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. 2021 Nov 9:2021:6607364.
doi: 10.1155/2021/6607364. eCollection 2021.

Mathematical Modelling of Destabilization Stress Factors of Stable-Elastic Fixation of Distal Trans- and Suprasyndesmotic Fibular Fractures

Andriy Chuzhak  1 , Vadym Sulyma  1 , Lіubomyr Ropyak  2 , Andrii Velychkovych  2 , Vasyl Vytvytskyi  2
Affiliations

Mathematical Modelling of Destabilization Stress Factors of Stable-Elastic Fixation of Distal Trans- and Suprasyndesmotic Fibular Fractures

Andriy Chuzhak et al. J Healthc Eng. .

Abstract

Introduction: Specification of possible stress factors destabilizing the fibula stable osteosynthesis by the intramedullary nail with distal blocking and elastic fixation of distal syndesmosis by the thread with endobuttons by mathematical modelling of distal unstable ankle injuries. Material and Methods. We studied the thread tension during the combined stable-elastic fixation of unstable injuries of the ankle joint in cross-syndesmosis fractures of the fibula (B, C Danis-Weber classification), which includes a one-time stable minimally invasive fixation with the intramedullary nail and elastic fixation by the thread with endobuttons. We used a titanium alloy for the intramedullary nail and polyester for the thread. The deformed state was studied using the methods of mechanics.

Results: A model of a fractured fibula blocked with the intramedullary nail and fixed with the elastic thread was developed. A formulation to specify the rational tension forces of the elastic thread depending on the parameters of the fibula and intramedullary blocking nail and on the location of the bone injury was obtained. The effect of foot rotation on the thread tension was investigated. The results of theoretical research should be implemented in medical practice.

Conclusions: A mathematical model of the damaged fibula blocked by the intramedullary nail and fixed with the elastic thread was developed. Dependences for calculation of tension of the fixing thread were obtained. A slight increase in thread tension during foot rotation was found.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
The general view of tibia (a), the model of intact fibula (b), and the model of tibia with the fracture blocked by the intramedullary nail and fixed by the elastic thread (c).
Figure 2
Figure 2
Angles of rotation of cross sections (a) and deflections (b) of the fibula: 1 is the fractured bone blocked by the intramedullary nail and fixed with the elastic thread; 2 is the healthy bone loaded with fixing thread.
Figure 3
Figure 3
Determination of the fixing thread tension force for the stable-elastic fixation of unstable fractures of the ankle joint with damage to syndesmosis for the person of high height (a) and for the person of low height (b). 1 is the fractured fibula blocked by the intramedullary nail; 2 is the healthy fibula.
Figure 4
Figure 4
The model of fibula displacement during rotation of the foot (a) and the dependence of the additional tension in the fixing thread refer to displacement (b): 1–d/a=2/3and D/a=1 and 2–d/a=1 andD/a=2.
See this image and copyright information in PMC

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