Trochanteric nail design using Thai proximal femoral anthropometry | |
| Author | Kriskrai Sitthiseripratip |
| Call Number | AIT DISS. no. ISE-03-01 |
| Subject(s) | Gamma rays Nails (Anatomy) Femur Geometrical models |
| Note | A dissertation submitted in partial fulfillment of the requirements for the degree of Doctoral of Engineering, School of Advanced Technologies |
| Publisher | Asian Institute of Technology |
| Series Statement | Dissertation ; no. ISE-03-01 |
| Abstract | The trochanteric Gamma nail (TGN, Stryker-Howmedica-Osteonics) is designed to stabilize fractures in trochanteric and subtrochanteric regions. Two main complications associated with the use of the TGN have been reported. First is the surgical problem with improper insertion of the nail and improper placement of the lag screw that may lead to mal-alignment of the fracture and the lag screw cutout of the femoral head respectively. Second is the geometric mismatch between bone and implant in the medullary canal that may cause serious complications such as jamming of the nail in the medullary canal and bursting of the proximal femur during the nail insertion. Fracture of the femur after nailing may occur, which is due mainly to the geometric mismatch. These problems may not occur if the implants are properly designed based on the morphometric data of the proximal femur from Thai population for which the implant will be used. The purpose of this study is to develop a new design of the trochanteric nail based on the morphometric data of the Thai proximal femur with the proper mechanical performance. The approach comprises mainly of three phases. The first phases is to develop a new and advance method of using CT images combined with 3D reverse engineering techniques to obtain the 3D geometric data and evaluate the geometric mismatch of a trochanteric Gamma nail (TGN) in the Thai proximal femur. The second phase is to investigate the in computro testing of the trochanteric Gamma nail in the trochanteric and subtrochanteric fracture models under single-legged stance loading by means of a finite element method. In addition, the influence of lateral muscle loading in the proximal femur was evaluated to determine the appropriate load boundary conditions in the finite element analysis for optimizing the design. The final phase is to combine the results from the first two phases and to develop further a proper design of the trochanteric nail (TN) based on the morphometric data of the Thai proximal femur with the proper mechanical performance. Finally, the new design of the trochanteric nail, which was designed based on the morphometric data of the Thai proximal femur and with the proper mechanical performance, was found that the lag screw and lag screw hole can be reduced from 12-mm to 11-mm. Furthermore the location of lag screw hole, distal locking screw hole in the nail and the length of the nail, lag screw and distal locking screw can be modified according to the 3D morphometric data, which would cover 95% confidence interval for the average size. This new design will provide better quality of fixation and clinical results in the Thai population as compared to the standard trochanteric Gamma nail (TGN). |
| Year | 2003 |
| Corresponding Series Added Entry | Asian Institute of Technology. Dissertation ; no. ISE-03-01 |
| Type | Dissertation |
| School | School of Advanced Technologies (SAT) |
| Department | Department of Industrial Systems Engineering (DISE) |
| Academic Program/FoS | Industrial Systems Engineering (ISE) |
| Chairperson(s) | Bohez, Erik L. J.;Banchong Mahaisavariya, M.D.; |
| Examination Committee(s) | Wuwongse, Vilas;Slaten, Jos Vander; |
| Scholarship Donor(s) | National Metal and Materials Technology Center (MTEC), Thailand; |
| Degree | Thesis (Ph.D.) - Asian Institute of Technology, 2003 |