Research Thesis

Biomechanical analysis of femoral fracture fixation using the Expert adolescent lateral femoral nail system.

Angadi, Darshan Srishail (2017). Biomechanical analysis of femoral fracture fixation using the expert adolescent lateral femoral nail system. University of Birmingham. M.D.

Abstract

Femoral fracture in adolescents is a severe injury. Recent studies of intramedullary nail fixation with rigid titanium alloy helical nail viz. Expert adolescent lateral femoral nail (ALFN) have reported good results. However, there is no in vitro biomechanical data available on this nail in the literature.
Experimental testing and finite element analysis (FEA) were used to establish the stiffness parameters of small composite femurs with simulated fractures stabilised using ALFN. In comparison to intact femur, construct stiffness ranged from maximum (114%) to minimum (20%) for healed fracture and segmental fracture, respectively. Simulation testing in SolidWorksTM was performed with validated FEA model to evaluate the effect of clinical and implant factors. Maximum predicted stress in the distal interlocking screw remained in an acceptable range (160.25 – 188.51 MPa) irrespective of the level of femoral shaft fracture with a relative decrease in stress values as the fracture callus healed over a 16 week period. The relative angle between the ALFN and proximal interlocking screw and implant material were two significant factors influencing stress at the interlocking screw and nail interface.
In conclusion, a rigid helical titanium alloy femoral intramedullary nail can perform satisfactorily under physiological loading conditions experienced in the perioperative period.

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Research

Book Chapters

Research thesis

Peer-review papers

Presentations

Podium

  • Mukartihal R, Angadi DS, Patil SS, Gurava Reddy AV, Bose VC, Pichai S, Rajasekaran S, Rajkumar N, Dhanasekararaja P Delayed and late prosthetic joint infections following total knee replacement: a multicenter study of fifteen thousand patients British Orthopaedic Association Congress 2021
  • Angadi DS, Coolican M ‘Functional and radiological outcomes of three tibial component fixation techniques: results of prospective randomised controlled trial’ British Association for Surgery of the Knee Annual and Combined Orthopaedic Knee Societies Meeting, 2020
  • Kandhari V, Angadi DS, Myat D, Fritsch B, Parker D, Coolican M ‘Long term survivorship outcomes and clinical outcomes of navigated lateral opening wedge distal femoral osteotomy for osteoarthritis of lateral compartment of knee’ British Orthopaedic Association Congress 2020
  • Angadi DS, Fleming T, Atwal N, Gosal H ‘Prospective evaluation of functional and radiological outcomes of arthroplasty for patellofemoral arthritis’ 79th Australian Orthopaedic Association Annual Scientific Meeting, 2019
  • Seewoonarain S, Angadi DS, Martin C ‘The use of Prothrombin Complex Concentrate (PCC) in hip fracture patients’. Annual Audit Symposium, Royal College of Surgeons of Edinburgh, 2016.
  • Angadi DS, Shepherd DE, Vadivelu R, Barrett T ‘Adolescent Femoral Fracture Fixation with Lateral Trochanteric Entry Rigid Helical Intramedullary Nail – A Biomechanical Evaluation’. XXV Congress of the International Society of Biomechanics, 2015
  • Elbashir M, Angadi DS, Latimer M. Paediatric Elbow: A Cross-sectional study of trochlea and olecranon ossification centres. European Orthopaedic Research Society Meeting, 2015
  • Angadi DS, Shepherd DE, Vadivelu R, Barrett T. ‘Rigid Helical Intramedullary Nail Fixation of Paediatric Femur Fractures – A Biomechanical Evaluation’. 16th EFORT Congress, 2015
  • Angadi DS, Shepherd DE, Vadivelu R, Barrett T ‘Orthogonal digital radiographs – a novel template for paediatric femur finite element model development’. 5th International Conference on Biomedical Engineering, 2014
  •  Bakersfield R, Rawal J, Angadi DS, Bowden B, Chojnowski A. ‘Clinical outcomes following operative management of dorsal fracture dislocation of the proximal interphalangeal joint in the hand.’ British Orthopaedic Association Annual Congress, 2012.
  • Rawal J, Barksfield R, Angadi DS, Pasapula C. ‘Overcorrection of the inter-metatarsal angle in corrective hallux valgus osteotomy leads to an increase in intra-articular pressures of the 1st metatarsal-phalangeal joint: a biomechanical simulation’. British Orthopaedic Association Annual Congress, 2012.
  • Angadi DS, Brown S, Crawfurd E.J.P. ‘A prospective long term study of a cemented titanium femoral stem.’ 12th EFORT Congress, 2011.
  • Angadi DS, Crawfurd EC. ‘A prospective randomised study of cemented all-polyethylene versus uncemented porous coated acetabular components’. American Academy of Orthopedic Surgeons Annual Congress, 2010.
  • Angadi DS, Brown S, Crawfurd EC. ‘Cemented all-polyethylene cups versus uncemented porous coated cups – 10 year results of prospective randomised study.’ 11th EFORT Congress, 2010.
  • Angadi DS, Vadivelu R, Deshmukh R.G. ‘Hip fracture patients and post-operative hyponatraemia- the Boston experience’. British Trauma Society and Hellenic Orthopaedic Meeting, 2005.
  • Angadi DS, Vadivelu R, Deshmukh R.G. ‘Hyponatraemia in proximal femoral fractures’. Indian Orthopaedic Association, Golden Jubilee Meeting, 2005.
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Poster

  • Coolican M, Angadi DS, Kandari V ‘Prospective Randomised Controlled Trial Of Three Tibial Component Fixation Techniques: Medium To Long Term Functional And Radiological Outcomes’ International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Global Congress 2021
  • Mukartihal R, Angadi DS, Ramesh PA, Singh NK, Mangukiya HJ, Agrawal B, Patil SS ‘Temporal changes in sleep quality and knee function following unilateral and bilateral total knee arthroplasty: a prospective study’ International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine (ISAKOS) Global Congress 2021
  • Muellner T, Raje AD, Angadi DS ‘Correlation between the tibial cutting guide/Jig and tibial resections in total knee arthroplasty: a prospective study’ European Society for Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA) Speciality Days, 2019
  • Angadi DS, Shepherd DE, Vadivelu R, Barrett T ‘Development and validation of a paediatric femur finite element model using orthogonal digital radiographs’. 7th World Congress of Biomechanics, 2014.
  • Angadi DS, Damany D, Farrar MJ. ‘Coblation for noninsertional Achilles tendonopathy’ British Orthopaedic Association Annual Congress, 2012
  • Yousef A, Angadi DS, Chari R. ‘A prospective study on home surveillance of wounds with serosanguinous discharge following hip and knee arthroplasty. 8th EFORT Congress, 2007.