REVERSE ENGINEERING OF THE MITKOVIC TYPE INTERNAL FIXATOR FOR LATERAL TIBIAL PLATEAU

In orthopaedic surgery it is very important to use proper fixation techniques in the treatment of various medical conditions, i.e. bone fractures or other traumas. If an internal fixation method, such as plating, is required, it is possible to use Dynamic Compression Plates (DCP) or Locking Compression Plates (LCP) and their variants. For DCP implants it is important to match the patient's bone shape with the most possible accuracy, so that the most frequent implant bending is applied in the surgery. For LCP implants it is not so important to match the patient’s bone shape, but additional locking screw holes are required. To improve the geometrical accuracy and anatomical correctness of the shape of DCP and to improve the LCP geometric definition, new geometrical modelling methods for the Mitkovic type internal fixator for Lateral Tibia Plateau are developed and presented in this research. The presented results are quite promising; it can be concluded that these methods can be applied to the creation of geometrical models of internal fixator customized for the given patient or optimized for a group of patients with required geometrical accuracy and morphological correctness

Interdisciplinary crossover for rapid advancements: Collaboration between medical and engineering scientists with the focus on Serbia

Napretku medicine su poslednjih decenija veoma mnogo doprineli pronalasci iz različitih oblasti inženjerstva. Polovinom dvadesetog veka uspostavlja se nova naučna oblast, biomedicinsko inženjerstvo (BI), koje se do sada razvilo u veoma složenu naučnu disciplinu koja je zahtevala i poseban obrazovni profil. Na univerzitetima širom sveta, kao i na nekoliko univerziteta u Srbiji ustanovljeni su različiti programi iz oblasti biomedicinskog inženjerstva. Takođe, u nekoliko naučnih institucija u Srbiji sprovode se intenzivna istraživanja u ovoj oblasti. U ovom radu prikazani su rezultati istraživanja nekoliko grupa naučnika iz oblasti inženjerstva i medicine sa ciljem da se ilustruje koliko je široko polje istraživanja u oblasti biomedicinskog inženjerstva i kakve su mogućnosti njihove primene u dijagnostici i lečenju različitih bolesti.Over the past decades, development of engineering sciences has vastly contributed to advancements in medicine by production of numerous devices for diagnostics and treatment. In the middle of the 20th century, a new scientific field, biomedical engineering (BE), was established, which has developed into an extremely complex scientific discipline requiring a distinctive educational profile. Various study programs in BE have been established at universities around the world but also at several universities in Serbia. Also, intensive research in this field is performed at several scientific institutions in Serbia. In the present paper, short summaries of the research results of several groups of engineers and medical doctors are presented as an illustration of the wide field of BE research and possibilities of its application in diagnosis and therapy of various diseases

Operation time and intraoperative fluoroscopy time in different internal fixation methods for subtrochanteric fractures treatment

Introduction/Objective. Subtrochanteric fractures are unstable, tending to a varus, antecurvatum, and shortening deformity. The aim of this paper was to compare operation time and fluoroscopy time between different internal fixation methods in the treatment of subtrochanteric fractures. Method. The prospective study of the group of 27 patients with a subtrochanteric fracture treated by the SIF (selfdynamisable internal fixator with a trochanteric unit) method had been done. Operation time and fluoroscopy time values from this group were compared to the same parameters data from the literature for intramedullary (IM) nails, proximal femur locking plates (PF-LCP), dynamic condylar screws (DCS), and the 95°-angled blade plate. Results. In the SIF group, operation time was 62.2 (25–140) minutes and fluoroscopy time was 43 (20–95) s. Average operation time from the literature data was: 102.1 (43–181) minutes for IM nail, 94.2 (75–129) minutes for PF-LCP, 105.3 (70–166) minutes for DCS and 221.5 (171–272) minutes for blade plate. Average fluoroscopy time from the literature data was: 109.6 (34–250) seconds for IM nail, 102.3 (47–180) seconds for PF-LCP, 238 seconds for DCS. Operation time and intraoperative fluoroscopy time were higher in IM nail, PF-LCP, DCS and blade plate comparing to SIF method (p < 0.05). Conclusion. The above mentioned difference could be explained by a degree of required accuracy in the initial operative technique maneuvers, by used number of screws and by the type of the fracture reduction performance in different fixation methods. Operation time during IM nailing of subtrochanteric fractures sometimes can be shorter than average operation time in SIF method, what could be explained by the skill of the surgeon to perform as fast closed reduction for insertion of guide wire. [Project of the Serbian Ministry of Education, Science and Technological Development, Grant no. III41017: Virtual human osteoarticular system and its application in preclinical and clinical practice

Open wedge osteotomy and callus distraction by means of the external fixator in distal femur and proximal tibia in knee arthrosis with valgus and varus deformity

Various methods can be applied for treatment of knee deformity. One of them is open wedge osteotomy and callus distraction by means of the external fixator. This paper presents the results of treatment of 16 patients with knee arthrosis associated with varus and valgus deformities (10 varus and 6 valgus deformities). Open wedge osteotomy of the varus deformity was performed in the proximal tibia, and in case of the valgus deformity in the distal part of the femur. The patients who were operated on had a knee varus larger than 10 degrees and a knee valgus larger than 12 degrees. Prior to open wedge osteotomy and application of the external fixator, knee arthroscopy was performed (meniscectomy, cartilage drilling and shaving, debridement, the extraction of loose bodies). After one-year follow-up, the final outcome of the treatment was positive in all patients. The treatment alleviated the pain in these patients. The method is minimally invasive and relatively easily applied. Mitkovic's external fixator type M20-CD-V allows for continuous callus distraction with simultaneous correction of the varus or valgus knee deformity