{"title":"不同空间配置的外固定器在粉碎性骺端骨折损伤控制手术中的比较研究","authors":"Yousof Mohandes, Mohammad Tahami, Amir R. Askari","doi":"10.1007/s40997-024-00777-8","DOIUrl":null,"url":null,"abstract":"<p>Fractures in the lower extremities are sometimes accompanied by severe damage, so definitive treatments with extensive surgical exposure are impractical. Extensive traumatization and swelling of surrounding tissue often dictate the use of external fixators as a temporary treatment for immediate stabilization of compound fractures. External fixation offers a variety of possible spatial configurations. Adequate fracture stabilization demands a good understanding of the stiffness, strength, sustainability, and tilting of external fixators of different frames. An improper frame can result in nonunion, malunion, delayed healing, and bone re-fracture, some of which are indications for revision surgery. This study employs a numerical approach to assess the stiffness, stress distribution, pin loosening, and interfragmentary displacement in different configurations of external fixators applied to a comminuted fracture in the diaphyseal region of the tibia. Unilateral fixators with single and double rods, bilateral, biplanar, and triangular frames with and without end cross-links are different configurations examined in-silico. Results show that the triangular frame with cross-links exhibits the stiffest, strongest, and most sustainable construct in axial, bending, and torsion modes. Except for the torsion mode, adding the end cross-links does little to increase the stiffness and strength of biplanar and triangular frames. Moreover, doubling the rod considerably improves construct stiffness and strength under axial compression load while appearing to be less superior in torsional stiffness and pin loosening. Furthermore, the bilateral frame demonstrates the most uniform displacement across the fracture gap. The results of this study could be used for preoperative planning of diaphyseal fracture management with external fixators.</p>","PeriodicalId":49063,"journal":{"name":"Iranian Journal of Science and Technology-Transactions of Mechanical Engineering","volume":null,"pages":null},"PeriodicalIF":1.5000,"publicationDate":"2024-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Comparative Study of External Fixators With Different Spatial Configurations in the Damage Control Surgery of Comminuted Diaphyseal Fracture\",\"authors\":\"Yousof Mohandes, Mohammad Tahami, Amir R. Askari\",\"doi\":\"10.1007/s40997-024-00777-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p>Fractures in the lower extremities are sometimes accompanied by severe damage, so definitive treatments with extensive surgical exposure are impractical. Extensive traumatization and swelling of surrounding tissue often dictate the use of external fixators as a temporary treatment for immediate stabilization of compound fractures. External fixation offers a variety of possible spatial configurations. Adequate fracture stabilization demands a good understanding of the stiffness, strength, sustainability, and tilting of external fixators of different frames. An improper frame can result in nonunion, malunion, delayed healing, and bone re-fracture, some of which are indications for revision surgery. This study employs a numerical approach to assess the stiffness, stress distribution, pin loosening, and interfragmentary displacement in different configurations of external fixators applied to a comminuted fracture in the diaphyseal region of the tibia. Unilateral fixators with single and double rods, bilateral, biplanar, and triangular frames with and without end cross-links are different configurations examined in-silico. Results show that the triangular frame with cross-links exhibits the stiffest, strongest, and most sustainable construct in axial, bending, and torsion modes. Except for the torsion mode, adding the end cross-links does little to increase the stiffness and strength of biplanar and triangular frames. Moreover, doubling the rod considerably improves construct stiffness and strength under axial compression load while appearing to be less superior in torsional stiffness and pin loosening. Furthermore, the bilateral frame demonstrates the most uniform displacement across the fracture gap. The results of this study could be used for preoperative planning of diaphyseal fracture management with external fixators.</p>\",\"PeriodicalId\":49063,\"journal\":{\"name\":\"Iranian Journal of Science and Technology-Transactions of Mechanical Engineering\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2024-05-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Iranian Journal of Science and Technology-Transactions of Mechanical Engineering\",\"FirstCategoryId\":\"5\",\"ListUrlMain\":\"https://doi.org/10.1007/s40997-024-00777-8\",\"RegionNum\":4,\"RegionCategory\":\"工程技术\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ENGINEERING, MECHANICAL\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Iranian Journal of Science and Technology-Transactions of Mechanical Engineering","FirstCategoryId":"5","ListUrlMain":"https://doi.org/10.1007/s40997-024-00777-8","RegionNum":4,"RegionCategory":"工程技术","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ENGINEERING, MECHANICAL","Score":null,"Total":0}
Comparative Study of External Fixators With Different Spatial Configurations in the Damage Control Surgery of Comminuted Diaphyseal Fracture
Fractures in the lower extremities are sometimes accompanied by severe damage, so definitive treatments with extensive surgical exposure are impractical. Extensive traumatization and swelling of surrounding tissue often dictate the use of external fixators as a temporary treatment for immediate stabilization of compound fractures. External fixation offers a variety of possible spatial configurations. Adequate fracture stabilization demands a good understanding of the stiffness, strength, sustainability, and tilting of external fixators of different frames. An improper frame can result in nonunion, malunion, delayed healing, and bone re-fracture, some of which are indications for revision surgery. This study employs a numerical approach to assess the stiffness, stress distribution, pin loosening, and interfragmentary displacement in different configurations of external fixators applied to a comminuted fracture in the diaphyseal region of the tibia. Unilateral fixators with single and double rods, bilateral, biplanar, and triangular frames with and without end cross-links are different configurations examined in-silico. Results show that the triangular frame with cross-links exhibits the stiffest, strongest, and most sustainable construct in axial, bending, and torsion modes. Except for the torsion mode, adding the end cross-links does little to increase the stiffness and strength of biplanar and triangular frames. Moreover, doubling the rod considerably improves construct stiffness and strength under axial compression load while appearing to be less superior in torsional stiffness and pin loosening. Furthermore, the bilateral frame demonstrates the most uniform displacement across the fracture gap. The results of this study could be used for preoperative planning of diaphyseal fracture management with external fixators.
期刊介绍:
Transactions of Mechanical Engineering is to foster the growth of scientific research in all branches of mechanical engineering and its related grounds and to provide a medium by means of which the fruits of these researches may be brought to the attentionof the world’s scientific communities. The journal has the focus on the frontier topics in the theoretical, mathematical, numerical, experimental and scientific developments in mechanical engineering as well
as applications of established techniques to new domains in various mechanical engineering disciplines such as: Solid Mechanics, Kinematics, Dynamics Vibration and Control, Fluids Mechanics, Thermodynamics and Heat Transfer, Energy and Environment, Computational Mechanics, Bio Micro and Nano Mechanics and Design and Materials Engineering & Manufacturing.
The editors will welcome papers from all professors and researchers from universities, research centers,
organizations, companies and industries from all over the world in the hope that this will advance the scientific standards of the journal and provide a channel of communication between Iranian Scholars and their colleague in other parts of the world.