Investigation of the stress-strain state of the tibia model with a fracture of the middle third of the tibia in different variants of osteosynthesis under conditions of increasing compressive load on the implant-bone system

Authors

  • M.Yu. Stroiev Kharkiv National Medical University, Kharkiv, Ukraine
  • M.I. Berezka Kharkiv National Medical University, Kharkiv, Ukraine
  • V.V. Grigoruk Kharkiv National Medical University, Kharkiv, Ukraine
  • M.Yu. Karpinsky Sytenko Institute of the Spine and Joints Pathology of NAMS of Ukraine, Kharkiv, Ukraine
  • О.V. Yaresko Kharkiv National Medical University, Kharkiv, Ukraine

DOI:

https://doi.org/10.22141/1608-1706.1.23.2022.878

Keywords:

osteosynthesis, tibia, middle third, weight

Abstract

Background. In the general structure of injuries, fractures of the bones of the lower extremities account for 47.3 %. Of these fractures, in the first place are the diaphyseal fractures of the shin bones, accounting for 45–56 %. The course of the fusion process has certain features in a third of cases, which are associated with excess weight. The purpose was to carry out a comparative analysis of the stress-strain state of the models of the tibia with a fracture of the tibia under the influence of a compressive load with different variants of osteosynthesis and depending on the patient’s weight. Materials and methods. A basic finite element model of the tibia was developed, which contained the tibia, fibula, and foot bones. In all joints, an interlayer was made between the bone elements with the mechanical properties of cartilage tissue. A fracture in the middle third of the tibia and three types of osteosynthesis were simulated using an external fixation apparatus, extramedullary plate, and intramedullary nail. All models were tested under the influence of vertical compressive loads of 700 and 1200 N. Results. Changes in tissue stress values depending on the patient’s weight have a linear relationship. An external fixation device and an intramedullary nail provide a decrease in the stress values in the fracture zone below the level of indices for an intact bone. The extracorporeal plate shows significantly worse indicators of the level of stress, both in the fracture zone and in the proximal tibia. In the distal region, the highest stress level is determined in the model with osteosynthesis with an external fixation device. In metal structures, the greatest stresses arise in the extramedullary plate. Around the fixing screws and rods, the highest stresses are determined when the apparatus is used on the lower rod. Conclusions. The worst indicators of the stress level in the fracture zone (from 26.5 to 45.4 MPa) and in the metal structure (from 227.5 to 389.9 MPa) were determined using an extra-bone plate, which is a consequence of the appearance of an additional bending moment as a result of its one-sided arrangement. Osteosynthesis using an external fixation device provides a fairly low level of stress (from 0.7 to 1.2 MPa) in the fracture zone, but the disadvantage is a high level of stress on the device itself (from 133.7 to 229.2 MPa) and in the remote department tibia (from 13.2 to 22.6 MPa), which is associated with the length of the levers, which are the fixing rods. The lowest stress indices in all elements of the model are determined when using osteosynthesis with an intramedullary nail, which is due to the central location of the main support along the load axis and short levers, which are fixing screws. The function of the dependence of the magnitude of stresses in the elements of the model is linear and directly proportional.

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References

Березовский В.А., Колотилов Н.Н. Биофизические характеристики тканей человека: Справочник. К.: Наукова думка, 1990. 224 с.

Стойко И.В., Бец Г.В., Бец И.Г., Карпинский М.Ю. Анализ напряженно-деформированного состояния дистального отдела голени и стопы при повреждениях pilon в условиях наружной фиксации при помощи стержневых аппаратов. Травма. 2014. Т. 15. № 1. С. 41-49. DOI: 10.22141/1608-1706.1.15.2014.81263.

Корж М.О., Романенко К.К., Прозоровський Д.В., Карпінський М.Ю., Яресько О.В. Математичне моделювання впливу деформації кісток гомілки на навантаження суглобів нижньої кінцівки. Травма. 2016. Т. 17. № 3. С. 23-24.

Васюк В.Л., Коваль О.А., Карпінський М.Ю., Яресько О.В. Математичне моделювання варіантів остеосинтезу переломів дистального метаепіфіза великогомілкової кістки типу С1. Травма. 2019. Т. 20. № 1. С. 37-46. DOI: 10.22141/1608-1706.1.20.2019.158666.

Gere J.M., Timoshenko S.P. Mechanics of Material. 1997. P. 912.

Зенкевич О.К. Метод конечных элементов в технике. М.: Мир, 1978. 519 с.

Алямовский А.А. SolidWorks/COSMOSWorks. Инженерный анализ методом конечных элементов. М.: ДМК Пресс, 2004. 432 с.

Гайко Г.В., Калашников А.В., Боер В.А. и др. Диафизарные переломы в структуре травматизма населения Украины. Тези доповідей XIV з’їзду ортопедів-травматологів України. Одеса, 2016. С. 9-10.

Березка М.І., Григорук В.В., Строєв М.Ю. Проблема надмірної ваги при лікуванні пацієнтів із переломами кісток гомілки. Міжнародний медичний журнал. 2021. № 2. С. 43-46.

Kinder F., Giannoudis P.V., Boddice T., Howard A. The Effect of an Abnormal BMI on Orthopaedic Trauma Patients: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2020. 9(5). 1302. https://doi.org/10.3390/jcm9051302

Parratte S., Pesenti S., Argenson J.N. Obesity in orthopedics and trauma surgery. Orthopaedics & traumatology, surgery & research: OTSR. 2014. 100(1 Suppl.). S91-S97. https://doi.org/10.1016/j.otsr.2013.11.003

Білінський П.І. Малоконтактний багатоплощинний остеосинтез діафізарних переломів кісток гомілки. Шпитальна хірургія. Журнал імені Л.Я. Ковальчука. 2015. № 3. С. 54-58.

Published

2022-05-16

How to Cite

Stroiev, M., Berezka, M., Grigoruk, V., Karpinsky, M., & Yaresko О. (2022). Investigation of the stress-strain state of the tibia model with a fracture of the middle third of the tibia in different variants of osteosynthesis under conditions of increasing compressive load on the implant-bone system. TRAUMA, 23(1), 19–29. https://doi.org/10.22141/1608-1706.1.23.2022.878

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Original Researches

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