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Fulltext Evaluation of limb load asymmetry using two new mathematical models

Kumar SN, Omar B, Joseph LH, Htwe O, Jagannathan K, Hamdan NM, et al.

Glob J Health Sci, 2015;7(2):1-7.
PMID: 25716372 DOI: 10.5539/gjhs.v7n2p1

Quantitative measurement of limb loading is important in orthopedic and neurological rehabilitation. In current practice, mathematical models such as Symmetry index (SI), Symmetry ratio (SR), and Symmetry angle (SA) are used to quantify limb loading asymmetry. Literatures have identified certain limitations with the above mathematical models. Hence this study presents two new mathematical models Modified symmetry index (MSI) and Limb loading error (LLE) that would address these limitations. Furthermore, the current mathematical models were compared against the new model with the goal of achieving a better model. This study uses hypothetical data to simulate an algorithmic preliminary computational measure to perform with all numerical possibilities of even and uneven limb loading that can occur in human legs. Descriptive statistics are used to interpret the limb loading patterns: symmetry, asymmetry and maximum asymmetry. The five mathematical models were similar in analyzing symmetry between limbs. However, for asymmetry and maximum asymmetry data, the SA and SR values do not give any meaningful interpretation, and SI gives an inflated value. The MSI and LLE are direct, easy to interpret and identify the loading patterns with the side of asymmetry. The new models are notable as they quantify the amount and side of asymmetry under different loading patterns.

Matched MeSH terms: Weight-Bearing*
Fulltext Use of Sawdust as admixture in cement-sand brick

Rosnani Ahmad, Rohaidah Md Nor, Siti Azliya Ismail

Pertanika Journal of Science & Technology, 2017;25(105):205-210.
MyJurnal

Sawdust is considered a waste material and a number of innovative ways are being taken to mitigate its effects on the environment. The use of sawdust as additional admixture in cement-sand brick production is an alternative option to mitigate the problem. In this study, three different types of cement-sand brick mixture in proportion of 1%, 2% and 3% of sawdust added to the normal mixture are prepared. Compression test was conducted on the brick mixture and results indicated 1% sawdust satisfy the Class 1 loadbearing brick whilst the 2% sawdust is slightly above the minimum required strength of 5.2 MN/ m2 for an ordinary quality brick set by the Standards MS 76:1972. Thus, the use of sawdust as admixture in cement-sand brick should not exceed 3%.

Matched MeSH terms: Weight-Bearing
A comparison of pressure distributions between two types of sockets in a bulbous stump

Gholizadeh H, Abu Osman NA, Eshraghi A, Arifin N, Chung TY

Prosthet Orthot Int, 2016 Aug;40(4):509-16.
PMID: 25583929 DOI: 10.1177/0309364614564022

BACKGROUND: This article describes a total surface bearing prosthetic socket for a patient (25-year-old female) with a bulbous stump.
CASE DESCRIPTION AND METHODS: The subject had unstable excessive soft tissue at the distal end of the residuum. After 2 years of prosthetic use, she experienced several problems, including pain in the residual limb and knee joint. Pressure distribution was evaluated during ambulation. We also designed a total surface bearing socket with Velcro as suspension system to distribute the load evenly on the residual limb, and to facilitate donning procedure.
FINDINGS AND OUTCOMES: The main site of weight bearing in the old prosthesis (patellar tendon bearing) was anterior proximal region of the residual limb, especially the patellar tendon. The pressure was almost 10 times higher than the distal region during level walking. Pressures were distributed more evenly with the total surface bearing socket design, and the donning was much easier.
CONCLUSION: Pressure distribution within the socket could be affected by socket design and suspension system. Using the total surface bearing socket and Velcro as suspension system might facilitate donning of prosthesis and reduce traction at the end of residual limb during the swing phase of gait.
CLINICAL RELEVANCE: Proper socket design and suspension system based on the amputees' need can facilitate rehabilitation process and lead to the amputee's satisfaction. The pressure is distributed more uniformly over the residual limb by the total surface bearing socket compared to the patellar tendon bearing socket for lower limb amputees with unusual stump shape.

Matched MeSH terms: Weight-Bearing/physiology*
Effect of nanofillers on the physico-mechanical properties of load bearing bone implants

Michael FM, Khalid M, Walvekar R, Ratnam CT, Ramarad S, Siddiqui H, et al.

Mater Sci Eng C Mater Biol Appl, 2016 Oct 01;67:792-806.
PMID: 27287178 DOI: 10.1016/j.msec.2016.05.037

Bones are nanocomposites consisting of a collagenous fibre network, embedded with calcium phosphates mainly hydroxyapatite (HA) nanocrystallites. As bones are subjected to continuous loading and unloading process every day, they often tend to become prone to fatigue and breakdown. Therefore, this review addresses the use of nanocomposites particularly polymers reinforced with nanoceramics that can be used as load bearing bone implants. Further, nanocomposite preparation and dispersion modification techniques have been highlighted along with thorough discussion on the influence that various nanofillers have on the physico-mechanical properties of nanocomposites in relation to that of natural bone properties. This review updates the nanocomposites that meet the physico-mechanical properties (strength and elasticity) as well as biocompatibility requirement of a load bearing bone implant and also attempts to highlight the gaps in the reported studies to address the fatigue and creep properties of the nanocomposites.

Matched MeSH terms: Weight-Bearing
Fulltext Dataset of computed N-value and factual N-value traced for Soil Subsurface Profiling

Jusoh H, Sabariah Binti Abd Manan T, Beddu S, Osman SBS, Jusoh MNH, Mohtar WHMW, et al.

Data Brief, 2020 Aug;31:105868.
PMID: 32637485 DOI: 10.1016/j.dib.2020.105868

Soil requires load bearing impact assessment for stability. Therefore, this study aims to utilize the multi-channel analysis surface wave (MASW) for soil subsurface investigation and profiling around Peninsular Malaysia. The standard penetration test (SPT) was conducted for comparison between factual N-value and computed N-value from shear wave velocity (Vs ) obtained from MASW using the Imai and Tonouchi equation. The correlation coefficient (R) and coefficient of determination, (R2 ), showed strong relationship between factual N-value and computed N-value. The model of Vs and factual N-value data distribution is non-normal but the analyzed relationship shows a significant level of p-value < 0.05. The R2 for each location of Vs -N-value relationship are ranging from 0.5 to 0.9.

Matched MeSH terms: Weight-Bearing
Fulltext Mechanical Properties of Glass Reinforced Hydroxyapatite

Muslim, Y.S., Knowles, J., Howlett, J.

Ann Dent, 2005;12(1):-.
MyJurnal

Hydroxyapatite (HA) has been increasingly used in biomedical applications due to its biocompatibility with living tissues. However, its use is limited to low load bearing areas due to the poor mechanical properties compared to bone. The aim of this project is to improve the mechanical properties of synthetic HA by optimising the processing method and also by using a phosphate based glass as a sintering aid to develop Glass Reinforced Hydroxyapatite (GR-HA). A phosphate based glass containing CaO, P2O5 and CaF2 was incorporated into HA at 2.5wt% and 5wt% additions during the milling process prior to sintering at 1300°C. The flexural strength mean values for GR-HA ranged from 80MPa to 110MPa. Pure HA exhibited a much lower flexural strength mean value ranging from 66MPa to 79MPa. The improved mechanical properties were associated with the occurrence of residual stress as a result of decomposition of HA to b-Tricalcium Phosphate (TCP) and in 5wt% GRHA to a-Tricalcium Phosphate (TCP).

Matched MeSH terms: Weight-Bearing
Fulltext A case series of acquired haemophilia in a Malaysian hospital: unpredictably rare medical emergency

Lee CP, Khalid BB

Oxf Med Case Reports, 2015 Oct;2015(10):330-2.
PMID: 26568837 DOI: 10.1093/omcr/omv055

Acquired haemophilia (AH) is a rare bleeding disorder characterized by the presence of acquired inhibitors against Factor VIII causing disruption of coagulation cascade. It has no known genetic inheritance, and diagnosis remains a challenge. The peculiar presentations are later age of onset as acute pain in weight-bearing joints and spontaneous muscle haematoma with isolated prolonged activated partial thrombin time (APTT). Prevalence is 1 per million per year affecting both genders equally where blood product transfusion is seen in almost 87% of cases. The direct cause of AH is still unknown, and autoimmune dysregulation has been postulated, which predisposes to the development of the factor inhibitors. Being extremely rare, we are reporting two consecutive patients diagnosed by unusual bleeding episodes with isolated prolonged APTT due to Factor VIII inhibitors. AH deserves a special mention as high index of suspicion is required. More studies are required to provide better guidance in diagnosis and management of this condition.

Matched MeSH terms: Weight-Bearing
Fulltext Numerical Prediction of Residual Stresses Distribution in Thin-Walled Press-Braked Stainless Steel Sections

Mutafi A, Yidris N, Koloor SSR, Petrů M

Materials (Basel), 2020 Nov 26;13(23).
PMID: 33256257 DOI: 10.3390/ma13235378

Stainless steels are increasingly used in construction today, especially in harsh environments, in which steel corrosion commonly occurs. Cold-formed stainless steel structures are currently increasing in popularity because of its efficiency in load-bearing capacity and its appealing architectural appearance. Cold-rolling and press-braking are the cold-working processes used in the forming of stainless steel sections. Press braking can produce large cross-sections from thin to thick-walled sections compared to cold-rolling. Cold-forming in press-braked sections significantly affect member behaviour and joints; therefore, they have attained great attention from many researchers to initiate investigations on those effects. This paper examines the behaviour of residual stress distribution of stainless steel press-braked sections by implementing three-dimensional finite element (3D-FE) technique. The study proposed a full finite element procedure to predict the residual stresses starting from coiling-uncoiling to press-braking. This work considered material anisotropy to examine its effect on the residual stress distribution. The technique adopted was compared with different finite element techniques in the literature. This study also provided a parametric study for three corner radius-to-thickness ratios looking at the through-thickness residual stress distribution of four stainless steels (i.e., ferritic, austenitic, duplex, lean duplex) in which have their own chemical composition. In conclusion, the comparison showed that the adopted technique provides a detailed prediction of residual stress distribution. The influence of geometrical aspects is more pronounced than the material properties. Neglecting the material anisotropy shows higher shifting in the neutral axis. The parametric study showed that all stainless steel types have the same stress through-thickness distribution. Moreover, R/t ratios' effect is insignificant in all transverse residual stress distributions, but a slight change to R/t ratios can affect the longitudinal residual stress distribution.

Matched MeSH terms: Weight-Bearing
Fulltext How the three arches of the foot intercorrelate

Gwani AS, Asari MA, Mohd Ismail ZI

Folia Morphol (Warsz), 2017;76(4):682-688.
PMID: 28553850 DOI: 10.5603/FM.a2017.0049

BACKGROUND: The foot is composed of medial, lateral and transverse arches which, particularly the medial arch, provide it with the ability to function both as a flexible and rigid structure for proper locomotion. Arches of the foot, as well as their effect on lower extremity function, have been studied. However, quantitative data on the relationship between these arches still remain scanty. The purpose of this study was, therefore, to examine how the three arches of the foot intercorrelate.
MATERIALS AND METHODS: Seventy-six participants (58 males, 18 females) were recruited to participate in the study. Bilateral weight-bearing lateral radiographs of the right foot were taken from each participant. Navicular heights (NH), medial cuneiform height (MCH), calcaneal inclination angle (CIA) and calcaneal-first metatarsal angle (C1MA) were measured to represent the medial arch. The lateral arch was represented by cuboid height (CH) and calcaneal-fifth metatarsal angle (C5MA) whereas; MCH and CH represented the transverse arch. Mean difference of variables between males and females was compared using independent t-test while the correlation between the variables was determined using Pearson correlation.
RESULTS: All the variables were not significantly related to gender. Significant moderate to excellent linear correlations were observed between the variables. CIA showed the strongest correlation with C1MA (r = -0.90) and C5MA (r = -0.84) whereas, CH had the least correlation with other variables.
CONCLUSIONS: The moderate to excellent correlations between the variables indicate that deformation or elevation of the medial arch may consequently result in similar movements of the lateral and transverse arches and vice versa.

Matched MeSH terms: Weight-Bearing
CNT and rGO reinforced PMMA based bone cement for fixation of load bearing implants: Mechanical property and biological response

Pahlevanzadeh F, Bakhsheshi-Rad HR, Kharaziha M, Kasiri-Asgarani M, Omidi M, Razzaghi M, et al.

J Mech Behav Biomed Mater, 2021 04;116:104320.
PMID: 33571842 DOI: 10.1016/j.jmbbm.2021.104320

Polymethyl methacrylate (PMMA) bone cements (BCs) have some drawbacks, including limited bioactivity and bone formation, as well as inferior mechanical properties, which may result in failure of the BC. To deal with the mentioned issues, novel bioactive polymethyl methacrylate-hardystonite (PMMA-HT) bone cement (BC) reinforced with 0.25 and 0.5 wt% of carbon nanotube (CNT) and reduced graphene oxide (rGO) was synthesized. In this context, the obtained bone cements were evaluated in terms of their mechanical and biological characteristics. The rGO reinforced bone cement exhibited better mechanical properties to the extent that the addition of 0.5 wt% of rGO where its compressive and tensile strength of bioactive PMMA-HT/rGO cement escalated from 92.07 ± 0.72 MPa, and 40.02 ± 0.71 MPa to 187.48 ± 5.79 MPa and 64.92 ± 0.75 MPa, respectively. Besides, the mechanisms of toughening, apatite formation, and cell interaction in CNT and rGO encapsulated PMMA have been studied. Results showed that the existence of CNT and rGO in BCs led to increase of MG63 osteoblast viability, and proliferation. However, rGO reinforced bone cement was more successful in supporting MG63 cell attachment compared to the CNT counterpart due to its wrinkled surface, which made a suitable substrate for cell adhesion. Based on the results, PMMA-HT/rGO can be a proper bone cement for the fixation of load-bearing implants.

Matched MeSH terms: Weight-Bearing
Fulltext Conservative Management of Calcaneal Fractures. ARetrospective Review of Treatment Outcome

Wong, H.Y., Vivek, A.S., To, BC Se

Malays Orthop J, 2008;2(1):28-32.
MyJurnal

Int roduction: Treatment of calcaneal fracture is still controversial and indication for surgery is not well
established. We are reporting the mid term outcome of calcanel fractures treated conservatively. Material and Methods: Patients admitted with calcaneal fractures from 1st November 2002 till 31st December 2004 and were treated conservatively were included in this study. The fractures were grouped according to Essex-Lopresti classification and their outcomes were assessed with the Maryland foot score. We also looked at time to weight bearing and returning to occupational activity. Results: Forty-four patients were included for evaluation. Patients with extraarticular calcaneal fractures had significantly higher rating scores compared to those with intraarticular fractures (98.2 and 88.8 respectively, with a p value = 0.0001). Generally, both group of patients had a good clinical outcome. 18 of the 44 patients (41%) started partial weight bearing before or at 6 weeks and 31 patients (72%) were able to start full weight bearing by 12 weeks. 31 patients (72%) were back to work 12 weeks after the injury. Conclusion: Conservative management for calcaneal fractures is an acceptable mode of treatment with satisfactory.

Matched MeSH terms: Weight-Bearing
Fulltext An investigation on longitudinal residual strains distribution of thin-walled press-braked cold formed steel sections using 3D FEM technique

Mutafi A, Yidris N, Ishak MR, Zahari R

Heliyon, 2018 Nov;4(11):e00937.
PMID: 30839801 DOI: 10.1016/j.heliyon.2018.e00937

Steel sections are normally shaped via cold work manufacturing processes. The extent of cold work to shape the steel sections might induce residual stresses in the region of bending. Previously, researchers had performed studies on the influences of local buckling on the failure behavior of steel compression members which shown that failure will happen when most of the yielding has extended to the middle surface in the bend region of the sections. Therefore, these cold work methods may have major effect on the behavior of the steel section and also its load-bearing capability. In addition, another factor may play significant role in formed section's load-bearing capacity which is the longitudinal residual strain. The longitudinal residual strain raised during forming procedure can be used to define the section imperfection of the formed section and its relation to the existence of defects. Therefore, the main motivation of this research paper is to perform three-dimensional finite element (3D-FE) to investigate peak longitudinal residual strains of a thin-walled steel plate with large bending angle along member length. A 3D finite element simulation in ABAQUS has been employed to simulate this forming process. The study concluded that the longitudinal residual strain at the section corner edge was higher than those at the rest of the corner region. These strains at the edge were higher than the yield strain

(

ε

y

)

of the formed section which occurred due to the lack of transverse restraint. This made the plate edge tended to bend toward the normal direction when it was under a high transverse bending. This causes a significant difference in longitudinal strain at the plate edge.

Matched MeSH terms: Weight-Bearing
Nanoreinforced Hydrogels for Tissue Engineering: Biomaterials that are Compatible with Load-Bearing and Electroactive Tissues

Mehrali M, Thakur A, Pennisi CP, Talebian S, Arpanaei A, Nikkhah M, et al.

Adv Mater, 2017 Feb;29(8).
PMID: 27966826 DOI: 10.1002/adma.201603612

Given their highly porous nature and excellent water retention, hydrogel-based biomaterials can mimic critical properties of the native cellular environment. However, their potential to emulate the electromechanical milieu of native tissues or conform well with the curved topology of human organs needs to be further explored to address a broad range of physiological demands of the body. In this regard, the incorporation of nanomaterials within hydrogels has shown great promise, as a simple one-step approach, to generate multifunctional scaffolds with previously unattainable biological, mechanical, and electrical properties. Here, recent advances in the fabrication and application of nanocomposite hydrogels in tissue engineering applications are described, with specific attention toward skeletal and electroactive tissues, such as cardiac, nerve, bone, cartilage, and skeletal muscle. Additionally, some potential uses of nanoreinforced hydrogels within the emerging disciplines of cyborganics, bionics, and soft biorobotics are highlighted.

Matched MeSH terms: Weight-Bearing
The inter-laboratory equivalence for lower limb kinematics and kinetics during unplanned sidestepping

Donnelly CJ, Weir G, Jackson C, Alderson J, Rafeeuddin R, Sharir R, et al.

Sports Biomech, 2024 Mar;23(3):324-334.
PMID: 33886425 DOI: 10.1080/14763141.2020.1860254

Much inter-intra-tester kinematic and kinetic repeatability research exists, with a paucity investigating inter-laboratory equivalence. The objective of this research was to evaluate the inter-laboratory equivalence between time varying unplanned kinematics and moments of unplanned sidestepping (UnSS). Eight elite female athletes completed an established UnSS procedure motion capture laboratories in the UK and Australia. Three dimensional time varying unplanned sidestepping joint kinematics and moments were compared. Discrete variables were change of direction angles and velocity. Waveform data were compared using mean differences, 1D 95%CI and RMSE. Discrete variables were compared using 0D 95% CI. The mean differences and 95%CI for UnSS kinematics broadly supported equivalence between laboratories (RMSE≤5.1°). Excluding hip flexion/extension moments (RMSE = 1.04 Nm/kg), equivalence was also supported for time varying joint moments between laboratories (RMSE≤0.40 Nm/kg). Dependent variables typically used to characterise UnSS were also equivalent. When consistent experimental and modelling procedures are employed, consistent time varying UnSS lower limb joint kinematic and moment estimates between laboratories can be obtained. We therefore interpret these results as a support of equivalence, yet highlight the challenges of establishing between-laboratory experiments or data sharing, as well as establishing appropriate ranges of acceptable uncertainty. These findings are important for data sharing and multi-centre trials.

Matched MeSH terms: Weight-Bearing
Fulltext Reliability, agreement, and validity of digital weighing scale with MatScan in limb load measurement

Kumar SN, Omar B, Htwe O, Joseph LH, Krishnan J, Jafarzedah Esfehani A, et al.

J Rehabil Res Dev, 2014;51(4):591-8.
PMID: 25144172 DOI: 10.1682/JRRD.2013.07.0166

Limb loading measurements serve as an objective evaluation of asymmetrical weight bearing in the lower limb. Digital weighing scales (DWSs) could be used in clinical settings for measurement of static limb loading. However, ambiguity exists whether limb loading measurements of DWSs are comparable with a standard tool such as MatScan. A cross-sectional study composed of 33 nondisabled participants was conducted to investigate the reliability, agreement, and validity of DWSs with MatScan in static standing. Amounts of weight distribution and plantar pressure on the individual lower limb were measured using two DWSs (A, B) and MatScan during eyes open (EO) and eyes closed (EC) conditions. The results showed that intra- and interrater reliability (3, 1) were excellent (0.94-0.97) within and between DWS A and B. Bland-Altman plot revealed good agreement between DWS and MatScan in EO and EC conditions. The area under the receiver operating characteristic curve was significant and identified as 0.68 (p = 0.01). The measurements obtained with DWSs are valid and in agreement with MatScan measurements. Hence, DWSs could be used interchangeably with MatScan and could provide clinicians an objective measurement of limb loading suitable for clinical settings.

Matched MeSH terms: Weight-Bearing*
Interface stress in socket/residual limb with transtibial prosthetic suspension systems during locomotion on slopes and stairs

Eshraghi A, Abu Osman NA, Gholizadeh H, Ali S, Abas WA

Am J Phys Med Rehabil, 2015 Jan;94(1):1-10.
PMID: 24919079 DOI: 10.1097/PHM.0000000000000134

This study aimed to compare the effects of different suspension methods on the interface stress inside the prosthetic sockets of transtibial amputees when negotiating ramps and stairs.

Matched MeSH terms: Weight-Bearing*
Dual photon excitation microscopy and image threshold segmentation in live cell imaging during compression testing

Moo EK, Abusara Z, Abu Osman NA, Pingguan-Murphy B, Herzog W

J Biomech, 2013 Aug 9;46(12):2024-31.
PMID: 23849134 DOI: 10.1016/j.jbiomech.2013.06.007

Morphological studies of live connective tissue cells are imperative to helping understand cellular responses to mechanical stimuli. However, photobleaching is a constant problem to accurate and reliable live cell fluorescent imaging, and various image thresholding methods have been adopted to account for photobleaching effects. Previous studies showed that dual photon excitation (DPE) techniques are superior over conventional one photon excitation (OPE) confocal techniques in minimizing photobleaching. In this study, we investigated the effects of photobleaching resulting from OPE and DPE on morphology of in situ articular cartilage chondrocytes across repeat laser exposures. Additionally, we compared the effectiveness of three commonly-used image thresholding methods in accounting for photobleaching effects, with and without tissue loading through compression. In general, photobleaching leads to an apparent volume reduction for subsequent image scans. Performing seven consecutive scans of chondrocytes in unloaded cartilage, we found that the apparent cell volume loss caused by DPE microscopy is much smaller than that observed using OPE microscopy. Applying scan-specific image thresholds did not prevent the photobleaching-induced volume loss, and volume reductions were non-uniform over the seven repeat scans. During cartilage loading through compression, cell fluorescence increased and, depending on the thresholding method used, led to different volume changes. Therefore, different conclusions on cell volume changes may be drawn during tissue compression, depending on the image thresholding methods used. In conclusion, our findings confirm that photobleaching directly affects cell morphology measurements, and that DPE causes less photobleaching artifacts than OPE for uncompressed cells. When cells are compressed during tissue loading, a complicated interplay between photobleaching effects and compression-induced fluorescence increase may lead to interpretations in cell responses to mechanical stimuli that depend on the microscopic approach and the thresholding methods used and may result in contradictory interpretations.

Matched MeSH terms: Weight-Bearing/physiology
Design of new generation femoral prostheses using functionally graded materials: a finite element analysis

Oshkour AA, Abu Osman NA, Yau YH, Tarlochan F, Abas WA

Proc Inst Mech Eng H, 2013 Jan;227(1):3-17.
PMID: 23516951

This study aimed to develop a three-dimensional finite element model of a functionally graded femoral prosthesis. The model consisted of a femoral prosthesis created from functionally graded materials (FGMs), cement, and femur. The hip prosthesis was composed of FGMs made of titanium alloy, chrome-cobalt, and hydroxyapatite at volume fraction gradient exponents of 0, 1, and 5, respectively. The stress was measured on the femoral prosthesis, cement, and femur. Stress on the neck of the femoral prosthesis was not sensitive to the properties of the constituent material. However, stress on the stem and cement decreased proportionally as the volume fraction gradient exponent of the FGM increased. Meanwhile, stress became uniform on the cement mantle layer. In addition, stress on the femur in the proximal part increased and a high surface area of the femoral part was involved in absorbing the stress. As such, the stress-shielding area decreased. The results obtained in this study are significant in the design and longevity of new prosthetic devices because FGMs offer the potential to achieve stress distribution that more closely resembles that of the natural bone in the femur.

Matched MeSH terms: Weight-Bearing/physiology*
Effect of Milwaukee brace on static and dynamic balance of female hyperkyphotic adolescents

Eshraghi A, Maroufi N, Sanjari MA, Saeedi H, Keyhani MR, Gholizadeh H, et al.

Prosthet Orthot Int, 2013 Feb;37(1):76-84.
PMID: 22751219 DOI: 10.1177/0309364612448805

Biomechanical factors, such as spinal deformities can result in balance control disorders.

Matched MeSH terms: Weight-Bearing/physiology
Simplifying four-strand flexor tendon repair using double-stranded suture: a comparative ex vivo study on tensile strength and bulking

Low TH, Ahmad TS, Ng ES

J Hand Surg Eur Vol, 2012 Feb;37(2):101-8.
PMID: 21636621 DOI: 10.1177/1753193411409840

We have compared a simple four-strand flexor tendon repair, the single cross-stitch locked repair using a double-stranded suture (dsSCL) against two other four-strand repairs: the Pennington modified Kessler with double-stranded suture (dsPMK); and the cruciate cross-stitch locked repair with single-stranded suture (Modified Sandow). Thirty fresh frozen cadaveric flexor digitorum profundus tendons were transected and repaired with one of the core repair techniques using identical suture material and reinforced with identical peripheral sutures. Bulking at the repair site and tendon-suture junctions was measured. The tendons were subjected to linear load-to-failure testing. Results showed no significant difference in ultimate tensile strength between the Modified Sandow (36.8 N) and dsSCL (32.6 N) whereas the dsPMK was significantly weaker (26.8 N). There were no significant differences in 2 mm gap force, stiffness or bulk between the three repairs. We concluded that the simpler dsSCL repair is comparable to the modified Sandow repair in tensile strength, stiffness and bulking.

Matched MeSH terms: Weight-Bearing/physiology

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