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

STRESSED AND DEFORMED STATE OF THE ACROMIOCLAVICULAR JOINT IN CASE OF DAMAGE TO THE INFERIOR ACROMIOCLAVICULAR LIGAMENT AND VARIOUS METHODS OF FIXATION

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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:

In case of dislocations of the acromial end of the clavicle (AEC), its stabilisation is achieved in two ways: clavicle – coracoid process, clavicle – acromion process. Fixation of the AEC to the acromion of the scapula is a priority. Aim: to conduct a comparative analysis of fixation of the acromial end of the clavicle by Weber, hook plate and the proposed construction by studying the stress-strain state of the acromioclavicular joint in case of damage to the inferior acromioclavicular ligament with different methods of fixation. A finite element model of the acromioclavicular joint was constructed. The damage to the inferior acromioclavicular ligament and fixation of the AEC were modelled in three ways: by Weber, hook plate, and the proposed construction. All types of fixators provide approximately the same level of stress in the bone elements of the model, but with Weber fixation, the stresses in the areas of contact with the wire on the AEC and on the acromion process of the scapula increase several times, which can cause bone destruction. The best distribution of stresses in both the bone elements of the model and the intact ligaments is provided by a hinge-type fixator. It is also the best by the criterion of minimising the value of relative deformations. The Weber fixation allows the reduction of the relative deformations of intact ligaments below the level of the model without fixation, but the stress distribution indicators in this model call into question the feasibility of using this technique. The hook plate fixator occupies an intermediate position relative to all the studied parameters. Weber fixation of the acromial end of the clavicle provides good results in terms of stress levels and relative deformations in intact ligaments but leads to a several-fold increase in the stress level on the AEC and acromion process of the scapula. The fixator of the proposed construction provides the best result, both in terms of stress distribution in the model elements and the value of relative deformations in intact ligaments. The hook plate fixation occupies an intermediate position in terms of all the studied parameters.

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Bibliography:

1. Buryanov О, Kvasha V, Сhekushyn D, Naumenko V. Analiz viddalenykh rezulʹtativ operatyvnoho likuvannya vyvykhiv akromialʹnoho kintsya klyuchytsi. Travma. 2021;22(6):4-9. DOI: doi.org/10.22141/1608-1706. [in Ukrainian].
2. 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 acromioclavicularе joint dislocations: a retrospective cohort study. BMC Musculoskelet Disord. 2022;23:42. DOI: 10.1186/s12891- 021-04987-y.
3. Ozan F, Gök S, Okur KT, Altun İ, Kahraman M, Günay AE, et al. Results of Tension Band Wiring Technique for Acute Rockwood Type III Acromioclavicularе Joint Dislocation. Cureus. 2020;12(12):e12203. DOI: 10.7759/cureus.12203.
4. 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 Biomed. 2021;92(5):e2021325. DOI: 10.23750/abm.v92i5.10678.
5. Xu D, Shi Y, Luo P, Wang W, Guo W, Lou W, et al. Influential factors of subacromial impingement syndrome after hook plate fixation for acromioclavicular joint dislocation. A retrospective study. Medicine (Baltimore). 2021;100(23):e26333. DOI: 10.1097/ MD.0000000000026333.
6. Bur’yanov 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 Ukrainy №12472. 2018 Kvit 25. [in Ukrainian].
7. Cowin SC. Bone Mechanics Handbook. 2nd ed. Boca Raton: CRC Press; 2001. 980 s.
8. 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.
9. 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.
10. 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.
11. Karpinsky M, Yaresko O, Pavlenko K, Topor V, Uvarova O, Popov O. Mathematical modeling of options for osteosynthesis of middle third clavicle fractures. OTP. 2014;(4):5-13. DOI: 10.15674/0030-5987201445-13.
12. 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.
13. Rao SS. The Finite Element Method in Engineering. Waltham: Butterworth-Heinemann; 2017. 782 p.
14. 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 1, 172, 330-344 pages, index UDC 616.71-007.44:612.015.1

DOI:

10.29254/2077-4214-2024-1-172-330-344