title: Comparison of the stability of various internal fixators used in the treatment of osteochondritis dissecans--a mechanical model.
abstract: The purpose of this study was to determine what characteristics of fixation devices used in the treatment of osteochondritis dissecans (OCD) contribute to improved stability to resist shear loading. An OCD model was designed using rigid polyurethane foam. Each specimen consisted of two components, an osteochondral fragment and a corresponding defect. A total of 40 specimens were prepared and assigned to one of four groups: control (no extrinsic stabilizer); two 2-mm-diameter Kirschner wires (K-wires), 40 mm in length; one threaded washer and a 28-mm screw; and one threaded washer and a 38 mm screw. Each specimen was mounted onto an Iosipescu shear test fixture and subjected to shear loads at a pseudo-static displacement rate of 0.075 mm/s. All groups demonstrated some stability; controls were significantly less stable than all other groups. The group with the threaded washer and 38-mm screw demonstrated the greatest stability (p < 0.001), and no difference was noted between the K-wire and 28-mm screw groups. These results suggest that, in this OCD model, friction conferred some intrinsic stability to resist loads in shear. However, stability was improved with the use of long implants that compressed the fragments together.
authors.affiliation: Cambridge Memorial Hospital, 11-350 Hespeler Road, Cambridge, Ontario N1R 7N7, Canada. mormcdlc@hotmail.com
authors.forename: Moreno
authors.initials: M
authors.lastname: Morelli
authors.forename: Philippe
authors.initials: P
authors.lastname: Poitras
authors.forename: Valentine
authors.initials: V
authors.lastname: Grimes
authors.forename: David
authors.initials: D
authors.lastname: Backman
authors.forename: Geoffrey
authors.initials: G
authors.lastname: Dervin
mesh_terms: D019643:Arthroplasty, Replacement / Q000295:instrumentation / Q000379:methods; D001696:Biomechanical Phenomena; D001863:Bone Screws; D016268:Internal Fixators; D007593:Joint Instability / Q000601:surgery*; D008422:Materials Testing / Q000379:methods*; D008954:Models, Biological; D010008:Osteochondritis Dissecans / Q000601:surgery*; D011140:Polyurethanes; D013314:Stress, Mechanical
chemical_list: D011140:Polyurethanes; C028279:polyurethane foam