Determining the Tightrope Tightening Force for Effective Fixation of the Tibiofibular Syndesmosis during Osteomeatal Synthesis of Fibula Injuries

Abstract

The issue of choosing the method for optimal surgical treatment of a broken fibula has been debatable for many years. At the same time, concomitant repair of tibiofibular syndesmosis injuries does not have a unified approach. It has been determined that osteosynthesis of broken shin bones with syndesmosis injury should combine stable fixation of the broken bone and should not limit the elastic properties of the syndesmosis. In case of a broken fibula, it is recommended to use a stable extracortical fixator and an elastic connection of the syndesmosis injury using a tightrope. An analytical model of the broken fibula, which is blocked with an extracortical fixator metal plate and elastically fixed with a tightrope, has been developed. The research object is the stress–strain state of the “broken fibula–extracortical titanium plate” composition under the action of tightrope tightening fixation. The main research result is an analytical dependence, which makes it possible to determine the permissible value of the tightrope tightening force for elastic fixation of the tibiofibular syndesmosis. The research results have been tested numerically, and the influence of the parameters of plate, bone and damage localization on the permissible value of the tightrope tightening force has been analyzed. By using the rational tightrope tightening force with stable–elastic fixation of the broken shin, it is possible to reduce the time before the start of loading on the injured extremity and accelerate the functional recovery of the patient.

Optimization of Technological Parameters of the Process of Forming Therapeutic Biopolymer Nanofilled Films

“…The coefficients of the approximating polynomial (6) and their variances were calculated according to known formulas. The significance of the regression coefficients was assessed by the Student's test.…”

“…Statistically insignificant coefficients were rejected. After that, the significant coefficients of the second-order regression equations were substituted into the formula (6).…”

“…Polymer nanomaterials, films, and coatings are widely used in various industries, including pharmaceuticals and medicine. Polymer tapes and films are used in equipment construction as working elements [ 1 , 2 ], to ensure the tightness of threaded joints during the life cycle of the product [ 3 , 4 ], for elastic fixation of broken bones during surgery on human limbs [ 5 , 6 ], for filtering liquids and gases [ 7 , 8 ], for aqueous nanostructures containing antimicrobials of natural origin have been developed to inactivate SARS-CoV-2 surrogates on surfaces [ 9 ], for wound healing [ 10 , 11 , 12 ] and dentistry [ 13 , 14 , 15 ].…”