Po wi kła nie zła ma nia ko ści udo wej sta bi li zo wa ne go gwoź dziem śród sz pi ko wym -nu me rycz na ana li za przy pad ku kli nicz ne go
STRESZ CZE NIECe lem pra cy by ła nu me rycz na ana li za przy pad ku zła ma nia ko ści udo wej sta bi li zo wa ne go gwoź dziem śród sz pi kowym i po twier dze nie wa run ków, któ re do pro wa dzi ły do wy kształ ce nia sta wu rze ko me go w miej scu zła ma nia.Ni sko ener ge tycz ne zła ma nie ko ści udo wej sta bi li zo wa no za po mo cą śród sz pi ko we go gwoź dzia krę ta rzo we go ChFN Sys tem z pi nem de ro ta cyj nym. Z wy ko rzy sta niem me to dy ele men tów skoń czo nych opra co wa ny zo stał układ kość -im plant, któ ry umo żli wił ob ser wa cję po la prze miesz czeń oraz od kształ ceń w re jo nie szcze li ny zła ma nia. Ob licze nia prze pro wa dzo no na 3 wa rian tach mo de lu, z gwoź dziem ty ta no wym (10 mm i 12 mm) oraz sta lo wym (10 mm). Ana li za roz kła du od kształ ceń wska za ła, że naj więk sze ich war to ści lo ka li zu ją się w szcze li nie zła ma nia i są wy ższe w przy pad ku za sto so wa nia im plan tu ze sto pu ty ta nu (0-17% vs 0-11%). Ru chy mię dzy odła mo we po wo do wa ne przyło żo nym ob cią że niem by ły ta kże wy ższe w przy pad ku za sto so wa niu im plan tu ze sto pu ty ta nu. Ana li za od kształ ceń wska za ła, że od se tek ele men tów w ob sza rze szcze li ny, po ten cjal nie zdol nych do two rze nia tkan ki kost nej jest wyższy w przy pad ku za sto so wa nia im plan tu sta lo we go.Mo żli we jest wska za nie miejsc, w któ rych zaj dzie nie ko rzyst na od bu do wa szcze li ny zła ma nia, co mo że do prowa dzić do po wsta nia sta wu rze ko me go. Za sto so wa nie im plan tu sta lo we go pod no si praw do po do bień stwo uzy ska nia sta bil ne go zro stu kost ne go.Słowa kluczowe: MeSH, hip frac tu res, pseu dar th ro sis, com pu ter si mu la tion
SUMMARYThe aim of this paper is to conduct a numerical analysis of a case of femoral fracture treated by intramedullary nailing and confirm the conditions which led to the formation of a pseudarthrosis at the fracture site.A low-energy femoral fracture was treated by placing a ChFN System intramedullary nail with a derotation pin. Using the finite element method, a bone-implant system was generated which made it possible to observe the dis placement area and strains in the region of the fracture gap. The calculations were conducted for 3 variants of the model, using a titanium nail (10 mm and 12 mm) and a steel one (10 mm). Analysis of strain distribution indicated that the highest strain values occur in the fracture gap and that they are higher when a titanium alloy is used (0-17% vs 0-11%). Interfragmentary movements caused by an imposed load were also higher when a titanium alloy implant was used. Strain analysis showed that the percentage of elements in the gap area which are potentially able to grow bone tissue is higher when a steel implant is used.It is possible to indicate sites where unfavourable fracture gap healing will take place, which may lead to the deve lopment of a pseud...
Introduction The treatment of femoral diaphyseal fractures by intramedullary nailing has become a common procedure in orthopaedic surgery. The purpose of this numerical simulation was to present how the changes in configuration of the stabilisation system can affect the stress and displacement state in the bone tissue and implanted device. Material and Methods The numerical comparison of the stabilisation variants for the type 32-A2 femoral diaphyseal fracture (according to the AO classification) performed by using the Charfix2 (ChM®) anatomical nail locked in a number of chosen ways. The displacement and the stress distributions both in the bone and implant were obtained and analysed by computational simulation. Results In all models, there was the same characteristic distribution, which shows there were minimal rotational movements of the bone around the anatomical axis. In all cases, stress concentrations were generated in the nail material in the area of the fracture gap. Conclusions The obtained results indicate that there is a visible advantage to one-plane distal stabilisation in the reduction of stresses regardless of the type of proximal stabilisation. The results of calculations indicate that the use of proximal stabilisation with a neck screw reduces the possibility of damage to the implant.
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