{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T11:11:54Z","timestamp":1759921914080,"version":"build-2065373602"},"reference-count":53,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sub-measure 1.1.1 of Smart Growth Operational Programme 2014\u20132020","award":["POIR.01.01.01-00-0246\/21-00"],"award-info":[{"award-number":["POIR.01.01.01-00-0246\/21-00"]}]},{"name":"European Regional Development Fund","award":["POIR.01.01.01-00-0246\/21-00"],"award-info":[{"award-number":["POIR.01.01.01-00-0246\/21-00"]}]},{"name":"The National Centre for Research and Development (NCBR)","award":["POIR.01.01.01-00-0246\/21-00"],"award-info":[{"award-number":["POIR.01.01.01-00-0246\/21-00"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JFB"],"abstract":"<jats:p>This study focuses on the development and evaluation of the OrthoNail hybrid intramedullary implant for lower limb lengthening in patients requiring significant skeletal reconstruction. The implant addresses the challenges in load-bearing during rehabilitation, providing a robust solution that is capable of supporting physiological loads. Mechanical tests, including axial compression, tension, torsion, and 3,4-point bending, determined the implant\u2019s load capacity and fatigue resistance, while finite element analysis assessed stress distributions in bone tissue and around screw holes during single-leg stance, with boundary conditions derived from Orthoload database data. The OrthoNail implant demonstrated excellent mechanical stability, sustaining torsional loads of up to 19.36 Nm at maximum elongation (80 mm) and 17.16 Nm at zero elongation. Under axial compression, it withstood forces of up to 1400 N, maintaining structural integrity. Fatigue testing revealed resilience under dynamic loading conditions for over 1,000,000 cycles at a load of 500 N, with no mechanical failure or material degradation observed. Stress concentrations near screw holes indicate areas for potential optimization. The findings indicate that the OrthoNail implant demonstrates excellent mechanical stability and is well-suited for clinical application, enabling early full weight-bearing during rehabilitation.<\/jats:p>","DOI":"10.3390\/jfb16010027","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T05:59:42Z","timestamp":1736920782000},"page":"27","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Analysis of the Feasibility of the OrthoNail Hybrid Intramedullary Implant in the Human Body with Respect to Material Durability"],"prefix":"10.3390","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7062-6357","authenticated-orcid":false,"given":"Dominika","family":"Grygier","sequence":"first","affiliation":[{"name":"Department of Vehicle Engineering, Faculty of Mechanical Engineering, Wroclaw University of Science and Technology, Smoluchowskiego 25 Str., 50-370 Wroclaw, Poland"},{"name":"Orthoget Sp. z o.o., Muchoborska 18, 54-424 Wroc\u0142aw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2216-5706","authenticated-orcid":false,"given":"Piotr","family":"Kowalewski","sequence":"additional","affiliation":[{"name":"Orthoget Sp. z o.o., Muchoborska 18, 54-424 Wroc\u0142aw, Poland"},{"name":"Department of Fundamentals of Machine Design and Mechatronic Systems, Faculty of Mechanical Engineering, Wroclaw University of Science and Technology, \u0141ukasiewicza 5, 50-371 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0675-9822","authenticated-orcid":false,"given":"Mariusz","family":"Opa\u0142ka","sequence":"additional","affiliation":[{"name":"Orthoget Sp. z o.o., Muchoborska 18, 54-424 Wroc\u0142aw, Poland"},{"name":"Department of Fundamentals of Machine Design and Mechatronic Systems, Faculty of Mechanical Engineering, Wroclaw University of Science and Technology, \u0141ukasiewicza 5, 50-371 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1518-2065","authenticated-orcid":false,"given":"Jakub J.","family":"S\u0142owi\u0144ski","sequence":"additional","affiliation":[{"name":"Orthoget Sp. z o.o., Muchoborska 18, 54-424 Wroc\u0142aw, Poland"},{"name":"Department of Mechanics, Materials and Biomedical Engineering, Faculty of Mechanical Engineering, Wroc\u0142aw University of Science and Technology, Smoluchowskiego 25, 50-372 Wroc\u0142aw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6179-9771","authenticated-orcid":false,"given":"Mateusz","family":"Dziubek","sequence":"additional","affiliation":[{"name":"Department of Vehicle Engineering, Faculty of Mechanical Engineering, Wroclaw University of Science and Technology, Smoluchowskiego 25 Str., 50-370 Wroclaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9509-354X","authenticated-orcid":false,"given":"Dariusz","family":"Pyka","sequence":"additional","affiliation":[{"name":"Department of Mechanics, Materials and Biomedical Engineering, Faculty of Mechanical Engineering, Wroc\u0142aw University of Science and Technology, Smoluchowskiego 25, 50-372 Wroc\u0142aw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"11","DOI":"10.7181\/acfs.2015.16.1.11","article-title":"Skull Reconstruction with Custom Made Three-Dimensional Titanium Implant","volume":"16","author":"Cho","year":"2015","journal-title":"Arch. Craniofacial Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"943","DOI":"10.1097\/SCS.0000000000002656","article-title":"Cranioplasty enhanced by three-dimensional printing: Custom-made three-dimensional-printed titanium implants for skull defects","volume":"27","author":"Park","year":"2016","journal-title":"J. Craniofacial Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1016\/j.brainresbull.2019.08.010","article-title":"The application of polyetheretherketone (PEEK) implants in cranioplasty","volume":"153","author":"Zhang","year":"2019","journal-title":"Brain Res. Bull."},{"key":"ref_4","first-page":"163","article-title":"Clinical study of 3D printed personalized prosthesis in the treatment of bone defect after pelvic tumor resection","volume":"29","author":"Xu","year":"2021","journal-title":"J. Orthop. Transl."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"363","DOI":"10.1007\/s11914-019-00535-9","article-title":"Biomechanics of Osteoporotic Fracture Fixation","volume":"17","author":"Hollensteiner","year":"2019","journal-title":"Curr. Osteoporos. Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1016\/S0021-9290(01)00037-9","article-title":"Loads acting in an intramedullary nail during fracture healing in the human femur","volume":"34","author":"Schneider","year":"2001","journal-title":"J. Biomech."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"515","DOI":"10.5312\/wjo.v12.i8.515","article-title":"International recognition of the Ilizarov bone reconstruction techniques: Current practice and research (dedicated to 100th birthday of G. A. Ilizarov)","volume":"12","author":"Malkova","year":"2021","journal-title":"World J. Orthop."},{"key":"ref_8","first-page":"175","article-title":"Osseointegration in skeletal reconstruction and rehabilitation: A review","volume":"38","author":"Rydevik","year":"2001","journal-title":"J. Rehabil. Res. Dev."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"285","DOI":"10.3109\/17453678608994393","article-title":"Osseointegration of titanium implants","volume":"57","author":"Carlsson","year":"1986","journal-title":"Acta Orthopaedica Scandinavica"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.clinbiomech.2011.08.009","article-title":"A novel intramedullary nail for micromotion stimulation of tibial fractures","volume":"27","author":"Dailey","year":"2012","journal-title":"Clin. Biomech."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"825","DOI":"10.1302\/2633-1462.210.BJO-2021-0121.R1","article-title":"Pilot study of micromotion nailing for mechanical stimulation of tibial fracture healing","volume":"2","author":"Dailey","year":"2021","journal-title":"Bone Jt. Open"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"4217","DOI":"10.1007\/s00266-024-04260-2","article-title":"Trends in Surgical and Nonsurgical Aesthetic Procedures: A 14-Year Analysis of the International Society of Aesthetic Plastic Surgery\u2014ISAPS","volume":"48","author":"Triana","year":"2024","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1177\/0748806819852014","article-title":"Current Trends of Cosmetic Surgical Procedures With the General Cosmetic Surgery Fellowships by the American Academy of Cosmetic Surgery","volume":"37","author":"Valina","year":"2020","journal-title":"Am. Cosmet. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"21","DOI":"10.5005\/jp-journals-10080-1574","article-title":"Trends and Practices in Limb Lengthening: An 11-year US Database Study","volume":"18","author":"Sabharwal","year":"2023","journal-title":"Strateg. Trauma Limb Reconstr."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1016\/S1740-1445(03)00003-2","article-title":"Body image and cosmetic medical treatments","volume":"1","author":"Sarwer","year":"2004","journal-title":"Body Image"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Dang, H.S., Nguyen, T.M.T., Wang, C.N., Day, J.D., and Dang, T.M.H. (2020). Grey System Theory in the Study of Medical Tourism Industry and Its Economic Impact. Int. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17030961"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"10","DOI":"10.23958\/ijirms\/vol05-i01\/614","article-title":"Low Cost, Quality Treatment and Excellent Hospitality Makes India the Best Destination for Medical Tourism","volume":"5","author":"Garg","year":"2020","journal-title":"Int. J. Innov. Res. Med. Sci."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1007\/s00266-015-0562-0","article-title":"Consensus on Changing Trends, Attitudes, and Concepts of Asian Beauty","volume":"40","author":"Liew","year":"2016","journal-title":"Aesthetic Plast. Surg."},{"key":"ref_19","first-page":"71","article-title":"Aesthetic medicine tourism\u2014Nature and scope of the services","volume":"8","author":"Panfiluk","year":"2016","journal-title":"Ekon. Zarz."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"597","DOI":"10.1007\/s11832-016-0791-z","article-title":"Cosmetic lengthening: What are the limits?","volume":"10","author":"Guerreschi","year":"2016","journal-title":"J. Child. Orthop."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1402","DOI":"10.1302\/0301-620X.87B10.16468","article-title":"Cosmetic bilateral leg lengthening experience of 54 cases","volume":"87","author":"Catagni","year":"2005","journal-title":"J. Bone Jt. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s12306-022-00752-z","article-title":"Current trends on limb length discrepancy treatment: Results of a survey among 11 dedicated Italian centres","volume":"107","author":"Origo","year":"2023","journal-title":"Musculoskelet. Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"341","DOI":"10.1302\/2046-3758.97.BJR-2019-0379.R1","article-title":"Cosmetic stature lengthening","volume":"9","author":"Marwan","year":"2020","journal-title":"Bone Jt. Res."},{"key":"ref_24","unstructured":"Standard, S.C., Herzenberg, J.E., and Green, S.A. (2019). Antegrade and Retrograde Femur Operative Technique, NuVasive."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1080\/17453674.2018.1534321","article-title":"Limb lengthening and deformity correction with externally controlled motorized intramedullary nails: Evaluation of 50 consecutive lengthenings","volume":"90","author":"Horn","year":"2019","journal-title":"Acta Orthop."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"790","DOI":"10.1097\/CORR.0000000000002036","article-title":"What Are the Potential Benefits and Risks of Using Magnetically Driven Antegrade Intramedullary Lengthening Nails for Femoral Lengthening to Treat Leg Length Discrepancy?","volume":"480","author":"Frommer","year":"2022","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1586\/17434440.2015.1005604","article-title":"PRECICE intramedullary limb lengthening system","volume":"12","author":"Paley","year":"2015","journal-title":"Expert Rev. Med. Devices"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.jajs.2014.06.007","article-title":"Removal of a broken distal cannulated intramedullary femoral nail with solid reamer with closed methods and without using C-arm: A case report","volume":"2","author":"Yadav","year":"2015","journal-title":"J. Arthrosc. Jt. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1080\/17453674.2021.1903278","article-title":"Pain, osteolysis, and periosteal reaction are associated with the STRYDE limb lengthening nail: A nationwide cross-sectional study","volume":"92","author":"Kold","year":"2021","journal-title":"Acta Orthop."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e0267","DOI":"10.2106\/JBJS.CC.19.00267","article-title":"Management of a Broken PRECICE Femoral Nail at an Ununited Distraction Osteogenesis Site: A Case Report","volume":"10","author":"Hidden","year":"2020","journal-title":"JBJS Case Connect."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.jcot.2020.06.005","article-title":"Post-retrieval functionality testing of PRECICE lengthening nails: The \u201cSleeper\u201d nail concept","volume":"14","author":"Eltayeby","year":"2021","journal-title":"J. Clin. Orthop. Trauma"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"108182","DOI":"10.1016\/j.ijscr.2023.108182","article-title":"Breakage of a re-activated PRECICE\u00ae nail: A case report","volume":"106","author":"Alrabai","year":"2023","journal-title":"Int. J. Surg. Case Rep."},{"key":"ref_33","unstructured":"(2021). Implants for Surgery\u2014Metallic Materials Part 3: Wrought Titanium 6-Aluminium 4-Vanadium Alloy (Standard No. ISO 5832-3:2021)."},{"key":"ref_34","unstructured":"(2018). Metallic Materials: Vickers Hardness Test. Part 1, Test Method (Standard No. PN-EN ISO 6507-1:2018)."},{"key":"ref_35","unstructured":"(2019). Metallic Materials\u2014Tensile Testing (Standard No. ISO 6892-1:2019)."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Silva Gomes, J., and Meguid, S. (2018, January 22\u201326). Structural validation of intramedullary nails: From experimentation to virtual testing. Proceedings of the 6th International Conference on Integrity-Reliability-Failure, Lisbon, Portugal.","DOI":"10.24840\/978-989-20-8313-1"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"593","DOI":"10.4236\/jbise.2012.510073","article-title":"Distal locking in femoral intramedullary nailing system: Is one cross screw sufficient?","volume":"5","author":"Karuppiah","year":"2012","journal-title":"J. Biomed. Sci. Eng."},{"key":"ref_38","unstructured":"(2016). Badania Nieniszcz\u0105ce\u2014Badania Wizualne\u2014Zasady Og\u00f3lne (Standard No. PN-EN 13018:2016-04)."},{"key":"ref_39","unstructured":"(2021). Metallic Materiale\u2014Bend Test (ISO 7438:2020) (Standard No. PN-EN ISO 7438:2021-04)."},{"key":"ref_40","unstructured":"(2024). Standard Specification and Test Methods for Intramedullary Fixation Devices (Standard No. ASTM F1264-16e1)."},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Little, R.E. (1975). Manual on Statistical Planning and Analysis for Fatigue Experiments, ASTM International.","DOI":"10.1520\/STP588-EB"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Baleani, M., Erani, P., Blaise, M., Fognani, R., Palmas, M., and Manfrini, M. (2022). Intercalary reconstruction of long bones by massive allograft: Comparison of construct stability ensured by three different host-graft junctions and two types of fixations in a synthetic femur model. Front. Pediatr., 10.","DOI":"10.3389\/fped.2022.868299"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1269","DOI":"10.1016\/j.clinbiomech.2008.06.011","article-title":"Internal femoral forces and moments during running: Implications for stress fracture development","volume":"23","author":"Edwards","year":"2008","journal-title":"Clin. Biomech."},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Becerra, L.H.C., Rodr\u00edguez, M.A.L.H., Arroyo, R.L., Sol\u00eds, H.E., and Castro, A.T. (2021). Effect of sterilization on 3-point dynamic response to in vitro bending of an Mg implant. Biomater. Res., 25.","DOI":"10.1186\/s40824-021-00207-9"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1007\/s00264-010-0983-y","article-title":"Comparison of mechanical rigidity between plate augmentation leaving the nail in situ and interlocking nail using cadaveric fracture model of the femur","volume":"35","author":"Park","year":"2011","journal-title":"Int. Orthop."},{"key":"ref_46","unstructured":"Untaroiu, C., Genovese, D., Ivarsson, J., and Crandall, J. (2008, January 8\u201310). A Finite Element Analysis of Mid-Shaft Femoral Tolerance under Combined Axial-Bending Loading. Proceedings of the 10th International LS-DYNA Conference, Detroit, MI, USA."},{"key":"ref_47","first-page":"12","article-title":"Effect of capsaicin-sensitive sensory neurons on bone architecture and mechanical properties in the rat hindlimb suspension model","volume":"10","author":"Zhang","year":"2017","journal-title":"J. Orthop. Transl."},{"key":"ref_48","unstructured":"Bergmann, G., and Damm, P. (2024, December 01). Julius Wolff Institute, Berlin Institute of Health at Charit\u00e9 Universit\u00e4tsmedizin Berlin, 2008. Available online: https:\/\/orthoload.com\/database\/?implantId=2355&activityId=2541&activityIndentationLevel=1&parameterId=1&parameterIndentationLevel=-1&patientId=h10r&fileId=h10r_260413_1_8&fileType=t&selectBox=file."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"23779608231167825","DOI":"10.1177\/23779608231167825","article-title":"Effect of Early Mobilization on Hip and Lower Extremity Postoperative: A Literature Review","volume":"9","author":"Aprisunadi","year":"2023","journal-title":"SAGE Open Nurs."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"2151459319826431","DOI":"10.1177\/2151459319826431","article-title":"Early Mobilization Post\u2013Hip Fracture Surgery","volume":"10","author":"Nguyen","year":"2019","journal-title":"Geriatr. Orthop. Surg. Rehabil."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"113","DOI":"10.2106\/JBJS.22.00283","article-title":"Mechanical Failures in Magnetic Intramedullary Lengthening Nails","volume":"105","author":"Hlukha","year":"2023","journal-title":"J. Bone Jt. Surg."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.jor.2024.05.018","article-title":"PRECICE nail bending in femur lengthening","volume":"56","author":"Ramlawi","year":"2024","journal-title":"J. Orthop."},{"key":"ref_53","unstructured":"(2021). Standard Specification for Wrought Titanium-6Aluminum-4Vanadium ELI (Extra Low Interstitial) Alloy for Surgical Implant Applications (Standard No. ASTM F136-13(2021)e1)."}],"container-title":["Journal of Functional Biomaterials"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2079-4983\/16\/1\/27\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:29:10Z","timestamp":1759919350000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2079-4983\/16\/1\/27"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,15]]},"references-count":53,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["jfb16010027"],"URL":"https:\/\/doi.org\/10.3390\/jfb16010027","relation":{},"ISSN":["2079-4983"],"issn-type":[{"type":"electronic","value":"2079-4983"}],"subject":[],"published":{"date-parts":[[2025,1,15]]}}}