Management of distal femoral diaphyseal fractures with string of pearls locking plate in dogs

2018 ◽  
Author(s):  
K. Manoj Kumar ◽  
V. Devi Prasad ◽  
N. Dhana Lakshmi ◽  
N.K.B. Raju
Keyword(s):  
Body Weight ◽  
Weight Bearing ◽  
Healing Time ◽  
Locking Plates ◽  
Fracture Stabilization ◽  
Diaphyseal Fractures ◽  
Cancellous Screws ◽  
Functional Limb ◽  
Fracture Stability ◽  
String Of Pearls

Distal femoral diaphyseal fractures in six dogs about 10-22 months old with body weight ranging from 12-25 kg were stabilized with String of Pearls (SOP) (Orthomed, UK) locking plates along with standard cortical and cancellous screws following standard AO/ASIF principles. Selection of appropriate size of plate and screws was according to body weight and type of fracture (2.7mm plate for dogs below 12 kg body weight and 3.5 mm plate for dogs above 12 kg body weight) which provided good fracture stability. The outcome of fracture stabilization and healing was evaluated with lameness grading and radiography. Postoperatively, all the animals showed weight bearing with early functional limb usage of grade I lameness and good joint mobility in an average of 7 weeks. Functional outcome was excellent in good in four cases and excellent in two cases. The average overall healing time in all the cases was 7-11 weeks. The fractures showed radiographically excellent postoperative healing of cortical union, absence of fracture lines with limited and also bridging callus. Based on present study, it was concluded that, String of Pearls (SOP) locking plates were good for stabilization of distal femoral diaphyseal fractures for early limb ambulance and healing.

scholarly journals Can Optimizing the Mechanical Environment Deliver a Clinically Significant Reduction in Fracture Healing Time?

Biomedicines ◽  
2021 ◽  
Vol 9 (6) ◽  
pp. 691
Author(s):  
Jan Barcik ◽  
Devakara R. Epari
Keyword(s):  
Fracture Healing ◽  
Bone Healing ◽  
Mechanical Stimulation ◽  
Callus Formation ◽  
Weight Bearing ◽  
Healing Process ◽  
Healing Time ◽  
Mechanical Environment ◽  
Clinically Significant ◽  
The Impact

The impact of the local mechanical environment in the fracture gap on the bone healing process has been extensively investigated. Whilst it is widely accepted that mechanical stimulation is integral to callus formation and secondary bone healing, treatment strategies that aim to harness that potential are rare. In fact, the current clinical practice with an initially partial or non-weight-bearing approach appears to contradict the findings from animal experiments that early mechanical stimulation is critical. Therefore, we posed the question as to whether optimizing the mechanical environment over the course of healing can deliver a clinically significant reduction in fracture healing time. In reviewing the evidence from pre-clinical studies that investigate the influence of mechanics on bone healing, we formulate a hypothesis for the stimulation protocol which has the potential to shorten healing time. The protocol involves confining stimulation predominantly to the proliferative phase of healing and including adequate rest periods between applications of stimulation.

Mechanical Failure of Angle Locking Plates in Distal Comminuted Tibial Fractures

2016 ◽  
Vol 695 ◽  
pp. 118-122 ◽  
Author(s):  
Razvan Ene ◽  
Zsombor Panti ◽  
Mihai Nica ◽  
Marian Pleniceanu ◽  
Patricia Ene ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Bone Healing ◽  
Tibial Fracture ◽  
Weight Bearing ◽  
Healing Process ◽  
Biomechanical Properties ◽  
Implant Failure ◽  
Locking Plates ◽  
Non Union ◽  
Tibial Pilon

Distal comminuted tibial fracture with or without intra-articular involvement is a very common injury of the lower limb, especially in younger patients due to high energy trauma. The anatomical and biomechanical properties of this segment of tibia, makes this pathology a major surgical challenge with a preserved clinical outcome. The aim of this study is to present different outcome of tibial fracture, treated with open reduction and internal fixation (ORIF) with titanium angle locking plates (ALP) and to underline the physiological and non-physiological bone healing effects on implants. In this study we included 48 patients with tibial pilon fracture who underwent to ORIF, applying ALP in the Orthopedics and Trauma department of the University Emergency Hospital in Bucharest. Due to preserved biomechanical properties of ALP and this anatomical region, weight bearing is not allowed till 6 to 8 weeks. Comminuted fracture of this part of tibia often have de-vascularized bony fragments which leads to delayed union or non-union. These complications often lead to implant failure, improper bone healing or non-union. Internal fixation with angle stable screws, offers a good stability of reduction in the early postoperative period. Titanium angle locking plates offers good anatomical reduction and stable fixation in the early period of healing process. Due to its rigid, fixed position of the screws in the plates, bone remodelling during healing process and early weight bearing, increases the mechanical failure of implant.Keywords: tibial pilon fractures, angle locking plates, implant failure.

Effect of maternal weight gain during pregnancy on exercise performance

1990 ◽  
Vol 68 (3) ◽  
pp. 1173-1176 ◽  
Author(s):  
M. W. Carpenter ◽  
S. P. Sady ◽  
M. A. Sady ◽  
B. Haydon ◽  
D. R. Coustan ◽  
...  
Keyword(s):  
Body Weight ◽  
Weight Gain ◽  
Exercise Performance ◽  
Weight Bearing ◽  
Work Load ◽  
Maternal Weight Gain ◽  
Maternal Weight ◽  
Exercise Tests ◽  
The Individual ◽  
Weight Gain During Pregnancy

We examined the effect of maternal weight gain during pregnancy on exercise performance. Ten women performed submaximal cycle (up to 60 W) and treadmill (4 km/h, up to 10% grade) exercise tests at 34 +/- 1.5 (SD) wk gestation and 7.6 +/- 1.7 wk postpartum. Postpartum subjects wearing weighted belts designed to equal their body weight during the antepartum tests performed two additional treadmill tests. Absolute O2 uptake (VO2) at the same work load was higher during pregnancy than postpartum during cycle (1.04 +/- 0.08 vs. 0.95 +/- 0.09 l/min, P = 0.014), treadmill (1.45 +/- 0.19 vs. 1.27 +/- 0.20 l/min, P = 0.0002), and weighted treadmill (1.45 +/ 0.19 vs. 1.36 +/- 0.20 l/min, P = 0.04) exercise. None of these differences remained, however, when VO2 was expressed per kilogram of body weight. Maximal VO2 (VO2max) estimated from the individual heart rate-VO2 curves was the same during and after pregnancy during cycling (1.96 +/- 0.37 to 1.98 +/- 0.39 l/min), whereas estimated VO2max increased postpartum during treadmill (2.04 +/- 0.38 to 2.21 +/- 0.36 l/min, P = 0.03) and weighted treadmill (2.04 +/- 0.38 to 2.19 +/- 0.38 l/min, P = 0.03) exercise. We conclude that increased body weight during pregnancy compared with the postpartum period accounts for 75% of the increased VO2 during submaximal weight-bearing exertion in pregnancy and contributes to reduced exercise capacity. The postpartum increase in estimated VO2max during weight-bearing exercise is the result of consistently higher antepartum heart rates during all submaximal work loads.

scholarly journals Prediction of pathological fracture in patients with metastatic disease of the lower limb

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Emma L. Howard ◽  
Paul Cool ◽  
Gillian L. Cribb
Keyword(s):  
Body Weight ◽  
Metastatic Disease ◽  
Lower Limb ◽  
Prospective Observational Study ◽  
Pathological Fracture ◽  
Weight Bearing ◽  
Total Body Weight ◽  
Threshold Level ◽  
Total Body ◽  
Optimum Threshold

Abstract The aim of this study was to investigate if the risk of pathological fracture can be predicted with the proportion of body weight that can be put through the affected leg in patients with metastatic bone disease of the lower limb. A prospective observational study was conducted in patients with metastatic disease in the lower limb. Receiver Operator Characteristic curves were used to identify the optimum threshold level of single stance weight bearing to predict fracture and compared to the Mirels score. Patients who underwent surgery could weight bear significantly less than those who did not have surgical intervention. The optimum threshold to predict pathological fracture was 85% of total body weight. No patient below the threshold level of 85% single stance body weight sustained a pathological fracture. The use of single stance body weight can be a useful in conjunction with the Mirels score to predict pathological fracture. If less than 85% of total body weight can be put through the affected limb, the risk of fracture increases, and consideration of treatment is suggested.

Biomechanical Testing of Locking and Nonlocking Plates in the Canine Scapula

2012 ◽  
Vol 48 (6) ◽  
pp. 372-378 ◽  
Author(s):  
Anthony E. Acquaviva ◽  
Emily I. Miller ◽  
David J. Eisenmann ◽  
Rick T. Stone ◽  
Karl H. Kraus
Keyword(s):  
Dynamic Compression ◽  
Plate Fixation ◽  
Biomechanical Testing ◽  
Osteoporotic Bone ◽  
Locking Plates ◽  
Pullout Strength ◽  
Modes Of Failure ◽  
Conventional Plate ◽  
String Of Pearls ◽  
Type Of Fracture

Locking plates have been shown to offer improved fixation in fractures involving either osteoporotic bone or bone with lesser screw pullout strength, such as thin and flat bones. Fractures of the scapular body are one type of fracture where the screw pullout strength using conventional plate fixation may not be sufficient to overcome physiologic forces. The purpose of this study was to compare the pullout strengths of locking plates to conventional nonlocking plates in the canine scapula. A 2.7 mm string of pearls plate (SOP) and a 2.7 mm limited contact dynamic compression plate (LC-DCP) were applied with similar divergent screws to the supraspinatus fossa of the scapula. Forces perpendicular to the plates were applied and both the loads at failure and modes of failure were recorded. No differences were noted in loads at failure between the two plating systems. Although the modes of failure were not significantly different, the SOP constructs tended to fail more often by bone slicing and coring, whereas the LC-DCP constructs failed primarily by screw stripping. Neither of the plate systems used in this study demonstrated a distinct mechanical advantage. The application and limitations of locking plate systems in various clinical situations require further study.

scholarly journals Sagittal-Plane Knee Moment During Gait and Knee Cartilage Thickness

2017 ◽  
Vol 52 (6) ◽  
pp. 560-566 ◽  
Author(s):  
Randy J. Schmitz ◽  
David Harrison ◽  
Hsin-Min Wang ◽  
Sandra J. Shultz
Keyword(s):  
Body Weight ◽  
Sagittal Plane ◽  
Femoral Condyle ◽  
Weight Bearing ◽  
Knee Extensor ◽  
Initial Step ◽  
Cartilage Thickness ◽  
Healthy Population ◽  
Tibiofemoral Angle ◽  
Control Factors

Context:  Understanding the factors associated with thicker cartilage in a healthy population is important when developing strategies aimed at minimizing the cartilage thinning associated with knee osteoarthritis progression. Thicker articular cartilage is commonly thought to be healthier cartilage, but whether the sagittal-plane biomechanics important to gait are related to cartilage thickness is unknown. Objective:  To determine the relationship of a weight-bearing region of the medial femoral condyle's cartilage thickness to sagittal gait biomechanics in healthy individuals. Design:  Descriptive laboratory study. Setting:  Laboratory. Patients or Other Participants:  Twenty-eight healthy participants (15 women: age = 21.1 ± 2.1 years, height = 1.63 ± 0.07 m, weight = 64.6 ± 9.9 kg; 13 men: age = 22.1 ± 2.9 years, height = 1.79 ± 0.05 m, weight = 75.2 ± 9.6 kg). Main Outcome Measure(s):  Tibiofemoral angle (°) was obtained via goniometric assessment, thickness of the medial femoral condyle cartilage (mm) was obtained via ultrasound imaging, and peak internal knee-extensor moment (% body weight · height) was measured during 10 trials of over-ground walking at a self-selected pace. We used linear regression to examine the extent to which peak internal knee-extensor moment predicted cartilage thickness after accounting for tibiofemoral angle and sex. Results:  Sex and tibiofemoral angle (12.3° ± 3.2°) were entered in the initial step as control factors (R2 = 0.01, P = .872). In the final step, internal knee-extensor moment (1.5% ± 1.3% body weight · height) was entered, which resulted in greater knee-extensor moment being related to greater cartilage thickness (2.0 ± 0.3 mm; R2Δ = 0.31, PΔ = .003). Conclusion:  Individuals who walked with a greater peak internal knee-extensor moment during gait had a cartilage structure that is generally considered beneficial in a healthy population. Our study offers promising findings that a potentially modifiable biomechanical factor is associated with cartilage status in a healthy population. Establishing these baseline relationships in uninjured populations may help us to better understand potential factors related to maladaptive gait patterns that predispose a person to adverse changes in the cartilage environment.

scholarly journals Body Weight Bearing on the Paretic Leg in Sit to Stand Movement of Stroke Patients

2006 ◽  
Vol 21 (2) ◽  
pp. 115-120
Author(s):  
Mutsumi UESUGI ◽  
Sumikazu AKIYAMA
Keyword(s):  
Body Weight ◽  
Weight Bearing ◽  
Stroke Patients ◽  
Sit To Stand

Upper and lower limb loading during weight-bearing activity in children: reaction forces and influence of body weight

2017 ◽  
Vol 36 (14) ◽  
pp. 1640-1647 ◽  
Author(s):  
M. C. Erlandson ◽  
S. Hounjet ◽  
T. Treen ◽  
J. L. Lanovaz
Keyword(s):  
Body Weight ◽  
Lower Limb ◽  
Weight Bearing ◽  
Limb Loading ◽  
Reaction Forces

scholarly journals The Effect of Walking Aids on Balance and Weight-Bearing Patterns of Patients With Hemiparesis in Various Stance Positions

2003 ◽  
Vol 83 (2) ◽  
pp. 112-122 ◽  
Author(s):  
Yocheved Laufer
Keyword(s):  
Body Weight ◽  
Patient Group ◽  
Weight Distribution ◽  
Comparison Group ◽  
Postural Sway ◽  
Weight Bearing ◽  
Community Dwelling ◽  
Assistive Device ◽  
Walking Aids ◽  
Base Of Support

Abstract Background and Purpose. Standard and quad canes are often prescribed to patients with hemiparesis, yet their effect on postural control remains unclear. Thus, the objective of this study was to examine the effects of standard and quad canes on postural sway and on weight-bearing patterns in patients with hemiparesis. Subjects. Thirty subjects with a diagnosis of unilateral hemiparesis following a stroke (patient group; mean age=71.2 years, SD=7.0) and 20 age-matched, community-dwelling volunteers without hemiparesis (comparison group; mean age=72.1 years, SD=5.2) participated in the study. Methods. Postural sway and percentage of body weight (%BW) borne by each extremity were measured in 3 positions: with the heels aligned with each other (aligned position) and in staggered foot positions with either the affected or unaffected extremity placed forward (affected FW and unaffected FW positions). All subjects were tested in each position with no cane, a standard cane, and a quad cane. The order of tests was randomized, and analysis of data included use of an analysis of variance and adjusted Tukey-Kramer tests. Results. In both the aligned and unaffected FW positions, postural sway was reduced only with the quad cane. Both types of canes reduced postural sway in the affected FW position; however, the quad cane had a greater effect. An asymmetrical weight distribution between the lower extremities did not change in the patient group across positions, even with walking aids. Discussion and Conclusion. A quad cane appears to be more effective than a standard cane in decreasing postural sway in patients with moderate impairment secondary to hemiparesis during stance. The greatest effect on postural sway occurred when the assistive device was contralateral to the foot placed forward. The use of a cane does not appear to adversely affect the asymmetrical weight-bearing pattern during stance that is characteristic of patients with hemiparesis, even when balance is challenged by decreasing the base of support.

scholarly journals Body weight homeostat that regulates fat mass independently of leptin in rats and mice

2017 ◽  
Vol 115 (2) ◽  
pp. 427-432 ◽  
Author(s):  
John-Olov Jansson ◽  
Vilborg Palsdottir ◽  
Daniel A. Hägg ◽  
Erik Schéle ◽  
Suzanne L. Dickson ◽  
...  
Keyword(s):  
Body Weight ◽  
Fat Mass ◽  
Weight Bearing ◽  
The Body ◽  
Bone Strain ◽  
Body Fat Mass ◽  
Feedback Systems ◽  
Diet Induced Obesity ◽  
Increased Risk ◽  
Rats And Mice

Subjects spending much time sitting have increased risk of obesity but the mechanism for the antiobesity effect of standing is unknown. We hypothesized that there is a homeostatic regulation of body weight. We demonstrate that increased loading of rodents, achieved using capsules with different weights implanted in the abdomen or s.c. on the back, reversibly decreases the biological body weight via reduced food intake. Importantly, loading relieves diet-induced obesity and improves glucose tolerance. The identified homeostat for body weight regulates body fat mass independently of fat-derived leptin, revealing two independent negative feedback systems for fat mass regulation. It is known that osteocytes can sense changes in bone strain. In this study, the body weight-reducing effect of increased loading was lost in mice depleted of osteocytes. We propose that increased body weight activates a sensor dependent on osteocytes of the weight-bearing bones. This induces an afferent signal, which reduces body weight. These findings demonstrate a leptin-independent body weight homeostat (“gravitostat”) that regulates fat mass.

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