scholarly journals Biomechanical study on the stress distribution of the knee joint after distal femoral fracture malunion with residual varus-valgus deformity 

2020 ◽  
Author(s):  
Ming Li ◽  
Pan Hu ◽  
Lijie Ma ◽  
Di Zhang ◽  
Wenli Chang ◽  
...  
Keyword(s):  
Stress Distribution ◽  
Knee Joint ◽  
Femoral Fracture ◽  
Femoral Fractures ◽  
Valgus Deformity ◽  
Biomechanical Study ◽  
Lower Limbs ◽  
Neutral Position ◽  
Distal Femoral Fracture ◽  
Lateral Plateau

Abstract Background: To investigate the effect of residual varus and valgus deformity on the stress distribution of knee joint after distal femoral fracture malunion. Methods: Fourteen adult cadaver specimens with formalin were selected to establish the femoral fractures models, which were fixed subsequently at neutral position (anatomical reduction) and malunion positions (at 3 degrees, 7 degrees, 10 degrees valgus positions and 3 degrees, 7 degrees, and 10 degrees varus positions). The stress distribution on the medial and lateral plateau of the tibia was quantitatively measured using ultra-low pressure sensitive film technology. The change of stress distribution of knee joint after femoral fracture malunion and the relationship between stress value and residual varus varus or valgus deformity were analyzed.Results: Under 400 N vertical load, the stress values on the medial and lateral plateau of the tibia at the neutral position were 1.162±0.114 MPa and 1.103±0.144 MPa, respectively. When compared with the stress values measured at the neutral position, the stress on the medial plateau of tibia were significantly higher at varus deformities and lower at valgus deformities, and the stress on the lateral plateau was significantly higher at valgus deformity and lower at varus deformities (all P<0.05). The stress values on the medial plateau of tibia were significantly higher than the corresponding data on the lateral plateau at neutral and 3 degrees, 7 degrees, 10 degrees varus deformities, respectively (all P<0.05), and significantly lower than the corresponding data on the lateral plateau at 3 degrees, 7 degrees, 10 degrees valgus deformities, respectively (all P<0.05). Conclusions: Residual varus and valgus deformity after femoral fracture malunion can cause obvious changes of the stress distribution of knee joint. Therefore, the distal femoral fracture should be anatomically reduced and rigidly fixed to avoid residual varus-valgus deformity and malalignment of lower limbs.

scholarly journals Biomechanical study on the stress distribution of the knee joint after distal femoral fracture malunion with residual varus-valgus deformity

2020 ◽  
Author(s):  
Ming Li ◽  
Pan Hu ◽  
Lijie Ma ◽  
Di Zhang ◽  
Wenli Chang ◽  
...  
Keyword(s):  
Stress Distribution ◽  
Knee Joint ◽  
Femoral Fracture ◽  
Femoral Fractures ◽  
Valgus Deformity ◽  
Biomechanical Study ◽  
Lower Limbs ◽  
Neutral Position ◽  
Distal Femoral Fracture ◽  
Lateral Plateau

Abstract Background To investigate the effect of residual varus and valgus deformity on the stress distribution of knee joint after distal femoral fracture malunion. Methods Fourteen adult cadaver specimens with formalin were selected to establish the femoral fractures models, which were fixed subsequently at neutral position (anatomical reduction) and malunion positions (at 3 degrees, 7 degrees, 10 degrees valgus positions and 3 degrees, 7 degrees, and 10 degrees varus positions). The stress distribution on the medial and lateral plateau of the femur was quantitatively measured using ultra-low pressure sensitive film technology. The change of stress distribution of knee joint after femoral fracture malunion and the relationship between stress value and residual varus varus or valgus deformity were analyzed. Results Under 400 N vertical load, the stress values on the medial and lateral plateau of the femur at the neutral position were 1.162 ± 0.114 MPa and 1.103 ± 0.144 MPa, respectively. When compared with the stress values measured at the neutral position, the stress on the medial plateau of femur were significantly higher at varus deformities and lower at valgus deformities, and the stress on the lateral plateau was significantly higher at valgus deformity and lower at varus deformities (all P < 0.05). The stress values on the medial plateau of tibia were significantly higher than the corresponding data on the lateral plateau at neutral and 3 degrees, 7 degrees, 10 degrees varus deformities, respectively (all P < 0.05), and significantly lower than the corresponding data on the lateral plateau at 3 degrees, 7 degrees, 10 degrees valgus deformities, respectively (all P < 0.05). Conclusions Residual varus and valgus deformity after femoral fracture malunion can cause obvious changes of the stress distribution of knee joint. Therefore, the distal femoral fracture should be anatomically reduced and rigidly fixed to avoid residual varus-valgus deformity and malalignment of lower limbs.

scholarly journals Biomechanical Study on the Stress Distribution of the Knee Joint After Distal Femoral Fracture Malunion With Residual Varus-valgus Deformity

2021 ◽  
Author(s):  
Ming Li ◽  
Pan Hu ◽  
Lijie Ma ◽  
Hao Du ◽  
Yanbin Zhu ◽  
...  
Keyword(s):  
Stress Distribution ◽  
Knee Joint ◽  
Femoral Fracture ◽  
Femoral Fractures ◽  
Valgus Deformity ◽  
Biomechanical Study ◽  
Neutral Position ◽  
Distal Femoral Fracture ◽  
Pressure Sensitive Film ◽  
Lateral Plateau

Abstract BackgroundThis study aims to examine the biomechanical influence of residual varus and valgus deformity after malunion of distal femoral fractures on the knee joint. MethodsWe selected 14 adult cadaver specimens to establish the femoral fractures models and subsequently fixed them at neutral position and malunion positions, i.e. at 3°, 7° and 10° at valgus and varus positions, respectively. Ultra-low pressure sensitive film technology was used to quantitatively measure the stress distribution on the medial and lateral plateau of the tibia.ResultsAt neutral position, with 400 N vertical load applied, the stress values of the medial and lateral plateau of tibia were 1.162±0.114 MPa and 1.103±0.144 MPa, respectively. Compared with those measured at neutral position, the stress on the medial plateau of the valgus tibia significantly increased, while that on the lateral plateau of the valgus tibia significantly decreased (both P<0.05). In contrast, the stress on the lateral plateau of the valgus tibia significantly increased, while that on the medial plateau of the valgus tibia significantly decreased (both P<0.05). The medial plateau of tibia demonstrated significantly higher stress values than those on the lateral plateau at neutral position and 3°, 7°, 10° varus deformities, respectively (all P<0.05), but showed significantly lower values than the those on the lateral plateau at 3°, 7°, 10° valgus deformities, respectively (all P<0.05). ConclusionsThe residual varus and valgus deformities after mulunion of the distal femoral fracture resulted in significant changes of the stress distribution of the knee joint. Anatomical reduction and firm fixation of distal femoral fracture should be as possible to be obtained to avoid possible varus and valgus deformities.

scholarly journals Biomechanical study on the stress distribution of the knee joint after residual rotation deformity of tibial fracture

2020 ◽  
Author(s):  
Ming Li ◽  
Yanbin Zhu ◽  
Ning Wei ◽  
Wenli Chang ◽  
Zeyue Jin ◽  
...  
Keyword(s):  
Stress Distribution ◽  
Knee Joint ◽  
Lower Limb ◽  
External Rotation ◽  
Biomechanical Study ◽  
Lower Limbs ◽  
Neutral Position ◽  
Lateral Stress ◽  
Significant Difference ◽  
The Difference

Abstract Objectives To investigate the effect of residual rotation deformity on the stress distribution of the knee joint after surgery to treat middle and upper tibial fractures. Methods Fourteen adult cadaver specimens that were preserved with formalin were included, and the tibias were randomly positioned at 0 degree, 5 degrees, 10 degrees, and 15 degrees from the line of force of the lower limb. These positions modeled deformities of 5 degrees, 10 degrees, and 15 degrees from the line of force. Low-pressure pressure-sensitive film technology measured the stress distribution of the knee joint under different degrees of rotation deformity. Results Under a vertical load of 400 N, the difference between the medial and lateral stress of the knee joint was significantly different between the different tibia deformities (P<0.05), and the medial stress of the knee joint was higher than the lateral stress. The current study showed that there were statistically significant differences in the medial stress on the knee joint at all angles (including the neutral position of 0 degrees) (F=89.753, P<0.001) . There was a statistically significant difference in the lateral stresses of the knee joint between different rotation deformities (including the neutral position of 0 degrees) (F=102.998, P<0.001). Conclusions Residual rotation deformity after fracture of middle and upper tibia can lead to poor alignment of lower limb force and change of articular contact characteristics of knee joint, especially external rotation of tibia.Therefore, orthopedic surgeons should correct the malalignment of lower limbs to the greatest extent and reduce the rotation deformity as far as possible.

scholarly journals Biomechanical Study on the Stress Distribution of the Knee Joint After Tibial Fracture Malunion with Residual Varus–Valgus Deformity

2020 ◽  
Vol 12 (3) ◽  
pp. 983-989
Author(s):  
Ming Li ◽  
Hengrui Chang ◽  
Ning Wei ◽  
Wenli Chang ◽  
Ying Yan ◽  
...  
Keyword(s):  
Stress Distribution ◽  
Knee Joint ◽  
Tibial Fracture ◽  
Valgus Deformity ◽  
Biomechanical Study

“FUNCTIONAL OUTCOME OF RETROGRADE NAILING IN THE MANAGEMENT OF SUPRACONDYLAR AND DISTAL FEMORAL FRACTURE”

2021 ◽  
pp. 107-109
Author(s):  
Avinash Kumar Choudhary ◽  
M.K Aseri ◽  
Sumit Machra ◽  
Devendra Singh
Keyword(s):  
Femoral Fracture ◽  
Distal Femur ◽  
Femoral Fractures ◽  
High Energy ◽  
Valgus Deformity ◽  
Minor Trauma ◽  
Rating Score ◽  
Joint Congruency ◽  
Distal Femoral Fractures

INTRODUCTION: Fractures of the Distal femur are complex injuries that pose a challenge to the orthopaedic surgeon. It constitutes about 6 % of all femoral fractures. It usually occurs during high energy trauma in younger patients and frequently are associated with concomitant injuries. In contrast, elderly patients with severe osteopenia might sustain solitary distal femoral fractures from minor trauma such as a simple fall. Proper diagnosis and treatment leads to early mobilization and rehabilitation of patients. MATERIAL AND METHODS :This prospective study was conducted in Department of Orthopedics at Dr. S. N. Medical College and Associated group of Hospital, Jodhpur ,Rajasthan ,India on 30 patients who underwent the surgery with retrograde intramedullary interlocking nail in the management of extra-articular supracondylar femoral fracture from August 2019 to November 2020. On follow up axial alignment was assessed and functional analysis was quantied using NEERS RATING SYSTEM, Radiographs was analyzed for correction, maintenance of position or loss of reduction. function around knee was accessed according to Schatzker and Lambert Criteria, measures the exion/extension , varus/valgus deformity , joint congruency and pain in operated patients. RESULTS: In our study 30 patients with supracondylar & distal femoral fractures based on AO Classication on MULLER ET AL underwent retrograde supracondylar nail, long term nal result were rated using NEER'S RATING SCORE , which gives point for pain, function, working, joint movement ,gross and radiological appearance. NEER'S RATING SCORE assigned for each patient after 24 weeks of follow up. After accessing this score out of total 30 patients, 10 have excellent score, 10 have good score, 8 have fair score and next 2 have poor score. Function around knee was accessed according to Schatzker and Lambert Criteria, measures the exion/extension , varus/valgus deformity , joint congruency and pain in operated patients,out of 30 patients 9 patients have an excellent result , 8 have good ,12 have fair and only 1 patient have poor result CONCLUSION:The retrograde intramedullary locked nail provides the surgeon with a different option in treatment of specic supracondylar fracture patterns. It offers a practical advantages of simple and efcient technique for patients with polytrauma, oating knee injuries and in elderly. this technique is very useful in distal femur fracture where antegrade nailing does not provide stability and also where plate xation is not suitable due to soft tissue condition.

scholarly journals SOCIO-DEMOGRAPHIC AND CLINICAL CHARACTERISTICS OF THE PATIENTS SUFFERING FROM DISTAL FEMORAL FRACTURE

2021 ◽  
Vol 5 (3) ◽  
Author(s):  
Amit Kumar ◽  
Sanjeev Gupta ◽  
Rameshwar Singh Manhas
Keyword(s):  
Femoral Fracture ◽  
Clinical Characteristics ◽  
Traffic Accidents ◽  
Road Traffic ◽  
Femoral Fractures ◽  
General Information ◽  
Age Group ◽  
Distal Femoral Fracture ◽  
Distal Femoral Fractures ◽  
Medical College

Background: Distal femoral fractures are the fractures which occurs in distal femur involving the intercondylar and supracondylar region. Currently they account for less than 1% of all fractures whereas among femoral fractures they account for 3% to 6%.These fractures are difficult to treat and notorious for the complications. Aim: To find the socio-demographic and clinical characteristics of the patients suffering from distal femoral fracture. Methodology: The present observational and prospective study was conducted in theDepartment of Orthopaedic, Govt. Medical College, Jammu, J&K for period of 1 year on 27 patients. General information including age, sex, residence, religion, marital status, side of fracture etc. were noted on separate sheet. All fractures were classified as per AO/Müller’s classification. Results: Majority of patients i.e. 40.8% were between 18-30 years age group. 66.6% patients were males and only 33.4% were females. 63% patients were from rural area and 37% patients from urban area. Maximum percentage of patients i.e. 59.3% from Hindu community and 66.7% were married. RTA was the most common mode of injury involving 74.1% patients whereas, right limb fractures were most commonly involving 66.7% patients. As per AO/Muller’s classification B3 and C1 were most common fractures affecting 18.6% patients each. Conclusion: From present study we conclude that the distal femoral fractures were more common in young age group and RTA is the most common cause. Hence it is recommended to the authorities to implement strict traffic rules so that over speeding of vehicle can be prevented which may lead to decrease in incidence of high velocity trauma. Key words: Fractures, Road traffic accidents, Injury.

scholarly journals A Comparison of Mortality following Distal Femoral Fractures and Hip Fractures in an Elderly Population

2014 ◽  
Vol 2014 ◽  
pp. 1-4 ◽  
Author(s):  
R. W. Jordan ◽  
G. S. Chahal ◽  
M. Davies ◽  
K. Srinivas
Keyword(s):  
Mortality Rate ◽  
Hip Fractures ◽  
Femoral Fracture ◽  
Elderly Population ◽  
Surgical Intervention ◽  
Femoral Fractures ◽  
Mortality Rates ◽  
Distal Femoral Fracture ◽  
Distal Femoral Fractures ◽  
One Year

Introduction. Patients suffering a distal femoral fracture are at a high risk of morbidity and mortality. Currently this cohort is not afforded the same resources as those with hip fractures. This study aims to compare their mortality rates and assess whether surgical intervention improves either outcome or mortality following distal femoral fractures. Methods. Patients over sixty-five admitted with a distal femoral fracture between June 2007 and 2012 were retrospectively identified. Patients mobility was categorised as unaided, walking aid, zimmer frame, or immobile. The 30-day, six-month, and one-year mortality rates were recorded for this group as well as for hip fractures during the same period. Results. 68 patients were included in the study. The mortality rate for all patients with distal femoral fractures was 7% at 30 days, 26% at six months, and 38% at one year, higher than hip fractures during the same period by 8%, 13%, and 18%, respectively. Patients managed surgically had lower mortality rates and higher mobility levels. Conclusion. Patients suffering a distal femoral fracture have a high mortality rate and surgical intervention seems to improve both mobility and mortality.

scholarly journals Outcome of Distal Femoral Fracture Treated with Locking Plate

2021 ◽  
Vol 15 (6) ◽  
pp. 2142-2144
Author(s):  
Muhammad Shoaib Zardad ◽  
Abdus S. Awan ◽  
Muhammad Younas ◽  
Shahkeel A. Shah ◽  
S. Sohail Akhtar ◽  
...  
Keyword(s):  
Femoral Fracture ◽  
Traffic Accidents ◽  
Locking Plate ◽  
Road Traffic ◽  
Femoral Fractures ◽  
Delayed Union ◽  
Distal Femoral Fracture ◽  
Non Union ◽  
One Year

Objective: The aim of this study is to determine the outcome of distal femoral fracture treated with locking plate. Study Design:Prospective study Place and Duration: Conducted at Orthopaedic Unit Ayub Medical Teaching Institute, Abbottabad for one year duration from 1stJanuary 2020 to 31st December 2020. Methods: Total 90 patients of both genders were presented in this study.Patients were aged between 18-80 years of age. Patients’ detailed demographics including age, sex and body mass index were recorded after taking informed written consent. All the patients had distal femoral fracture treated with locking plate. Radiological assessment was done. Mean union time and complications associated to procedure were examined.Functional outcomes were analyzed according to the Flyn’s criteria. Follow-up was taken at 6 months postoperatively. Complete data was analyzed by SPSS 24.0 version. Results:There were 58 (64.4%) patients were males and 32 (35.6%) were females. Mean age of the patients were 42.61±12.88 years with mean BMI 27.65±9.56 kg/m2. According AO/OTA classification 55 (61.1%) had A1, A2 fracture was among 18 (20%) cases and the rest were 17 (18.9%) had A3. 62 (68.9%) fractures were caused due road traffic accidents, falling from height were among 17 (18.9%) cases and 11 (12.2%) cases were due to sports. Right side fracture was the most common side of fracture among 54 (60%). Mean union time among patients was 5.16±1.27 months.According to Flyn’s criteria, 38 (42.2%) cases had excellent results, 32 (35.6%) patients had good, fair results were among 16 (17.8%) cases and poor results were among 4 (4.4%) cases. Complications were delayed union, stiffness, varus deformityand non union observed among all cases. Conclusion: We concluded in this study that the locking plate for the treatment of distal femoral fractures was effective in terms of good results with fewer complications. Keywords:Distal femoral fracture, Locking plate, RTA, Complications

scholarly journals Pressure Change Of Fixed Rotational Deformities In The Femur In Human Cadaver Knees-A Biomechanical Study

2021 ◽  
Author(s):  
Yuwen Peizhi ◽  
Hongzhi Lv ◽  
Yanbin Zhu ◽  
Wenli Chang ◽  
Ning Wei ◽  
...  
Keyword(s):  
Knee Joint ◽  
Internal Rotation ◽  
Contact Pressure ◽  
Tibial Plateau ◽  
Lower Limbs ◽  
Lateral Side ◽  
Neutral Position ◽  
Relative Pressure ◽  
Rotational Deformity ◽  
Significant Difference

Abstract Background: Closed intramedullary interlocking nailing is a standard treatment for femoral shaft fractures, but incidences of rotational malalignment after operation is really high. Poor reduction and postoperative malunion lead to many clinical symptoms and long term degenerative arthritis. It has been proved that uneven stress is the mechanical cause of knee joint degeneration, but few studies pay attention to the effect of femur rotational deformity on knee joint contact pressure.This study aim to quantitatively evaluate the relation between residual rotational deformity in femur and contact pressure of knee joint. Methods: Fourteen cadaveric Lower limbs were selected and autopsied, rotatory fixation model with different angles were then made. Connect each model on the biomechanical machine and apply a vertical load to 400N. The contact pressure was quantitatively measured using ultra-low-pressure sensitive film technology. FPD-305E density meter and FPD-306E pressure converter were used to read relative pressure values. Contact pressure on medial and lateral tibial plateau in different femoral rotational deformities were compared. Analysis were done using SPSS software.Results: The medial group show a significant difference on tibial plateau (F=92.114, P<0.01), further test showed statistically significant differences of pairwise comparisons between 0°, 5°, 10°, 15° internal rotation deformity (P<0.05). There is no significant difference in lateral group (ꭓ2=9.967, P<0.01). The medial contact pressure is 0.940±0.177 MPa and the lateral is 1.008±0.219 MPa at neutral position, no statistically significant was found, so is 5° of internal rotational deformity. But the medial contact pressure are all higher than the lateral side at 5°, 10°, 15° of external rotation, and 10°, 15° of internal rotation. Conclusion: Obvious contact pressure changes on tibial plateau were observed in rotatory deformity femur, which is closely related to the occurrence of knee osteoarthritis. Doctors should detect rotational deformity as much as possible during operation and perform anatomical reduction, for patients with residual rotational deformities, indication of osteotomy should not be too broad.

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