Mechanical Evaluation of Two Canine Iliac Fracture Fixation SysteMS

Twenty-three canine pelves were tested bilaterally to determine the stiffness and strength of intact ilium and stabilized oblique iliac osteotomies that simulated a common clinical fracture. Fixation systems tested were three 4.0 mm cancellous screws inserted ventral to dorsal across the osteotomy site and one laterally placed five hole 3.5 mm dynamic compression plate. Specimens were mechanically tested to failure under torsional, axial, or axial plus bending loads. Lag screw fixation was stiffer and stronger than plate fixation in all testing modes. The differences were statistically significant (p less than .05) in the torsional and axial plus bending loading modes. Fatigue testing was performed on implanted specimens with low-level cyclic loading under axial plus bending loading conditions. Physiologic loading conditions failed to produce mechanical failure of either fixation system after 100,000 cycles.     

A Biomechanical Comparison of 7-Hole 3.5 mm Broad and 5-Hole 4.5 mm Narrow Dynamic Compression Plates

Seven-hole 3.5 mm broad and 5-hole 4.5 mm narrow dynamic compression plates were applied to paired canine cadaveric tibias in a stable fracture model. Paired tibias were tested to acute failure in rotation and four-point bending, and to fatigue failure in four-point bending. Resistance to screw pullout was measured for three 3.5 mm cortical screws and two 4.5 mm cortical screws inserted in the configurations of the bone plates. All plate-bone systems failed by fracture of the bone through a screw hole. The 3.5 mm plate-bone system was stronger in acute failure in rotation and in four-point bending. There was no difference in stiffness, and no difference in the number of cycles to failure in fatigue testing. Three 3.5 mm screws had greater resistance to pullout than two 4.5 mm screws. Results indicate that the 7-hole 3.5 mm broad dynamic compression plate has a biomechanical advantage over the 5-hole 4.5 mm narrow dynamic compression plate.     

An In Vitro Biomechanical Comparison of Dynamic Condylar Screw Plate Combined with a Dorsal Plate and Double Plate Fixation of Distal Diaphyseal Radial Osteotomies in Adult Horses

Objective— To compare stiffness and strength of a dynamic condylar screw plate combined with dorsal broad dynamic compression plate (DCS–bDCP) fixation with double broad dynamic compression plate (dbDCP) fixation used to repair oblique distal fractures of adult equine radii. Study Design— Experimental. Sample Population— Adult equine radii (n=10 pair). Methods— An unconstrained three‐dimensional loading–measurement system was used to determine stiffness of a 50 mm long intact, and then DCS–bDCP or dbDCP‐plated osteotomized/ostectomized segment of radii when subjected to a nondestructive sequence of compression, torsion, and lateral‐to‐medial (LM), medial‐to‐lateral (ML), cranial‐to‐caudal (CrCa), and caudal‐to‐cranial (CaCr) bending. Uniform load over the entire length of construct identified its weakest characteristics during torsion and LM and CrCa bending to failure. Results— No difference was observed between osteotomized/ostectomized DCS–bDCP and dbDCP construct stiffness for all 6 loading modes, and strength for all 3 failure loads. Ostectomized DCS–bDCP and dbDCP construct stiffness was significantly lower than osteotomized radii, the latter approaching intact for axial, LM, and CrCa bending. Most frequent failure was bone fracture through exit site of a screw located adjacent to osteotomy/ostectomy. Conclusions— DCS–DCP and dbDCP constructs had comparable strength and stiffness when repairing osteotomies/ostectomies in equine adult radius bone. Fracture reduction increased stiffness that approached intact bone for loads that placed the unplated side in compression. Clinical Relevance— DCS–bDCP and dbDCP constructs are comparable in stiffness and strength when applied to oblique distal diaphyseal osteotomies/ostectomies in equine radius bone. However, the DCS's localized effect on distal epiphyseal structure because of additional bone removal remains to be investigated under in vivo articular loading conditions.     

Arthrodesis of the Equine Proximal Interphalangeal Joint: A Biomechanical Comparison of Two 7-Hole 3.5-mm Broad and Two 5-hole 4.5-mm Narrow Dynamic Compression Plates

OBJECTIVE: To compare the biomechanical characteristics and mode of failure of two different dynamic compression plate (DCP) techniques for proximal interphalangeal joint (PIPJ) arthrodesis in horses. STUDY DESIGN: Randomized block-design blocking on horse (1-5), method of fixation (two 7-hole, 3.5-mm broad DCP vs two 5-hole, 4.5-mm narrow DCP), side (left, right), and end (front, hind). Constructs were loaded to failure in 3-point bending in a dorsal-to-palmar (plantar) direction. SAMPLE POPULATION: Ten paired limbs from 5 equine cadavers. METHODS: Two 7-hole, 3.5-mm broad dynamic compression plates (bDCP) were used in 1 limb of a pair, and two 5-hole 4.5-mm narrow dynamic compression plates (nDCP) were used on the contralateral limb. Plates were positioned abaxially across the dorsomedial and dorsolateral aspect of the PIPJ. Arthrodesis constructs were loaded (19 mm/s) in 3-point bending in a dorsal-to-palmar (plantar) direction using a materials-testing machine. Composite stiffness, yield point, and maximal bending moment at failure were obtained from bending moment-angular deformation curves. Data were analyzed using ANOVA, X(2) analysis, and Fisher's exact tests; the power of the test was calculated when differences were not significant. RESULTS: There were no significant differences in composite stiffness (P >.05; power = 0.8 @ delta = 21.9%), yield point (P >.05; power = 0.8 @ delta = 34.4%), or maximal bending moment (P >.05; power = 0.8 @ delta = 17.8%) between the two fixation techniques. For bDCP constructs, 11% (15 of 140) of the 3.5-mm screws were damaged; 7 of the screw heads pulled through plates where the plates bent, 1 screw head broke off, and 7 screws were bent or pulled out of the phalanx. For nDCP constructs, 8% (8 of 100) of the 4.5-mm screws were damaged; 1 screw head pulled through a plate, 1 screw head broke off, and 6 screws were bent or pulled out of the phalanx. CONCLUSIONS: There were no biomechanical or failure differences between bDCP and nDCP fixation of the PIPJ in horses when evaluated in single-cycle 3-point bending to failure. CLINICAL RELEVANCE: There is no biomechanical advantage to the use of two 7-hole, 3.5-mm bDCP in equine proximal interphalangeal arthrodesis compared with two 5-hole, 4.5-mm nDCP. Two 5-hole, 4.5-mm nDCP may be easier to place, whereas two 7-hole, 3.5-mm bDCP may provide more versatility in fracture repair.     

An in vitro biomechanical comparison between prototype tapered shaft cortical bone screws and AO cortical bone screws for an equine metacarpal dynamic compression plate fixation of osteotomized equine third metacarpal bones

OBJECTIVES: To compare biomechanical properties of a prototype 5.5 mm tapered shaft cortical screw (TSS) and 5.5 mm AO cortical screw for an equine third metacarpal dynamic compression plate (EM-DCP) fixation to repair osteotomized equine third metacarpal (MC3) bones. STUDY DESIGN: Paired in vitro biomechanical testing of cadaveric equine MC3 with a mid-diaphyseal osteotomy, stabilized by 1 of 2 methods for fracture fixation. ANIMAL POPULATION: Adult equine cadaveric MC3 bones (n=12 pairs). METHODS: Twelve pairs of equine MC3 were divided into 3 groups (4 pairs each) for (1) 4-point bending single cycle to failure testing, (2) 4-point bending cyclic fatigue testing, and (3) torsional single cycle to failure testing. An EM-DCP (10-hole, 4.5 mm) was applied to the dorsal surface of each, mid-diaphyseal osteotomized, MC3 pair. For each MC3 bone pair, 1 was randomly chosen to have the EM-DCP secured with four 5.5 mm TSS (2 screws proximal and distal to the osteotomy; TSS construct), two 5.5 mm AO cortical screws (most proximal and distal holes in the plate) and four 4.5 mm AO cortical screws in the remaining holes. The control construct (AO construct) had four 5.5 mm AO cortical screws to secure the EM-DCP in the 2 holes proximal and distal to the osteotomy in the contralateral bone from each pair. The remaining holes of the EM-DCP were filled with two 5.5 mm AO cortical screws (most proximal and distal holes in the plate) and four 4.5 mm AO cortical screws. All plates and screws were applied using standard AO/ASIF techniques. Mean test variable values for each method were compared using a paired t-test within each group. Significance was set at P<.05. RESULTS: Mean 4-point bending yield load, yield bending moment, bending composite rigidity, failure load and failure bending moment of the TSS construct were significantly greater (P<.00004 for yield and P<.00001 for failure loads) than those of the AO construct. Mean cycles to failure in 4-point bending of the TSS construct was significantly greater (P<.0002) than that of the AO construct. The mean yield load and composite rigidity in torsion of the TSS construct were significantly greater (P<.0039 and P<.00003, respectively) than that of the AO construct. CONCLUSION: The TSS construct provides increased stability in both static overload testing and cyclic fatigue testing. CLINICAL RELEVANCE: The results of this in vitro study support the conclusion that the EM-DCP fixation using the prototype 5.5 mm TSS is biomechanically superior to the EM-DCP fixation using 5.5 mm AO cortical screws for the stabilization of osteotomized equine MC3.     

An in vitro biomechanical study of bone plate and interlocking nail in a canine diaphyseal femoral fracture model

OBJECTIVE: To compare the structural properties and the interfragmentary motion in ostectomized canine femurs stabilized with either an 8-mm interlocking nail system (IN) or a 10-hole dynamic compression broad plate (DCP). ANIMAL OR SAMPLE POPULATION: Ten pairs of adult canine femurs with a 25-mm mid-diaphyseal gap. METHODS: Bone specimens were divided into 2 groups (10 femurs each). Left femurs were stabilized with a DCP and 8 bicortical screws; right femurs were stabilized with an IN and 3 screws. Mechanical tests were performed in eccentric axial loading and in craniocaudal bending. The testing was first conducted nondestructively and then until breakage. Structural properties, ie, stiffness, yield limits, and failure limits, were determined. Interfragmentary motion was measured during nondestructive tests with the use of an optoelectronic device. Axial, transverse, and rotational motions were calculated. Mean values of stiffness, yield and failure limits, and axial and shear motions for each fixation method were compared using a paired t test within each group (P <.05). RESULTS: Mean (+/-SD) values of stiffness and failure limit were significantly higher for IN constructs than for DCP constructs in compression, while there was little difference in the results between each tested group in bending. Mean yield load values were significantly higher for IN than for DCP specimens in compression as well as in bending. The axial-motion analysis revealed significant differences between IN and DCP groups during bending tests only. The highest score of transverse motion at the gap was recorded during bending tests, and was higher for DCP than for IN specimens. There were insignificant differences between the two groups with regard to rotation around the diaphyseal axis. CONCLUSIONS AND CLINICAL RELEVANCE: Structural properties and interfragmentary shear motion analysis demonstrated a much higher rigidity in the IN-bone than in the DCP-bone constructs.     

Ex Vivo Biomechanics of Kirschner-Ehmer External Skeletal Fixation Applied to Canine Tibiae

The purpose of this study was to determine the respective contribution of each of the following parameters to the compressive, bending, and torsional rigidity of the Kirschner-Ehmer (KE) external fixation splint as applied to canine tibiae with an osteotomy gap: bilateral versus unilateral splints; increasing the number of fixation pins; altering the diameter of fixation pins and side bars; decreasing side bar distances from the bone; increasing pin separation distances in each pin group; decreasing distances between pin groups; altering pin clamp orientation; and altering side bar conformation. Bilateral splints were 100% (mean) stiffer than unilateral splints, with stiffness enhanced to the greatest extent in mediolateral bending and torsion. Increasing pin numbers stiffened both bilateral (mean, 41%; 8 versus 4) and unilateral splints (mean, 14%; 8 versus 4). Medium KE splints were 85% (mean) stiffer than small KE splints. Decreasing side bar distances to the bone from 1.5 cm to 1.0 cm to 0.5 cm increased stiffness of both bilateral and unilateral splints by a mean of 13% to 35%. Widening pin spacing from 1.67 cm to 2.5 cm increased stiffness in craniocaudal bending only (56% increase, bilateral splints; 73% increase, unilateral splints). Decreasing the distance between pin groups from 5.84 cm to 2.5 cm increased stiffness in torsion between 23% (unilateral splints) and 45% (bilateral splints) and decreased stiffness of unilateral splints by 29% in craniocaudal bending. Altering pin clamp configuration so that the bolts of the clamp were inside the side bar rather than outside the side bar increased stiffness in axial compression only (73% increase, bilateral splints; 54% increase, unilateral splints). Conforming the lateral side bar to the tibiae increased only axial compressive stiffness by 77% but was no different than placing the clamps inside the side bars of an unconformed bilateral splint. These results quantify the relative importance of specific parameters affecting KE splint rigidity as applied to unstable fractures in the dog.     

Structural Properties of Interlocking Nails, Canine Femora, and Femur-Interlocking Nail Constructs

Using standard material testing techniques (bending stiffness, torsional stiffness, and maximum torque to failure or yield torque), the structural properties of interlocking nails (IN), canine femora, and IN/femur constructs were determined. Specimens that were tested included: 6 and 8 mm diameter IN with 5 to 10 screw holes (n = 18), and intact canine femora (n = 10), which also, with an IN inserted, formed the intact construct (IC) group, (n = 10). Specimens in the IC group were first tested with an 8 mm diameter IN with zero screws, followed by one and two screws (4.5 mm diameter) in the proximal and distal femur. A fracture model construct (FMC), (n = 14), consisting of a transverse femoral osteotomy with a 3 mm gap, was used with either 6 mm or 8 mm IN. In the 6 mm FMC, one and two 3.5 mm screws were used sequentially in the proximal and distal femoral segment. In the 8 mm FMC, one and two 3.5 mm screws and one and two 4.5 diameter screws were used similarly. When bending forces were applied parallel to IN screw holes, mean IN stiffness was 20% less than with forces perpendicular to the holes (n = 18), (P <.05). Eight-millimeter IN were 220% stiffer in torsion and 270% stiffer in bending than 6 mm IN (P <.05). Six-millimeter IN had approximately 32% of the bending stiffness and torsional stiffness of intact femurs (P <.05). Eight-millimeter IN had 93% and 79% of the bending stiffness and torsional stiffness, respectively, of intact femurs. Intact femur constructs (8 mm IN with four, 4.5 mm screws) had 147% of the bending stiffness (P <.05), and similar torsional stiffness and maximum torque, as intact femora (P >.05). The mean values of 6 mm FMC with four screws (3.5 mm) were 21% and 33% in torsional stiffness and bending stiffness, respectively, of intact femora values. When tested in torsion, 8 mm FMC failed by bone fracture; 6 mm FMC, in contrast, underwent plastic deformation. In comparing FMC stabilized with an 8 mm IN with two screws (4.5 mm diameter) in each bone segment, to intact femurs, the maximum torque was similar, FMC torsional stiffness was 40% (P <.05), and FMC bending stiffness was 65% (P <.05). These 8 mm FMC percentages are comparable to human IN fracture model construct values, indicating that the 8 mm IN/four screw construct should provide adequate stabilization for many canine diaphyseal femoral fractures.     

An In Vitro Biomechanical Study of a Multiplanar Circular External Fixator Applied to Equine Third Metacarpal Bones

The biomechanical characteristics of a 4-ring circular multiplanar fixator applied to equine third metacarpal bones with a 5 mm mid-diaphyseal osteotomy gap were studied. Smooth Steinmann pins, either 1/8 inch, 3/16 inch, or 1/4 inch, were driven through pilot holes in the bone in a crossed configuration and full pin fashion and fastened to the fixator rings using cannulated fixation bolts. The third metacarpal bone fixator constructs were tested in three different modes (cranial-caudal four-point bending, axial compression, and torsion). Loads of 2,000 N were applied in bending and axial compression tests and a load of 50 N ± m was applied during testing in torsion. Fixator stiffness was determined by the slope of the load displacement curves. Three constructs for each pin size were tested in each mode. Comparisons between axial stiffness, bending stiffness, and torsional stiffness for each of the three different pin sizes were made using one-way analysis of variance. There was no visually apparent deformation or permanent damage to the fixator frame, and no third metacarpal bone failure in any of the tests. Plastic deformation occurred in the 1/8 inch pins during bending, compression, and torsion testing. The 3/16 inch and 1/4 inch pins elastically deformed in all testing modes. Mean (±SE) axial compressive stiffness for the 1/8 inch, 3/16 inch, and 1/4 inch pin fixator constructs was: 182 ± 16 N/mm, 397 ± 21 N/mm, and 566 ± 8.7 N/mm; bending stiffness was 106 ± 3.3 N/mm, 410 ± 21 N/mm, and 548 ± 12 N/mm; and torsional stiffness was 6.15 ± 0.82 N.m/degree, 7.14 ± 0.0 N±m/degree, and 11.9 ± 1.0 N.m/degree respectively. For statically applied loads our results would indicate that a 4-ring fixator using two 1/4 inch pins per ring may not be stiff enough for repair of an unstable third metacarpal bone fracture in a 450 kg horse.     

An in vitro biomechanical comparison of a prototype equine metacarpal dynamic compression plate fixation with double dynamic compression plate fixation of osteotomized equine third metacarpal bones

OBJECTIVES: To compare the monotonic biomechanical properties of a prototype equine third metacarpal dynamic compression plate (EM-DCP) fixation with a double broad dynamic compression plate (DCP) fixation to repair osteotomized equine third metacarpal (MC3) bones. STUDY DESIGN: In vitro biomechanical testing of paired cadaveric equine MC3 with a mid-diaphyseal osteotomy, stabilized by 1 of 2 methods for fracture fixation. POPULATION: Twelve pairs of adult equine cadaveric MC3 bones. METHODS: Twelve pairs of equine MC3 were divided into 3 test groups (4 pairs each) for (1) 4-point bending single cycle to failure testing, (2) 4-point bending cyclic fatigue testing, and (3) torsional testing. The EM-DCP (10-hole, 4.5 mm) was applied to the dorsal surface of one randomly selected bone from each pair. Two DCPs, 1 dorsally (10-hole, 4.5 mm broad) and 1 laterally (9-hole, 4.5 mm broad) were applied to the contralateral bone from each pair. All plates and screws were applied using standard AO/ASIF techniques to MC3 bones that had mid-diaphyseal osteotomies. Mean test variable values for each method were compared using a paired t-test within each group. Significance was set at P<.05. RESULTS: Mean 4-point bending yield load, yield bending moment, bending composite rigidity, failure load and failure bending moment of the EM-DCP fixation were significantly greater (P<.0001) than those of the double broad DCP fixation. Mean cycles to failure in 4-point bending of the EM-DCP fixation was significantly greater (P<.0008) than that of the double broad DCP fixation. Mean yield load, composite rigidity, and failure load in torsion of the EM-DCP fixation were significantly greater (P<.0035) than that of the double broad DCP fixation. CONCLUSION: The EM-DCP provides increased stability in both static overload testing and cyclic fatigue testing. CLINICAL RELEVANCE: Results of this in vitro study support the conclusion that the prototype EM-DCP fixation is biomechanically superior to the double broad DCP fixation for the stabilization of osteotomized equine MC3.     

Stifle arthrodesis in two cats

Two Domestic Shorthaired cats were admitted after sustaining multiligamentous injuries of the stifle joint. In one cat, prosthetic ligamentous reconstruction was unsuccessful at maintaining normal stifle stability. Both cats were treated with stifle arthrodesis using internal fixation with a plate and screws without external coaptation. In one case, arthrodesis was achieved using a 2.7 mm 16-hole dynamic compression plate placed medially. In the second case, a 2.7 mm 14-hole dynamic compression plate was placed cranially. No major complications were noted, and both cats were able to return to good levels of activity in the medium term.     

Comparison of locking and conventional screws for maintenance of tibial plateau positioning and biomechanical stability after locking tibial plateau leveling osteotomy plate fixation

Objective— To compare locking screws with conventional screws inserted in the tibial plateau fragment for reduction and stability of the construct after tibial plateau leveling osteotomy (TPLO), using a locking TPLO plate.
Study Design— Experimental biomechanical study.
Animals— Cadaveric canine pelvic limbs (n=8 pairs).
Methods— TPLO was stabilized with either conventional cortical screws or locking screws in a compressed osteotomy model. Titanium pins inserted into the tibial plateau and proximal metaphysis were used to track bone fragment location by computed tomography (CT) imaging. CT imaging was performed after osteotomy reduction, after plate stabilization, and after 30,000 cycles of axial compression testing. After 30,000 cycles, cyclic loading was continued with monotonically increasing peak-load until failure.
Results— The magnitude of rotation about the sawing axis was significantly greater for the conventional screw group because of plate application ( P =.009). Translational movement of the tibial plateau fragment toward the plate was significantly greater for the conventional screw group ( P =.006). There were no significant differences between groups in stiffness or number of cycles to failure.
Conclusion— Maintenance of tibial plateau position was significantly superior for the locking screw group during plate application; however, screw type had no effect on fixation stability under cyclic loading.
Clinical Relevance— These results suggest that conventional screws and careful contouring of the TPLO plate can provide comparable mechanical stability to fixation with locking screws in the tibial plateau under load-sharing conditions, but potentially at the expense of osteotomy reduction.     

A Biomechanical Evaluation and Assessment of the Accuracy of Reduction of Two Methods of Acetabular Osteotomy Fixation in Dogs

Objective—To compare the accuracy of reduction, biomechanical characteristics, and mode of failure of two methods of acetabular osteotomy repair. Study Design—Acetabular osteotomies were created in 16 paired hemipelves and stabilized with a screw/wire/polymethylmethacrylate composite fixation technique (SWP) or a 2-mm veterinary acetabular plate (VAP). Eight intact hemipelves were used as controls. Sample Population—Twelve canine cadavers. Methods—Accuracy of osteotomy reduction was evaluated grossly and by measurement of articular incongruencies formed in polyvinylsiloxane impression casts. Acetabula were loaded in modified bending until failure using a universal testing machine. Data from load-deformation curves were used to determine the biomechanical characteristics of the repaired and intact acetabula. Mode of failure was evaluated grossly and radiographically. Results—Osteotomy reduction was superior in acetabula stabilized with SWP. Mean values ± standard deviation for load at failure and stiffness of the intact acetabula were 2,796 ± 152.9 N and 267.5 ±61.9 N/mm. Corresponding values for SWP and VAP were 1,192 ± 202.7 N and 136.3 ± 76.5 N/mm, and 1,100.5 ± 331.6 N and 110.0 ± 51.3 N/mm, respectively. The mean load at failure and stiffness of intact acetabula was significantly greater than acetabula stabilized with SWP or VAP. There was no significant difference between SWP and VAP for load at failure or stiffness. Failure of acetabula stabilized with SWP occurred by fracture of the polymethylmethacrylate and ventrolateral bending of the wires. Acetabula stabilized with VAP failed by ventrolateral twisting of the plate and bending of the caudal screws. Conclusions—SWP and VAP provide comparable rigidity, however, the SWP facilitates more accurate osteotomy reduction. Clinical Relevance—These findings support the use of the SWP technique as an alternative method of acetabular fracture repair.     

Static strength evaluation of two modified unilateral external skeletal fixators

The relative static strengths of two modified unilateral external skeletal fixation configurations, intended for use in humeral and femoral fracture management, were compared with each other and with a type la (unilateral, uniplanar) and a type lb (unilateral, biplanar) configuration, using an in vitro model. The parameters of yield strength, ultimate (failure) strength and stiffness (slope) were measured for each of the four configurations in the disruptive modes of axial compression, craniocaudal bending and lateromedial bending. The two modified unilateral configurations (models 3 and 4) were biomechanically superior to the type la configuration (model 1) for all parameters, when loaded in axial compression and craniocaudal bending. Model 3 was stronger than the type lb (model 2) configuration for all parameters when loaded in axial compression. There were no significant differences among the models with lateromedial bending loads, except for the parameter of stiffness. The results of this study suggest that the two modified unilateral configurations are biomechanically superior to the type la fixator configuration. The results also suggest that the modified unilateral configurations equal or exceed the biplanar configuration (model 2) in stiffness when loaded in axial compression.     

An in vitro biomechanical comparison of a limited-contact dynamic compression plate fixation with a dynamic compression plate fixation of osteotomized equine third metacarpal bones

OBJECTIVES: To compare the monotonic biomechanical properties and fatigue life of a broad, limited contact, dynamic compression plate (LC-DCP) fixation with a broad, dynamic compression plate (DCP) fixation to repair osteotomized equine 3rd metacarpal (MC3) bones. STUDY DESIGN: In vitro biomechanical testing of paired cadaveric equine MC3 with a mid-diaphyseal osteotomy, stabilized by 1 of 2 methods for fracture fixation. ANIMAL POPULATION: Twelve pairs of adult equine cadaveric MC3 bones. METHODS: Twelve pairs of equine MC3 were divided into 3 test groups (4 pairs each) for (1) 4-point bending single cycle to failure testing, (2) 4-point bending cyclic fatigue testing, and (3) torsional single cycle to failure testing. An LC-DCP (8-hole, 4.5 mm) was applied to the dorsal surface of 1 randomly selected bone from each pair. One DCP (8-hole, 4.5 mm broad) was applied dorsally to the contralateral bone from each pair. All plates and screws were applied using standard AO/ASIF techniques to MC3 bones that had mid-diaphyseal osteotomies. Mean test variable values for each method were compared using a paired t-test within each group. Significance was set at P<.05. RESULTS: The mean 4-point bending yield load, yield bending moment, composite rigidity, failure load, and failure bending moment of LC-DCP fixation were significantly greater (P<.01) than those of broad DCP fixation. Mean cycles to failure for 4-point bending was significantly (P<.001) greater for broad DCP fixation compared with broad LC-DCP fixation. Mean yield load, mean composite rigidity, and mean failure load in torsion was significantly (P<.02) greater for broad LC-DCP fixation compared with broad DCP fixation. CONCLUSION: Broad LC-DCP offers increased stability in static overload testing, however, it offers significantly less stability in cyclic fatigue testing. CLINICAL RELEVANCE: The clinical relevance of the cyclic fatigue data supports the conclusion that the broad DCP fixation is biomechanically superior to the broad LC-DCP fixation in osteotomized equine MC3 bones despite the results of the static overload testing.     

An in vitro biomechanical comparison of two interlocking-nail systems for fixation of ostectomized equine third metacarpal bones

OBJECTIVE--To compare the mechanical properties of 2 interlocking-nail systems for fixation of ostectomized equine third metacarpi (MC3): (1) a standard interlocking nail with 2 parallel screws proximal and distal to a 1-cm ostectomy; and (2) a modified interlocking nail with 2 screws proximal and distal to a 1-cm ostectomy with the screws offset by 30 degrees. ANIMAL OR SAMPLE POPULATION--Twelve pairs of adult equine forelimbs intact from the midradius distally. METHODS--Twelve pairs of equine MC3 were divided into 2 test groups (6 pairs each): torsion and caudocranial 4-point bending. Standard interlocking nails (6-hole, 13-mm diameter, 230-mm length) were placed in 1 randomly selected bone from each pair. Modified interlocking nails (6-hole, 13-mm, 230-mm length, screw holes offset by 30 degrees) were placed in the contralateral bone from each pair. All bones had 1-cm mid-diaphyseal ostectomies. Six construct pairs were tested in caudocranial 4-point bending to determine stiffness and failure properties. The remaining 6 construct pairs were tested in torsion to determine torsional stiffness and yield load. Mean values for each fixation method were compared using a paired t test within each group. Significance was set at P <.05. RESULTS--Mean (+/-SEM) values for the MC3-standard interlocking-nail composite and the MC3-modified interlocking-nail composite, respectively, in 4-point bending were: composite rigidity, 3,119 +/- 334.5 Nm/rad (newton. meter/radian) and 3,185 +/- 401.2 Nm/rad; yield bending moment, 205.0 +/- 18.46 Nm and 186.7 +/- 6.17 Nm; and failure bending moment, 366.4 +/- 21.82 Nm and 378.1 +/- 20.41 Nm. There were no significant differences in the biomechanical values for bending between the 2 fixation methods. In torsion, mean (+/-SEM) values for the MC3-standard interlocking-nail composite and the MC3-modified interlocking-nail composite were: composite rigidity, 135.5 +/- 7.128 Nm/rad and 112.5 +/- 7.432 Nm/rad; gap stiffness, 207.6 +/- 10.57 Nm/rad and 181.7 +/- 12.89 Nm/rad; and yield load, 123.3 +/- 2.563 Nm and 107.5 +/- 8.353 Nm, respectively. Composite rigidity and gap stiffness for standard interlocking-nail fixations were significantly higher than the modified interlocking-nail fixation technique in torsion. Yield load had a tendency to be higher for the standard interlocking-nail fixation (P =.15). CONCLUSIONS--No significant differences in biomechanical properties were identified between a standard interlocking nail and one with the screw holes offset by 30 degrees in caudocranial 4-point bending. The standard interlocking nail was superior to the modified interlocking nail in torsional gap stiffness and composite rigidity. The torsional yield load also tended to be higher for the standard interlocking nail. CLINICAL RELEVANCE--The standard interlocking nail with parallel screw holes is superior to a modified interlocking nail with the screw holes offset by 30 degrees in ostectomized equine MC3 bones in vitro when tested in torsion.     

In vitro comparison of three fixation methods for humeral fracture repair in adult horses

The stiffness, load to failure, and bending moments of adult intact equine humeri and humeri repaired with 3 fixation techniques were determined in vitro. Bones were tested in axial compression (30 pairs), mediolateral 3-point bending (15 pairs), and caudocranial 3-point bending (15 pairs). An oblique osteotomy of 1 humerus of each pair was performed to simulate the long spiral oblique fractures that occur clinically in horses. Bones were repaired in 3 ways: group 1--nylon band cerclage fixation (20 bones); group 2--multiple intramedullary pinning (20 bones); and group 3--nylon band cerclage fixation and multiple intramedullary pinning (20 bones). Intact bones were significantly (P less than 0.05) stronger than repaired bones in each testing mode. Bones repaired with bands only were significantly less stiff in bending than were bones repaired with pins only or with pins and bands. In compression, only specimens repaired with pins and bands were significantly stiffer than were bones repaired with bands only. Bones repaired with bands only required significantly less load to failure in compression and in caudocranial bending than did bones repaired with pins only or with pins and bands. Bones repaired with pins only deformed through the full displacement of the actuator (5 cm), and pins deformed plastically. Bones repaired with pins and bands were stiffer and had higher bending moments than did bones repaired with pins only, but the differences were not significant.     

Comparison of a 3-hole 4.5-mm Dynamic Compression Plate and a 7-hole 5.5-mm Y Locking Compression Plate for Arthrodesis of the Proximal Interphalangeal Joint in Horses—an Ex Vivo Biomechanical Study

The objective of this study was to compare the biomechanical properties in a single cycle axial loading test and the types of failures in two constructs (a 3-hole 4.5-mm dynamic compression plate (DCP) and 7-hole 5.5-mm Y locking compression plate (Y-LCP)) in equine proximal interphalangeal joint (PIJ) arthrodesis. One limb in each pair was randomly assigned to PIJ arthrodesis using a 3-hole 4.5-mm DCP combined with two transarticular 5.5-mm cortical screws, whereas the contralateral limb was submitted to PIJ arthrodesis using a 7-hole Y-shaped 5.0-mm LCP in conjunction with one transarticular 4.5-mm cortical screw inserted through the central plate hole. Cortical screws were inserted in lag fashion. Constructs were submitted to a single axial load cycle to failure. Construct stiffness, load, and deformation were analyzed. Dynamic compression plate and Y-LCP arthrodesis constructs did not differ significantly and were equally resistant to axial loading under the conditions studied (DCP and Y-LCP group stiffness, 5685.22 N/mm and 6591.10 N/mm, respectively). Arthrodesis of the PIJ using a DCP and two transarticular 5.5-mm cortical screws or a Y-LCP yielded biomechanically equivalent outcomes under the test conditions considered. However, Y-LCP provides less impact in the palmar/plantar bone. Application of Y-LCP with unicortical screws has equivalent biomechanical characteristics of DCP and may be a safe option for PIJ arthrodesis, where potential trauma secondary to applying bicortical screws in the palmar/plantar aspect of the pastern can be avoided.     

A mechanical comparison of 4.5 mm narrow and 3.5 mm broad plating systems for stabilization of gapped fracture models

OBJECTIVE: To evaluate and compare the mechanical properties of 4.5 narrow and 3.5 broad plating systems using their respective cortical and cancellous screws in unstable, central, and eccentric gap fracture models. STUDY DESIGN: Mechanical evaluation and comparison of 2 dynamic compression plate (DCP) systems. SAMPLE POPULATION: Eighteen cortical and 30 cancellous gapped fracture models. METHODS: DCP (4.5 mm narrow, 3.5 mm broad) with their respective cortical screws were applied to cortical bone density polyurethane foam blocks to construct center gap cortical fracture models that were tested in gap closing monotonic 4-point bending. DCP (4.5 mm narrow, 3.5 mm broad) with their respective cancellous screws were applied to cancellous bone density polyurethane foam blocks to construct eccentric gap cancellous fracture models. The cancellous constructs were tested in monotonic gap opening and gap closing cantilever bending and in cyclic axial loading. Univariate and multivariate repeated measures ANOVA were used to compare the maximum loads at failure of the 4.5 mm constructs and 3.5 mm constructs. RESULTS: The 4.5 mm narrow plating system withstood significantly higher loads at failure than the 3.5 mm broad plating system in 4-point bending (P<.0001) and gap opening cantilever bending (P<.0001). The 4.5 mm system failed in gap closing cantilever bending by plastic deformation of the plate, whereas the 3.5 mm system failed by screw pullout. There was no difference between the 2 systems in cyclic axial loading. CONCLUSION: Results indicate that the 4.5 mm narrow plating system has a mechanical advantage over the 3.5 mm broad plating system for stabilization of gapped fracture models. CLINICAL RELEVANCE: The 4.5 mm narrow plating system may be mechanically advantageous compared with the 3.5 mm broad plating system for stabilizing unreconstructed comminuted long bone fractures in large dogs.     

Biomechanical Comparison of Two Plating Techniques for Fixation of Acetabular Osteotomies in Dogs

OBJECTIVE: To compare the failure properties of a 5-hole, 2.7-mm curved acetabular plate (AP) to a 5-hole, 3.5-mm reconstruction plate (RP) when applied to acetabular osteotomies. STUDY DESIGN: Cadaver study. ANIMALS OR SAMPLE POPULATION: Pelves of 8 mature, large-breed dogs. METHODS: A 5-hole, 2.7-mm AP and a 5-hole, 3.5-mm RP were contoured and applied to the dorsal acetabulum of each pelvis. A central acetabular fracture was simulated after plate application by a transverse osteotomy with a fine saw. Each acetabulum was loaded in a weight-bearing direction. A load-deformation curve was produced for each construct, and biomechanical properties of the AP and RP were compared with the Student's paired t-test. A P value of < .05 was considered significant. RESULTS: For the AP and RP composite respectively, the mean +/- SD maximum load to failure was 2,721 +/- 632 N and 2,488 +/- 800 N, the stiffness was 4.8 +/- 1.8 N/m and 5.3 +/- 1.9 N/m, and the energy absorbed was 15.1 +/- 5.2 Nm and 16.3 +/- 8.3 Nm. None of these differences was statistically significant. CONCLUSIONS: Both fixation techniques provided comparable strength, stiffness, and energy absorbed under the loading conditions of this study. CLINICAL RELEVANCE: Because of the relative ease of application, the 2.7-mm curved AP may be the practical choice for acetabular fracture repair in large dogs.