Failure Investigation of a Tibiotalocalcaneal Arthrodesis System

Tarun Goswami; Dinesh Gudapaneni; Matthew Slocum; Puchwein Paul; Sommitsch Christof

doi:10.1016/j.engfailanal.2015.11.025

Failure Investigation of a Tibiotalocalcaneal Arthrodesis System

Tarun Goswami, Dinesh Gudapaneni, Matthew Slocum, Puchwein Paul, Sommitsch Christof

Wright State University

Research output: Contribution to journal › Article › peer-review

Abstract

<p> <p id="x-x-sp0180"> Ankle disorders such as arthritis and trauma are treated with Arthrodesis where an intramedullary (IM) nail is inserted in the ankle to fuse the joints. Fusion reduces pain and has been proposed as gold standard. Nailing is used in a variety of situations, particularly to treat fractures in long bones. This paper describes failure analysis of an ankle intramedullary nailing system implanted in a 49-year old male patient. The failure location was proximal of the two distal interlocking screw holes laterally. The medical devices are regulated in the United States, the material of the nail conformed to the ISO specification requirements. Optical and <a href="https://www.sciencedirect.com/topics/engineering/scanning-electron-microscope" title="Learn more about scanning electron microscopes from ScienceDirect's AI-generated Topic Pages"> scanning electron microscopes </a> were used to identify the <a href="https://www.sciencedirect.com/topics/engineering/fracture-origin" title="Learn more about fracture origin from ScienceDirect's AI-generated Topic Pages"> fracture origin </a> . <a href="https://www.sciencedirect.com/topics/engineering/finite-element-analysis" title="Learn more about Finite element analysis from ScienceDirect's AI-generated Topic Pages"> Finite element analysis </a> (FEA) was performed to determine maximum Von Mises stresses from torsion and translation movements. <a href="https://www.sciencedirect.com/topics/engineering/axial-load" title="Learn more about Axial load from ScienceDirect's AI-generated Topic Pages"> Axial load </a> to failure of the implant was determined by conducting numerical analysis. The implant failed due to multiple factors involving clinical and biomechanical parameters exceeding the nail strength. Lack of proper bone purchase while inserting the screw and interference with the IM nail wall initiated the crack. The force and torque developed during the gait propagated the crack to a length of 0.4–0.6 mm, upon subsequent use the cracked device was unable to load-bear resulting in <a href="https://www.sciencedirect.com/topics/engineering/premature-failure" title="Learn more about premature failure from ScienceDirect's AI-generated Topic Pages"> premature failure </a> . </p></p>

Original language	American English
Journal	Engineering Failure Analysis
Volume	59
DOIs	https://doi.org/10.1016/j.engfailanal.2015.11.025
State	Published - Jan 1 2016

Keywords

Ankle
Arthrodesis
Fracture
IM nail

Disciplines

Biomedical Engineering and Bioengineering
Engineering
Industrial Engineering
Operations Research, Systems Engineering and Industrial Engineering

Access to Document

10.1016/j.engfailanal.2015.11.025License: Unspecified

Cite this

@article{f93fd1139d8246e7bb7ba3423e860811,

title = "Failure Investigation of a Tibiotalocalcaneal Arthrodesis System",

abstract = " Ankle disorders such as arthritis and trauma are treated with Arthrodesis where an intramedullary (IM) nail is inserted in the ankle to fuse the joints. Fusion reduces pain and has been proposed as gold standard. Nailing is used in a variety of situations, particularly to treat fractures in long bones. This paper describes failure analysis of an ankle intramedullary nailing system implanted in a 49-year old male patient. The failure location was proximal of the two distal interlocking screw holes laterally. The medical devices are regulated in the United States, the material of the nail conformed to the ISO specification requirements. Optical and scanning electron microscopes were used to identify the fracture origin . Finite element analysis (FEA) was performed to determine maximum Von Mises stresses from torsion and translation movements. Axial load to failure of the implant was determined by conducting numerical analysis. The implant failed due to multiple factors involving clinical and biomechanical parameters exceeding the nail strength. Lack of proper bone purchase while inserting the screw and interference with the IM nail wall initiated the crack. The force and torque developed during the gait propagated the crack to a length of 0.4–0.6 mm, upon subsequent use the cracked device was unable to load-bear resulting in premature failure . ",

keywords = "Ankle, Arthrodesis, Fracture, IM nail",

author = "Tarun Goswami and Dinesh Gudapaneni and Matthew Slocum and Puchwein Paul and Sommitsch Christof",

year = "2016",

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doi = "10.1016/j.engfailanal.2015.11.025",

language = "American English",

volume = "59",

journal = "Engineering Failure Analysis",

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AU - Slocum, Matthew

AU - Paul, Puchwein

AU - Christof, Sommitsch

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Ankle disorders such as arthritis and trauma are treated with Arthrodesis where an intramedullary (IM) nail is inserted in the ankle to fuse the joints. Fusion reduces pain and has been proposed as gold standard. Nailing is used in a variety of situations, particularly to treat fractures in long bones. This paper describes failure analysis of an ankle intramedullary nailing system implanted in a 49-year old male patient. The failure location was proximal of the two distal interlocking screw holes laterally. The medical devices are regulated in the United States, the material of the nail conformed to the ISO specification requirements. Optical and scanning electron microscopes were used to identify the fracture origin . Finite element analysis (FEA) was performed to determine maximum Von Mises stresses from torsion and translation movements. Axial load to failure of the implant was determined by conducting numerical analysis. The implant failed due to multiple factors involving clinical and biomechanical parameters exceeding the nail strength. Lack of proper bone purchase while inserting the screw and interference with the IM nail wall initiated the crack. The force and torque developed during the gait propagated the crack to a length of 0.4–0.6 mm, upon subsequent use the cracked device was unable to load-bear resulting in premature failure .

AB - Ankle disorders such as arthritis and trauma are treated with Arthrodesis where an intramedullary (IM) nail is inserted in the ankle to fuse the joints. Fusion reduces pain and has been proposed as gold standard. Nailing is used in a variety of situations, particularly to treat fractures in long bones. This paper describes failure analysis of an ankle intramedullary nailing system implanted in a 49-year old male patient. The failure location was proximal of the two distal interlocking screw holes laterally. The medical devices are regulated in the United States, the material of the nail conformed to the ISO specification requirements. Optical and scanning electron microscopes were used to identify the fracture origin . Finite element analysis (FEA) was performed to determine maximum Von Mises stresses from torsion and translation movements. Axial load to failure of the implant was determined by conducting numerical analysis. The implant failed due to multiple factors involving clinical and biomechanical parameters exceeding the nail strength. Lack of proper bone purchase while inserting the screw and interference with the IM nail wall initiated the crack. The force and torque developed during the gait propagated the crack to a length of 0.4–0.6 mm, upon subsequent use the cracked device was unable to load-bear resulting in premature failure .

KW - Ankle

KW - Arthrodesis

KW - Fracture

KW - IM nail

UR - https://corescholar.libraries.wright.edu/bie/226

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DO - 10.1016/j.engfailanal.2015.11.025

M3 - Article

VL - 59

JO - Engineering Failure Analysis

JF - Engineering Failure Analysis

ER -

Failure Investigation of a Tibiotalocalcaneal Arthrodesis System

Abstract

Keywords

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