Key concepts in public policy: student workbook.
Explore the source record for details and available documents.
Curriculum↗
Biomedical subjects
S C Roe
Publications and source records attributed to S C Roe.
An in vitro comparison of hollow ground and trocar points on threaded positive-profile external skeletal fixation pins in canine cadaveric bone.
OBJECTIVE: To compare the microstructural damage created in bone by pins with lathe-cut and rolled-on threads, and to determine the peak tip temperature and damage created by positive-profile external fixator pins with either hollow ground (HG) or trocar (T) tips during insertion. STUDY DESIGN: An acute, in vitro biomechanical evaluation. SAMPLE POPULATION: Twenty-seven canine tibiae. METHODS: Lathe-cut thread design with T point (LT-T), rolled-on thread design with T point (RT-T), and rolled-on thread design with HG point (RT-HG) pins were evaluated. Twenty pins of each type were inserted under constant drilling pressure into 12 canine tibiae (12 diaphyseal and 8 metaphyseal sites per pin type). Peak pin tip temperature, drilling energy, end-insertional pin torque, and pullout force were measured for each pin. For the histologic study, five pins of each type were inserted into cortical and cancellous sites in 15 additional tibiae. Entry and exit damage, and thread quality were assessed from 100 micron histologic sections by using computer-interfaced videomicroscopy. RESULTS: T-tipped pins reached higher tip temperature in both diaphyseal and metaphyseal bone compared with HG-tipped pins. RT-T pins had higher pullout strength (diaphyseal) and end-insertional torque compared with other combinations. No differences in drilling energy or insertional bone damage was found between the three pin types (P < .05). CONCLUSIONS: T-tipped pins mechanically outperformed HG-tipped pins. Pin tip and thread design did not significantly influence the degree of insertional bone damage. CLINICAL RELEVANCE: T-tipped pins may provide the best compromise between thermal damage and interface friction for maximizing performance of threaded external fixator pins.
Animals↗
Evaluation of collagen as a retainer for autogenous cancellous bone used in repair of full thickness cortical bone defects.
A commercially available collagen sponge acting as a cylindrical retainer containing autogenous cancellous bone graft was proposed for treatment of full thickness cortical defects in dogs. Three groups of three dogs each were subjected to removal of at least 1.5 cm of the tibial diaphyses. All tibias were stabilized with bilateral external fixators. Group 1 received collagen surrounding an autogenous cancellous bone graft. Group 2 received collagen and group 3 received no treatment of the ostectomy site. The collagen sponge appeared to allow vascularization of the bone graft as evidenced by new bone formation and was resorbed by 3 months after implantation. Radiographic, histomorphologic, and histomorphometric evaluation at 3 months after surgery showed a greater per cent of bone in the ostectomy site in group 1.
Animals↗
Biomechanical evaluation of a toggle pin technique for management of coxofemoral luxation.
Toggle pin stabilization is an accepted technique for the management of coxofemoral (CF) luxation in dogs. The purpose of this study was to determine, in vitro, the respective contributions of several aspects of toggle pin repair to the overall stability of fixation. Factors evaluated were the manner and frequency with which toggle pins oriented on insertion, effect of orientation on toggle pin strength, effect of suture type on ligament prosthesis strength and load sustained by the fixation, and comparison of repair using a modified toggle design to that of capsulorrhaphy. When placed in cadavers using standard technique, conventional toggle pins were found to orient significantly more frequently in one of two possible positions. Mechanical testing of fixations performed in experimentally luxated cadaver hips demonstrated a high (12/20) incidence of toggle pin failure using the conventional implant in the most common orientation. When tested alone, toggle pins were weakest mechanically in this orientation. Rotating the implant 180 degrees increased mean load to failure by 249%. There was no significant difference in load sustained by conventional toggle fixations using No. 2 braided polyester versus 50 lb test monofilament nylon as the suture ligament prosthesis. However, the higher stiffness of the polyester suture may be more favorable for use in this application. Fixation using a toggle rod designed to allow evaluation of construct stability when failure of the toggle is eliminated resulted in an increase in maximum load sustained before luxation (47% of the intact control hips). This load was not significantly different than the resistance to luxation afforded by capsulorrhaphy. This study suggests that when implanting conventional toggle pins, consideration should be given to ensuring placement in the strongest orientation.
Animals↗
Osteosarcoma eight years after total hip arthroplasty.
This report presents a case of osteosarcoma of the femoral diaphysis associated with chronic stimulation of the area by an unstable femoral prosthesis after total hip arthroplasty performed 8 years previously. The pathogenesis of this transformation may be similar to that proposed for fracture-associated sarcoma. Neoplasia should be considered as a possible late complication of total hip arthroplasty.
Animals↗
In vitro biomechanical and histological assessment of pilot hole diameter for positive-profile external skeletal fixation pins in canine tibiae.
This study was conducted to evaluate the effect of pilot hole (PH) diameter (0, 1.5, 2.0, 2.7, 3.1, 3.3, 3.5, and 3.7 mm) on the biomechanical and microstructural performance of positive-profile threaded external skeletal fixation pins (3.18 mm inner diameter, 3.97 mm outer diameter) using cadaveric canine tibiae. Eight pins per pilot hole diameter (four pins per bone) were used to assess differences in end-insertional torque and pin pull-out strength. Histological evaluation of eight bicortical pin tracts per pilot hole diameter was accomplished using computer-interfaced videomicroscopy on specimens processed using a bulk-staining technique. Compared with no predrill, use of 2.7 mm PH increased end-insertional torque and pull-out strength by 25% and 13.5%, respectively. No significant differences were observed in biomechanical variables for the PH diameter range of 2.0 to 3.1 mm. Compared with no predrill, use of a 3.1 mm PH increased thread area by 18%. Microfracturing around the threads decreased as PH diameter increased. Damage to the interface at the entry and exit sites of both near and far cortices also decreased as PH diameter increased. It was concluded that predrilling a PH whose diameter approximates, but does not exceed the inner diameter of the positive profile pin will not only improve initial pin stability compared with no predrilling, but it will also reduce microstructural damage that may lead to excessive bone resorption and premature pin loosening.
Animals↗
Epoxy putty for free-form external skeletal fixators.
OBJECTIVE: To evaluate the suitability of epoxy putty for use as a connecting beam material in a free-form external skeletal fixator. DESIGN: Mechanical evaluation of beams and the pin-material interface of commonly used methacrylates and the proposed epoxy putty. PROCEDURE: The apparent modulus, bending strength, and toughness of 10 beams of three methacrylates (Technovit, APEF System, Bone Cement) and three epoxy putties (Oatey Epoxy Putty, All-Metals PowerPoxy, and Plumber's PowerPoxy) were determined in three-point bending. The shear strength of smooth and roughened-shaft pins embedded in the three methacrylates and the Oatey Epoxy Putty was determined by pull-out testing. RESULTS: The epoxy putties had similar strength, greater apparent modulus, and reduced toughness when compared with the methacrylates. The shear strength of the smooth pin interface with the Oatey Epoxy putty was greater than that with the methacrylates. The interface with roughened pins was much stronger than that with smooth pins for all materials tested. CLINICAL RELEVANCE: Epoxy putty is a suitable material for free-form external fixators. It is easy to handle, inexpensive, and has suitable setting times and mechanical properties.
Animals↗
Mechanical characteristics and comparisons of cerclage wires: introduction of the double-wrap and loop/twist tying methods.
OBJECTIVE: Evaluate the mechanical properties of twist, loop, double loop, double-wrap and loop/twist cerclage. METHODS: The initial tension generated by 18 cerclage of each type was determined using a materials testing machine after tying around a testing jig. Six wires from each type were distracted and the initial stiffness and yield load were determined. Yield behavior was further investigated in six wires of each type by determining the load required to reduce cerclage tension below 30 Newton (N) following and incremental (50 N) stepwise load and unload regimen. The amount of collapse of the simulated bone fragments that resulted in the reduction of initial tension to 30 N was measured for the final six wires of each group. Data were analyzed by analysis of variance and a multiple comparison test. RESULTS: Twist type cerclage generated less tension than loop-type cerclage. The yield load of these two types was similar. Double-loop and double-wrap cerclage generated superior tension and resisted a greater load before loosening. Loop/twist cerclage had an intermediate initial tension but had the greatest resistance to loading. In the collapse test, the greater the initial tension, the more collapse could occur before the wire was loose. For all types of cerclage wire fixation, a reduction of diameter of the testing jig of more than 1% caused loosening. CLINICAL RELEVANCE: Double-loop and double-wrap cerclage provide greater compression of fragments and resist loads associated with weight-bearing better than the twist and loop methods. Loop/twist cerclage may have advantages because of their superior resistance to loading. All cerclage will loosen if fracture fragments collapse.
Animals↗
Hinged Ilizarov external fixation for correction of antebrachial deformities.
OBJECTIVE: To evaluate hinged circular external fixation for correction of antebrachial deformities in dogs. STUDY DESIGN: Uncontrolled clinical trial. ANIMAL POPULATION: Seven client-owned dogs. METHODS: Six dogs had one radius corrected and one dog had both radii corrected. Preoperative planning included measurement of the craniocaudal and mediolateral angular deformities, rotational deformity, length deficit, origin of deformity, graphical or mathematical determination of the amplitude and direction of the actual limb deformity, and frame assembly. RESULTS: Preoperatively, function and cosmesis were assessed to be fair to poor in all dogs. Deformity correction started 48 to 60 hours postoperatively and ranged from 0.46 mm to 1.36 mm twice daily. Hospitalization time ranged from 4 to 6 days. Corrections were mostly made by the owners, at home. Lengthening and angular correction ranged from 3 to 38 mm and 18 degrees to 48 degrees. Mean residual deformities were 2.7% of radial length and 2.7 degrees. The time duration with the circular external fixators in place ranged from 29 to 71 days. Two additional surgeries were necessary in one dog because of wire breakage. Mean follow-up was 40 months. Long-term function and cosmesis were good to excellent in all dogs. CONCLUSION: Although complications were present in six of seven dogs, the outcome of hinged Ilizarov external fixation was successful in all dogs treated for deformities of the antebrachium. CLINICAL RELEVANCE: Despite complex preoperative planning, the placement of hinged circular external fixators is straightforward, and allows precise correction of complex antebrachial deformities with minimal tissue trauma.
Animals↗
Holding power of different pin designs and pin insertion methods in avian cortical bone.
OBJECTIVE: To measure pullout strength of four pin types in avian humeri and tibiotarsi bones and to compare slow-speed power and hand insertion methods. STUDY DESIGN: Axial pin extraction was measured in vitro in avian bones. ANIMAL POPULATION: Four cadaver red-tailed hawks and 12 live red-tailed hawks. METHODS: The pullout strength of four fixator pin designs was measured: smooth, negative profile threaded pins engaging one or two cortices and positive profile threaded pins. Part 1: Pins were placed in humeri and tibiotarsi after soft tissue removal. Part 2: Pins were placed in tibiotarsi in anesthetized hawks using slow-speed power or hand insertion. RESULTS: All threaded pins, regardless of pin design, had greater pullout strength than smooth pins in all parts of the study (P < .0001). The cortices of tibiotarsi were thicker than the cortices of humeri (P < .0001). There were few differences in pin pullout strengths between threaded pin types within or between bone groups. There were no differences between the pullout strength of pins placed by slow-speed power or by hand. CONCLUSIONS: There is little advantage of one threaded pin type over another in avian humeri and tibiotarsi using currently available pin designs. There were few differences in pin pullout strengths between humeri and tibiotarsi bones. It is possible that the case of hand insertion in thin cortices minimizes the potential for wobbling and therefore minimizes the difference between slow-speed drill and hand insertion methods. CLINICAL RELEVANCE: Threaded pins have superior bone holding strength in avian cortices and may be beneficial for use with external fixation devices in birds.
Animals↗
Biomechanical comparison of the trocar tip point and the hollow ground tip point for smooth external skeletal fixation pins.
OBJECTIVE: To compare the insertional characteristics of external fixator pins with hollow ground (HG), modified HG, and trocar (T) points. STUDY DESIGN: An acute, in vitro biomechanical evaluation. SAMPLE POPULATION: Thirteen radii from canine cadavers. METHODS: A total of 16 T-tipped and 16 HG-tipped pins were inserted into 8 canine radii. Ten pins of each modification of the HG tip (length of the cutting edge reduced by 0.127 mm and 0.254 mm, respectively) were inserted into another five radii. All pins were inserted with low-speed power drilling and 80 N drilling load. Differences between peak tip temperature, drilling energy, and pullout force were determined for each pin type at both diaphyseal and metaphyseal locations. RESULTS: HG-tipped pins showed a 40% lower tip temperature in diaphyseal bone, a 25% reduction in drilling energy in diaphyseal bone, and a reduction of pullout force in both diaphyseal (65%) and metaphyseal (50%) bone compared with T-tipped pins. HG 0.254-mm pins generated higher tip temperatures and had greater pullout than HG pins in diaphyseal bone. CONCLUSIONS: The HG tip was a more efficient design; however, the reduction in pullout force suggests that, because a better hole was drilled, radial preload is reduced. Reduction of the cutting edge by 0.254 mm increased the pullout force but also increased the temperatures. CLINICAL RELEVANCE: Thermal and microstructural damage are reduced by the HG tip, but pin-bone interface stability is also compromised. The use of a tip with 0.254 mm reduction in the cutting edge may optimize the biological and mechanical factors at the pin-bone interface.
Animals↗
Assessment of the directional elastic moduli of ewe vertebral cancellous bone by vibrational testing.
The ovariectomized ewe is being used as an animal model for postmenopausal osteoporosis. Data on the mechanical properties of ewe vertebral cancellous bone is needed to assess its effectiveness as a model for vertebral osteoporosis. This study utilized traditional compression testing and a novel nondestructive vibrational testing method to assess the directional mechanical properties of ewe vertebral cancellous bone. Composition and density properties were also assessed. It was hypothesized that vibrational testing would have utility in that it would allow for the anisotropic stiffness of cancellous bone to be assessed nondestructively. The present study has found that ewe vertebral cancellous bone has similar physical and mechanical properties to humans. The vibrational testing method described was able to nondestructively provide a valid measure of stiffness that was correlated with stiffness estimates from traditional compression testing. Furthermore, the stiffness measure from the vibration test was found to be sensitive to the architecture of cancellous bone. These results suggest the promise of this testing method for the nondestructive mechanical assessment of skeletal tissue.
Animals↗
Axial vibration of threaded external fixation pins: detection of pin loosening.
The hypothesis of this study was that a nondestructive vibrational method could detect bone lysis at the external fixation pin-bone interface prior to current clinical and radiographic methods. In vitro models were used to simulate changes observed during pin loosening in vivo. Fixation pin axial natural frequency decreased with decreasing tensile modulus of the material into which it was implanted. In a live animal study the right tibia of 12 dogs was fractured and stabilized with a four-pin unilateral external fixation frame. The axial natural frequency of each pin was measured and radiographs were taken at 0, 2, 4, 6, 8, and 10 weeks after surgery. The natural frequency did not change when the first radiographic changes around the interface were observed. Pins were palpably stable at this point. As loosening progressed, the natural frequency did decrease. Frequency and quasistatic tests of dissected pin-bone structures revealed a good correlation between natural frequency and pin-bone interface stiffness. In addition, the measurement of natural frequency was more sensitive to bone structure changes at the pin-bone interface than low-load quasi-static stiffness. Therefore, a nondestructive vibration technique could be used instead of low-load quasistatic tests for assessing the pin-bone interface ex. vivo.
Animals↗
CE footprints on Arizona highways.
Explore the source record for details and available documents.
Arizona↗
Demineralized bone matrix (DBM)
Explore the source record for details and available documents.
Animals↗