Details

Autor(en) / Beteiligte

• Kaya, Volkan
• Kilic, Feyzi
• Yamak, Fatih
• Ekin, Elif Evrim
• Basar, Hakan
• Misir, Abdulhamit

Titel

Biomechanical and fracture characteristics of different filling and fixation methods applied to various proximal tibial metaphyseal defect sizes in an ovine model

Ist Teil von

• Clinical biomechanics (Bristol), 2022-03, Vol.93, p.105597-105597, Article 105597

Ort / Verlag

England: Elsevier Ltd

Erscheinungsjahr

2022

Quelle

Alma/SFX Local Collection

Beschreibungen/Notizen

• Ideal treatment method based on the size of the defect in local aggressive bone tumors is yet to be described. We evaluated the mechanical behavior of different fixation methods for various defect sizes located in the proximal tibia. Ninety-one sheep tibiae were distributed in five groups. Each study group was further divided into three subgroups, forming 25%, 50%, and 75% metaphyseal defects. The five groups were divided as follows: 1) control group where tibiae remained intact (n = 7); 2) isolated defect created, without filling (n = 21); 3) filling with cement (n = 21); 4) application of two subchondral cortical screws in addition to cement (n = 21); and 5) application of plate-screw fixation in addition to cement (n = 21). A loading test simulating the axial load applied by the distal femur to the tibia plateau was performed. The maximum failure load was compared between groups according to the defect size and fixation method. In 25% defects, group 5 had significantly higher failure load than other groups. However, in 50% and 75% defects, additional fixation did not increase the failure load. Also, additional screw fixation did not increase failure load in all defect sizes. There was a significant positive correlation between fracture morphology and defect size, fixation method, and failure load. Additional plate-screw fixation would increase the stability in defects ≤25%. In defects ≥50%, additional fixation does not increase stability. Screw fixation in addition to cementing does not increase stability in all defect sizes. •The biomechanical performance of different fixation methods was evaluated•The effects of both the defect size and the treatment are evaluated.•Plate screw fixation was found to be the most robust fixation method for all defect sizes.•The robustness of screw fixation significantly decreased between 25% and 50% defect size.•Fracture complexity and defect size, and fixation method were significantly correlated.