TRANSTİBİAL VE TRANSFEMORAL AMPUTELERİN DENGE VE DÜŞME DÜZEYLERİNİN KARŞILAŞTIRILMASI Comparison of Balance and Falling Levels of Transtibial and Transfemoral Amputees

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TRANSTİBİAL VE TRANSFEMORAL AMPUTELERİN DENGE VE DÜŞME DÜZEYLERİNİN KARŞILAŞTIRILMASI Comparison of Balance and Falling Levels of Transtibial and Transfemoral Amputees

The Effect of Midshaft Clavicle Fractures on Acromioclavicular and Coracoclavicular Joint in Axial Malrotation; Finite Element Analysis

Purpose: Plate-screw fixation and sprains are commonly used methods in the surgical treatment of midshaftclavicle fractures. Generally, rotational deformities are neglected during surgery. Main goal is; investigatedthe effect of malrotational midshaft clavicle deformity on acromioclavicular and coracoclavicular joint withfinite element analysis method.Material methods: The anatomical shoulder joint was modeled using computed tomography images. Themidshaft fracture was formed on the clavicle. The fractures were rotated at 5 °, 10 °, 15 ° and 20 ° in theanterior and posterior axial rotation, respectively; malunion models were created. The resulting modelswere made non-linear using the finite element program ANSYS (version 18) and the same boundaryconditions were applied in all models.Results: At different rotational degrees of the fracture line, tensions were calculated in acromioclavicularand coracoclavicular joints. Anterior and posterior axial rotation in midshaft clavicle fracture increases thetension on acromioclavicular and coracoclavicular joints. Especially lodings in posterior axial rotation ofmidshaft clavicle fracture is more than the anterior.Conclusions: Rotational deformities in the surgery of the midshaft clavicle fractures affect the shoulderjoint biomechanics, resulting in an increase in the loading on AK and CC joints. This may cause pain in theshoulder joint, which may lead to joint degeneration later on.

Keywords:

Clavicle fractures, Axial malrotation Finite element analysis,

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1. Lord S, Ward J, Williams P, Anstey K. Physiological factors associated with falls in older community-dwelling women. J Am Geriatr Soc. 1994;42: 1110-7. 2. Aile ve Sosyal Politikalar Bakanlığı, 2013: 2. 3. Dajpratham P, Tantiniramai S, Lukkapichonchut P, Kaewnaree S. Factors Associated with Vocational Reintegration Among the Thai Lower Limb Amputees. Journal of the Medical Association of Thailand. 2008;91 (2): 234-39. 4. Deans SA, Mcfadyen AK, Rowe PJ. Physical Activity and quality of life: A study of a lower-limb amputee population. Prosthetics and Orthotics International. 2008; 32 (2): 186-200. 5. Raya MA, Gailey RS, Fiebert IM, Roach EM. Impairment variables predicting activity limitation in individuals with lower limb amputation. Prosthetics and Orthotics International. 2010; 34(1): 73–84. 6. Dillingham TR, Pezzin LE, MacKenzie EJ. Limb amputation and limb deficiency: Epidemiology and recent trends in the United States. South Med J. 2002;95(8):875–83. 7. Powell LE, Myers AM. The Activities-specific Confidence (ABC) Scale. J Gerontol A Biol Sci Med Sci. 1995;50: 28–34. 8. Myers AM, Powell LE, Maki BE, Holliday PJ, Brawley LR, Sherk W. Psychological indicators of balance confidence: relationship to actual and perceived abilities. J Gerontol A Biol Sci Med Sci. 1996;51: 37–43. 9. Tennstedt S, Howland J, Lachman M, Peterson E, Kasten L, Jette A. A randomized, controlled trial of a group intervention to reduce fear of falling and associated activity restriction in older adults. J Gerontol B Psychol Sci Soc Sci. 1998;53: 384–92. 10. Tinetti ME, Powell L. Fear of falling and low self-efficacy: a cause of dependence in elderly persons. Gerontology. 1993;48: 35–8.