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  • 11
    Electronic Resource
    Electronic Resource
    Springer
    Archives of orthopaedic and trauma surgery 109 (1990), S. 144-149 
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The significance of postoperative mechanical stability to bone repair of comminuted fractures was investigated in an animal experimental study comparing four commonly employed operative methods of fracture stabilization: 1. Plate osteosynthesis combined with lag screw fixation; 2. Bridging plate osteosynthesis; 3. External fixation; 4. Static interlocking intramedullary nailing. As fracture model, a triple wedge osteotomy of the right sheep tibia was used. In regard to biomechanical strength, the method which gave best postoperative stability, plate osteosynthesis in combination with interfragmentary lag screws, did not result in the best bone repair. In this experimental setup, stabilization by bridging methods, inducing bone healing by secondary intention, gave better bone regeneration in the experimental fractures.
    Type of Medium: Electronic Resource
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  • 12
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary In an experimental study on sheep the effects of fibrin adhesive system (FAS), plasma factor XIII (FXIII), and calcitonin on autologous cancellous bone grafts were studied. Drill holes in the tibia were filled with transplant bone, either untreated or locally treated with fibrin adhesive, with or without plasma factor XIII. We used 24 sheep, divided into three groups. Plasma factor XIII and calcitonin were administered parenterally; the third group received no treatment. For evaluation we carried out quantitative bone and fluorescence morphometry and microangiography. We found that local fibrin adhesive significantly decreased the remodeling and growth of the transplanted cancellous bone. Plasma factor XIII, given parenterally, increased the amount of bone in the transplant site; calcitonin showed no visible effect.
    Type of Medium: Electronic Resource
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  • 13
    Electronic Resource
    Electronic Resource
    Springer
    Archives of orthopaedic and trauma surgery 106 (1986), S. 42-46 
    ISSN: 1434-3916
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Die stabilisierende Wirkung verschiedener bei der Behandlung der Schultereckgelenkssprengung Verwendung findender Implantate wurde in einem biomechanischen Test in vitro untersucht. In einer speziellen Testvorrichtung wurden Kunststoffmodelle and Leichenpräparate auf verschiedene Weise beansprucht. Neben der Höhe der acromioclavicularen Gelenksstufe wurden die coracoclaviculare Abstandszunahme wie such die Implantatssteifigkeit bestimmt. Ein guter Stabilisationseffekt, verbunden mit einer zufriedenstellenden, weniger rigiden Fixation des AC-Gelenkes zum Schutz des frisch rekonstruierten Kapselbandapparates, wurde für die Spickdrahttransfixation mit kombinierter Cerclage ermittelt. Die auftretenden Scher- and Biegekräfte können mit dieser Methode neutralisiert werden, wdhrend die anderen Verfahren zum Teil gravierende Nachteile aufweisen. In Fallen chronischer AC-Gelenk-Instabilität kann mit einem Kohlenstoffaserband biomechanisch geniigende Stabilitäterzielt werden.
    Notes: Summary A biomechanical in vitro test was performed to determine the stabilizing effect of various implants for the surgical treatment of the torn acromioclavicular joint. In a specially designed testing device, plastic and cadaver specimens of the shoulder girdle were stressed in various ways. Different dislocations between the acromion and the clavicle and between the clavicle and the coracoid were determined, as well as the stiffness of the implants. A convenient stabilizing effect combined with less rigid fixation to secure the newly treated AC joint was provided by K-wire fixation with cerclage. Interfering shear and bending stresses could be avoided with this method, while the other implants showed various disadvantages. From a biomechanical point of view, a carbon-fiber ligament replacement provides sufficient stability in cases of chronic acromioclavicular separation.
    Type of Medium: Electronic Resource
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  • 14
    Electronic Resource
    Electronic Resource
    Springer
    Calcified tissue international 60 (1997), S. 194 -199 
    ISSN: 1432-0827
    Keywords: Key Words: Fracture repair — Biomechanics — Quantitative computed tomography — Histology — Radiography.
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine , Physics
    Notes: Abstract. An experimental fracture model was used to assess bone mineral density at the fracture site by peripheral computed tomography and to compare the model with biomechanical, histological, and radiographic methods for the quantification of the fracture repair process. Transverse osteotomies in the mid-diaphysis of 28 tibia of sheep were externally fixed and mineral densities, cross-sectional areas, flexural rigidities, tissue composition, and projected callus area were calculated after 9 weeks of healing time. BMD measured by pQCT was strongly correlated with histologically determined percentages of mineralized tissue in the osteotomy gap (R 2= 0.71) and in the periosteal callus (R 2= 0.62). The percentage of mineralized tissue in the osteotomy gap was the best predictor of the flexural rigidity of the tibiae (R 2= 0.74). Because of high correlations with the histological findings, the volumetric BMD at the level of the osteotomy gap was also strongly correlated with the biomechanical findings (R 2= 0.70). Neither the cross-sectional area in pQCT nor the projected callus area in plane film radiography were positively correlated to the flexural rigidity of the tibiae. Quantitative computed tomography proved to be a successful estimator for the prediction of the mechanical stability of healing bones. The noninvasive procedure is a reliable tool for the quantification of the fracture repair process in experimental studies and may be useful for treatment decisions in particular clinical situations.
    Type of Medium: Electronic Resource
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  • 15
    ISSN: 1432-0932
    Keywords: Spinal biomechanics Stiffness ; Motion ; Calf ; In vitro testing
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The availability of human cadaveric spine specimens for in vitro tests is limited and the risk of infection is now of vital concern. As an alternative or supplement, calf spines have been used as models for human spines, in particular to evaluate spinal implants. However, neither qualitative nor quantitative biomechanical data on calf spines are available for comparison with data on human specimens. The purpose of this study was to determine the fundamental biomechanical properties of calf spines and to compare them with existing data from human specimens. Range of motion, neutral zone, and stiffness properties of thoracolumbar calf spines (T6-L6) were determined under pure moment loading in flexion and extension, axial left/right rotation and right/left lateral bending. Biomechanical similarities were observed between the calf and reported human data, most notably in axial rotation and lateral bending. Range of motion in the lumbar spine in flexion and extension was somewhat less in the calf than that typically reported for the human, though still within the range. These results suggest that the calf spine can be considered on a limited basis as a model for the human spine in certain in vitro tests.
    Type of Medium: Electronic Resource
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  • 16
    ISSN: 1432-0932
    Keywords: Key words Spine ; Biomechanics ; Implant testing ; In vitro testing ; Test standard
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract New implants and new surgical approaches should be tested in vitro for primary stability in standardized laboratory tests in order to decide the most appropriate approach before being accepted for clinical use. Due to the complex and still unknown loading of the spine in vivo a variety of different test loading conditions have been used, making comparison of the results from different groups almost impossible. This recommendation was developed in a series of workshops with research scientists, orthopedic and trauma surgeons, and research and development executives from spinal implant companies. The purpose was to agree on in vitro testing conditions that would allow results from various research groups to be compared. This paper describes the recommended loading methods, specimen conditions, and analysis parameters resulting from these workshops.
    Type of Medium: Electronic Resource
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  • 17
    ISSN: 1432-0932
    Keywords: Key words Cervical spine ; Biomechanics ; Flexibility ; Interbody fusion device
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Interbody fusion cages are small hollow implants that are inserted into the intervertebral space to restore physiological disc height and to allow bony fusion. They sometimes cause clinical complications due to instability, subsidence or dislocation. These are basic biomechanical parameters, which influence strongly the quality of a fusion device; however, only few data about these parameters are available. Therefore, the purpose of the present study was to investigate the primary stabilizing effect of four different cervical fusion devices in in vitro flexibility tests. Twenty-four human cervical spine segments were used in this study. After anterior discectomy, fusion was performed either with a WING cage (Medinorm AG, Germany), a BAK/C cage (Sulzer Spine-Tech, USA), an AcroMed cervical I/F cage (DePuy AcroMed International, UK) or bone cement (Sulzer, Switzerland). All specimens were tested in a spine tester in the intact condition and after implantation of one of the four devices. Alternating sequences of pure lateral bending, flexion-extension and axial rotation moments (± 2.5 Nm) were applied continuously and the motions in each segment were measured simultaneously. In general, all tested implants had a stabilizing effect. This was most obvious in lateral bending, where the range of motion was between 0.29 (AcroMed cage) and 0.62 (BAK/C cage) with respect to the intact specimen (= 1.00). In lateral bending, flexion and axial rotation, the AcroMed cervical I/F cages had the highest stabilizing effect, followed by bone cement, WING cages and BAK/C cages. In extension, specimens fused with bone cement were most stable. With respect to the primary stabilizing effect, cages, especially the AcroMed I/F cage but also the WING cage and to a minor extent the BAK/C cage, seem to be a good alternative to bone cement in cervical interbody fusion. Other characteristics, such as the effect of implant design on subsidence tendency and the promotion of bone ingrowth, have to be determined in further studies.
    Type of Medium: Electronic Resource
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  • 18
    ISSN: 1432-0932
    Keywords: Key words Posterior instrumentation ; Occipito-cervical spine ; Biomechanical testing, in vitro
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Posterior instrumentation of the occipito-cervical spine has become an established procedure in a variety of indications. The use of rod-screw systems improved posterior instrumentation as it allows optimal screw positioning adapted to the individual anatomic situation. However, there are still some drawbacks concerning the different implant designs. Therefore, a new modular rod-screw implant system has been developed to overcome some of the drawbacks of established systems. The aim of this study was to evaluate whether posterior internal fixation of the occipito-cervical spine with the new implant system improves primary biomechanical stability. Three different internal fixation systems were compared in this study: the CerviFix System, the Olerud Cervical Rod Spinal System and the newly developed Neon Occipito Cervical System. Eight human cervical spine C0/C5 specimens were instrumented from C0 to C4 with occipital fixation, transarticular screws in C1/C2 and lateral mass or pedicle screws in C3 and C4. The specimens were tested in flexion/extension, axial rotation, and lateral bending using pure moments of ± 2.5 Nm without axial preload. After testing the intact spine, the different instrumentations were tested after destabilising C0/C2 and C3/C4. Primary stability was significantly increased, in all load cases, with the new modular implant system compared to the other implant systems. Pedicle screw instrumentation tended to be more stable compared to lateral mass screws; nevertheless, significant differences were observed only for lateral bending. As the experimental design precluded any cyclic testing, the data represent only the primary stability of the implants. In summary, this study showed that posterior instrumentation of the cervical spine using the new Neon Occipito Cervical System improves primary biomechanical stability compared to the CerviFix System and the Olerud Cervical Rod Spinal System.
    Type of Medium: Electronic Resource
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  • 19
    ISSN: 1432-0932
    Keywords: Key words Lumbar spine ; Metastases ; Corpectomy ; Vertebral body replacement ; Biomechanics
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Metastatic spine lesions frequently require corpectomy in order to achieve decompression of the spinal cord and restoration of spinal stability. A variety of systems have been developed for vertebral body replacement. In patients with prolonged life expectancy due to an improvement of both systemic and local therapy, treatment results can be impaired by a loosening at the implant-bone interface or mechanical failure. Furthermore, early detection of a metastatic recurrence using sensitive imaging modalities like computed tomography (CT) and magnetic resonance imaging (MRI) is possible in these patients without artefact interference. The aim of our pilot study was to evaluate the clinical applicability and results of a new radiolucent system for vertebral body replacement in the lumbar spine. The system consists of bone-integrating biocompatible materials – a polyetherurethane/bioglass composite (PU-C) replacement body and an integrated plate of carbon-fibre reinforced polyetheretherketone (CF-PEEK) – and provides high primary stability with anterior instrumentation alone. In a current prospective study, five patients with metastatic lesions of the lumbar spine were treated by corpectomy and reconstruction using this new system. Good primary stability was achieved in all cases. Follow-up (median ¶15 months) using CT and MRI revealed progressive osseous integration of the PU-C spacer in four patients surviving more than 6 months. Results obtained from imaging methods were confirmed following autopsy by biomechanical investigation of an explanted device. From these data, it can be concluded that implantation of the new radiolucent system provides sufficient long-term stability for the requirements of selected tumour patients with improved prognosis.
    Type of Medium: Electronic Resource
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  • 20
    ISSN: 1432-0932
    Keywords: Key words Spinal biomechanics ; Intersegmental muscle forces ; Operative decompression ; Instrumented stabilization
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Laminectomy is the accepted treatment for spinal canal stenosis in cases where conservative treatment has failed. Opinions diverge on the resulting clinical instability and the necessity of instrumented stabilization. The present biomechanical study was performed to determine the functional impairment following laminectomy and the stabilizing effect of flexible and rigid devices. This was the first time that the effects of agonist and antagonist intersegmental lumbar muscle forces acting on intact, unstable and instrumentally stabilized functional spinal units have been investigated. Six human cadaveric lumbar spines were tested in a spine tester. The coactivation of agonist and antagonist muscle forces resulted in increased stability under the load conditions of bending and rotation; a slight increase in the range of motion was noted during flexion. The functional impairment following laminectomy was corrected by ligamentoplasty and by means of muscle forces. Ligamentoplasty appears to be an alternative to decompression with spondylodesis, especially in patients with well-developed muscles.
    Type of Medium: Electronic Resource
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