Internal mechanical conditions in the soft tissues of a residual limb of a trans-tibial amputee

Portnoy, Sigal; Yizhar, Ziva; Shabshin, Nogah; Itzchak, Y; Kristal, Anat; Dotan-Marom, Y.; Siev-Ner, Itzhak; Gefen, Amit

doi:10.1016/j.jbiomech.2008.03.035

Cited by 102 publications

(93 citation statements)

References 37 publications

(33 reference statements)

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“…On the interface between the residuum and the liner 50 kPa maximum pressure was observed at the inferior-anterior part of the soft tissue (Figure 6b) as a result of the same loading condition. The results obtained are in agreement with a previous study [26] showing that stresses were concentrated in the flap tissue under the tibia's end and, therefore, a further study is needed on the clinical relevance in identifying risk factors of developing a deep-tissue injury (DTI) and other complications. …”

Section: Model Of Pressure Distribution In Residuumsupporting

confidence: 91%

Computational Modelling of Mechanical Behavior of Biological Tissues for Biomedical Applications

Li¹,

Liu²,

Du³

et al. 2016

Proceedings of the VII European Congress on Computational Methods in Applied Sciences and Engineering (ECCOMAS Congress 2016)

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Section: Model Of Pressure Distribution In Residuumsupporting

confidence: 91%

Computational Modelling of Mechanical Behavior of Biological Tissues for Biomedical Applications

Li¹,

Liu²,

Du³

et al. 2016

Proceedings of the VII European Congress on Computational Methods in Applied Sciences and Engineering (ECCOMAS Congress 2016)

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“…For a below the knee amputee (BK), Portnoy et al 24 found 85% and 129% peak compressive and tensile strain respectively, while in this study the peak principal logarithmic strain values are 110% for P4 and 82.3% for P2 in compressive and tensile strain respectively. The differences can be associated with the patient specific models since the models developed by Portnoy et al 24 were for BK amputees, while the models developed in this study were for above the knee amputees, also the constitutive equations used are different; Portnoy et al 24 used viscoelastic, while linear elastic behaviour was used here.…”

Section: Discussioncontrasting

confidence: 48%

“…For soft tissues a viscoelastic representation may be adequate as used by Portnoy et al 24 However, there are no measurements on the empirical constants used for the strain energy function of the viscoelastic formulation. Thus, in order to be able to compare our results, all materials used in this analysis were defined as elastic, linear, homogeneous and isotropic, according to the definitions used by other aut hors.…”

Section: Materials Propertiesmentioning

confidence: 99%

Incidence of the boundary condition between bone and soft tissue in a finite element model of a transfemoral amputee

Ramírez

Vélez

2012

Prosthetics &Amp; Orthotics International

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Background: Many finite element investigations have been made in the field of lower limb prosthetics; however, friction between bone and soft tissues as a boundary condition has not been considered. Objectives: To establish whether the change in the contact boundary condition between bone and soft tissues in a transfemoral amputee affects the stress-strain state on the residual limb. Study Design: Finite element analysis comparison. Methods: Finite element models of four transfemoral amputees were developed. In these models the socket, soft tissues and femur were included and two simulations were made for each model, in one of them the interaction between bone and soft tissues was defined as tied (there is no relative displacement between surfaces) and in the other it was defined as a friction boundary condition. Results: The von Mises stress and strain peaks are higher when the friction definition is used than for tied contact definition. The distribution pattern of stresses and strains also change when the contact definition varies from tied to friction. Conclusions: It was concluded that the friction between bone and soft tissues have a significant impact on the results of finite element models of lower limb prosthetic systems, and therefore in its predictive capabilities. Clinical relevanceUnderstanding the bone-soft tissue interaction can lead to more realistic and accurate finite element models used to predict the stress-strain state in the residual limb of prosthetic users and therefore predict the occurrence of deep tissue injuries.

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“…While not as dynamically accurate [3,[16][17][18], X-ray images can be more clear and encompassing. X-ray was used in addition to fluoroscope to ensure accurate recording of the interface in the event the fluoroscope did not provide a discernable difference.…”

Section: Socket Position and Coronal Hip Anglementioning

confidence: 99%

Transfemoral sockets with vacuum-assisted suspension comparison of hip kinematics, socket position, contact pressure, and preference: Ischial containment versus brimless

Kahle

Highsmith²

2013

J Rehabil Res Dev

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Abstract-The objective of this study was to investigate the effect of brimless compared with ischial ramus containment (IRC) prosthetic sockets when using vacuum-assisted suspension (VAS) on persons with a unilateral transfemoral amputation (TFA). A randomized crossover design with a 2 d accommodation was used. People with unilateral TFA (n = 9 analyzed) were enrolled. Interventions were IRC VAS and brimless VAS sockets. Main outcome measures included coronal hip angle and vertical and lateral socket movement as measured by X-ray, skin pressure measured by Tekscan, and preference measured subjectively. The brimless design was statistically equivalent to IRC in all measured coronal hip angles and vertical and lateral socket displacement. The peak/stance mean pressure in the medial proximal aspect of the socket was 322 mmHg in the IRC compared with 190 mmHg in the brimless condition. Except for medial proximal pressure, no other measures reached statistical significance. All subjects reported the brimless design to be more comfortable than the IRC in short-term preference. Brimless VAS socket design may be a clinically viable choice for people with TFA.

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Internal mechanical conditions in the soft tissues of a residual limb of a trans-tibial amputee

Cited by 102 publications

References 37 publications

Computational Modelling of Mechanical Behavior of Biological Tissues for Biomedical Applications

Computational Modelling of Mechanical Behavior of Biological Tissues for Biomedical Applications

Incidence of the boundary condition between bone and soft tissue in a finite element model of a transfemoral amputee

Transfemoral sockets with vacuum-assisted suspension comparison of hip kinematics, socket position, contact pressure, and preference: Ischial containment versus brimless

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