Buryanov O. A., Kvasha V. P., Naumenko V. O., Karpinsky M. Yu., Yaresko O. V.

STUDY OF THE STRESS-DEFORMATION STATE OF MODELS OF THE HUMERUS IN CASE OF SUPRACONDYLAR TRANSVERSE FRACTURES IN CHILDREN AND ADOLESCENTS WITH DIFFERENT OPTIONS OF PERCUTANEOUS FIXATION

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About the author:

Buryanov O. A., Kvasha V. P., Naumenko V. O., Karpinsky M. Yu., Yaresko O. V.

Heading:

CLINICAL AND EXPERIMENTAL MEDICINE

Type of article:

Scientific article

Annotation:

Fractures of the distal epimetaphysis of the humerus in children and adolescents are one of the most common injuries. Currently, there are two most common configurations for fixation of supracondylar fractures in children: a crossed spokes design and a design using 2 or 3 lateral spokes with their divergence in the coronal plane. The aim is to compare the level of stresses in a model of the humerus with a supracondylar transverse fracture with different variants of percutaneous fixation under the influence of different loads. A basic finite element model of the humerus was developed, based on which a model of a supracondylar transverse fracture was created. Two variants of osteosynthesis were modelled: two spokes placed crosswise and a bundle of three spokes. The models were subjected to tension, bending and twisting. Cross fixation with two spokes provides a more even distribution of stresses in the bone elements of the humerus. Lateral fixation with three spokes minimises the medial epicondyle stress and doubles the lateral epicondyle stress. This is due to the unilateral passage of the spokes’ bundle. At the same time, the medial epicondyle remains unfixed. At the same time, a more rigid fixation of the lateral epicondyle causes an increase in the stress level in the lateral epicondyle. The study identified the advantages of the cross-fixation method with two spokes over the lateral method with three spokes for all load variants. The symmetrical arrangement of the spokes during cross fixation of bone fragments allows for an even distribution of the load between the epicondyles. It ensures a relatively low stress value in them. Unilateral passage of the spokes’ bundle leads to a significant 2-2.5-fold increase in stresses on the epicondyle through which the fixation elements are passed. On the opposite epicondyle, the stresses, on the contrary, are reduced to a minimum, because the bone regenerant is too soft to resist any load, which can cause instability.

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Bibliography:

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Publication of the article:

«Bulletin of problems biology and medicine», 2024 Issue 2, 173, 174-189 pages, index UDC 616.717.4–089.2–027.45(004.942)(477)

DOI:

10.29254/2077-4214-2024-2-173-174-189