Femur Transvers Kırıklarında Plak ve İntramedüller Çivi Kullanımının Mekanik Yönden Değerlendirilmesi

Femur ve tibia gibi uzun kemikler darbe, aşırı yükleme gibi sebeplerden dolayı şaft bölgelerinden kırılabilmektedir. Bu kırıkların iyileşebilmesi için kırık bölgesinin stabil bir şekilde sabitlenmesi gerekir. Bu sabitleme için plaklar ve intramedüler çiviler sıklıkla kullanılmaktadır. Ancak mekanik yönden bu iki implantın hangisinin daha başarılı olduğu bilinmemektedir. Bu çalışmada, femur şaft kırıklarında kullanılan plak ve intramedüler çivi kullanımının mekanik açıdan değerlendirilmesi yapılması amaçlanmıştır. Yöntem olarak, kemik ve implantlar üzerindeki gerilmeleri incelemede sıklıkla tercih edilen sonlu elemanlar yöntemi kullanılmıştır. Kemik ve implant modelleri oluşturulmuş ve bilgisayar ortamında bu modeller ameliyata uygun olarak birleştirilmiştir. Femur başına 750 N kuvvet uygulanmış ve distal femurdan sabitlenmiştir. Toplamda sağlam femur modeli de olmak üzere üç model oluşturulmuştur. Referans olarak sağlam femur modeli üzerinde oluşan gerinim dağılımları dikkate alınmıştır. Sonuçları değerlendirirken femur üzerinde oluşan gerinim değerleri ve implantlar üzerinde oluşan maksimum von Mises gerilme değerleri incelenmiştir. Ayrıca kırık hattında meydana gelen gerilme değerleri de dikkate alınmıştır. Sonuç olarak, femur şaft kırıklarında intramedüller çivi kullanımının stress kalkanı açısından daha başarılı bulunmuştur.

Anahtar Kelimeler:

Femur şaft kırığı, Plak, İntramedüller çivi, Sonlu elemanlar analizi

Mechanical Evaluation of the Use of Plate and Intramedullary Nails in Femur Transverse Fractures

Long bones such as the femur and tibia can be broken from the shaft region due to impact, oandrload, etc.. The fracture region has to be fixed stably in order to heal the fracture. However, it is not known which of these two implants is more successful mechanically. Plates and intramedullary nails are frequently used for this fixation. The aim of this study was to evaluate the use of plates and intramedullary nails used in femur shaft fractures mechanically. The finite element method, which is frequently preferred, has been used as a method to examine the stresses on the modelled bone and implants. The bone and implants were created and combined with each other according to surgical procedure. 750 N force was applied to the femur head and the distal end of the femur was fixed. Three finite element models were created, including the intact femur model. The strain distributions on the femur intact femur were taken as reference. The strain values on the femur and the maximum von Mises stress values on the implants were examined to evaluate the results. In addition, the stress values in the fracture line were also taken into consideration to evaluate the results. In conclusion, the use of intramedullary nails in femur shaft fractures was found to be more successful in terms of stress shielding.

Keywords:

Femur shaft fracture, Plate, Intramedullary nail, Finite element analysis,

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