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dc.contributor.authorMcCormick, Jeremy J.
dc.contributor.authorLi, Xinning
dc.contributor.authorWeiss, Douglas R.
dc.contributor.authorBilliar, Kristen L.
dc.contributor.authorWixted, John J.
dc.date2022-08-11T08:10:07.000
dc.date.accessioned2022-08-23T16:56:25Z
dc.date.available2022-08-23T16:56:25Z
dc.date.issued2010-10-15
dc.date.submitted2011-05-26
dc.identifier.citationJ Orthop Surg Res. 2010 Oct 14;5:74. <a href="http://dx.doi.org/10.1186/1749-799X-5-74">Link to article on publisher's site</a>
dc.identifier.issn1749-799X (Linking)
dc.identifier.doi10.1186/1749-799X-5-74
dc.identifier.pmid20942976
dc.identifier.urihttp://hdl.handle.net/20.500.14038/42926
dc.description.abstractBACKGROUND: Knee or tibiotalocalcaneal arthrodesis is a salvage procedure, often with unacceptable rates of nonunion. Basic science of fracture healing suggests that compression across a fusion site may decrease nonunion. A novel ratcheting arthrodesis nail designed to improve dynamic compression is mechanically tested in comparison to existing nails. METHODS: A novel ratcheting nail was designed and mechanically tested in comparison to a solid nail and a threaded nail using sawbones models (Pacific Research Laboratories, Inc.). Intramedullary nails (IM) were implanted with a load cell (Futek LTH 500) between fusion surfaces. Constructs were then placed into a servo-hydraulic test frame (Model 858 Mini-bionix, MTS Systems) for application of 3 mm and 6 mm dynamic axial displacement (n = 3/group). Load to failure was also measured. RESULTS: Mean percent of initial load after 3-mm and 6-mm displacement was 190.4% and 186.0% for the solid nail, 80.7% and 63.0% for the threaded nail, and 286.4% and 829.0% for the ratcheting nail, respectively. Stress-shielding (as percentage of maximum load per test) after 3-mm and 6-mm displacement averaged 34.8% and 28.7% (solid nail), 40.3% and 40.9% (threaded nail), and 18.5% and 11.5% (ratcheting nail), respectively. In the 6-mm trials, statistically significant increase in initial load and decrease in stress-shielding for the ratcheting vs. solid nail (p = 0.029, p = 0.001) and vs. threaded nail (p = 0.012, p = 0.002) was observed. Load to failure for the ratcheting nail; 599.0 lbs, threaded nail; 508.8 lbs, and solid nail; 688.1 lbs. CONCLUSION: With significantly increase of compressive load while decreasing stress-shielding at 6-mm of dynamic displacement, the ratcheting mechanism in IM nails may clinically improve rates of fusion.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=20942976&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1186/1749-799X-5-74
dc.rights<p>© 2010 McCormick et al; licensee BioMed Central Ltd.</p> <p>This is an Open Access article distributed under the terms of the Creative Commons Attribution License (<a href="http://creativecommons.org/licenses/by/2.0">http://creativecommons.org/licenses/by/2.0</a>), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p>
dc.subjectArthrodesis
dc.subjectBone Nails
dc.subjectOrthopedics
dc.subjectRehabilitation and Therapy
dc.titleBiomechanical investigation of a novel ratcheting arthrodesis nail
dc.typeJournal Article
dc.source.journaltitleJournal of orthopaedic surgery and research
dc.source.volume5
dc.identifier.legacyfulltexthttps://escholarship.umassmed.edu/cgi/viewcontent.cgi?article=1012&amp;context=ortho_pp&amp;unstamped=1
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/ortho_pp/13
dc.identifier.contextkey2032251
refterms.dateFOA2022-08-23T16:56:25Z
html.description.abstract<p>BACKGROUND: Knee or tibiotalocalcaneal arthrodesis is a salvage procedure, often with unacceptable rates of nonunion. Basic science of fracture healing suggests that compression across a fusion site may decrease nonunion. A novel ratcheting arthrodesis nail designed to improve dynamic compression is mechanically tested in comparison to existing nails.</p> <p>METHODS: A novel ratcheting nail was designed and mechanically tested in comparison to a solid nail and a threaded nail using sawbones models (Pacific Research Laboratories, Inc.). Intramedullary nails (IM) were implanted with a load cell (Futek LTH 500) between fusion surfaces. Constructs were then placed into a servo-hydraulic test frame (Model 858 Mini-bionix, MTS Systems) for application of 3 mm and 6 mm dynamic axial displacement (n = 3/group). Load to failure was also measured.</p> <p>RESULTS: Mean percent of initial load after 3-mm and 6-mm displacement was 190.4% and 186.0% for the solid nail, 80.7% and 63.0% for the threaded nail, and 286.4% and 829.0% for the ratcheting nail, respectively. Stress-shielding (as percentage of maximum load per test) after 3-mm and 6-mm displacement averaged 34.8% and 28.7% (solid nail), 40.3% and 40.9% (threaded nail), and 18.5% and 11.5% (ratcheting nail), respectively. In the 6-mm trials, statistically significant increase in initial load and decrease in stress-shielding for the ratcheting vs. solid nail (p = 0.029, p = 0.001) and vs. threaded nail (p = 0.012, p = 0.002) was observed. Load to failure for the ratcheting nail; 599.0 lbs, threaded nail; 508.8 lbs, and solid nail; 688.1 lbs.</p> <p>CONCLUSION: With significantly increase of compressive load while decreasing stress-shielding at 6-mm of dynamic displacement, the ratcheting mechanism in IM nails may clinically improve rates of fusion.</p>
dc.identifier.submissionpathortho_pp/13
dc.contributor.departmentDepartment of Orthopedics and Physical Rehabilitation
dc.source.pages74


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