• 제목/요약/키워드: Plate and screw

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3차원 유한 요소법을 이용한 골절판의 응력 해석 (Numerical Stress Analysis of bone plate System using 3-dimensional finite element method)

  • 김현수;권영수
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1991년도 춘계학술대회
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    • pp.74-78
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    • 1991
  • Conventional compression bone fracture plates sometimes cause osteoporosis under the plate due to their high rigidity which in turn transfer physiological load mostly through the plates and screws. In order to prevent the osteopenia we have designed a system which have a viscoelastic washer between plate and screw head. The washer is made of a biocompatible ploymer (untra high molecular weight polyethylene, UHMWPE). Three-dimensional finite element meshes of the human femur with the conventional and new concept bone plate ere generated and the comparative stress analyses are performed with static half-stance loading condition. The results of analyses showed that could reduce the stress shielding effect compared with the conventional plate.

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해부학적 잠김 압박 금속판을 이용한 원위 비골 골절의 치료 (Operative Treatment with Anatomically Preshaped Locking Compression Plate in Distal Fibular Fracture)

  • 정형진
    • 대한족부족관절학회지
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    • 제17권2호
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    • pp.130-135
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    • 2013
  • Purpose: Preshaped Locking compression plate(LCP) has holes with fixed angle between screw and plate and have advantage firm fixation because it has stability of angular and axial deformity. We evaluated usefulness of LCP after open reduction and internal fixation in distal fibular fracture. Materials and Methods: Between December 2011 and May 2012, 23 patients with fracture of distal fibula were followed up at least 12 months underwent open reduction and internal fixation with LCP. There were 15 males and 8 females with a mean age 39.8(20~69) years. According to Danis-Weber classification, there were 20 cases of type B and 3 cases of type C. There were 13 cases of isolated lateral malleolus fractures, 1 case of bimalleolar fracture, 6 cases of trimalleolar fractures and 3 cases of distal tibia fractures with proximal fibula fracture. Intraoperatively, we assessed whether preshaped LCP fit lateral margin of distal fibula or not and evaluated quality of reduction and postoperative complications. The cases were analyzed by radiological bone union time and clinical results according to the criteria of Meyer Results: Of all cases, complete bone union was achieved and average radiological bone union time was 7.3(6~12) weeks. The clinical results were excellent in 18 cases(78%), good in 5 cases(22%). There were 5 cases of plate with 3 holes, 13 cases of plate with 4 holes, 2 cases of plate with 5 holes, 1 case of plate with 6 holes and 2 cases of plate with 7 holes. The average number of screws at proximal fragement was 2.5 and at distal fragment was 3.5. In 14 cases (60.8 %), we needed re-bending of plate because the distance between plate and lateral cortical margin of distal fibula was more than 5 mm at anteroposterior X-ray after reduction. All cases have anatomical reduction and there were no complications of wound infections. There were no complaint about hardware irritation. Conclusion: At fractures of distal fibula,preshaped LCP had a excellent stability although far cortex was not fixed with screw and bending of plate. And there are less complications of hardware irritation and wound problems. But, Some complement would be needed because there were no complete fitting between precontour of LCP and lateral cortical margin of distal fibula.

흡수성 스크류를 이용한 하악과두 골절의 치료 (TREATMENT OF CONDYLE FRACTURE WITH RESORBABLE SCREW)

  • 여인범;민승기;오승환;권경환;최상문;박상규
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제28권6호
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    • pp.559-564
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    • 2006
  • According to the development of operation technique and biologic materials, oromaxillofacial surgery department have used many kinds of metal and biologic materials in ORIF and plastic surgery. In maxillofacial fracture, ORIF with metal plate and screw have short healing period and good prognosis. But ORIF with metal materials have many complications as maxillofacial abnormal growth, screw loosening, bone malunion. And metal materials have not used in infection site. The purpose of this study is to evaluate the clinical value of 10 condylar fracture patients operated with absorbable screw at Wonkwang university. Ten patients(8 males, 2 female, mean aged 28) who had mandibular condyle process fracture treated with PLLA implants(poly-l-lactide) was recalled for follow-up clinical and radiologic examination for 10 years. Mouth opening recorvered to more than 35mm and occlusion was stable in all patients. All fractured mandibular condyles showed anatomic good reduction and long-term stability with the use of resorbable miniplates and screw. Bone healing was satisfactory in all patients, and there was no evidence of abnormal resorption of condylar process.

생체 역학적 분석에 의한 Compression Hip Screw의 디자인 요소에 대한 평가 (Mechanical Response of Changes in Design of Compression Hip Screws with Biomechanical Analysis)

  • 문수정;이희성;권순영;이성재;안세영;이훈
    • 한국정밀공학회:학술대회논문집
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    • 한국정밀공학회 2004년도 추계학술대회 논문집
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    • pp.1172-1175
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    • 2004
  • At present, CHS(Compression Hip Screw) is one of the best prosthesis for the intertrochanteric fracture. There is nothing to evaluate the CHS itself with the finite element analysis and mechanical tests. They have same ways of the experimental test of the ASTM standards. The purpose of this study is to evaluate the existing CHS and the new CHS which have transformational design factors with finite element analysis and mechanical tests. The mechanical tests are divided into compression tests and fatigue test for evaluating the failure load, strength and fatigue life. This finite element method is same as the experimental test of the ASTM standards. Under 300N of compression load at the lag screw head. There are less differences between Group (5H, basic type) and Group which has 8 screw holes. However, there are lots of big differences between Group and Group which is reinforced about thickness of the neck range. Moreover, the comparison of Group and Group shows similar tendency of the comparison of Group and Group . The Group is reinforced the neck range from Group. After the experimental tests and the finite element analysis, the most effective design factor of the compression hip screws is the reinforcement of the thickness, even though, there are lots of design factors. Moreover, to unite the lag screw with the plate and to analyze by static analysis, the result of this method can be used with experimental test or instead of it.

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근위 상완골 골절에서 잠김 압박 금속판과 비잠김 금속판 고정의 방사선학적 임상적 추시 결과 비교 (Comparison of Radiologic and Clinical Results between Locking Compression Plate and Unlocked Plate in Proximal Humerus Fractures)

  • 김재화;이윤석;안태근;최정필
    • Clinics in Shoulder and Elbow
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    • 제11권2호
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    • pp.143-149
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    • 2008
  • 목적: 근위 상완골 골절에서 잠김 압박 금속판과 비잠김 금속판 고정의 방사선학적 임상적 추시 결과를 비교 분석하고자 하였다. 대상 및 방법: 2003년부터 2007년 까지 본원에서 근위 상완골 골절로 입원하였던 87명의 환자중 금속판 고정술을 시행 받았던 환자 20명을 대상으로 하였으며 20명의 환자는 잠김 압박 금속판 고정을 시행하였던 환자 10명, 비잠김 금속판 고정을 시행하였던 환자 10명의 두 군으로 나뉘었다. 각각의 환자군은 수술 직후와 수술 후 6개월 뒤 방사선 사진상 상완골의 경간각, 골유합까지 소요된 시간, 합병증의 빈도 그리고 마지막 추시 당시의 Constant score를 측정하여 서로 비교 분석 하였다. 결과: 상완골의 경각간 및 골유합, Constant score에 대해서 두 군은 유의한 차이를 보이지 않았으나 비잠김 금속판을 사용한 군에서 나사 풀림 현상이 3례에서 발견되었다. 결론: 추시 결과상 잠김 압박 금속판의 사용이 비잠김 금속판에 비하여 임상적, 방사선학적으로 유의한 차이는 없었으나 근위 상완골 골절의 치료에서 나사 풀림 현상 등의 합병증이 적은 잠김 압박 금속판을 사용하는 것이 더 효과적일 것으로 사료된다.

Three-dimensional finite element analysis of the stress distribution and displacement in different fixation methods of bilateral sagittal split ramus osteotomy

  • Yun, Kyoung In;Cho, Young-Gyu;Lee, Jong-Min;Park, Yoon-Hee;Park, Myung-Kyun;Park, Je Uk
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제38권5호
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    • pp.271-275
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    • 2012
  • Objectives: This study evaluated a range of fixation methods to determine which is best for the postoperative stabilization of a mandibular osteotomy using three-dimensional finite element analysis of the stress distribution on the plate, screw and surrounding bone and displacement of the lower incisors. Materials and Methods: The model was generated using the synthetic skull scan data, and the surface model was changed to a solid model using software. Bilateral sagittal split ramus osteotomy was performed using the program, and 8 different types of fixation methods were evaluated. A vertical load of 10 N was applied to the occlusal surface of the first molar. Results: In the case of bicortical screws, von-Mises stress on the screws and screw hole and deflection of the lower central incisor were minimal in type 2 (inverted L pattern with 3 bicortical repositioning screws). In the case of plates, von-Mises stress was minimal in type 8 (fixation 5 mm above the inferior border of the mandible with 1 metal plate and 4 monocortical screws), and deflection of the lower central incisor was minimal in types 6 (fixation 5 mm below the superior border of the mandible with 1 metal plate and 4 monocortical screws) and 7 (fixation 12 mm below the superior border of the mandible with 1 metal plate and 4 monocortical screws). Conclusion: Types 2 and 6 fixation methods provide better stability than the others.

The effect of fixation plate use on bone healing during the reconstruction of mandibular defects

  • Hong, Khang Do Gia;Kim, Seong-Gon;Park, Young-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제45권5호
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    • pp.276-284
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    • 2019
  • Objectives: This study sought to compare efficiency results between the use of a customized implant (CI) and a reconstruction plate (RP) in mandibular defect reconstruction in an animal model. Materials and Methods: Fifteen rabbits underwent surgery to create a defect in the right side of the mandible and were randomly divided into two groups. For reconstruction of the mandibular defect, the RP group (n=5) received five-hole mini-plates without bone grafting and the CI group (n=10) received fabricated CIs based on the cone-beam computed tomography (CBCT) data taken preoperatively. The CI group was further divided into two subgroups depending on the time of CBCT performance preoperatively, as follows: a six-week CI (6WCI) group (n=5) and a one-week CI (1WCI) group (n=5). Daily food intake amount (DFIA) was measured to assess the recovery rate. Radiographic images were acquired to evaluate screw quantity. CBCT and histological examination were performed in the CI subgroup after sacrifice. Results: The 1WCI group showed the highest value in peak average recovery rate and the fastest average recovery rate. In terms of reaching a 50% recovery rate, the 1WCI group required the least number of days as compared with the other groups ($2.6{\pm}1.3days$), while the RP group required the least number of days to reach an 80% recovery rate ($7.8{\pm}2.2days$). The 1WCI group showed the highest percentage of intact screws (94.3%). New bone formation was observed in the CI group during histological examination. Conclusion: Rabbits with mandibular defects treated with CI showed higher and faster recovery rates and more favorable screw status as compared with those treated with a five-hole mini-plate without bone graft.

하악 과두 골절의 관혈적 정복시 고정 방법에 따른 임상적 평가 (CLINICAL EVALUATION OF TREATMENT OUTCOME OF PLATING TECHNIQUE OF FIXATION FOR MANDIBULAR CONDYLAR FRACTURE)

  • 손정희;박지화;김진수;변기정
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제27권2호
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    • pp.164-170
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    • 2005
  • The purpose of this study was to compare a sample of patients who had condylar fractures treated with open reduction using different plating techniques, to evaluate which plating technique is useful for stable fixation for fractures of the mandibular condyle and to evaluate effectiveness of resorbable miniplate. There were 60 patients (41 males, 19 females) whose condylar fractures were treated with open reduction. Rigid fixation was performed with a single miniplate, double miniplate ot one miniplate & one microplate and single resorbable plate. All patients remained intermaxillary fixation for 1 week postoperatively. Active physiotherapy was started after 2 weeks postoperatively. Radiographic evaluation (plate fracture, plate bending, screw loosening, displacement of condyle etc.) was performed at pre-operative, immediate, 2 weeks, 1 month, 3 months, 6 months after surgery. Clinical evaluation included degree of mouth opening, occlusion, mandibular lateral excursion, infection and facial nerve paralysis. In radiographic evaluation, displacement of fractured condylar segment associated with plate bending or screw loosening were showed 6 cases and 3 cases for single miniplate system and resorbable miniplate system. There was no patients who have this problem on double miniplate system. The results revealed that the application of two miniplates were more recommendable than single miniplates. When we select resorbable miniplate system, we should consider the type of fractures, post-operative treatment protocol and surgical technique.

Experimental investigation of thin steel plate shear walls with different infill-to-boundary frame connections

  • Vatansever, Cuneyt;Yardimci, Nesrin
    • Steel and Composite Structures
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    • 제11권3호
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    • pp.251-271
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    • 2011
  • To make direct comparisons regarding the cyclic behavior of thin steel plate shear walls (TSPSWs) with different infill-to-boundary frame connections, two TSPSWs were tested under quasi-static conditions, one having the infill plate attached to the boundary frame members on all edges and the other having the infill plate connected only to the beams. Also, the bare frame that was used in the TSPSW specimens was tested to provide data for the calibration of numerical models. The connection of infill plates to surrounding frames was achieved through the use of self-drilling screws to fish plates that were welded to the frame members. The behavior of TSPSW specimens are compared and discussed with emphasis on the characteristics important in seismic response, including the initial stiffness, ultimate strength and deformation modes observed during the tests. It is shown that TSPSW specimens achieve significant ductility and energy dissipation while the ultimate failure mode resulted from infill plate fracture at the net section of the infill plate-to-boundary frame connection after substantial infill plate yielding. Experimental results are compared to monotonic pushover predictions from computer analysis using strip models and the models are found to be capable of approximating the monotonic behavior of the TSPSW specimens.

THE CLINICAL STUDY OF MANDIBULAR FRACTURE

  • 이동근;임창준
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제11권1호
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    • pp.69-77
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    • 1989
  • This is a retrospective study on 219 patients with mandibular fracture. The patients were treated in the Dept. of Oral Maxillofacial Surgery of WON KWANG UNIV. HOSPITAL from Aug. 1, 1984 to Sept. 30. 1988. The results were as follows. 1. The mandibular fractures occured most frequently in the twenties(35%) and male were predominant (74.7%) than females. 2. The most frequent etiologic factor was traffic accident(34.3%). 3. The most common location of fracture was symphysis(37.1%). And angle(27.6%), condyle(25.7%), ramus(1.6%) were next in order of frequency. 4. In mandible fracture, they have an average 1.8 fracture line. 5. The use of plate & screw system were more increased in the comparison of each year. 6. Intermaxillary fixation period was more reduced from the concept of 6 weeks fixation, due to the use of Plate & screw system. 7. Postoperative acute wound infection was developed 9.6% in 219 mandibular fracture patients. The compression osteosynthesis was most common cause of acute wound infection than any other treatment method. 8. Postoperative malocclusion was developed 4% in 219 mandibular fracture. And the compression osteosynthesis was most common cause of malocclusion. 9. Acute wound infection was detailed by the approach method. The Intraoral & extraoral combination method was most common cause on acute infection and intraoral, extraoral approach method was next in order of frequency. 10. Normal mouth opening process was proportioned to IMF period. The short IMF period have a fast normal mouth opening process.

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