Biomechanical Effects of Four Different Configurations In Salter Harris Type 4 Distal Femoral Epiphyseal Fractures

Yıl 2020, Cilt: 23 Sayı: 1, 151 - 159, 01.03.2020

Kadir Gök , Sermet İnal Arif Gök

https://doi.org/10.2339/politeknik.474787

Öz

Bu çalışmada, distal femurun Salter Harris (SH) Tip 4 epifiz kırığında
redüksiyon sonrası stabilizasyon için kullanılan Parallel K-wires, Parallel Screw, Upper K-wire-Lower
Screw, Upper Screw-Lower K-wire olmak üzere 4 farklı
konfigürasyonun, aksiyel, rotasyonel ve eğme kuvvetleri altında,  biyomekanik etkilerini tanımlayıp hangisinin
daha avantajlı olduğu araştırıldı. 4 farklı konfigürasyon SolidWorks programı
ile modellendi ve bilgisayar destekli sayısal analizler sonlu elemanlar
yazılımı ile gerçekleştirildi. Herbir konfigürasyon için, ağ süreci, sınır
şartları ve malzeme modeli sonlu elemanlar yazılımında uygulandı. Buna ek
olarak, epifiz plağının gelişimindeki von-Mises gerilme değerleri, vidalar ve K-tellerindeki gerilme değerleri
hesaplanmıştır. Frontal,
sagittal ve transvers düzlemde bükme (varus-valgus açılımı, ön-arka açısal
kapanma) ve burulma kuvvetleri altındaki fizis çizgi üzerinde tüm
konfigürasyonlarda gerilme değerlerinde genel olarak yakın bir eğilim vardır. Eksenel
kuvvetler düşünüldüğünde, en yüksek gerilme, fisizte paralel K-telleri
konfigürasyonunda bulunurken, en düşük gerilme paralel vida konfigürasyonunda
bulundu. Paralel vida konfigürasyonunda fiksasyon
tipinin kullanılması avantajlı bulunmuştur. Ek olarak, SH tipi 4 epifiz kırıklarında,
K-teli konfigürasyonunda fiksasyon tipi dezavantajlı bulunmuştur.

Anahtar Kelimeler

Biomechanics, Salter Harris Type 4, Kirschner wire, finite element analysis

Biomechanical Effects of Four Different Configurations In Salter Harris Type 4 Distal Femoral Epiphyseal Fractures

Öz

In this study, the
biomechanicaleffects of four different configurations (Parallel K wires,
Parallel Screw, Upper K wire-Lower Screw, Upper Screw-Lower K wire), which are
used for stabilizing Salter-Harris (SH) Type 4 epiphyseal fracture of distal
femur after reduction process, on the epiphyseal plate has been investigated
under axial, rotational and bendingforces in order to determine the most
advantageous configuration. The fourdifferent configurations have been modeled
by using SolidWorks and computer-aided numerical analyses were performed by
finite element analysis software. The mesh process, boundary conditions and
material model have been applied in finite element analysis software for each
configuration. In addition, von-Mises stress values on epiphyseal plate, screws
and K wires have been calculated. There is a general near trend on stress
values in all configurations on physis line under bending (varus-valgus
angulation, anterior-posterior angulation) and torsional forces in the frontal,
sagittal and transverse plane respectively. Considering the axial forces, the
highest stress was found on parallel K- wires configuration in physis while the
lowest stress was found in parallel screw configuration. It has been found
particularly advantageous to use fixation type in parallel screw configuration.
In addition, in SH type 4 epiphyseal fracture, fixation type is found to be
disadvantageous in K wire configuration.

Anahtar Kelimeler

Biomechanics, Salter Harris Type 4, Kirschner wire, finite element analysis, epiphyseal plate

Kaynakça

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