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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. and Theobald, P. S. 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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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: 20 Apr 2020 13:00

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