Identification of the damage mechanism in orthopaedic implant. Case study including the biomechanical analysis

Abstract

Implant breaking destabilizing the fracture may be caused by its structural defect, inappropriate use, or massive overloads. We present the patient, who broke the plate stabilizing comminuted clavicular fracture at the sixth postoperative week due to the, primarily reported, simple loading of the limb that should not exceeded admissible limits. Macroscopic examination excluded its manufacturing defect of an explant, but revealed areas of fatigue fractures, as well as anterior and inferior bending of its edges. Mechanical analysis proved sufficient material durability. Those findings clearly showed that the plate broke in consequence of repetitive overloads exceeding its durability. Patient, when acquitted with those results, confessed that the plate broke, while fishing. Moreover, he reported an episode of alcohol overuse that could contribute to implant failure bringing the risk of additional injury. Biomechanical analysis confirmed that mechanical loads throwing the spinner exceed values adequate for plate breaking. Thus, the real circumstances of the complication seem to be unveiled pointing out to facts that some patients disobey postoperative recommendations to avoid overloading of stabilized extremity, thus participating actively in this type of complications, that they dissemble the real circumstances of the complications, and that they may exhibit risky and irrational behavior. Basing on the presented case we concluded that in some cases plaster cast immobilization supporting stabilized fracture may be beneficial precluding banned activities and preventing from secondary injuries reducing the risk of postoperative complications.