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Evaluation of stabilization of intra-articular fracture of distal humerus – finite element study

Treść / Zawartość
Identyfikatory
Warianty tytułu
Języki publikacji
EN
Abstrakty
EN
The treatment of comminuted fractures of distal humerus poses a challenge for orthopaedics. Previous studies assessing the global stiffness of the bone – stabilizer system – made it impossible to explicitly indicate an optimal configuration of the locking plates in the treatment of this kind of fractures. The aim of the present research was to comparatively analyze the stabilization conditions of intraarticular fractures of distal humerus with the use of various configurations of the stabilizer. Methods: The research was based on the analysis of mutual displacements of bone fragments. Such evaluation was performed with the use of numerical simulation conducted with the use of the finite element method. A realistic model of humerus was based on the CT data. Three spatial configurations of the stabilizer (parallel, posteromedial and posterolateral) were considered. The mutual displacements of bone fragments as well as the deformity of the stabilizer under various loading conditions were analyzed. Results: In most cases, the parallel setting of the plates ensures a better stabilization of the bone fragments than the perpendicular configuration. The most difficult conditions of stabilization were obtained for the lateral bone fragment. The value of the fragments’ displacements significantly increases for loading directions occurring with ascending flexion angle of the joint. Conclusions: In most cases, the parallel setting of the plates ensures a better stabilization of the bone fragments than the perpendicular configuration.
Rocznik
Strony
153--163
Opis fizyczny
Bibliogr. 26 poz., rys., tab., wykr.
Twórcy
  • Faculty of Mechanical Engineering, Bialystok University of Technology, Białystok, Poland
  • Faculty of Mechanical Engineering, Bialystok University of Technology, Białystok, Poland
  • Department of Traumatology and Orthopaedics, Military Institute of Medicine, Warsaw, Poland
  • Department of Traumatology and Orthopaedics, Military Institute of Medicine, Warsaw, Poland
Bibliografia
  • [1] AMIR S., JANNIS S., DANIEL R., Distal humerus fractures: a review of current therapy concepts, Curr. Rev. Musculoskelet. Med., 2016, 9, 199–206.
  • [2] ARNANDER M.W., REEVES A., MACLEOD I.A. et al., A biomechanical comparison of plate configuration in distal humerus fractures, J. Orthop. Trauma, 2008, 22, 332–336.
  • [3] BLACK J., HASTINGS G., Titatium and titanium alloys, [in:] J. Black, G. Hastings (Eds.), Handbook of biomaterial properties, Chapman & Hall, 1998, 179–200.
  • [4] BOGATAJ M., KOSEL F., NORRIS R. et al., Biomechanical study of different plate configurations for distal humerus osteosynthesis, Med. Biol. Eng. Comput., 2015, 53, 381–392.
  • [5] CALIŞAL E., UĞUR L., Evaluation of the plate location used in clavicle fractures during shoulder abduction and flexion movements: a finite element analysis, Acta Bioeng. Biomech., 2018, 20 (4), 41–46.
  • [6] CLAVERT P., DUCROT G., SIRVEAUX F. et al., Outcomes of distal humerus fractures in patients above 65 years of age treated by plate fixation, Orthop. Traumatol. Surg. Res., 2013, 99, 771–777.
  • [7] DIEDERICHS G., ISSEVER A.S., GREINER S. et al., Three- -dimensional distribution of trabecular bone density and cortical thickness in the distal humerus, J. Shoulder Elb. Surg., 2009, 18, 399–407.
  • [8] GOT C., SHUCK J., BIERCEVICZ A. et al., Biomechanical comparision of parallel versus 90-90 plating of bicolumn distal humerus fractures with intra-articular comminution, J. Hand Surg., 2012, 37A, 2512–2518.
  • [9] GREIWE R.M., Distal humerus fractures: open reduction and internal fixation, [in:] M. Greiwe (1st Ed.), Shoulder and Elbow Trauma and its Complications, Vol. 2: The Elbow, Woodhead Publishing, 2016, 65–97.
  • [10] JUNG S.W., KANG S.H., JEONG M., LIM H.S., Triangular fixation technique for bicolumn restoration in treatment of distal humerus intercondylar fracture, Clin. Orthop. Surg., 2016, 8, 9–18.
  • [11] KINCAID B.L., AN K.-N., Elbow joint biomechanics for preclinical evaluation of total elbow prostheses, J. Biomech., 2013, 46, 2331–2341.
  • [12] KOONCE R.C., BALDINI T.H., MORGAN S.J., Are conventional reconstruction plates equivalent to precontoured locking plates for distal humerus fracture fixation? A biomechanics cadaver study, Clin. Biomech., 2012, 27, 697–701.
  • [13] KRUSZEWSKI A., PISZCZATOWSKI S., PIEKARCZYK P., KWIATKOWSKI K., Biomechanical evaluation of the stabilization used in the treatment of the distal humerus intra articular fractures, IFMBE Proc., 2015, 50, 75–78.
  • [14] KUDO T., HARA A., IWASE H., ICHIHARA S., NAGAO M., MARUYMA Y. et al., Biomechanical properties of orthogonal plate configuration versus parallel plate configuration using the same locking plate system for intra-articular distal humeral fractures under radial or ulnar column axial load, Injury, 2016, 47, 2071–2076.
  • [15] MACLEOD A.R., SIMPSON A.H., PANKAJ P., Age-Related Optimization of Screw Placement for Reduced Loosening Risk in Locked Plating, J. Orthop. Res., 2016, 34, 1856– 1864.
  • [16] MURRAY I.A., JOHNSON G.R., A study of the external forces and moments at the shoulder and elbow while performing everyday tasks, Clin. Biomech., 2004, 19, 586–594.
  • [17] O’DRISCOLL S.W., Optimizing stability in distal humeral fracture fixation, J. Shoulder Elb. Surg., 2005, 14 (1, Suppl. S), 186–194.
  • [18] PENZKOFER R., HUNGERER S., WIPF F. et al., Anatomical plate configuration affects mechanical performance in distal humerus fracture, Clin. Biomech., 2010, 25, 972–978.
  • [19] PUCHWEIN P., WILDBURGER R., ARCHAN S. et al., Outcome of type C (AO) distal humeral fractures: follow-up of 22 patients with bicolumnar plating osteosynthesis, J. Shoulder Elbow Surg., 2011, 20, 631–636.
  • [20] RHO J.Y., HOBATHO M.C., ASHMAN R.B., Relations of mechanical properties to density and CT numbers in human bone, Med. Eng. Phys., 1995, 17, 347–355.
  • [21] RUEDI T.P., BUCKLEY R., MORAN C.G., AO principle of Fracture management, Thieme, Stuttgart 2007.
  • [22] SCHWARTZ A., OKA R., ODELL T. et al., Biomechanical comparison of two different periarticular plating systems for stabilization of complex distal humerus fracture, Clin. Biomech., 2006, 21, 950–5.
  • [23] SHIN S.J., SOHN H.S., DO N.H., A clinical comparison of two different double plating methods for intraarticular distal humerus fracture, J. Shoulder Elb. Surg., 2010, 19, 2–9.
  • [24] SCHMIDT-HORLOHE K.H., BONK A., WILDE P. et al. Promising results after a treatment of simple and complex distal humerus type C fractures by angular-stable double-plate osteosynthesis, J. Orthop. Trauma, 2013, 99, 531–541.
  • [25] THEIVENDRAN K., DUGGAN P.J., DESHMUKH S.C., Surgical treatment of complex distal humeral fractures: Functional outcome after internal fixation using precontoured anatomic plates, J. Shoulder Elbow Surg., 2010, 19, 524– 532.
  • [26] ZALAVRAS C.G., VERCILLO M.T., BONG JAE J. et al., Biomechanical evaluation of parallel versus orthogonal plate fixation of intra-articular distal humerus fractures, J. Shoulder Elb. Surg., 2011, 20, 12–20.
Uwagi
Opracowanie rekordu ze środków MNiSW, umowa Nr 461252 w ramach programu "Społeczna odpowiedzialność nauki" - moduł: Popularyzacja nauki i promocja sportu (2020).
Typ dokumentu
Bibliografia
Identyfikator YADDA
bwmeta1.element.baztech-ae1da50b-4d9c-4282-97b5-94a9bc1508f7
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