Os problemas freqüentes de patologias ortopédicas e traumáticas da coluna vertebral envolvem a colocação de fixadores internos (parafusos longos, os quais são inseridos nos pedículos posteriores até os corpos vertebrais e conectados por fios nas hastes longitudinais podendo ser fixados em todas as posições pelas porcas). Estes fixadores foram simulados no computador através da construção de modelos geométricos dos mesmos, utilizando o software ANSYS 5.5, que consiste de várias ferramentas para análise do projeto baseado no método dos elementos finitos. Foi também utilizado um software para a modelagem das peças e do conjunto do fixador já existente chamado SOLID EDGE, e logo em seguida o mesmo foi transferido para o software ANSYS 5.5 e simulado. Esta comparação servirá como complemento para possíveis modificações das montagens, dimensões e aplicações, não necessitando de novos ensaios mecânicos na máquina universal de ensaios e sim realizando simulações computadorizadas / The frequent problems of orthopedic and traumatic pathologies of the spinal column that involves the placement of an internal fixator (long screws, which are inserted in the subsequent pedicle until the vertebral and connected by bodies for wires in the longitudinal stems could be fastened in all the positions by the screw). These fixators were simulate in the computer through the construction of geometric models of the same ones, using the software ANSYS 5.5, that consists of several tools for analysis of the project based on the method of the finite elements. It was also used a software for the modelling of the pieces and of the group of the fixador already called existent SOLID EDGE, and then the same was transferred to the software ANSYS 5.5 and simulated. This comparison will serve a complement for possible modifications of the assemblies, dimensions and applications, not needing new mechanical test in the universal machine test but accomplishing computerized simulations

Os problemas freqüentes de patologias ortopédicas e traumáticas da coluna vertebral envolvem a colocação de fixadores internos (parafusos longos, os quais são inseridos nos pedículos posteriores até os corpos vertebrais e conectados por fios nas hastes longitudinais podendo ser fixados em todas as posições pelas porcas). Estes fixadores foram simulados no computador através da construção de modelos geométricos dos mesmos, utilizando o software ANSYS 5.5, que consiste de várias ferramentas para análise do projeto baseado no método dos elementos finitos. Foi também utilizado um software para a modelagem das peças e do conjunto do fixador já existente chamado SOLID EDGE, e logo em seguida o mesmo foi transferido para o software ANSYS 5.5 e simulado. Esta comparação servirá como complemento para possíveis modificações das montagens, dimensões e aplicações, não necessitando de novos ensaios mecânicos na máquina universal de ensaios e sim realizando simulações computadorizadas / The frequent problems of orthopedic and traumatic pathologies of the spinal column that involves the placement of an internal fixator (long screws, which are inserted in the subsequent pedicle until the vertebral and connected by bodies for wires in the longitudinal stems could be fastened in all the positions by the screw). These fixators were simulate in the computer through the construction of geometric models of the same ones, using the software ANSYS 5.5, that consists of several tools for analysis of the project based on the method of the finite elements. It was also used a software for the modelling of the pieces and of the group of the fixador already called existent SOLID EDGE, and then the same was transferred to the software ANSYS 5.5 and simulated. This comparison will serve a complement for possible modifications of the assemblies, dimensions and applications, not needing new mechanical test in the universal machine test but accomplishing computerized simulations

The Clamp-Rod Internal Fixator (CRIF) is a fracture fixation implant with growing popularity among veterinarian’s for its versatility and ease of use. Although the CRIF is currently in clinical use, relatively few reports exist describing the biomechanical properties and clinical results of this system. The objective of this study was to determine the in vitro biomechanical properties of a 5mm CRIF/rod construct to a 3.5mm Limited Contact-Dynamic Compression Plate (LC-DCP/rod) construct using a canine femoral gap model. Paired canine femora were treated with 40mm mid-diaphyseal ostectomies and randomly assigned to CRIF/rod or LC-DCP/rod. Five pairs of constructs were tested in bending and five pairs were evaluated in torsion. Single ramp to failure tests were conducted to evaluate construct stiffness, yield load, and failure mode. While CRIF/rod and LC-DCP/rod were not significantly different when evaluated in bending, LC-DCP/rod constructs are significantly more rigid than CRIF/rod constructs at higher torsional loads. Below 10degrees of twist, or 4.92Nm torque, the LC-DCP/rod and CRIF/rod were not statistically different in torsion. Catastrophic injuries of the metacarpophalangeal joint resulting in the disruption of the suspensory apparatus are the most common fatal injuries in thoroughbred racehorses. Fetlock arthrodesis is a procedure designed to mitigate suffering from injury as well as degenerative diseases affecting articulation. The objective of this study is to assess the in vitro biomechanical behavior of techniques for fetlock arthrodesis. Twelve forelimb pairs were collected from adult horses euthanized for reasons unrelated to disease of the metacarpophalangeal joint (MCP). A 14-16-hole broad 4.5mm Locking Compression Plate (LCP) was compared to a 14-16 hole broad Dynamic Compression Plate (DCP). Both constructs used a two “figure-eight” 1.25mm stainless steel wire tension band. Fatigue tests and to failure tests were conducted. There were no significant differences in stiffness between groups for fatigue tests. Stiffness increased after the first fatigue cycle for the LCP/wire (80.56+/-52.22%) and DCP/wire (56.58+/-14.85%). Above 3.5mm of axial deformation there was a statistical difference between the stiffness of the LCP/wire (3824.12+/-751.84 N/mm) and the DCP/wire (3009.65+/-718.25 N/mm) (P=0.038). The LCP/wire showed increased stiffness above 3.5mm compression compared to the DCP/wire. Under fatigue testing conditions the constructs are not statistically different.

Bei der internen, extramedullären Osteosynthese des distalen Femurs, auf die sich diese Arbeit fokussiert, haben sich in den letzten Jahren interessante Entwicklungen vollzogen. Ausgehend von unzufriedenstellenden Komplikationsraten wurden neue Wege in der Versorgung dieser schwierigen Frakturen gesucht. Osteosynthesematerialien, Repositionstechniken, die Technik der Implantatplatzierung und die Implantate selbst, bei denen die Entwicklung zu winkelstabilen Systemen gegangen ist, haben sich grundlegend geändert. Die vorliegende Arbeit analysiert in einer retrospektiven Studie distale Femurfrakturen, die zwischen dem 1.1.1995 und 31.9.2000 entweder mit einem Fixateur interne (LISS) oder mit der konventionellen Plattenosteosynthese versorgt wurden. In die Studie konnten 51 Patienten mit 54 distalen Femurfrakturen eingeschlossen werden. Die Infektionsrate war in der LISS-Gruppe (0% versus 11,1%) nichtsignifikant geringer, die Rate der verzögerten Frakturheilungen war nichtsignifikant höher. Die einzige verzögerte Frakturheilung (LISS-Gruppe), die einer sekundären chirurgischen Intervention bedurfte, wurde bei einer Patientin mit einem großen Knochendefekt gesehen, der ohne primäre Spongiosaplastik therapiert worden war. Pseudarthrosen traten in beiden Gruppen nicht auf. Die Rate des Materialversagens unterschied sich nicht signifikant. Beim LISS kam es nicht, wie bei den konventionellen Implantaten zu sekundären Repositionsverlusten, es wurden aber im Anfang der klinischen Einführung proximale Schraubenausrisse aufgrund einer Fehlplatzierung gesehen. Es konnte gezeigt werden, dass es durch die Verwendung des LISS und die indirekten Repositionstechniken zu keiner Zunahme der Achsfehlstellungen oder der Operationszeit kam. Die funktionellen Einzelergebnisse und die Punktzahl der erhobenen Scores (Neer-Score und Lysholm-Score) unterschieden sich nicht signifikant. / Internal, extramedullary osteosynthesis of distal femoral fractures which are focussed on in this study has been influenced by interesting developments in recent years. Driven by unsatisfying complication rates new fracture treatments have been looked for. Osteosynthesis materials, reduction techniques, techniques of implant placement and implants themselves - where development went to angular stable systems - have changed decisively. This study analyzes in a retrospective setting distal femoral fractures which were treated between 1.1.1995 and 31.9.2000 either with an internal fixator (LISS) or with conventional plate osteosynthesis. In this study 51 patients with 54 distal femoral fractures could be included. The Infection rate was non significantly lower in the LISS group (0% versus 11,1%), the rate of delayed union was non significantly higher. The only delayed union in the LISS group which needed secondary surgical intervention was seen in a patient with considerate bone loss which was not treated by primary bone grafting. Non-unions were not seen in either group. The rate of implant failure did not differ significantly. In the LISS group no secondary loss of reduction (like in the group with conventional plate osteosyntesis) was seen but proximal screw pull out due to malplacement was reported in the beginning of clinical introduction. It could be demonstrated the LISS and indirect reduction leading not to a higher rate of malalignement nor to prolonged theatre times. Functional results and the point score of the Neer Score and the Lysholm Score showed no significant difference.

Introduction: Vertically unstable sacral transforaminal fractures can be stabilized both with a transiliac internal fixator (TIFI) or iliosacral screws (IS). Goals: 1. comparison of radiological and clinical results between dorsal pelvic segment stabilization with TIFI, IS respectively, 2. evaluation and comparison of biomechanical parameters of TIFI and IS construct. Material and methods of clinical study: Prospective study, both TIFI and IS group had 32 patients, the most of injuries were assessed as type C1.3, only patients with a high-energy mechanism of injury were included. Radiological results were evaluated according Matta, clinical results according Majeed score, Pelvic Outcome Score. Categorical data were evaluated by two-sided Fishers exact test or Pearson's χ2 test, continuous data by Student's t-test, a test result with p <0.05 was considered as statistically significant. Methods of biomechanical study: Using CT images, finite element model of the pelvis was developed. Pohlemann type II fracture was simulated and fixed either with TIFI or two IS. The sacral base was loaded vertically (250-500 N), displacement magnitudes on medial and lateral fracture surface and the maximum bone stress were calculated. The intact pelvis was used as a reference. Stiffness was determined by linear...

Distal radius fractures are one of the most common fractures. In case of a complicated fracture, it is necessary to proceed with surgical treatment using an internal plate fixator. The aim of this thesis was to perform a stress-strain analysis of an internal plate fixator attached to the distal radius using bone screws. Computational modeling using finite element method was used to assess the mechanical interactions among the individual elements of this system. The stress-strain analysis was performed for three different types of fixation in geometry models including a distal radius fracture and a healed distal radius and for three different types of loads. In the evaluation of the results, the influence of the type of load and the influence of the healing of the bone tissue were assessed. For the bending load, which was the most critical, the yield strength was not exceeded in the plate or in the bone screws, and therefore irreversible plastic deformation of the material did not occur.

Introduction: Vertically unstable sacral transforaminal fractures can be stabilized both with a transiliac internal fixator (TIFI) or iliosacral screws (IS). Goals: 1. comparison of radiological and clinical results between dorsal pelvic segment stabilization with TIFI, IS respectively, 2. evaluation and comparison of biomechanical parameters of TIFI and IS construct. Material and methods of clinical study: Prospective study, both TIFI and IS group had 32 patients, the most of injuries were assessed as type C1.3, only patients with a high-energy mechanism of injury were included. Radiological results were evaluated according Matta, clinical results according Majeed score, Pelvic Outcome Score. Categorical data were evaluated by two-sided Fishers exact test or Pearson's χ2 test, continuous data by Student's t-test, a test result with p <0.05 was considered as statistically significant. Methods of biomechanical study: Using CT images, finite element model of the pelvis was developed. Pohlemann type II fracture was simulated and fixed either with TIFI or two IS. The sacral base was loaded vertically (250-500 N), displacement magnitudes on medial and lateral fracture surface and the maximum bone stress were calculated. The intact pelvis was used as a reference. Stiffness was determined by linear...

In der vorliegenden tierexperimentellen Studie wurde die Frakturheilung an der diaphysären Schafstibia mit dem Fixateur intern zur Plattenosteosynthese und zur unaufgebohrten Marknagelung verglichen. Zu diesem Zweck wurde ein neues, geschlossenes Frakturmodell mit Weichteilschaden entwickelt und in einer ersten Versuchsreihe validiert. In den anschließenden beiden Hauptversuchen erfolgte der direkte Vergleich des Fixateur intern zu beiden anderen Stabilisierungsverfahren. Zur Beurteilung der Frakturheilungen wurden radiologische, histologische und biomechanische Messungen, sowie in vivo Belastungsmessungen beider Hinterläufe der Schafe durchgeführt. Im Vergleich zur Plattenosteosynthese ergab sich eine schnellere Frakturheilung nach Fixateur intern Stabilisierung. Diese Vorteile zeigten sich nach 12 Wochen mit signifikanten Unterschieden in den biomechanischen und histologischen Resultaten. Durch die Beinbelastungsmessungen konnte ausgeschlossen werden, daß diese Ergebnisse auf mögliche Unterschiede in dem Belastungsverhalten der Tiere und somit auf unterschiedliche mechanische Kallusstimulation zurückzuführen sind. Im Vergleich zur Marknagelung wurden keine signifikanten Unterschiede in den biomechanischen Messungen festgestellt. In der histologischen Auswertung fand sich zu beiden Zeiträumen eine gleiche Kallusmenge mit vergleichbaren mineralisierten Anteilen. Unterschiede zeigten sich nur in dem Verhältnis endostaler zu periostaler Kallusbildung. Diese Ergebnisse wurden mit den ersten klinischen Resultaten von zwei multizentrischer Studien zur Anwendung von Fixateur intern Systemen in Verbindung gesetzt. Den experimentellen und klinischen Ergebnissen zu Folge, ist der Fixateur intern aus biologischer und biomechanischer Sicht der Plattenosteosynthese überlegen, und stellt zur Marknagelung - insbesondere im metaphysären Bereich - eine sichere Alternative. / In the presented study fracture healing of the sheep tibia treated with an internal fixator were compared to conventional plate osteosynthesis and intramedullary nailing. For that reason a new fracture model with a reproducible closed soft tissue damage were developed and validated in a pilot study on the sheep tibia. In both main experiments a direct comparision of the internal fixator were preformed to one of the other stabilization options. Fracture healing were ranked by radiological, histological and biomechanical data, as well as in vivo measurements of both hind legs of the sheep. In comparison to conventional plating a more rapid healing of the fracture were observed after internal fixator stabilization. Those differences were significant for the biomechanical as well as the histological data after 12 weeks. However, in comparision to intramedullary unreamed nailing no significant differences were detected in respect to biomechanical stiffness and strength. In the histological measurements a similar amount of the overall callus with a similar grade of bone mineralisation were present after 6 as well as after 12 weeks. Only the relation between endostal and periostal callus differed between the internal fixator and the nailing group. Those experimental results were correlated with the first clinical results of two multicenter studies using the new internal fixator systems. Based on the experimental and the clinical results, the internal fixator is superior compared to conventional plate osteosynthesis in respect to the biology and biomechanics, and seems to be a safe alternative - especial in the metaphysis area - to intramedullary nailing.