_of pedicle screw spinal fixation for fractures 椎弓根螺钉脊柱内固定骨折的比较课件

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1、Bridgevs.TensionBandConstructforSpinalFracturesFixation:ABiomechanicalAnalysisC.Richards,J.Ouellet,M.Fouse,N.Noiseux,P.Jarzem,R.Reindl,D.Giannitsios,T.SteffanORTHOPAEDICRESEARCHLABORATORYDivisionofOrthopaedicSurgery,McGillUniversityProblemTraditionalpediclescre

2、winstrumentation:ParalleltoendplateKyphoticcollapseisaknowncomplicationRiskofposteriorpulloutifnotsupportedanteriorlyHypothesisForspinalfracturefixationbridge-typefixation=divergentscrewsvs.tension-band=parallelscrewsSignificantlystifferBetterresistancetofailure

3、inkyphosisBetterresistancetoscrewpull-outHypothesis>Hypothesis>PurposeBridgevs.TensionBandConstructsConstructstiffnessUltimatefailureloadStiffnessUltimateFailureLoadMaterialsandMethodsFiniteElementAnalysisofASTMPolyethyleneConstructsMethodsandMaterialsFiniteElem

4、entAnalysisofASTMPolyethyleneConstructsMechanicaltestingofASTMPolyethyleneConstructMethodsandMaterialsFiniteElementAnalysisofASTMPolyethyleneConstructsMechanicaltestingofASTMPolyethyleneConstructMechanicaltestingofCadavericConstructsASTMCorpectomyModelUHMWPEbloc

5、ksWorstcasescenarioforvertebralbodyfractureFollowedpreciselyforT-BConstructsPediclescrewsinsertedparalleltohorizontalplaneASTMCorpectomyModelAlteredforBridgeConstructsChangeinpediclescreworientationw.r.t.horizontalplane16.5ºsuperiorly26.4ºinferiorlyFiniteElement

6、AnalysisLinearFEA3-DmodelsofASTMconstructsMechanicalpropertiesofpolyethyleneandtitaniumFiniteElementAnalysisModelsloadedat100N,300N,&600NDisplacementdatageneratedforeachloadPolyethyleneConstruct6constructsbuilt3TB3BridgeConstructsloadedusingMTSLoadanddisplacemen

7、tdatageneratedCadavericConstructs6malecadaversdissected3MatchedpairsbasedonVertebralbodysizeandBMDinstrumented@T11-L13–TBConstruct3–BridgeConstruct#2OsteotomeCadavericConstructsPottedinPMMAAnterosuperiorendplateofsuperiorvertebrafreeAnteroinferiorendplateofinfer

8、iorvertebrafreeCadavericConstructsLoadedusingMTSLoadanddisplacementdatageneratedResults–Stiffness(N/mm)34.121.617.320.615.218.4FEAPolyethyleneCadaversp=0.015p=0.012Re