Dinamik skapulatorasik stabilizasyon sistem tasarımı
Yükleniyor...
Dosyalar
Tarih
2015
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Düzce Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
İnsan omuz eklemi; humerus (kol), klavikula (köprücük), skapula (kürek), kosta (kaburga) ve sternum (iman tahtası) kemiklerinden oluşan vücudun en karmaşık ve hareket genişliği en fazla olan eklemidir. Omuz ekleminin bu geniş hareket kabiliyeti glenohumeral (GH), akromioklavikular (AK), sternoklavikular (SK) ve skapulotorasik (ST) eklemler ile sağlanır. Bu eklemlerden biri olan ST eklemin hareketleri omuz kinezyolojisi açısından büyük bir öneme sahiptir ve skapulayı etkileyen patolojiler direk veya dolaylı olarak GH eklem fonksiyonunu etkilemektedir. Konservatif veya dinamik cerrahilerle başarı elde edilemeyen olgularda hem kozmetik hem de GH eklemin fonksiyonunu arttırmak için kurtarıcı yöntem olarak skapulotorasik füzyon (STF) ameliyatları tercih edilmektedir. STF cerrahisi sonrası omuz ekleminde fonksiyonel artışın tam olarak elde edilememesinden dolayı bu sorunun ortadan kaldırılması için yeni sistemlere ihtiyaç duyulmaktadır. Bu tez çalışmasının amacı STF sonrası GH ve AK eklemlerde oluşan gerilmeleri, sonlu elemanlar analiz yöntemi kullanılarak araştırmak ve STF cerrahisi yerine kullanılabilecek yeni bir implant tasarlanarak mevcut sonuçlar ile implantın kullanıldığı modellerde elde edilen sonuçları kıyaslayarak yeni bir dinamik skapulotorasik stabilizasyon (DSS) sisteminin uygulanabilirliğini sonlu elemanlar analiz yöntemi ile değerlendirmektir. Bu çalışmada, sağlıklı insan omuz kavşağı kesitlerini içeren bilgisayarlı tomografi görüntüleri MIMICS® programı kullanılarak üç boyutlu referans omuz modeli oluşturulmuştur. Bu model üzerinde skapula, STF cerrahisine göre doğru açıda döndürülerek kaburgalara sabitlenerek ikinci model, daha sonra ise referans model üzerine uygun şekilde yerleştirilen yeni tasarlanmış implantlı model oluşturulmuştur. Cad programında yumuşak doku ve kıkırdak yapılar modellendikten sonra, oluşturulan her üç modelde sonlu elemanlar programı kullanılarak analiz edilmiştir. Tez çalışmasından elde edilen sonuçlara göre STF cerrahisinin omuz eklemi bağ ve kıkırdak yapılarını olumsuz etkilediği, DSS sistemi kullanıldığı durumlarda ise elde edilen maksimum eşdeğer gerilmelerin referans modele daha yakın olduğu ve yeni tasarlanan implantın dayanıklılığının kullanılabilir ölçüde yeterli olduğu görülmüştür. Sonuç olarak, daha fazla hareketle beraber sabitliği de sağlayan DSS sistemi, bu amaçla üretimi planlanan öncül implant olarak bu tez çalışmasında değerlendirilmiş olup üretim için olumlu sonuçlar elde edilmiştir.
Human shoulder joint is the most complex joint of the body, having the largest range of motion. Shoulder Joint complex consist of humerus (arm), clavicle (collarbone), scapula (shoulder blade), costa (rib) and sternum (rib cage) bones. This wide movement ability of the shoulder joint is enabled by glenohumeral (GH), acromioclavicular (AC), sternoclavicular (SC) and scapulothoracic (ST) joints. The ST joint is one of these aforementioned joints, that has a great significance in terms of shoulder kinesiology .Due to some specific pathologies the ST motion may directly or indirectly affect the GH joint functions. Scapulothoracic fusion (STF) may be an alternative and salvage procedure in the treatment of above mentioned disorders which could not be treated conservatively or using other dynamic surgical techniques. The primary indication of STF is pain relief; the secondary is improvement of function. We hypothesized that; STF may increase the loadings on GH, AC joints and ligaments by affecting the scapular motion, which is important for scapulohumeral rhythm. So new systems may be required to decrease loadings on shoulder girdle and increase the functional results. The aim of this thesis study is to research the distensions which occur in GH and AC joints after STF surgery by using the finite elements analysis method and to evaluate the feasibility of a new dynamic scapulothoracic stabilization (DSS) system with finite elements analysis method by designing a new implant which could be used instead of STF surgery. In this study, three-dimensional reference shoulder model was created by using computed tomography images consisting of healthy human shoulder junction sections with MIMICS® program. Second model was formed by rotating the scapula on this model in a straight angle compared to STF surgery and stabilizing it to the ribs, afterwards newly-designed implanted model which was suitably placed on the reference model was formed. After modelling soft tissue and cartilage structures in Cad program, all three models were analyzed by using the finite elements program. According to the results obtained from the thesis study, it was observed that STF surgery affects ligaments and cartilage structures negatively, maximum equivalent stresses obtained in case of DSS system were closer to the reference model and the durability of the newly-designed implant was sufficient in terms of usability. In conclusion, DSS system which ensures stabilization as well as more movement was evaluated as precursor implant planned to be produced with this purpose and positive results were obtained for its production.
Human shoulder joint is the most complex joint of the body, having the largest range of motion. Shoulder Joint complex consist of humerus (arm), clavicle (collarbone), scapula (shoulder blade), costa (rib) and sternum (rib cage) bones. This wide movement ability of the shoulder joint is enabled by glenohumeral (GH), acromioclavicular (AC), sternoclavicular (SC) and scapulothoracic (ST) joints. The ST joint is one of these aforementioned joints, that has a great significance in terms of shoulder kinesiology .Due to some specific pathologies the ST motion may directly or indirectly affect the GH joint functions. Scapulothoracic fusion (STF) may be an alternative and salvage procedure in the treatment of above mentioned disorders which could not be treated conservatively or using other dynamic surgical techniques. The primary indication of STF is pain relief; the secondary is improvement of function. We hypothesized that; STF may increase the loadings on GH, AC joints and ligaments by affecting the scapular motion, which is important for scapulohumeral rhythm. So new systems may be required to decrease loadings on shoulder girdle and increase the functional results. The aim of this thesis study is to research the distensions which occur in GH and AC joints after STF surgery by using the finite elements analysis method and to evaluate the feasibility of a new dynamic scapulothoracic stabilization (DSS) system with finite elements analysis method by designing a new implant which could be used instead of STF surgery. In this study, three-dimensional reference shoulder model was created by using computed tomography images consisting of healthy human shoulder junction sections with MIMICS® program. Second model was formed by rotating the scapula on this model in a straight angle compared to STF surgery and stabilizing it to the ribs, afterwards newly-designed implanted model which was suitably placed on the reference model was formed. After modelling soft tissue and cartilage structures in Cad program, all three models were analyzed by using the finite elements program. According to the results obtained from the thesis study, it was observed that STF surgery affects ligaments and cartilage structures negatively, maximum equivalent stresses obtained in case of DSS system were closer to the reference model and the durability of the newly-designed implant was sufficient in terms of usability. In conclusion, DSS system which ensures stabilization as well as more movement was evaluated as precursor implant planned to be produced with this purpose and positive results were obtained for its production.
Açıklama
YÖK Tez No: 394482
Anahtar Kelimeler
Biyomühendislik, Bioengineering
