Kanchanomai et al. [10] | 14 hole, Locking compression plate (for femur) | 316L Stainless steel | Excessive walking before adequate healing of fracture | - -
Striation spacing: 1 μm at the middle of the fracture
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Thickness of LCP: 5 mm
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Estimated no. cycles from crack initiation to bottom: 5000 cycles
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Estimated number of cycles for complete fracture: 42,000 (8 days of walking)
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Sub-surface inclusion found at initiation of crack site
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Thapa et al. [11] | 10 hole, Locking compression plate | Stainless steel | Corrosion-fatigue | - -
Striation spacing: at crack initiation—0.3 μm, at fracture surface—1.72 μm (crack length—1 mm).
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Estimated no. of cycles after crack initiation: 2035 cycles
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Corrosion (rusting) visible on surface
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Carbon intermetallic-inclusion found
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Karmacharya et al. [12] | 8 hole, Reconstructive locking plate | 316L Stainless steel | Corrosion | - -
Mechanically intact & no significant damage visible
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Majid et al. [13] | Lumbar plates (113 plates were studied) | 316L Stainless steel | Corrosion | - -
72.5% (majority) of plates showed corrosion.
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Fe, Cr and Ni (preferential) metal ions were released into body due to corrosion
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Corrosion occurred at screw-plate interface (fretting/crevice)
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Varadharajan et al. [14] | Hemi-toe implant | Cobalt chromium alloy | Failed clinically | - -
Mechanically intact & no significant damage visible
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Anterior/middle surface exhibited more scratching/debris deposition—can be indicative of damage to HMWPE bearing
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Coat spalling may indicate device loosening
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Sudhakar et al. [15] | Nail for Shinbones | 316L Stainless steel | Ductile fracture and nonmetallic inclusions | - -
Ductile fracture facilitated by micro-fracture due to non-metallic inclusion (125 um) is predominant mode of failure
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Sivakumar et al. [16] | 6 hole, Tubular compression bone plate (for femur) | 316L Stainless steel | Improper fixation | - -
Pitting potential of implant is due to higher Chromium—2.3% and Nickel—4% contents.
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Fracture was at 5th countersunk hole of plate
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“Beach marks” at outer edge of crack indicate torsional force
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Grain size and inclusion content did not meet ASTM requirement
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Bone plate was placed anteriorly rather than laterally which does not allow for proper compression
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Screw head and screw hole mismatch
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Marcomini et al. [17] | Femoral Locking compression plate | Stainless steel (not 316L due to higher content of Ni and P) | Non-conformity of the material | - -
Phosphorus content 0.26% over superior limit
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SEM showed evidence of brittle fracture due to segregation of P in grain boundaries
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Steel was cold worked which contributed to brittle fracture
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Cahoon et al. [18] | McLaughlin plate for hip (7 other implants discussed) | Cast Vitallium | Fracture in the area where maximum stresses were expected | - -
Period of time the implant served: 1 year
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Fatigue strength decreased due to increase in porosity
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Cahoon et al. [18] | V-Moore plate and screws | 316L Stainless steel | Crevice corrosion | - -
Period of time the implant served: 1 year
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Tissue reaction due to severe crevice corrosion
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Cahoon et al. [18] | Nail plate | 316L Stainless steel | Fracture due to bending (while trying to fit the patient) | - -
Punching of screw holes too close and too near to the edge of the nail plate
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To dissolve the precipitation of chromium carbide, it was heat treated at: 1040 °C for 1 h.
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Azevedo et al. [19] | 13 hole reconstruction plate for osteosynthesis | Plate: CP Titanium Screws: Titanium-6Al-4V alloy | Corrosion-fatigue | - -
Intergranular cracking formation: 15 μm deep on notch surface
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Reduction of area featured: 55% approximately.
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Equiaxed α grains and Intergranular β platelets revealed
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Corrosion observed on intergranular β-phase which was in contact with body fluid
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De Medeiros et al. [20] | Hemimandibles with assistive 4 hole plates | 5052-F Aluminum | Fracture due to ductile overload | - -
Number of plates fractured in the upper part of the hole to the right of the fracture line: 5
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Surface: Dim and grayish showing intense plastic deformation
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Plates failed due to ductile fracture mechanism alluding to proper manufacturing
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Roffey et al. [21] | Femoral stem | M30NW High nitrogen Stainless steel | Failure at a point of maximum stress due to bending and torsional loading | - -
No. of fracture initiation points: 2
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Large Beach marks indicate large number of cycles to failure
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Visible ratchet marks indicative of fatigue failure
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Scratching and scoring patterns support post-manufacturing damage
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Fatigue fracture pattern confirms mechanical damage prior to fracture
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Initial fracture occurred in region of lowest cross-sectional area
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Mechanical damage to surface during implantation led to initiating fatigue crack
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Goswami et al. [22] | IM nail | Titanium | Axial, bending, and torsion forces | - -
Interference between screw, core-lock caps, and IM nail
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Lack of purchase to bone
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Pre-crack due to interference
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Striation spacing = 10–15 µm
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Azevedo et al. [23] | Femoral compression plate | Stainless steel | Fretting-fatigue | - -
Underside of screw-head and plate hole countersink showed marks of wear and corrosion that led to removal of passivation layer
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Chemical composition did not meet ISO 5832-I standards which decreases corrosion resistance
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Presence of fretting corrosion may suggest screw loosening
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Fatigue striations (spacing = 0.6 µm) associated with secondary cracking
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Azevedo et al. [26] | Femoral nail-plate | Stainless steel | Fatigue fracture | - -
Multiple nucleation sites present at high-stress concentration points
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Chemical composition failed to meet ISO 5832-I standards
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Azevedo et al. [23] | Titanium oral maxilla-facial plate | CP Titanium | Corrosion-fatigue | - -
Evidence of brittle fracture shown by no gross plastic deformation near fracture surface
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Presence of fissure striations, complex furrow structures, secondary intergranular cracking
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Intergranular cracking near surface of origin indicative of corrosion—fatigue mechanism
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ISO 5832-2 standards were met for chemical composition of CP titanium
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