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Development of personalized osteotomy technique for the first metatarsal bone

机译:第一个跖骨骨的个性化骨质切开技术的开发

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Surgical methods form the basis of modern approach to forefoot deformities correction. Scientific and practical interestin this topic is based on the patients’ growing need for specialized care, which is required by 64% of women and 25% ofmen. In most cases, there is bilateral deformation of both feet. Some scientists are strongly against simultaneous surgeryon both feet. It is obvious that the solution regarding acceptability of the load in the early postoperative period requiresquantitative individual assessment. This assessment can be performed using biomechanics. This paper presents thetechnique for assessing the bone-screw system when performing corrective osteotomies of the first metatarsal bone basedon biomechanical methods. This technique allows to perform comparative analysis of various osteotomy methods for aparticular patient. In this study we examined Chevron and Scarf osteotomy with displacement of bone fragments by 1/3and 2/3 with different fixation variants. To solve this problem, personalized geometric models of the first metatarsalbone were built on the basis of computed tomography data using 3D Slicer and SolidWorks systems. The implant modelswere built as well. Finite element analysis was carried out using Ansys Workbench software. The focus of the study wasto analyse stresses that occur on the plantar surface of the first metatarsal bone head during walking. Assessment of themaximum allowable shift of bone fragments for normalization of the forefoot deformities was carried out. The developedtechnique allows to choose osteotomy variant and justify the possibility of simultaneous surgery on both feet for aparticular patient.
机译:手术方法构成了现代方法的基础,用于前足畸形校正。科学与实际的兴趣在本主题的基础上是基于患者日益增长的专业护理,这是64%的妇女所需的,25%男人。在大多数情况下,双脚都有双边变形。一些科学家强烈反对同时手术双脚。很明显,术后早期负载可接受性的解决方案需要定量个体评估。可以使用生物力学进行该评估。本文呈现用于评估骨螺杆系统在执行第一个跖骨骨骼的矫正骨质术时论生物力学方法。该技术允许对A的各种截骨术方法进行比较分析特定患者。在这项研究中,我们通过1/3检查了骨碎片位移的雪佛龙和围巾骨质图和2/3,具有不同的固定变体。解决这个问题,第一个跖骨的个性化几何模型骨骼是基于使用3D Slicer和SolidWorks系统的计算机断层扫描数据构建的。植入模型也建成了。使用ANSYS Workbench软件进行有限元分析。研究的重点是分析步行期间第一个跖骨头的跖面上发生的应力。评估这一点进行了骨片段的最大允许偏移用于预调节畸形的标准化。发达国家技术允许选择截骨变异,并证明双脚同时手术的可能性特定患者。

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