiVA.org:kth-353921DiVA, id: diva2:1900996
Note

QC 20240926

Available from: 2024-09-25 Created: 2024-09-25 Last updated: 2025-02-17Bibliographically approved

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Hutchinson, DanielSan Jacinto García, JorgeMalkoch, Michael

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