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Purpose
The aim of this study was to compare several osteosynthesis techniques (intramedullary headless compression screws, T-plates, and Kirschner wires) for distal epiphyseal fractures of proximal phalanges in a human cadaveric model.
Methods
A total of 90 proximal phalanges from 30 specimens (index, ring, and middle fingers) were used for this study. After stripping off all soft tissue, a transverse distal epiphyseal fracture was simulated at the proximal phalanx. The 30 specimens were randomly assigned to 1 fixation technique (30 per technique), either a 3.0-mm intramedullary headless compression screw, locking plate fixation with a 2.0-mm T-plate, or 2 oblique 1.0-mm Kirschner wires. Displacement analysis (bending, distraction, and torsion) was performed using optical tracking of an applied random speckle pattern after osteosynthesis. Biomechanical testing was performed with increasing cyclic loading and with cyclic load to failure using a biaxial torsion-tension testing machine.
Results
Cannulated intramedullary compression screws showed significantly less displacement at the fracture site in torsional testing. Furthermore, screws were significantly more stable in bending testing. Kirschner wires were significantly less stable than plating or screw fixation in any cyclic load to failure test setup.
Conclusions
Intramedullary compression screws are a highly stable alternative in the treatment of transverse distal epiphyseal phalangeal fractures. Kirschner wires seem to be inferior regarding displacement properties and primary stability.
Clinical relevance
Fracture fixation of phalangeal fractures using plate osteosynthesis may have the advantage of a very rigid reduction, but disadvantages such as stiffness owing to the more invasive surgical approach and soft tissue irritation should be taken into account. Headless compression screws represent a minimally invasive choice for fixation with good biomechanical properties.
The predictive control of commercial vehicle energy management systems, such as vehicle thermal management or waste heat recovery (WHR) systems, are discussed on the basis of information sources from the field of environment recognition and in combination with the determination of the vehicle system condition.
In this article, a mathematical method for predicting the exhaust gas mass flow and the exhaust gas temperature is presented based on driving data of a heavy-duty vehicle. The prediction refers to the conditions of the exhaust gas at the inlet of the exhaust gas recirculation (EGR) cooler and at the outlet of the exhaust gas aftertreatment system (EAT). The heavy-duty vehicle was operated on the motorway to investigate the characteristic operational profile. In addition to the use of road gradient profile data, an evaluation of the continuously recorded distance signal, which represents the distance between the test vehicle and the road user ahead, is included in the prediction model. Using a Fourier analysis, the trajectory of the vehicle speed is determined for a defined prediction horizon.
To verify the method, a holistic simulation model consisting of several hierarchically structured submodels has been developed. A map-based submodel of a combustion engine is used to determine the EGR and EAT exhaust gas mass flows and exhaust gas temperature profiles. All simulation results are validated on the basis of the recorded vehicle and environmental data. Deviations from the predicted values are analyzed and discussed.