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Analiza porównawcza wybranych wariantów stabilizacji złamania kości ramiennej za pomocą gwoździa śródszpikowego

Słowiński Jakub J., Kęszycki Dawid, Kudłacik Konrad

Inżynier i Fizyk Medyczny

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2019

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Vol. 8, nr 2

141--144

PL

Złamanie kości ramiennej stanowi blisko 1,5% wszystkich złamań, ale ze względu na wiek zróżnicowana jest przyczyna powstawania urazu. Leczenie operacyjne, stosowane w bardziej rozległych i skomplikowanych urazach, polega na stabilizacji za pomocą implantów płytkowych bądź gwoździ śródszpikowych. W ramach przeprowadzonej analizy numerycznej stabilizacji złamania trzonu kości ramiennej porównano 4 metody zespolenia tytanowego gwoździa śródszpikowego z odłamami kostnymi. Wyniki przeprowadzonych symulacji wykazały, że w zakresie analizowanych danych, każdy z testowanych wariantów umożliwia uzyskanie zrostu kostnego. Maksymalne przemieszczenia międzyodłamowe mieściły się w zakresie 325-540 μm, co stanowi wartość korzystną dla procesów zrostu. Także wartości naprężeń odnotowanych dla poszczególnych modeli nie wskazały na przekroczenie doraźnych wartości na wytrzymałość. Uzyskane wyniki sugerują, że dla danego przypadku każdy z wariantów stabilizacji pozwoli na uzyskanie pozytywnych efektów leczenia.

EN

Fractures of the humerus constitute nearly 1.5% of all fractures, but due to age, the cause of the injury varies. The surgical treatment, used in more extensive and complicated injuries, consists in stabilization with the help of plate implants or intramedullary nails. As part of the numerical analysis of the stabilization of the humerus fracture, 4 methods of the intramedullary nail fixation were compared. The results of the conducted simulations showed that in the range of the analyzed data, each of the tested variants allows for bone union. Maximal interfragmentary movement was in the range of 325-540 μm, which is a favorable value for bone union processes. Also the stresses recorded for individual models did not exceeded the strength of used materials. The obtained results suggest that each of the stabilization variants will allow to obtain positive treatment effects.

2

Fixation of distal fibular fractures: A biomechanical study of plate fixation techniques

Marvan J., Horak Z., Vilimek M., Horny L., Kachlik D., Baca W.

Acta of Bioengineering and Biomechanics

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2017

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Vol. 19, no. 1

33--39

EN

Ankle fractures are complex injuries with variable prognoses that depend upon many factors. The aim of the treatment is to restore the ankle joint biomechanical stability with maximum range of motion. Most ankle fractures are fibular fractures, which have a typical oblique fracture line in the distal fibula located in the area of the tibiofibular syndesmosis. The aim of this study was to simulate numerically several fixation techniques of the distal fibular fractures, evaluate their stability, determine their impact on surrounding tissue load, and correlate the results to clinical treatment experience. The following three models of fibular fracture fixation were used: (a) plate fixation with three screws attached above/below and lag screws, (b) plate fixation with two screws attached above/below and lag screws, and (c) three lag screws only. All three fracture fixation models were analyzed according to their use in both healthy physiological bone and osteoporotic bone tissue. Based on the results of Finite Element Analysis for these simulations, we found that the most appropriate fixation method for Weber-B1 fibular fractures was an unlocked plate fixation using six screws and lag screws, both in patients with physiological and osteoporotic bone tissue. Conversely, the least appropriate fixation method was an unlocked plate fixation with four screws and lag screws. Although this fixation method reduces the stress on patients during surgery, it greatly increased loading on the bone and, thus, the risk of fixation failure. The final fixation model with three lag screws only was found to be appropriate only for very limited indications.

3

An alternative approach for the interpretation of data from three-point bending of long bones

Kourkoulis S. K., Kouvaka A., Andriakopoulou C., Dontas I.

Engineering Transactions

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2016

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Vol. 64, iss. 4

401--407

EN

An alternative approach for elaborating the raw data obtained from three-point bending tests of long bones of Wistar rats is described. The aim of the study is to provide mechanical properties of the bone tissue which are independent of the bone geometric characteristics. The study is carried out experimentally ex vivo. It is indicated that ignoring the actual shape of the bone’s critical cross-section (i.e., the section where fracture occurs) and the inclination of the loading axis with respect to the principal centroidal axes of the critical section, may lead to erroneous results concerning the strength of the tissue.

4

Opis przypadku pacjentki leczonej w centrum hiperbarii tlenowej i leczenia ran w Bydgoszczy

Zieliński E., Lipińska A., Grobelska K., Siermontowski P.

Polish Hyperbaric Research

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2015

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nr 1(50)

25--30

EN

This article presents a description of a case of a patient diagnosed with complicated inflammation of the tibia bone, who was treated hyperbarically, in order to underline the advantages of this method of treatment used not as an alternative to antibiotics and surgery, but as a supportive method.

PL

W niniejszym opracowaniu przedstawiamy opis przypadku pacjentki z rozpoznanym powikłanym zapaleniem kości piszczeli, leczony hiperbarycznie, podkreślając korzyści tej metody leczenia stosowanej nie jako alternatywy do leczenia chirurgicznego i antybiotykoterapii ale jako metody wspomagającej.

5

An alternative method in fixation of tibial transverse fractures by intramedullar nailing : Biomechanical and histopathologic investigation

Aksakal B., Varis O., Say Y., Kom M., Yilmaz E.

Acta of Bioengineering and Biomechanics

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2013

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Vol. 15, no. 2

81--90

EN

A new method was used in fixation of tibial bone fractures. Intramadular nailing (IMN) has been used into mid-diaphysis on left tibias of New Zeland rabbits (n = 5) via an in vivo work. To enable fixation of fracture, without causing too much screw damage on bone and avoiding malunion, nano- and micro-scale hydroxyapatite (HA) was coated at two ends (25 mm in length) of intramadular nails before implantation. After six weeks of survival period and sacrifizing, biomechanical tests and histopathologic examinations were executed. Such experiments have revealed that good stabilization and hence better fracture union for both treated IMN groups (NHA and MHA) over the standard IMN’. Pull-out tests showed the tensile strengths obtained to be significantly higher for the nano (NHA) and micro scale-MHA coated IMN compared to the uncoated standard IM nailing.

6

Analiza wytrzymałościowa MES stabilizacji kości piszczeli metodą ZESPOL z uwzględnieniem własności ortotropowych kości

Kozub B., Matuszyk Ł., Łagan S.

Aktualne Problemy Biomechaniki

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2011

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z. 5

63--68

PL

W niniejszej pracy poruszono problem stabilizacji ukośnie złamanej kości piszczelowej przy wykorzystaniu systemu ZESPOL. W celu zaprezentowania rozkładu naprężeń oraz odkształceń wykonano, przy zastosowaniu metody elementów skończonych model układu stabilizator-kość, który został poddany numerycznej wytrzymałościowej analizie. W modelu została uwzględniona struktura kości zbitej jak i trabekularnej, przy zachowaniu własności ortotropowych. Analizę wytrzymałościową wykonano zarówno dla kości zdrowej jak i osteoporotycznej.

EN

The present work deals with the problem of stabilization of fractured tibia with application of ZESPOL system. In order to present the stress and deformation distribution, a model of the stabilizer-bone system was performed using the finite element method. The model has been subjected to strength analysis. The structure of compact and trabecular bone was incorporated into the model while retaining orthotropic properties. Strength analysis was performed for both the healthy and osteoporotic bone.

7

Analiza sprężysto - plastyczna układów biomechanicznych

John A., Wysota P.

Aktualne Problemy Biomechaniki

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2007

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z. 1

83--88

PL

W pracy przeprowadzono analizę wytrzymałościową liniowo sprężystą i sprężysto-plastyczną i porównano wyniki w przypadku dwóch układów biomechanicznych: połączenia odłamów kostnych kości udowej stabilizatorem płytkowym Polfix oraz połączenia kręgów szyjnych kręgosłupa stabilizatorem D-Fun-M. Zbadano wpływ obciążenia układów, materiałów przyjętych na implanty oraz typu rozpatrywanego zagadnienia na wielkości charakteryzujące stan wewnętrzny ośrodka (naprężenia, odkształcenia). Jest to istotne w przypadku dużych obciążeń (lub przeciążenia) układu.

EN

The subject of the paper concerns strength analysis of two biomechanical structures: the joint of the femur bone and the plate stabilizer Polfix and the joint of cervical vertebras of spine by the stabilizer D-Fun-M. Reactions in these objects are investigated. In order to achieve the results, the models of the structures is prepared and computed with finite element method. On the base of the numerical models the elastoplastic analysis of the structures was performed. The attention is concentrated on the investigation of the interdependence between.

8

Concept of bone fracture healing measure used load measuring in external fixators

Jasińska-Choromańska D.

Zeszyty Naukowe Katedry Mechaniki Stosowanej / Politechnika Śląska

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2006

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z. 26

149-154

EN

The measurement of osteogenesis gives the possibility to more precise diagnostics of the fractures, and can be also applied to the computer techniques like e.g. artificial intelligence. The treatment of long bone fractures by external fixators affords an unique opportunity to control the healing of the fracture by measuring the tension on the frame, that occurs under the load given to the bone and rely on the mechanical properties of the fracture. The paper presents some information about one of the diagnosis method using to the bone fracture healing.

9

Structure and operation of skeletal apparatus of authors own design for the repair of zygato-orbical fractures

Pelc R., Cieślik T., Habelak M., Adwent M.

Acta of Bioengineering and Biomechanics

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2003

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Vol. 5, nr 2

101-106

EN

Zygomatico-orbital fractures are a frequent sequel to trauma of the facial skeleton. The treatment of these fractures is various, depending on their clinical and radiological pictures. The authors describe these methods of positioning and immobilization of zygomatico-orbital fractures that have been used for years. In ihis context, the Jankowski's frame and its subscquent modifications should be mentioned. The paper presents the project and operation patterns of a framework device being designed by authors and used in reposition and fixation of zygomatico-orbilal fractures. This device was successfully used in ihe treatment of 70 patients.

10

Treatment ways after the fracture of upper part of femur in the aspect of early patient's function

Konieczny G., Wrzosek Z.

Acta of Bioengineering and Biomechanics

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2002

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Vol. 4, nr 2

81-89

EN

Proximal femoral fractures occur most often in people over 60 (mainly women), that is, people whose physical fitness is already somehow limited. That is why proper choice of therapeutic management (conservative therapy or surgical procedure) is so crucial. As conservative therapy is connected with long-term hypokinesis, management of surgical procedure seems to be justified - it mobilises the patient early. We analysed 24 cases of patients with fracture of proximal part of femur treated in 4 four different ways. The first two groups comprised patients with fracture of the neck of the femur. Some of them were treated by implantation of endoprosthesis (group I), others by functional therapy (group II). The next two groups comprised patients with trochanteric fracture. Some of these patients were treated using DHS system (group III) and others with the aid of tractor (group IV). Analysis of the above groups concerns movement and functional possibilities of the patients from the beginning of rehabilitation process to the second week of its realisation.

11

Distraction osteogenesis and fracture healing : differences and similarities

Kuryszko J., Kuropka P., Jedrzejowska I.

Acta of Bioengineering and Biomechanics

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2000

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Vol. 2, nr 2

83-88

EN

In experimental research dealing with repair osteogenesis different aspects of its course are stressed. The osteotomy type influences osteoinduction and development of blood vessels, whereas biomechanical features of bone tissue are obtained by proper stabilisation of newly formed callus. Different directions of callus evolution create their final morphology. In this paper, similarities and differences in regenerate and callus morphology are compared in detail.