Hybrid locking pancarpal arthrodesis plates were designed with either a round (RH) or an oval (OH) radiocarpal hole, the latter allowing varied screw positioning. Due to concerns about potential decreased structural properties of the OH design, our aim was to compare the mechanical behavior of the contrasting plates using combined finite element analysis (FEA) and mechanical testing. Pancarpal arthrodesis plates with RH or OH design were assigned to three fixation techniques ( = 6), prebent at 20°, and fixed to canine forelimb models with simulated radius and radiocarpal and 3rd metacarpal bones. OH plates were instrumented with a radiocarpal screw inserted either most proximal (OH-P) or most distal (OH-D). Specimens were axially loaded to 300 N over 10 ramped cycles at 0.5 Hz. Plate strains were measured with strain gauges placed at areas of highest deformations as predicted by FEA under identical loading conditions. FEA predicted the highest strains (m/m) adjacent to the radiocarpal hole (2,500 [RH], 2,900 [OH-P/OH-D]) and plate bending point (2,250 [RH], 1,900 [OH-P/OH-D]). Experimentally, peak radiocarpal hole strains were not influenced by the OH screw position (3,329 ± 443 [OH-P], 3,222 ± 467 [OH-D]; = 0.550) but were significantly higher compared to the RH design (2,123 ± 154; < 0.001). Peak strains at the bending point were significantly lower for OH-P (1,792 ± 174) and OH-D (1,806 ± 194) versus RH configurations (2,158 ± 114) ( ≤ 0.006). OH plates demonstrated highest peak strains next to the radiocarpal hole and were associated with more heterogenous plate strain distribution. Structural weakening associated with radiocarpal OH plate design could result in decreased fixation strength and increased risk of plate fatigue failure.
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http://dx.doi.org/10.1155/2021/2526879 | DOI Listing |
Front Bioeng Biotechnol
March 2023
College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States.
Pancarpal canine arthrodesis (PCA) sets immobilization of all three carpal joints dorsal plating to result in bony fusion. Whereas the first version of the plate uses a round hole (RH) for the radiocarpal (RC) screw region, its modification into an oval hole (OH) in a later version improves versatility in surgical application. The aim of this study was to mechanically investigate the fatigue life of the PCA plate types implementing these two features-PCA-RH and PCA-OH.
View Article and Find Full Text PDFJ Wrist Surg
February 2023
Seradge Medical, Oklahoma City, Oklahoma.
Even though the scapholunate interosseous ligament is the most common wrist ligament injury, its treatment remains a challenge for hand surgeons. We report on a surgical treatment (Dynadesis) for dynamic scaphoid instability (DSI) with a 20-year follow-up period. Dynadesis utilizes antagonist forearm muscles in order to synergistically provide dynamic stabilization to the scaphoid when the wrist is loaded.
View Article and Find Full Text PDFBiomed Res Int
September 2021
College of Veterinary Medicine, Michigan State University, 736 Wilson Rd., East Lansing, MI 48824, USA.
Hybrid locking pancarpal arthrodesis plates were designed with either a round (RH) or an oval (OH) radiocarpal hole, the latter allowing varied screw positioning. Due to concerns about potential decreased structural properties of the OH design, our aim was to compare the mechanical behavior of the contrasting plates using combined finite element analysis (FEA) and mechanical testing. Pancarpal arthrodesis plates with RH or OH design were assigned to three fixation techniques ( = 6), prebent at 20°, and fixed to canine forelimb models with simulated radius and radiocarpal and 3rd metacarpal bones.
View Article and Find Full Text PDFOper Orthop Traumatol
February 2021
Klinik Orthopädie und Unfallchirurgie, Luzerner Kantonsspital Luzern, Spitalstrasse I, 6000, Luzern 16 I, Switzerland.
Objective: Minimally invasive temporary internal wrist arthrodesis as an alternative treatment method in complex distal radius fractures.
Indications: Complex distal radius fractures with dorsal and/or palmar comminution and little to no reconstruction possibilities, radiocarpal ligamentous injury, need for early weight bearing through the affected wrist (walking aids).
Contraindications: Complex hand injuries limiting the possibility to safely secure the plate at either the metacarpal or the radial shaft.
Oper Orthop Traumatol
October 2020
AUVA Unfallkrankenhaus Lorenz Böhler - European Hand Trauma Center, 1200, Wien, Österreich.
Objective: Radioscapholunate (RSL) arthrodesis with distal scaphoidectomy using an angular stable plate and palmar access in post-traumatic or degenerative osteoarthritis limited to the radiocarpal joint.
Indications: Osteoarthritis limited to the radiocarpal joint with intact mediocarpal joint after malunited intra-articular distal radius fractures, rheumatoid osteoarthritis, scapholunate advanced collapse (SLAC) up to stage II.
Contraindications: Mediocarpal osteoarthritis, poor patient compliance, SLAC from stage III, osteitis.
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