Calculating stress magnitude between sternotomy closures and sternum.
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Humans↗
Biomedical subjects
D E Shepherd
Publications and source records attributed to D E Shepherd.
Slippage of a spinous process hook during flexion in a flexible fixation system for the lumbar spine.
This study was undertaken to measure the amount of slippage of a spinous process hook (that forms part of a flexible fixation system) during flexion. Human cadaveric lumbar spines (10) were fitted with the device. A rig was designed to apply flexural displacements to a spine using a materials testing machine. Spherical markers were attached to the spine and hook. As a spine was flexed a digital video camera was used to record the positions of the markers. The movements of the markers were measured using interactive computer software to assess any slippage of the spinous process hook. During flexion the overall mean hook slippage was measured to be 0.10mm (standard deviation 0.04mm). The mean hook slippage, for each of the 10 specimens, was in the range of 0.05-0.14mm. The results imply that slippage of a spinous process hook during flexion is small.
Adult↗
Spinous process strength.
STUDY DESIGN: Mechanical testing of cadaveric lumbar spines and dual energy radiograph absorptiometry scanning were performed. OBJECTIVES: To devise a technique to measure the strength of lumbar spinous processes and to determine the bone mineral density of the vertebrae used. SUMMARY OF BACKGROUND DATA: The spinous process has been identified as the weakest part of the anatomy to which a flexible fixation device can be attached. It was unknown if the spinous processes could withstand the forces applied by the device. METHODS: A hook was fitted to the spinous process of 32 lumbar vertebrae. A custom-built rig was designed to secure a vertebra to a materials testing machine. A loop of cord was passed over a bar mounted on the crosshead of the machine and around the two bollards of the hook. As the crosshead was raised, a tension was applied to the cord. Each vertebra was tested to failure. The bone mineral density of each vertebra was then measured using dual energy radiograph absorptiometry. RESULTS: Failure of the specimens occurred by failure of the spinous process, pedicles, or vertebral body. The logarithm (base 10) of the load (N) at which failure occurred was 2.53 +/- 0.3, which corresponded to a mean failure load of 339 N. The bone mineral density of each vertebral body varied between 0.263 and 0.997 g/cm2. A significant linear correlation was found between bone strength and bone mineral density (P < 0.0001). CONCLUSIONS: Specimens with a bone mineral density in the range of 0.263-0.997 g/cm2 failed at a mean load of 339 N when the load was applied through the spinous process hook of a flexible fixation device.
Absorptiometry, Photon↗
Design of an occipito-cervical fixation device.
Metal plates may be used to stabilize the cervical spine. The plates are attached to the posterior of the vertebra by placing screws into the lateral masses. The plating may be extended, in the form of rod or plate, to connect with and support the occiput. Several problems, such as screw loosening and the plate obscuring the surgeon's view as a screw is being inserted, have been identified with present plate systems. This paper describes the initial design for a cervical fixation device to overcome these problems, and the design and development that was undertaken to enable a prototype device to be manufactured.
Bone Plates↗
Design of spinous process hooks for flexible fixation of the lumbar spine.
A prototype flexible fixation system for the lumbar spine was subjected to tensile testing to failure and cyclic tensile testing in order to determine any regions of weakness. The system consisted of a spinous process hook and two laminar hooks made of stainless steel (316L). Each laminar hook was attached to the spinous process hook by a loop of polyester braid secured by a crimped metal sleeve. In five tensile tests, the system failed by irreversible deformation of the spinous process hook at 2.5 +/- 0.3 kN (mean +/- standard deviation). In three cyclic tests, in which the applied tension varied sinusoidally between 0.04 and 0.4 kN at a frequency of 5 Hz, failure occurred after less than 400,000 loading cycles. This occurred as a result of fatigue crack initiation and propagation in the spinous process hook. A finite element model showed a stress concentration in the region where the crack occurred, which raised the applied stress above the tensile fatigue strength of this stainless steel. The spinous process hook was redesigned for manufacture in a titanium alloy (Ti-6AI-4V ELI) to minimize artefacts in magnetic resonance imaging. Further finite element models showed no unacceptable stress concentrations.
Alloys↗
Mechanical testing of a flexible fixation device for the lumbar spine.
The aim of this study was to test mechanically a new flexible fixation system for the lumbar spine. This device incorporates loops of polyester braid which are secured by a crimped titanium sleeve. In tensile tests, all loops failed, by slippage through the crimped sleeve, at 434 +/- 25 N (mean +/- standard deviation from five loops) for a single crimp and 415 +/- 15 N (from five loops) for two crimps. The intact system was then tested according to the ASTM standard. In a static test, all five specimens failed by slippage of the braid through the sleeve. Initial slippage occurred between 600 and 700 N, but the mean maximum load sustained was 1090 +/- 140 N. Dynamic tests were performed on ten constructs at a frequency of 5 Hz, under a range of loading conditions. The maximum load applied in any of the tests was 825 N. Two constructs did not complete the required 5 x 10(6) test cycles because of fracture of their spinous process hooks. However, other tests, under the same conditions, showed no signs of failure. Fracture occurred as a result of fretting damage from the recommended stainless steel roll pins.
Biomechanical Phenomena↗
Development of surgical instruments for implanting a flexible fixation device for the lumbar spine.
A new flexible fixation device for the lumbar spine has been developed. This paper describes the development and evaluation of two surgical instruments required for implanting this device. Prototypes were designed, manufactured and then evaluated for use in surgery. Further evaluation was performed, if necessary, and the design finalized, in accordance with BS EN 12011. This process involved close collaboration between engineers and surgeons.
Equipment Design↗
The 'instantaneous' compressive modulus of human articular cartilage in joints of the lower limb.
METHODS: The instantaneous compressive modulus of articular cartilage was surveyed in 11 sets of human lower limb joints obtained from the ipsilateral side. The average modulus for the entire joint surface of each joint and the topographical variations in the modulus within each joint were examined for all 11 sets, and subjected to statistical analysis. RESULTS: Within each set of joints (hip, knee and ankle), the ankle always had a significantly greater mean compressive modulus than the hip and knee (P < 0.001-P < 0.05). In seven sets of joints, there was no significant difference between the mean compressive moduli of the knee and hip joints. In three sets of joints, the compressive modulus of the knee was significantly greater than that of the hip (P < 0.001-P < 0.01), while in only one set of joints was the compressive modulus of the hip significantly greater than that of the knee (P < 0.01). CONCLUSION: The topographical variations in the cartilage instantaneous compressive modulus over the surfaces of the lower limb joints were matched by differences in the stresses occurring in different areas of each joint. The results of the present study corroborate previous findings and show that the site-specific stresses and corresponding values of the instantaneous cartilage compressive modulus over the surfaces of lower limb joints were correlated (r = 0.82 at P < 0.01), thus adding credence to the conditioning hypothesis of cartilage by prevalent stress.
Adult↗
Thickness of human articular cartilage in joints of the lower limb.
OBJECTIVES: (a) To determine the topographical variations in cartilage thickness over the entire surfaces of cadaveric lower limb joints, and (b) to examine the correlations between: cartilage thickness and its site specific modulus; cartilage thickness and donor age, weight, height, and body mass index. METHODS: The cartilage thickness of 11 sets of cadaveric human joints each comprising an ankle, knee, and hip was measured using a needle probe technique. Statistical analysis was used to compare the cartilage thickness of the different lower limb joints and the differences in cartilage thickness over the surface of individual joints. It was further examined whether cartilage had a correlation with its stiffness, and any of the details of the specimen donors such as age, weight, height, and body mass index. RESULTS: The mean cartilage thickness of the knee was significantly greater than that of the ankle and hip (p < 0.001) in all 11 sets of joints, while the cartilage thickness of the hip was significantly greater than that of the ankle in 10 sets of joints (p < 0.001). The mass of specimen donors was found to correlate with the mean cartilage thickness of all three lower limb joints. A correlation was also found between the height of donors and the mean cartilage thickness of the knee and hip joints, while only in the ankle joint was a correlation found between the mean cartilage thickness and the body mass index of the specimen donors. A further correlation was found between cartilage thickness and its modulus; the thinner the cartilage, the higher the modulus. CONCLUSIONS: The thickness of articular cartilage seems to be related to the congruance of a joint; thin cartilage is found in congruent joints such as the ankle, whereas thick cartilage is found in incongruent joints such as the knee. The correlations in this study imply that the larger and heavier was a donor the thicker was the cartilage in the lower limb joints. The data further suggest the presence of an inverse relation between the mean cartilage thickness and mean compressive modulus in each of the joints examined.
Adult↗
A technique for measuring the compressive modulus of articular cartilage under physiological loading rates with preliminary results.
This paper describes a technique and apparatus for measuring the compressive modulus of articular cartilage under physiological loading rates. The compressive modulus is the most relevant property to the primary function of articular cartilage i.e., load carriage. It has been determined previously from measurement of cartilage deformation under slow or almost static loading conditions. The modulus was based on deformations occurring 2 s after the initial application of load which greatly reduces its relevance since in physiological conditions joint loading occurs within 10-150 ms. Five human knee joints have been used to test the apparatus before a major study is undertaken. The preliminary results from these joints show that the compressive modulus of articular cartilage measured within physiological loading time intervals was much greater than previously reported. The compressive modulus at 20 ms was in the range 4.4-27 MPa and was between 32 and 75 per cent greater than its value obtained at 2 s after loading.
Biomechanical Phenomena↗
Influence of partial excision of carcinogen treated hamster cheek pouch on subsequent tumour development.
Hamster cheek pouch was treated with carcinogen for 5 or 8 weeks. Part of the carcinogen treated area was excised and the lesion allowed to heal by secondary intention. At follow-up the biopsied pouches were compared with control pouches and potentiation of the development of carcinomas was seen. It is suggested that these results have relevance to the previously demonstrated tumour potentiating effect of cryosurgery in hamster cheek pouch, in that the important tumour potentiating influence may be regeneration involving dysplastic epithelium and not a function of cryosurgery per se.
9,10-Dimethyl-1,2-benzanthracene↗
The morbidity of bicoronal flaps in maxillofacial surgery.
Bicoronal flaps have been used in neurosurgery to gain access to the anterior cranium for over a century. A previous paper by Henderson and Jackson (1973) described the good access afforded by the flap for Le Fort II osteotomies. This paper reviews the morbidity of the procedure in 24 patients in whom bicoronal flaps were raised for access to the mid and upper facial skeleton.
Adolescent↗