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  1. Finite element analysis of Puddu and Tomofix plate fixation for open wedge high tibial osteotomy
    Raja Izaham RM, Abdul Kadir MR, Abdul Rashid AH, Hossain MG, Kamarul T
    Injury, 2012 Jun;43(6):898-902.
    PMID: 22204773 DOI: 10.1016/j.injury.2011.12.006
    The use of open wedge high tibial osteotomy (HTO) to correct varus deformity of the knee is well established. However, the stability of the various implants used in this procedure has not been previously demonstrated. In this study, the two most common types of plates were analysed (1) the Puddu plates that use the dynamic compression plate (DCP) concept, and (2) the Tomofix plate that uses the locking compression plate (LCP) concept. Three dimensional model of the tibia was reconstructed from computed tomography images obtained from the Medical Implant Technology Group datasets. Osteotomy and fixation models were simulated through computational processing. Simulated loading was applied at 60:40 ratios on the medial:lateral aspect during single limb stance. The model was fixed distally in all degrees of freedom. Simulated data generated from the micromotions, displacement and, implant stress were captured. At the prescribed loads, a higher displacement of 3.25 mm was observed for the Puddu plate model (p<0.001). Coincidentally the amount of stresses subjected to this plate, 24.7 MPa, was also significantly lower (p<0.001). There was significant negative correlation (p<0.001) between implant stresses to that of the amount of fracture displacement which signifies a less stable fixation using Puddu plates. In conclusion, this study demonstrates that the Tomofix plate produces superior stability for bony fixation in HTO procedures.
    Matched MeSH terms: Osteotomy/instrumentation
  2. Fulltext Case report: migration of a broken screw to the knee joint after hardware failure following closing wedge distal femoral osteotomy
    Lee YS, Lee SH, Lee ES, Fong TS
    BMC Musculoskelet Disord, 2019 Mar 20;20(1):118.
    PMID: 30894158 DOI: 10.1186/s12891-019-2505-4
    BACKGROUND: We report a case of hardware failure after distal femoral osteotomy (DFO) with a broken screw pulled out from the locking hole and positioned within the knee joint.

    CASE PRESENTATION: A 57-year-old man presented to our orthopedic outpatient department with 3-months history of an unusual painful swelling at the operated area following DFO. The leakage of joint fluid from the penetrated suprapatellar pouch was assumed to be the reason for this complication.

    CONCLUSIONS: The overall aim of this case report is to provide a lesson to budding surgeons who might experience a similar situation that cannot be easily explained, like the unexpected complication in the present case.

    Matched MeSH terms: Osteotomy/instrumentation
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