Опубликовать статью

Информационное партнерство

Инфоресурсы

Контакты

«

Vol. 20, Art. 31 (pp. 373-384)    |    2019       

»

Mathematical background of transosseus osteosynthesis with short wires with open-ended exterior supports

Kashansky Y.B., Kondratiev I.P., Kucheev I.O., Polikarpov A.V., Savkin N.M.

SPB I. I. Dzhanelidze Research Institute of Emergence Medicine

Brief summary

In recent years, there are more and more followers of the implementation of minimally invasive treatment methods in medicine. A similar trend is observed in the modern traumatology. Besides that, the financial component of administering of first aid to the injured is not the least in medicine. In this respect, it is of material interest to apply various systems and devices for fixing fractures using short divergent wires fixed in the open-ended exterior supports. The study of this issue in the literature was given not the attention requisite. We have attempted to bridge this gap. The presented work provides the scientific basis for the implementation of this type of osteosynthesis. It is provided its mathematical background. The optimal angles and planes of introduction of the wires has been determined. It is shown the dependence of the bone - construction joint strength on their size and introduction form. To study the strength characteristics and clinical usage potential for osteosynthesis of the wire systems with an open-ended exterior supports. Two alternative constructions were brought under study: 1. Single and parallel arrangement of wires (rods). 2. The beam arrangement of wires (rods). In addition, a comparison was made of alternative constructions in terms of their functional advantages. The comparison was made under the same working conditions as applied to the position of the mechanics of a deformable solid. To study the maximum rigidity of the system and its maximum strength, mathematical calculations were carried out using well-known formulas for their determination. The data obtained allowed us to conclude that single and parallel systems are more pliable than beam systems. The angle between them should not be less than 6 ?. In this case, the displacement of the nodal point in the system even from two spokes with an angle of 20 ? is almost two times less than that of a rod with a diameter of 5 mm. In addition, with an increase in the number of spokes and planes formed by them, the strength of the system increases.


Key words

traumatology, minimally invasive osteosynthesis, K-wires, mathematical background for osteosynthesis.

Reference list

1. Ponomarev S.D., Biderman V.L., Liharev K.K., Fedosev V.I. Rascheti na prochnost v mashinostroenii. - T.1-3. - M.: Mashgiz, 1956-1959. - 884 s.; 974 s.; 1118 s.


2. Glazer R. Ocherk osnov biomehaniki / Pod redakciei S.A. Regirera. - M.: Mir, 1988. - 128 s.


3. Alffram P.A. Epidemiology of fractures of the forearm. A biomechanical investigation of bone strength / P.A.Alffram, G.C.Bauer // J. Bone Joint Surg. Amer. - 1962. - Vol. 44, suppl. A. - P. A105-A114.


4. Athar S.M. Is external fixation a better way than plaster to supplement K-wires in non-comminuted distal radius fractures? / S.M.Athar, N.Ashwood, G.Aerealis, G.I.Bain // Postgrad. Med. J. - 2018. - N 94 (1107). - P. 20-24.


5. Obert L. Anatomy and biomechanics of distal radius fractures: A literature review / L.Obert, J.Uhring, P.B.Rey et al. // Chir Main. - 2012. - Vol. 31, N 6. - P. 287-297.


6. Handoll H.H. Different methods of external fixation for treating distal radial fractures in adults / H.H.Handoll, J.S.Huntley, R.Madhok // Cochrane Database Syst. Rev. - 2008. - N 1. - Art. CD006522.


7. Mah E.T. Percutaneous Kirschner wire stabilisation following closed reduction of Colles' fractures / E.T.Mah, R.N.Atkinson // J. Hand Surg. Br. - 1992. - Vol. 17, N 1. - P. 55-62.


8. Buchanan D. Which Are the Most Relevant Questions in the Assessment of Outcome after Distal Radial Fractures? / D.Buchanan, D.Prothero, J.Field // Adv. Orthop. - 2015. - Vol. 2015. - Art. ID 460589. - 6 p.


9. Htrnigou P. History of external fixation for treatment of fractures / P.Hernigou // Int.Orthop. - 2017. - Vol. 41, N 4. - P. 845-853.


10. Landgren M. Distal radius fractures: Outcome and new methods of surgical treatment: Doctoral dissertation. - Bergen, 2017. - 77 p.


11. Ma C. External fixation is more suitable for intra-articular fractures of the distal radius in elderly patients / C.Ma, Q.Deng, H.Pu et al. // Bone Res. - 2016. - Vol. 4. - Art. 16017.


12. Micic I. The role of additional k-wires on AO type C distal radius fracture treatment with external fixator in young population / I.Micic, E.Kholinne, Y.Sun et al. // Adv. Orthop. - 2019. - Vol. 2019. - Art. 8273018.


13. Sadighi A. Outcomes of Percutaneous pinning in treatment of distal radious fractures / A.Sadighi, M.Bazavar, A.Moradi,B.Eftekharsadat// Pakistan J. Biol.Sci. - 2010. - Vol. 13, N 14. - P. 706-710.


14. Saving J. External fixation versus volar locking plate for unstable dorsally displaced distal radius fractures-a 3-year follow-up of a randomized controlled study / J.Saving, A.Enocson, S.Ponzer et al. // J. Hand Surg. Am. - 2019. -Vol. 44, N 1. - P. 18-26.


15. Wang D. Locking plate versus external fixation for type C distal radius fractures: A meta-analysis of randomized controlled trials / D.Wang, L.Shan, J.L.Zhou // Chin. J. Traumatol. - 2018. -Vol. 21, N 2. - P. 113-117.