Assessment of stress-strain distribution in flatfoot deformity (part 1)

Korolkov, Oleksandr; Rakhman, Paviel; Karpinsky, Mykhaylo; Shishka, Igor; Yaresko, Oleksandr

doi:10.15674/0030-59872017480-84

Cited by 5 publications

(4 citation statements)

References 8 publications

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“…За основу обрано модель дистального кінця нижньої кінцівки, розроблену в лабораторії біомеханіки ДУ «Інститут патології хребта та суглобів імені професора М.І. Ситенка НАМН України» (ІПХС) [10] (рис. 1).…”

Section: матеріали та методи дослідженняunclassified

Study of stress distribution under the influence of bending load in models of different options for osteosynthesis of tibia bones with fractures in the middle third of their congenital pseudarthrosis in children with incomplete growth

Korzh,

Khmyzov,

Katsalap

et al. 2023

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Congenital pseudoarthrosis of the bones of the lower leg is a rare disease characterized by the presence of non-union (pseudoarthrosis) of the bones of the lower leg, which does not grow independently. The majority of surgical techniques involve the removal of pathological soft tissues in the zone of pseudarthrosis followed by bone autoplasty and fixation of tibial bone fragments in external fixation devices or with the help of intramedullary fixators. Purpose - to investigate the stress-deformed state of models of the leg in the presence of pseudarthrosis in the middle third under the influence of bending load and their osteosynthesis using intramedullary rods of various designs in children with incomplete growth. Materials and methods. Mathematical modeling of 3 variants of osteosynthesis of lower leg bones with congenital pseudarthrosis in the middle third was performed: 1 - rod without rotational stability; 2 - rod with rotational stability; 3 - rod with rotational stability and blocked movement during compression. The stress-strain state of the models under the influence of a bending load of 300 N was studied. Results. When using a rotationally unstable «growing» rod, maximum stress levels of 18.5 MPa and 23.1 MPa are determined at the proximal and distal ends of the tibia, respectively. In the fracture zone, the stress level is minimal and does not exceed 0.2 MPa. In the diaphyseal part, stresses are determined at the level of 0.3 MPa and 0.4 MPa above and below the fracture zone, respectively. In the zone of the fracture of the fibula, the stress level is also not significant - 0.7 MPa and 0.8 MPa in the proximal and distal fragments. The use of a rod with rotational stability does not lead to any significant changes in the stress-strain state of the model compared to tibial osteosynthesis with a rotationally unstable rod. The use of an intramedullary rod with blocked movement during compression allows to reduce the values of stresses at the proximal and distal ends of the tibia - up to 16.9 MPa and 21.2 MPa, respectively. In all control points of the diaphyseal part of the tibia, the stresses are minimal and equal to 0.2 MPa. It should be noted that in this case the stresses in the area of the fracture of the fibula, where they do not exceed the mark of 0.1 MPa, are almost negligible. Conclusions. Under bending loads, all types of intramedullary rods provide a minimum level of stress in the tibial fracture zone. Additional rotational and longitudinal stability of the rods allow to slightly reduce the level of stress in the proximal and distal ends of the tibia. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

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Section: матеріали та методи дослідженняunclassified

Study of stress distribution under the influence of bending load in models of different options for osteosynthesis of tibia bones with fractures in the middle third of their congenital pseudarthrosis in children with incomplete growth

Korzh,

Khmyzov,

Katsalap

et al. 2023

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“…Для вирішення поставленого завдання раніше розроблено [6,7] математичну скінченно-елементну модель (МСЕМ) дистального кінця нижньої кінцівки із доповненнями, яка містила кісткові елементи стопи та гомілки (рис. 1).…”

Section: матеріал і методиunclassified

Mathematical Modeling of the Stress-Strain Relations of the Foot Elements in the Conditions of Lateral Malleolus Hypoplasia

Shishka¹,

Korolkov²,

Karpinsky³

et al. 2022

OTP

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One of the most common complications of long-term talocrural joint (TCJ) injury is the development of chronic instability. Among the risk factors for its occurrence - congenital or acquired shortening (hypoplasia) of the lateral malleolus of varying degrees. Objective. Determine the effect of lateral malleolus hypoplasia on the distribution of stresses in the bone and ligament elements of the foot. Methods. Mathematical modeling of the distal end of thelower extremity was performed. There are two variants of the position of the heel bone — varus and valgus with an angle of deviation from the vertical axis in both cases 15°. A vertical distributed load of 700 N was applied to the tibial plateau. On the supporting surface of the feet model's were rigidly fixed. Measurements of mechanical stresses were performed at control points. According to the criteria for estimating the stress-strain relations (SSR), the Misesstress was used. Results. It was determined that lateral malleolus hypoplasia increases the values of stresses on the lateral side of the distal tibial bone from 6.3 MPa to 6.4 MPa, from the medial — on the heel bone from 5.8 MPa to 6.0 MPa, talus from 2.1 MPa to 2.3 MPa. SSR on TCJ are also varies. In the case of a neutral position of the heel bone, lateral malleolus hypoplasia causes a decrease in the values of the ligaments on the lateral side of the TCJ,which can be explained by their elongation and, consequently, the projection increase in length In the case of varus or valgus position of the heel bone under conditions of lateral ankle hypoplasia, it was found that the varus position of the heel bone overstrains the ligaments on the lateral side, valgus - from the medial. Conclusions. Decreased stress in the ligaments of the TCJ in cases of valgus or varus position of the heel bone is one of the factors reducing the functional stability of the joint and may be the cause of its chronic instability.

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“…Матеріали та методи дослідження У лабораторії біомеханіки ДУ «Інститут патології хребта та суглобів імені професора М. І. Ситенка НАМН України» проведено математичне моделювання остеосинтезу першої плеснової кістки в корекції вальгусної деформації першого пальця стопи за допомогою проксимальної остеотомії. Для цього обрано базову скінчено-елементну модель стопи [2,9,14], наведену на рисунку 1.…”

Section: оригінальні дослідження ортопедіяunclassified

“…За скінчений елемент обирали 10-вузловий тетраедр із квадратичною апроксимацією. Механічні властивості біологічних тканин обирали за даними літератури [2,9,10,14]. Характеристики штучних матеріалів обирали за даними технічної літератури [11].…”

Section: оригінальні дослідження ортопедіяunclassified

Biomechanical rationale for choosing a means of fixation of bone fragments during proximal osteotomy of the first metatarsal bone

Prozorovskiy¹,

Romanenko²,

Karpinsky³

et al. 2022

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One of the most common pathologies that occurs in static deformities of the anterior joint of the foot in the foot is valgus deformity of the first toe. Distal or diaphyseal osteotomies are used for mild degrees, and proximal osteotomies for severe ones. Spikes, screws or plates with angular stability are most often used to fix bone fragments. Purpose - with the help of biomechanical studies, to study the stress-deformed state of the foot model with different options for osteosynthesis of the first metatarsal bone after the proximal osteotomy. Materials and methods. Mathematical modeling of osteosynthesis of the first metatarsal bone during correction of valgus deformity of the first toe using proximal osteotomy was carried out. Three variants of osteosynthesis were modeled: Kirschner pins, screws, and a bone plate. Results. During osteosynthesis with spikes, maximum stresses of 2.1 MPa occur in distal fragment. In the proximal fragment, the stresses are twice as low - 1.2 MPa. The tension in the resection zone is 0.1 MPa. During osteosynthesis with screws, the stresses in the proximal and distal fragments of the bone are almost the same, and are 0.9 MPa and 0.8 MPa, respectively. The tension in the osteotomy zone is 0.1 MPa. Osteosynthesis with a bone plate provides a low level of stresses in the osteotomy zone - 0.1 MPa, as well as an even distribution of stresses between the proximal and distal fragments of the metatarsal bone - 0.8 MPa and 0.7 MPa, respectively. During osteosynthesis with spikes and screws, the relative deformation of the bone regenerate does not exceed 0.13%. During osteosynthesis with a bone plate, this figure reaches 0.5%. Conclusions. For osteosynthesis of bone fragments during proximal osteotomy of the first metatarsal bone in order to eliminate valgus deformity of the first toe, spikes, screws and a bone plate can be used. All investigated types of osteosynthesis provide a low level of stress in the osteotomy zone of the first metatarsal bone, but, according to the criterion of stress values in the proximal and distal fragments of the bone, osteosynthesis with spikes showed the worst result, and osteosynthesis with a bone plate showed the best. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.

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Assessment of stress-strain distribution in flatfoot deformity (part 1)

Cited by 5 publications

References 8 publications

Study of stress distribution under the influence of bending load in models of different options for osteosynthesis of tibia bones with fractures in the middle third of their congenital pseudarthrosis in children with incomplete growth

Study of stress distribution under the influence of bending load in models of different options for osteosynthesis of tibia bones with fractures in the middle third of their congenital pseudarthrosis in children with incomplete growth

Mathematical Modeling of the Stress-Strain Relations of the Foot Elements in the Conditions of Lateral Malleolus Hypoplasia

Biomechanical rationale for choosing a means of fixation of bone fragments during proximal osteotomy of the first metatarsal bone

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