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Orthopaedic Proceedings
Vol. 93-B, Issue SUPP_II | Pages 99 - 99
1 May 2011
Martin V Sanchez J Castaño M Viñas A González-orús A De Pedro J Dominguez J
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For the treatment of the fractures of the proximal extremity of the femur two predominant systems exist: the intramedular nail and the sliding screw plate.

The variables at the moment, to be considered, are the weight, age and type of fracture. The principal aims are: To develop models of finite elements of both types of implants and of two types of fracture (stable and unstable), and to integrate the models of finite elements of the implants in the model of fractured femur, to obtain the mechanical behavior of both types of implants and them to fit to the model of finite elements.

The analyzed models have been the gamma-3 nail (Stryker, USA) and the PerCutaneus Compression Plate (PCCP), (Gotfried, Israel). The real geometry has been created in the program SolidWorks 11.0 to be treated later in the program of calculation by means of finite elements Ansys.

The assembly with nail is more rigid (11.51 mm) that with plate (11.95 mm) on having had a few minor displacements. The tensions that appear in the nail (446 MPa) are major that those of the plate (132.93 MPa), in the unstable fractures.

In the unstable fractures, the intramedular nail is more rigid than the system of plate. The tensions to which the nail meets submitted are superior to those of break for what the nail would not be capable of supporting the first cycles of load. It is for it, that the system to using in these cases would be the sliding screw plate.


Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_II | Pages 334 - 334
1 May 2009
Delp M Dominguez J Allen M Prisby R
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Introduction: Bone loss occurs as a consequence of disuse. Using the hindlimb-unloaded (HU) rat, the purpose of this study was to determine whether skeletal unloading and reloading alters regional bone blood flow (microspheres) and PNA vasodilator responsiveness (in vitro).

Results: Femoral bone and marrow perfusion were reduced after 10 minutes, 7 days and 28 days of HU. Further, when the hindlimb skeleton is reloaded for 10 minutes following 14 days HU, bone and marrow perfusion were lower than that in standing control animals (e.g., femoral proximal metaphysis: Control, 20 ± 3 ml/min/100g; HU, 13 ± 3 ml/min/100g). PNA endothelium-dependent vasodilation was attenuated with 14 days of HU (Control, 84 ± 5% maximal relaxation; HU, 55 ± 7% maximal relaxation).

Discussion: The HU-associated changes bone perfusion and endothelium-dependent vasodilation correspond to unloading-induced changes in bone structure. These results support the hypothesis that alterations in bone blood flow and vascular signaling may modulate bone remodeling.


Orthopaedic Proceedings
Vol. 91-B, Issue SUPP_II | Pages 334 - 334
1 May 2009
Dominguez J Prisby R Behnke B Allen M Delp M
Full Access

Introduction: The purpose of this study was to determine whether regional blood flow (microspheres) in the femur is diminished with aging, and whether a reduction in flow is associated with impaired endothelium-dependent vasodilation.

Materials and Methods: Blood flow and PNA endothelium-dependent vasodilation was measured in young (4–6 months old) and aged (24–26 months old) male Fischer-344 rats.

Results: Blood flow in the aged rats was ~25% lower in femoral bone and 45% lower in diaphyseal marrow. Endothelium-dependent vasodilation was lower with old age (young: 83 ± 6% maximal relaxation; aged: 62 ± 5% maximal relaxation) and was mediated through impairment of the NOS signaling pathway, which resulted in a lower nitric oxide bioavailability (young: 168 ± 56 nM nitric oxide; aged: 50 ± 7 nM nitric oxide).

Discussion: Such age-related changes in bone perfusion and nitric oxide signaling could impact clinical bone loss, increase risk of fracture, and impair fracture healing in the elderly.