An in-vitro animal bone model study to predict spiral fracture strength of long bones in the young infant

Malik, S.S., Malik, S., Shenoy, R., Jones, M.D. ORCID: https://orcid.org/0000-0002-6058-6029 and Theobald, P. S. ORCID: https://orcid.org/0000-0002-3227-7130 2019. An in-vitro animal bone model study to predict spiral fracture strength of long bones in the young infant. Journal of Clinical Orthopaedics and Trauma 10 (4) , pp. 744-749. 10.1016/j.jcot.2018.10.001

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Abstract

Introduction The risk of fracture from a non-accidental injury is highest in the infant age group. A spiral fracture of the long bone can occur equally from accidental and non-accidental causes, meaning the clinical judgement of non-accidental injury in an infant is particularly challenging. This study aimed to assist in differentiating accidental, from non-accidental, injury in infants, by establishing whether correlation exists between geometry and torsional strength in the immature long bone. Methods Immature porcine third and fourth metacarpals (n = 21) were imaged with a dual energy x-ray absorptiometry (DEXA) scanner to measure their linear bone mineral content (BMCL), bone mineral density (BMD) and section modulus (Z). The specimens were then subjected to a torque of one degree per second until failure. The failure strength and the three DEXA measures were analyzed for a correlation. Results The mean failure strength of 11 successful tests was 13.71Nm (+/-SD 2.42Nm), with correlation to BMCL, BMD and Z described by r2 = 0.81, 0.283 and 0.75 respectively. Conclusion This study is a novel attempt at estimating torsional strength of long bones in a specific paediatric age group using a size-matched animal bone model. It found a strong correlation between bone and fracture strength parameters over the BMCL range of 0.59–0.77 g/cm.

Item Type:	Article
Date Type:	Publication
Status:	Published
Schools:	Engineering
Publisher:	Elsevier
ISSN:	0976-5662
Date of First Compliant Deposit:	19 October 2018
Date of Acceptance:	2 October 2018
Last Modified:	06 May 2023 10:02
URI:	https://orca.cardiff.ac.uk/id/eprint/116001

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