Buryanov O. A., Kvasha V. P., Chekushyn D. A., Zadnichenko M. O., Karpinsky M. Yu., Yaresko O. V.

ANALYSIS OF STRESS DISTRIBUTION IN THE ACROMIOCLAVICULAR JOINT IN CASE OF DAMAGE TO THE CONOID LIGAMENT AND DIFFERENT METHODS OF FIXATION

---

Show/Download

About the author:

Buryanov O. A., Kvasha V. P., Chekushyn D. A., Zadnichenko M. O., Karpinsky M. Yu., Yaresko O. V.

Heading:

METHODS AND METHODOLOGIES

Type of article:

Scientific article

Annotation:

The most common methods of fixation for dislocations of the acromial end of the clavicle (AEC) are the hook plate and the Weber method using sintered wire. Due to the lack of clear knowledge about which method of fixation is the best, additional research is needed to determine the proportion of static stabilisers. The study aimed to perform a comparative analysis of the stress-strain state of the acromioclavicular joint in case of conoid ligament (lig. conoideum) injury and fixation of the acromial end of the clavicle by Weber, hook plate and the proposed construction. In the present study, we modelled the damage to the ligaments of the acromiocoracoid complex, namely the lig. conoideum, and fixation of the acromial end of the clavicle in three ways: Weber, hook plate, and the proposed construction. The models were studied under loads acting on the acromioclavicular joint when the upper limb was abducted at an angle of 90°. It has been established that in the case of lig. conoideum injury, the best results in reducing the stress level in the intact ligaments are provided by Weber fixation of the AEC. However, this fixation method leads to increased stresses in the wire to a level that exceeds the tensile strength of the surgical steel from which it is made. A partial solution to this problem may be using titanium wire, which has twice the tensile strength of surgical steel. The hinge-type fixator ensures the best distribution of stresses in the bone elements of the model and a fairly low level of stresses in intact ligaments. The hook plate fixator is in the middle position in terms of stress levels. Regarding relative deformations in the ligaments, it is inferior to all other fixation methods. The Weber fixation of the acromial end of the clavicle provides the lowest level of stress in intact ligaments, but the level of stress in the sintered wire during abduction of the limb in conditions of lig. conoideum injury exceeds the tensile strength of surgical steel. The hook plate fixator occupies an intermediate position in stress level but is inferior to all other fixation methods in relative deformations in the ligaments. The hinge-type fixator provides the best distribution of stresses in the bone elements of the model, as well as a relatively low level of stresses and the magnitude of relative deformations in intact ligaments.

Tags:

Bibliography:

1. Buryanov О, Kvasha V, Сhekushyn D, Naumenko V. Analiz viddalenykh rezulʹtativ operatyvnoho likuvannya vyvykhiv akromialʹnoho kintsya klyuchytsi. Travma. 2022;22(6):4-9. DOI: 10.22141/1608-1706. [in Ukrainian].
2. Sobolevskiy Y, Burjanov O, Kvasha V, Chekushyn D, Omelchenko T, Kovalchuk D. Anatomical and biomechanical role of static stabilizers of the acromiaoclavicular joint. Wiadomosci Lekarskie Medical Advances. 2023;LXXVI(12):2607-2613. DOI: 10.36740/WLek202312109.
3. Fosser M, Camporese A. Operative treatment of acute acromioclavicular joint dislocations graded Rockwood III-V: a retrospective and comparative study between three different surgical techniques. Acta bio-medica: Atenei Parmensis. 2021;92(5):e2021325. DOI: 10.23750/ abm.v92i5.10678.
4. Oh HS, Kim S, Hyun JH, Kim MS. Effect of subacromial erosion shape on rotator cuff and clinical outcomes after hook plate fixation in type 5 acromioclavicular joint dislocations: a retrospective cohort study. BMC musculoskeletal disorders. 2022;23(1):42. DOI: 10.1186/ s12891-021-04987-y.
5. Ozan F, Gök S, Okur KT, Altun İ, Kahraman M, Günay AE, et al. Midterm Results of Tension Band Wiring Technique for Acute Rockwood Type III Acromioclavicular Joint Dislocation. Cureus. 2020;12(12):e12203. DOI: 10.7759/cureus.12203.
6. Burʺyanov OA, Kvasha VP, Chekushyn DA, Zadnichenko MO, Karpinsʹkyy MYU, Yaresʹko OV. Napruzheno-deformovanyy stan nadplechovo-klyuchychnoho suhloba pry ushkodzhenni nyzhnʹoyi nadplechovo-klyuchychnoyi zvʺyazky i riznykh sposobakh fiksatsiyi. Visnyk problem biolohiyi i medytsyny. 2024;1(172):330-344. DOI: 10.29254/2077-4214-2024-1-172-330-344. [in Ukrainian].
7. Burʺyanov OA, Kvasha VP, Martsʹokha AV, Chekushyn DA, vynakhidnyky; Natsionalʹnyy medychnyy universytet imeni O.O.Bohomolʹtsya, patentovlasnyk. Pozasuhlobovyy dynamichnyy fiksator pry vyvykhakh akromialʹnoho kintsya klyuchytsi. Patent Ukrayiny №12472. 2018 Kvit 25. [in Ukrainian].
8. Cowin SC. Bone Mechanics Handbook. 2nd ed. Boca Raton: CRC Press; 2001. 980 s.
9. Boccaccio A, Pappalettere C. Theoretical Biomechanics. Prague: IntechOpen; 2011. Chapter, Mechanobiology of Fracture Healing: Basic Principles and Applications in Orthodontics and Orthopaedics; p. 21-48. DOI: 10.5772/ 19420.
10. Niinomi M. Mechanical biocompatibilities of titanium alloys for biomedical applications. J Mech Behav Biomed Mater. 2008;1(1):30-42. DOI: 10.1016/j.jmbbm.2007.07.001.
11. Woo SL, Abramowitch SD, Kilger R, Liang R. Biomechanics of knee ligaments: injury, healing, and repair. Journal of Biomechanics. 2006;39:1-20. DOI: 10.1016/j.jbiomech.2004.10.025.
12. Karpinsky M, Yaresko O, Pavlenko K, Topor V, Uvarova O, Popov O. Matematychne modelyuvannya variantiv osteosyntezu klyuchytsi za yiyi perelomiv u seredniy tretyni. Orthopaedics Traumatology and Prosthetics. 2014;(4):5-13. DOI: 10.15674/0030-5987201445-13. [in Ukrainian].
13. Chang YW, Hughes RE, Su FC, Itoi E, An KN. Prediction of muscle force involved in shoulder internal rotation. Journal of Shoulder and Elbow Surgery. 2000;9(3):188-195.
14. Rao SS. The Finite Element Method in Engineering. Waltham: Butterworth-Heinemann; 2017. 782 p.
15. Kurowski PM. Engineering Analysis with COSMOSWorks 2007. Mission: SDC Publications; 2007. 263 p.

Publication of the article:

«Bulletin of problems biology and medicine», 2024 Issue 3, 174, 243-256 pages, index UDC 616.71-007.44:612.015.1

DOI:

10.29254/2077-4214-2024-3-174-243-256