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the evaluation of fixation, and the plate and its function were evaluated employing twoapproaches, i.e., measurement and analysis. To contribute to the development of stems in thefuture, the effects of the plate, which has become infrequently used in clinical practice, were reevaluated.MethodsIn this study, to clarify the usefulness and effectiveness of anintertrochanteric plate, we evaluated the following three items:(i) Pressure measurement wasperformed using stems with and those without a plate (collar stems), and the pressuredistribution was compared between the two types of stem. (ii) Two finite element (FE) modelswith or without a plate were constructed, and the pressure immediately below the plate wascompared between the two models by finite element analysis (FEA). (iii) Two FE models with aplate that is slightly movable or immovable were constructed, and the stress distribution andrelative micromotion were compared between the two models by FEA.Findings andInterpretation The results showed that the intertrochanteric plate markedly lowered themaximum pressure compared to a collar. The plate, which is added under the collar, candisperse the pressure on bone like a washer under a screw. The pressure was lower than thevalue that may cause stem fracture. The results were verified by FE analysis under similarmeasurement conditions (Figure 1). Therefore, we speculated that the plate absorbed andscattered the load applied on the femoral head, reducing pressure at the bone-stem interface,and also reduced radial pressure in the stem axis direction, preventing excessive pressureconcentration through its micromotion. The micromotion was lower for the model with amovable than for that with a fixed plate, suggesting that the former is not prone to loosening.Thus, micromotion of the intertrochanteric plate is effective for fixation. The movableintertrochanteric plate is useful to avoid excessive stress concentration and loosening. Wejudged the intertrochanteric plate to be useful for primary stem fixation.FiguresPoster: 88Trafermin and Sugar Therapy for Infection and Skin Ulcer After TotalKnee Arthroplasty.*Tomotaro Sato - Nagoya Medical Center - Nagoya, JapanAtsushi Kaneko - NHO Nagoya Medical Center - Nagoya, JapanDaihei Kida - NHO Nagoya Medical Center - Nagoya, Japan*Email: satotomo@nnh.hosp.go.jpBacterial infection and skin ulcer are major problems in Total Knee Arthroplasty (TKA). Sugar(sucrose) has been used for wound care in many countries because it absorbs fluid, stimulatesgranulation, and suppress growth of bacteria. Trafermin (basic fibroblast growth factor : bFGF)accelerates granulation and improves quality of wound healing. We have used Trafermin andsugar for treatment of skin ulcer and infection after TKA, and followed up for minimum oneyear.Four infected TKA with skin ulcer were treated with Trafermin and sugar. Two wereosteoarthritis and two were rheumatoid arthritis knees. Implants were removed in two casesfile:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]