Paul Zalzal1, Oleg Safir2, Adel Alhalawani3,4, Marcello Papini3, Mark Towler3,4. 1. Oakville Trafalgar Memorial Hospital, Oakville, L6J 3L7, Ontario, Canada. 2. Mount Sinai Hospital, Toronto, M5G 1X5, Ontario, Canada. 3. Department of Mechanical and Industrial Engineering, Ryerson University, Toronto, M5B 2K3, Ontario, Canada. 4. Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, M5B 1W8, Ontario, Canada.
Abstract
OBJECTIVE: To develop a surgical technique for percutaneous upper extremity fracture fixation using a novel glass-based adhesive. METHODS: Three intact upper extremity cadaveric specimens with undisturbed soft tissues were obtained. Two were used to model a wrist fracture, and the third to model a proximal humerus fracture. Fractures were produced using a small osteotome in a percutaneous fashion. Banna Bone Adhesive (BBA) was delivered to the fracture site percutaneously using a 16 gauge needle under bi-planar fluoroscopic guidance. After setting of the adhesive, the specimens were dissected to qualitatively assess BBA delivery and placement. RESULTS: The adhesive could readily be delivered through the 16 gauge needle with an appropriate amount of pressure applied to the syringe. Using the fluoroscope, the adhesive could be seen to flow into the fracture site with minimal extravagation into the surrounding soft tissues. Successful bonding of the fracture fragments was observed. CONCLUSIONS: Percutaneous delivery of BBA into a fracture of the distal radius and proximal humerus may be a feasible fracture fixation technique. Biomechanical testing and animal model testing are required to further develop this procedure.
OBJECTIVE: To develop a surgical technique for percutaneous upper extremity fracture fixation using a novel glass-based adhesive. METHODS: Three intact upper extremity cadaveric specimens with undisturbed soft tissues were obtained. Two were used to model a wrist fracture, and the third to model a proximal humerus fracture. Fractures were produced using a small osteotome in a percutaneous fashion. Banna Bone Adhesive (BBA) was delivered to the fracture site percutaneously using a 16 gauge needle under bi-planar fluoroscopic guidance. After setting of the adhesive, the specimens were dissected to qualitatively assess BBA delivery and placement. RESULTS: The adhesive could readily be delivered through the 16 gauge needle with an appropriate amount of pressure applied to the syringe. Using the fluoroscope, the adhesive could be seen to flow into the fracture site with minimal extravagation into the surrounding soft tissues. Successful bonding of the fracture fragments was observed. CONCLUSIONS: Percutaneous delivery of BBA into a fracture of the distal radius and proximal humerus may be a feasible fracture fixation technique. Biomechanical testing and animal model testing are required to further develop this procedure.
Authors: Kai O Böker; Katharina Richter; Katharina Jäckle; Shahed Taheri; Ingo Grunwald; Kai Borcherding; Janek von Byern; Andreas Hartwig; Britt Wildemann; Arndt F Schilling; Wolfgang Lehmann Journal: Materials (Basel) Date: 2019-11-30 Impact factor: 3.623