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Orthopedic Biomechanics 沈文哲 台灣 高雄市 博正醫院
Course Objectives Why are we studying this? Terminology Understanding the condition Management of fractures Design and application of implants
Stress Strain Curve Strain
Load Deformation Curve
Tension band Converts tension forces into compression forces
Which is Strongest? How many twists are needed?
Which hand do you hold the cane? 1) Rt side 2) Left side 3) No difference 4) Depends on the lumbar spine status Osteonecrosis Rt hip is painful
The Non-Painful Side
Which leg goes first when climbing stairs? Rt knee is painful
好腳上天堂, 壞腳下地獄 Painful knee kept straight.
Which brace to order?
Think of the Forces 3-point fixation
Where to place the knot? Submandibular position “long drop” 83kg – 173 cm 51kg – 244 cm hyperextension distraction
Fracture Patterns AO classification (Muller)
Classification Based on Mechanism of Injury Allen classification of cervical spine injuries
Plate Fixation 6 wks3 mo1 yr
A Load Bearing Construct 1 mo12 mo
How long a plate? What kind of screw? Lag screw
What angle? Where to put the plate?
Placement of Implant
How long? How thick? Titanium? Solid? Cross section? Fluted? Tapered? Bowing? Reaming? Interlocking? Cost!
Stress risers Removal?
Load Sharing and Stress Shielding Re-fracture
Wolff’s Law Bone deposits along lines of stress transmission
External Fixators Rubber band
Hip Screws Gamma nail
Choice of Implant
Choices of Stem
“ 軟骨凸出壓迫神經 ”
Rank the intradiscal pressures Bending forward at waist Squatting Sitting Standing Supine
How big can you make the hole? 1) 75% of lamina 2) 50% of lamina 3) 75% of facet 4) 50% of facet 5) 25% of facet
Spondylolisthesis Reduction flexion
Missing Anterior Strut
Fatigue Failure of the Screw
Fusion Cage 椎籠 “ 子彈 ” Anterior Strut Only
Does Not Resist Extension Forces
40% Failure Rate Biomechanically, an anterior strut requires posterior support. “Supported on two rollers”
Combined Ant/Post Fusion
Stress Transfer 6 wks post-op 2 yrs post-op
13+2 ♀ Menarche: 6 mo Risser II
13+2 ♀ 7
3-D Vector Analysis Instrumentation design Translate or Rotate?
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Back Safety. © Business & Legal Reports, Inc Session Objectives You will be able to: Understand how back injuries occur Prevent back injuries Use.
ORDERED TO: REDUCE PHYSICAL ACTIVITY REDUCE PAIN ENCOURAGE REST REGAIN STRENGTH PROMOTE HEALING MAY BE ON: COMPLETE (STRICT) BED REST BEDREST WITH BATHROOM.
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Neck & Back Care Michelle Kwong B.HSci(Phty), MSPA, Cert. Clinical Pilates Principal Physiotherapist Practice Director
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GCSE Physical Education Information/Discussion Practical Application Links Diagram/Table Activity Revision MAIN MENU The Muscular, Skeletal, Respiratory.
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