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. 2020 Mar 7;13(5):1201.
doi: 10.3390/ma13051201.

Failure Analysis of Retrieved Osteosynthesis Implants

Mihai Nica  1   2 , Bogdan Cretu  2 , Dragos Ene  1   3 , Iulian Antoniac  4 , Daniela Gheorghita  4 , Razvan Ene  1   2
Affiliations

Failure Analysis of Retrieved Osteosynthesis Implants

Mihai Nica et al. Materials (Basel). .

Abstract

Failure of osteosynthesis implants is an intricate matter with challenging management that calls for efficient investigation and prevention. Using implant retrieval analysis combined with standard radiological examination, we evaluated the main causes for osteosynthesis implant breakdown and the relations among them for a series of cases. Twenty-one patients diagnosed with implant failure were assessed for this work. For metallurgical analysis, microscopy techniques such as scanning electron microscopy (SEM), stereomicroscopy, and optical microscopy were employed. The results showed that material structural deficiencies (nine patients) and faulty surgical techniques (eight patients) were the main causes for failure. An important number of patients presented with material structural deficiencies superimposed on an imperfect osteosynthesis technique (six patients). Consequently, the importance of failure retrieval analysis should not be overlooked, and in combination with other investigational techniques, must provide information for both implant manufacturing and design improvement, as well as osteosynthesis technique optimization.

Keywords: analysis; failure; implant; osteosynthesis; retrieval.

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Conflict of interest statement

The authors declare no conflict of interest

Figures

Figure 1
Figure 1
Deforming forces acting on long bones.
Figure 2
Figure 2
Radiological aspects of fractures with deterioration of osteosynthesis material: humerus fracture (a) and femoral fracture (b).
Figure 3
Figure 3
Optical microscopy images of experimental samples obtained from retrieved intramedullary nails made of stainless-steel type 316L: 500 × (a), 1000 × (b).
Figure 4
Figure 4
The macroscopic aspect (a,b) and stereomicroscopy images (c,d) of the fractured zone of some retrieved intramedullary nails.
Figure 5
Figure 5
Scanning electron micrographs showing fracture surface morphology on failure region for retrieved intramedullary nails: 100 × (a,b), 60 × (c), 500 × (d,e), 45 × (f).
Figure 6
Figure 6
Radiography of a clinical case with failure of a Gamma Nail—72-year-old female patient.
See this image and copyright information in PMC

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