TY - JOUR T1 - Klavikula Kırıklarında Plak Uygulamasının Yerleşim Konumuna Göre Yorulma Davranışının Sonlu Elemanlar Yöntemi ile İncelenmesi TT - Investigation of Fatigue Behaviour Of Plate Applications In Clavicle Fractures By Finite Element Method According to The Plate Replacement Position AU - Uğur, Levent AU - Karadeniz, Selami AU - Özkan, Arif AU - Gültekin, Alper PY - 2019 DA - March DO - 10.2339/politeknik.466176 JF - Politeknik Dergisi PB - Gazi Üniversitesi WT - DergiPark SN - 2147-9429 SP - 69 EP - 74 VL - 22 IS - 1 LA - tr AB - Amaç; Klavikula, omuz ve kolunhareketlerinde önemli bir göreve sahip olan anatomik bir yapıdır. Klavikulakırıkları iskelet sistemi yaralanmaları içerisinde sık karşılaşılan birproblemlerdendir. Klavikula kırıklarında, kırığın türüne göre çeşitliimplantlar kullanarak omuzun ağrısız ve fonksiyonlarını en uygun düzeyegetirmek asıl amaçtır. Bu çalışmada klavikula kırıklarındakullanılan anatomik plak uygulamasının biyomekanik açıdan incelenmesiamaçlanmıştır.Yöntem; Bu çalışmada, DICOMformatında bilgisayarlı tomografi görüntüleri kullanılarak normal anatomiyesahip klavikula modellenmiş ve klavikula üzerinde kırık hattı oluşturularaksuperior ve anteriora plak yerleştirilmiştir. Plaklarda meydana gelengerilmeler, oluşturulan modeller üzerine eksenel kompresyon ve konsol bükmeyüklemeleri uygulanarak non-lineer sonlu elemanlar yöntemi ile incelenmiştir.Analizler, ANSYS (surum 18) sonlu elemanlar programında yapılmış vetüm modellerde aynı sınır şartları uygulanmıştır.Bulgular; Analizlerde plaklarüzerinde meydana gelen maksimum eşdeğer gerilmelere (MES) bakılmış ve özellikleanteriora yerleştirilen plakta gerilmenin azaldığı tespit edilmiştir. Klavikulaüzerine yerleştirilen plakların konumlarına göre yorulma davranışlarıkarşılaştırılmıştır.Sonuçlar; Bu çalışmada,klavikulanın anteriorüne yerleştirilen plaklarda gerilmenin daha az olduğusonlu elemanlar yöntemi ile gösterilmiştir. Ayrıca, anterior bölgeyeyerleştirilen plakların en uzun ömre sahip olmasından dolayı kırılma kararlığıaçısından daha güvenli olduğu belirlenmiştir. KW - Omuz KW - klavikula KW - plak KW - Sonlu Elemanlar Analizi N2 - Background:The clavicle is an anatomical structure whıch has an important role on themovements of the shoulder and arm. Clavicular fractures are a common problem inskeletal system injuries. The main purpose is to achieve a painless shoulderjoint and to optimise its function ıin clavicle fractures.n this study, it wasaimed to investigate biomechanically the application of anatomic plaque used inclavicle fractures.Methods: In this study, a normal anatomical clavicle wasmodeled using computed tomography images in DICOM format, a fracture line wascreated on the clavicle and the plate was placed superiorly and anteriorly.Thestresses on the plates under axial compression and console bending wereinvestigated on the formed models by using finite element method. Analyzes weremade non-linear using ANSYS (v.18) and same limit conditions were applied inall models. Findings: The maximum equivalent stresses (MES) on the plaques wereobserved in the analyzes and it was found that the tension on the plaque,especially placed anteriorly, decreased.Fatigue behaviours were comparedaccording to the positions  of the platesplaced on the clavicle. Results: In this study, the finite element method wasused which showed less tension on the plates placed on the anterior of theclavicle.It was also found that the plates placed in the anterior region weresafer in terms of fatigue fracture stability due to longest longevity of theplates. CR - [1] Gustilo, R.B., R.M. Mendoza, and D.N. Williams, "Problems in the management of type III (severe) open fractures: a new classification of type III open fractures. " Journal of Trauma and Acute Care Surgery, 24(8): 742-746,( 1984.) CR - [2] Postacchini, F., et al., "Epidemiology of clavicle fractures." Journal of Shoulder and Elbow Surgery, 11(5): 452-456,( 2002). CR - [3] Robinson, C.M., "Fractures of the clavicle in the adult: epidemiology and classification." The Journal of bone and joint surgery. British volume, 80(3): 476-484,( 1998). CR - [4] Nordqvist, A. and C. Petersson, "The incidence of fractures of the clavicle." Clinical Orthopaedics and Related Research, 127-132,( 1994). CR - [5] Canadian, O.T.S., "Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures. A multicenter, randomized clinical trial". The Journal of bone and joint surgery. American 89(1): 1, (2007). CR - [6] Eden, L., et al., "Biomechanical comparison of the locking compression superior anterior clavicle plate with seven and ten hole reconstruction plates in midshaft clavicle fracture stabilisation." International orthopaedics,. 36(12): 2537-2543,(2012). CR - [7] Renfree, T., B. Conrad, and T. Wright, "Biomechanical comparison of contemporary clavicle fixation devices." The Journal of hand surgery, 35(4): 639-644,( 2010). CR - [8] Nourian, A., et al., "Midshaft Fractures of the Clavicle: A Meta-analysis Comparing Surgical Fixation Using Anteroinferior Plating Versus Superior Plating." Journal of orthopaedic trauma, 31(9): 461-467,( 2017). CR - [9] Marie, C., "Strength analysis of clavicle fracture fixation devices and fixation techniques using finite element analysis with musculoskeletal force input." Medical & biological engineering & computing, 53(8): 759-769,( 2015). CR - [10] Uğur, L., "Pedikül vidasının yerleşim konumuna göre yorulma davranışının sonlu elemanlar yöntemiyle incelenmesi." Sakarya University Journal of Science, 20(2): 301-306,( 2016). CR - [11] Favre, , et al., "Superior versus anteroinferior plating of the clavicle: a finite element study. Journal of orthopaedic trauma", 25(11): 661-665,( 2011). CR - [12] Iannolo, M., et al., "Forces across the middle of the intact clavicle during shoulder motion." Journal of shoulder and elbow surgery, 19(7): 1013-1017(2010). CR - [13] Scepi, M., et al., "A three-dimensional model of the shoulder girdle. Forces developed in deltoid and supraspinatus muscles during abduction." Surgical and Radiologic Anatomy, 26(4): 290-296,( 2004). CR - [14] Altamimi, S.A. and M.D. McKee, "Nonoperative treatment compared with plate fixation of displaced midshaft clavicular fractures:" Surgical technique. JBJS, 90(Supplement_2_Part_1): 1-8,( 2008). CR - [15] Althausen, L., et al., "Clinical and financial comparison of operative and nonoperative treatment of displaced clavicle fractures." Journal of shoulder and elbow surgery, 22(5): 608-611,( 2013) CR - [16] Xu, J., et al.,"Operative versus nonoperative treatment in the management of midshaft clavicular fractures: a meta-analysis of randomized controlled trials." Journal of shoulder and elbow surgery, 23(2): 173-181,( 2014). CR - [17] Hill, J.M., M.H. Mcguire, and L.A. Crosby, "Closed treatment of displaced middle-third fractures of the clavicle gives poor results." The Journal of bone and joint surgery. British , 79(4): 537-538,( 1997). CR - [18] Iannotti, M., et al., "Effects of plate location and selection on the stability of midshaft clavicle osteotomies: a biomechanical study. " Journal of shoulder and elbow surgery, 11(5): 457-462,( 2002). CR - [19] Chen, C.-E., R.-J. Juhn, and J.-Y. Ko, "Anterior-inferior plating of middle-third fractures of the clavicle." Archives of orthopaedic and trauma surgery, 130(4): 507-511, (2010). CR - [20] Kloen, , et al., "Anteroinferior plating of midshaft clavicular nonunions." Journal of orthopaedic trauma, 16(6): 425-430, (2002). UR - https://doi.org/10.2339/politeknik.466176 L1 - https://dergipark.org.tr/tr/download/article-file/546163 ER -