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Bone plates
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Series: ASM Handbook
Volume: 11A
Publisher: ASM International
Published: 30 August 2021
DOI: 10.31399/asm.hb.v11A.a0006811
EISBN: 978-1-62708-329-4
Abstract
Bearing in mind the three-legged stool approach of device design/manufacturing, patient factors, and surgical technique, this article aims to inform the failure analyst of the metallurgical and materials engineering aspects of a medical device failure investigation. It focuses on the device "failures" that include fracture, wear, and corrosion. The article first discusses failure modes of long-term orthopedic and cardiovascular implants. The article then focuses on short-term implants, typically bone screws and plates. Lastly, failure modes of surgical tools are discussed. The conclusion of this article presents several case studies illustrating the various failure modes discussed throughout.
Series: ASM Failure Analysis Case Histories
Publisher: ASM International
Published: 01 June 2019
DOI: 10.31399/asm.fach.med.c0048413
EISBN: 978-1-62708-226-6
Abstract
A type 316L stainless steel angled plate failed. The fatigue fracture was found to have occurred at a plate hole. Symmetric cyclic bending forces were revealed by the fatigue damage at the fracture edge at the top surface of the plate. Fatigue striations and slip bands produced on the surface during cyclic loading were observed. The material was showed by the deformation structure to be in the cold-worked condition and was termed to not be the cause of the implant failure.
Book Chapter
Series: ASM Failure Analysis Case Histories
Publisher: ASM International
Published: 01 June 2019
DOI: 10.31399/asm.fach.med.c0048407
EISBN: 978-1-62708-226-6
Abstract
The plate used to treat a pseudarthrosis in the proximal femur was investigated for reasons of non-progress of healing. Fatigue cracks were revealed on the top surface of the small section of the plate at the fifth screw hole. The plate was found to be heavily loaded by comparison of intensity of these structures, compared to results of systematic crack-initiation experiments. It was revealed by fatigue bending tests that the fatigue life of plates with asymmetrically arranged holes is at least as long as for plates with holes situated in the center. Fatigue began at the large section only after a fatigue crack begins to propagate into the small plate section. A large secondary crack which had developed parallel to the main crack in the center of the surface was revealed. The fifth hole was situated at the transition between the supporting bone and the defect and hence stress concentration was revealed to be high.
Series: ASM Failure Analysis Case Histories
Publisher: ASM International
Published: 01 June 2019
DOI: 10.31399/asm.fach.med.c0048420
EISBN: 978-1-62708-226-6
Abstract
Fretting and fretting corrosion at the contact area between the screw hole of a type 316LR stainless steel bone plate and the corresponding screw head was studied. The attack on the 316LR stainless steel was only shallow. Mechanical grinding and polishing structures were exhibited by a large portion of the contact area. Fine corrosion pits in the periphery were observed and intense mechanical material transfer that can take place during fretting was revealed. Smearing of material layers over each other during wear was observed and attack by pitting corrosion was interpreted to be possible.
Series: ASM Failure Analysis Case Histories
Publisher: ASM International
Published: 01 June 2019
DOI: 10.31399/asm.fach.med.c9001579
EISBN: 978-1-62708-226-6
Abstract
Stainless steel is frequently used for bone fracture fixation in spite of its sensitivity to pitting and cracking in chloride containing environments (such as organic fluids) and its susceptibility to fatigue and corrosion fatigue. A 316L stainless steel plate implant used for fixation of a femoral fracture failed after only 16 days of service and before bone callus formation had occurred. The steel used for the implant met the requirements of ASTM Standard F138 but did contain a silica-alumina inclusion that served as the initiation point for a fatigue/corrosion fatigue fracture. The fracture originated as a consequence of stress intensification at the edge of a screw hole located just above the bone fracture; several fatigue cracks were also observed on the opposite side of the screw hole edge. The crack propagated in a brittle-like fashion after a limited number of cycles under unilateral bending. The bending loads were presumably a consequence of leg oscillation during assisted perambulation.
Series: ASM Failure Analysis Case Histories
Publisher: ASM International
Published: 01 June 2019
DOI: 10.31399/asm.fach.med.c0048397
EISBN: 978-1-62708-226-6
Abstract
A large portion of the four-hole Lane plate disintegrated and consisted mainly of corrosion products after remaining in the body for 26 years. Transformation structures and carbides were exhibited by the plate which was made from chromium steel. Minimal corrosion was exhibited by the soft austenitic 304 stainless steel used to make the screws. The corrosion products of the plate were revealed by microprobe analysis to impregnate the surrounding tissues. Improper material selection was concluded to be the reason for the general corrosion behavior.
Series: ASM Failure Analysis Case Histories
Publisher: ASM International
Published: 01 June 2019
DOI: 10.31399/asm.fach.med.c0048410
EISBN: 978-1-62708-226-6
Abstract
A narrow bone plate made of type 316 stainless steel and used to stabilize an open midshaft femur fracture failed. A crack at a plate hole next to the fracture site had been revealed by a radiograph taken 13 weeks after the operation. The plate was revealed to be slightly bent in the horizontal plane, and the fracture gap was considerably open. The screws and plates supplied by different manufacturers were revealed to be different with respect to microcleanliness (primary inclusion content) of the materials and only one of them was found to be according to specifications. The local crack formation was influenced by the presence of larger inclusions. The screw failed was revealed to have failed through a fatigue mechanism by the presence of striations in the scanning electron micrograph. The crack in the plate was revealed to have originated at the upper, outer corner of the plate by the beach marks which indicated the action of asymmetric bending and rotational forces.