The paper presents an analysis of the distribution of dislocations in the case of fixation of a mandible low subcondylar fracture. Three types of elements have been used for fixation: NiTi shape-memory staples, miniaturized titanium plates and the Synthes compression plate, also called the Synthes zygomatic plate. The analysis was conducted using the finite element method. The degree of the mobility of the fractures was analysed as well as the tendency towards their separation on the basis of value analysis and the distribution of dislocation areas. The results obtained allowed a preliminary assessment of predicted healing effects and the possibility of being able to predict developing complications after osteosynthesis with the use of the elements analysed.
W pracy przedstawiono badania mechaniczne spawanych, nadsprężystych drutów NiTi, z których wykonano okrągłe sprężyny użyte w eksperymentalnym leczeniu ścieśnienia czaszki u dzieci. Druty w temperaturze pokojowej mają strukturę fazy macierzystej B2. Na krzywych DSC spoin laserowych i po zgrzewaniu oporowym pojawiły się dodatkowe efekty cieplne świadczące o zmianach struktury pod wpływem procesu spawania. W próbach rozciągania wykazano słabszą wytrzymałość na zerwanie drutów spawanych laserowo na zakładkę i drutów zgrzewanych doczołowo na zgrzewarce zwarciowej w porównaniu z drutami nie spawanymi. Wielokrotne uginanie do kształtu elipsy pierścieni spawanych laserowo nie powodowało wyraźnych zmian własności sprężystych i uszkodzeń spawów.
EN
The article presents mechanical experiments on superelastic NiTi welded wires out of which round springs used in experimental treatment of craniostenosis in children were made. XRD analysis proved that the wires in room temperature had the structure of B2 parent phase. On DSC curves of laser welds and after resistance welding additional thermal effects showing structural changes of the structure under the influence of the process of welding appeared. Tensile tests showed smaller tensile strength of laser overlap welded wires and butt welded wires on a short-circuit welder in comparison with samples of non-welded wires. Multiple bending of laser-welded rings to the shape of an ellipse did not result in the clear changes of elastic properties and damages of welds.
Podstawowym założeniem było osiągnięcie ciągłej, stałej siły w szerokim zakresie deformacji nasprężystych pierścieni użytych w korekcji czaszkowej. Nasprężyste własności pierścieni uzyskano w procesie starzenia uprzednio ukształtowanych pierścieni, które powoduje znaczące umocnienie, jako rezultat wydzielania koherentnych cząstek Ni4Ti3.
EN
The basic assumption was to achieve a continuous and constant force in a wide range of deformations superelastic rings used for cranial correction. Superelastic properties of the rings were induced in the process of ageing of the already formed rings which causes significant hardening as a result of the precipitation of coherent Ni4Ti3 particles.
Opracowano proces indukowania własności nadsprężystych pierścieni i sprężyn do klinicznego modelowania czaszki u dzieci z kraniostenozą. Zdolność do nadsprężystego odkształcania pierścieni uzyskano na drodze starzenia ukształtowanych pierścieni wywołującego istotne umocnienie wskutek wydzielania koherentnych cząstek Ni4Ti3. Charakterystyka odkształcania pierścienia do elipsy i powrót do stanu początkowego wykazuje, że zachodzi ono przy stałej sile.
EN
The process of induction the superelastic properties of rings and springs for clinical modeling of the skull in children with craniostenosis has been worked out. Superelastic properties of the rings were induced in the process of ageing of the already formed rings that caused significant hardering as a result of the precipitation/liberation of coherent Ni4Ti3 particles. The deformation of the ring to its elliptic shape and the release of this deformation proceed at constant force.
The article presents studies of the superelastic NiTi and shape memory TiNiCo devices for the experimental distraction of mandibular bones in young pigs. The new method of gradual bone lengthening has two variants. In the first one distraction devices make use of two U-shaped NiTi superelastic springs that are extend, with constant force, the corpus of the mandible enfeebled by the decortication. The other variant uses double Ω-shaped springs that use the shape memory effect during gradual heating by the electric current in the temperature range 40-55°C drawing the bone fragments after osteotomy. On the basis of the X-ray phase analysis and the DSC analysis the wires which after special treatment show superelasticity in ambient temperature and shape memory in the desirable temperature range of about 40 to 55°C were chosen. Prototypes of the distractors were fabricated, suitable shapes and dimensions were selected, and different ways to fix them to the bones were tested on the models. Forces of the superelastic arches generated during stretching and unloading and distraction forces of the shape memory distractors generated during the process to regain the shape while being heated by the electric current were measured. In animal experiments the operations were performed on two pigs where NiTi superelastic distraction devices and TiNiCo shape memory distractors were used and placed subcutaneously, immediately on the bone under the periosteum. As a result of animal experiments about 10 mm lengthening of the pig mandible was obtained with the use of superelastic distraction devices.
The method of objective assessment of the correctness mandible bones fracture slit was proposed in the research. At present, treatment results are evaluated by comparing pantomographic pictures made before and after integration. It is not an objective method; the estimation of the integration correctness coefficient is not possible, either. The use of computer processing enables introducing the relative mandible faction dislocation coefficient. Thanks to this, measurable determination of bone faction reposition correctness on pantomograms made after osteosynthesis is possible.
At present, in mandibular fractures surgical treatment reposition and titanium miniplates osteosynthesis is the most common method used. The treatment results are assessed on the basis of comparative analysis of two radiograms taken before and after fixations of fractures. In this article the objective method of radiological assessment of osteosynthesis is presented. The crucial part of the method is the computer program which was created at The Institute of Computer Biomedical Systems, Silesian University in Katowice. Comparison of placement of bone fragments on a pair of pantomograms taken before and after a particular surgical operation was done. To make the process of the results evaluation an objective one a new parameter - the relative dislocation coefficient - was implemented. Achieved results enable to assess correctness of bone fracture reposition on the pantomographical pictures taken twice, once before and the next time after osteosynthesis.
The authors report on the application of the NiTi and TiNiCo shape memory clamps for the connection of bone fracture in 81 patients suffering from mandible fractures. They have also made an attempt of work out a new, so far not used, method of gradual bone lengthening which uses NiTi superelastic distraction devices. So far to operations have been performed on two pigs where the U-shaped NiTi superelastic distraction devices where used and placed immediately on the bone above the periosteum. Too few attempts are not enough to allow for an objective evaluation of the proposed method of bone lengthening.
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