فهرست:
1 فصل اول مقدمه. 1
1.1 تثبیت جناغ سینه. 2
1.2 هدف پژوهش.... 5
1.3 خلاصه فصل‌های بعدی.. 5
2 فصل دوم جراحی قفسه سینه. 6
2.1 آمار جراحی قلب باز 7
2.2 آناتومی قفسه سینه. 8
2.2.1 قفسه سینه. 8
2.2.2 دنده‌ها 9
2.2.3 مهره‌های شرکت‌کننده در ساختمان قفسه سینه. 10
2.2.4 جناغ سینه. 11
2.2.5 عضلات سینه. 11
2.2.6 پرده دیافراگم. 13
2.2.7 چگونگی حرکت دنده‌ها در حین تنفس.... 14
2.2.8 تغییر شکل قفسه سینه. 14
2.3 آناتومی جناغ سینه. 15
2.3.1 ساختار و عملکرد. 15
2.3.2 پوکی استخوان.. 18
2.3.3 چالشهای وابسته به آناتومی و فیزیولوژی مرتبط با تثبیت جناغ. 18
2.4 استرنوتومی.. 19
2.5 نحوه بارگذاری جناغ. 20
3 فصل سوم روشهای بستن و تثبیت جناغ سینه. 22
3.1 تثبیت غیر سفت... 23
3.1.1 تثبیت باسیم. 23
3.2 تثبیت سفت و سخت... 25
3.2.1 سیستم بستن سریع جناغ تالن.. 26
3.2.2 سیستم پیچ و پلاک... 26
3.2.2.1 سیستم پیچ و پلاک ضدلق بودن.. 32
3.2.2.2 طرح میکروتثبیت کننده بایومت.... 32
3.2.2.3 سیستم پلاک ویالپی فوت گروه اسمیت و نفیو. 33
3.2.2.4 سیستم تیاس قفل رزوهای کیالاس مارتین... 34
3.2.2.5 سیستم قفل سریع سینتز سیاسالپی... 35
3.2.3 سیستم تثبیت کننده زیپفیکس.... 36
3.3 جمع‌بندی.. 40
4 فصل چهارم شبیه‌سازی بستن و تثبیت جناغ سینه. 44
4.1 مدل المان محدود. 45
4.1.1 الگوریتم حل مسئله. 45
4.1.2 هندسهی مدل.. 47
4.1.2.1 مدلسازی قفسه سینه. 48
4.1.2.2 مدلسازی زیپ فیکس..... 58
4.1.2.3 مونتاژ مدل سه‌بعدی... 61
4.1.3 خواص مواد ورودی نرم افزار 62
4.1.4 مراحل شبیه‌سازی.. 62
4.1.5 شرایط تقابل.. 63
4.1.6 نیرو و شرایط مرزی.. 63
4.1.7 مش بندی.. 65
5 فصل پنجم نتایج و بحث... 67
5.1 نتایج مدلسازی.. 68
5.1.1 نتایج مرحله اول مدلسازی؛ بسته شدن زیپ فیکس ها 68
5.1.2 نتایج مرحله دوم مدلسازی؛ اعمال نیروی فیزیولوژیکی.. 75
5.2 بحث و نتیجه گیری.. 85
5.2.1 مرحله اول؛ بسته شدن زیپفیکس ها 85
5.2.2 مرحله دوم؛ اعمال نیروی فیزیولوژیک... 87
6 فصل ششم جمع‌بندی و پیشنهاد‌ها 90
منابع و مراجع.. 95
منبع:
[1] V. L. Roger, A. S. Go, D. M. Lloyd-Jones, R. J. Adams, J. D. Berry, T. M. Brown, M. R. Carnethon, S. Dai, G. de Simone, and E. S. Ford;“Heart disease and stroke statistics—2011 update a report from the American Heart Association”,Circulation,No. 4, pp. e18-e209,2011.
[2] A. Casha, L. Yang, P. Kay, M. Saleh, and G. Cooper;“A biomechanical study of median sternotomy closure techniques”,European journal of cardio-thoracic surgery,No. 3, pp. 365-369,1999.
[3] D. Song, "Design of a Screw Plate System to Minimize Screw Loosening in Sternal Fixation," Worcester Polytechnic Institute, 2011.
[4] E. L. Bek, K. L. Yun, G. S. Kochamba, and T. A. Pfeffer;“Effective median sternotomy closure in high-risk open heart patients”,The Annals of thoracic surgery,No. 4, pp. 1317-1318,2010.
[5] W. Ozaki, S. R. Buchman, M. D. Iannettoni, and E. P. Frankenburg;“Biomechanical study of sternal closure using rigid fixation techniques in human cadavers”,The Annals of thoracic surgery,No. 6, pp. 1660-1665,1998.
[6] D. Buckley, "Design of a Unicortical Screw-Plate System for the Optimization of Sternal Fixation," Worcester Polytechnic Institute, 2012.
[7] http://www.medgadget.com/2008/08/the_sternal_talon_is_it_a_chest_zipper_or_is_it_an_armor.html [Online].
[8] http://www.nia.nih.gov/newsroom/2008/03/americans-living-longer-enjoying-greater-health-and-prosperity-important [Online].
[9] http://www.quiz.biz/quizz-311743.html [Online].
[10] http://en.wikipedia.org/wiki/File:Chest.jpg [Online].
[11] http://www.newhealthguide.org/Sternum-Pain.html [Online].
[12] J. C. Dieselman, "Comparison of Alternative Rigid Sternal Fixation Techniques," University of Massachusetts Medical School, 2011.
[13] http://www.todayifoundout.com/index.php/2010/06/what-causes-the-pain-in-your-side-you-may-occasionally-feel-while-running/ [Online].
[14] http://www.britannica.com/EBchecked/topic/565822/sternum [Online].
[15] H. Gray, Gray's Anatomy: With original illustrations by Henry Carter: Arcturus Publishing, 2009.
[16] N. Özkaya, M. Nordin, D. Goldsheyder, and D. Leger, Fundamentals of biomechanics: equilibrium, motion, and deformation: Springer, 2012.
[17] A. Ratnovsky and D. Elad;“Anatomical model of the human trunk for analysis of respiratory muscles mechanics”,Respiratory physiology & neurobiology,No. 3, pp. 245-262,2005.
[18] J. E. Hall, Guyton and Hall Textbook of Medical Physiology: Enhanced E-book: Elsevier Health Sciences, 2010.
[19] http://nof.org/articles/235 [Online].
[20] C. Cohen and L. V. Griffin;“A biomechanical comparison of three sternotomy closure techniques”,The Annals of thoracic surgery,No. 2, pp. 563-568,2002.
[21] C. Wangsgard, D. J. Cohen, and L. V. Griffin;“Fatigue testing of three peristernal median sternotomy closure techniques”,Journal of cardiothoracic surgery,No. 1, pp. 52,2008.
[22] S. Pai, "In vivo characterization of respiratory forces on the sternal midline following median sternotomy," Worcester Polytechnic Institute, 2005.
[23] S. Pai, N. J. Gunja, E. L. Dupak, N. L. McMahon, T. P. Roth, J. F. Lalikos, R. M. Dunn, N. Francalancia, G. D. Pins, and K. L. Billiar;“In vitro comparison of wire and plate fixation for midline sternotomies”,The Annals of thoracic surgery,No. 3, pp. 962-968,2005.
[24] A. R. Casha, L. Yang, and G. J. Cooper;“Measurement of chest wall forces on coughing with the use of human cadavers”,The Journal of thoracic and cardiovascular surgery,No. 6, pp. 1157-1158,1999.
[25] U. K. Dasika, D. R. Trumble, and J. A. Magovern;“Lower sternal reinforcement improves the stability of sternal closure”,The Annals of thoracic surgery,No. 5, pp. 1618-1621,2003.
[26] D. R. Trumble, W. E. McGregor, and J. A. Magovern;“Validation of a bone analog model for studies of sternal closure”,The Annals of thoracic surgery,No. 3, pp. 739-744,2002.
[27] S. Pai, R. M. Dunn, R. Babbitt, H. M. Strom, J. F. Lalikos, G. D. Pins, and K. L. Billiar;“Characterization of forces on the sternal midline following median sternotomy in a porcine model”,Journal of biomechanical engineering,No. 5, pp. 051004,2008.
[28] L. Bakalova, "development of a bilateral rigid sternum closure testing system," Worcester Polytechnic Institute, 2010.
[29] http://www.biomet.com/microfixation/products.cfm?pdid=9&majcid=37&prodid=205 , Final-Bluparts.pdf [Online].
[30] J. Ahn, "Design of an optimized rigid fixation system for the osteoporotic sternum," Worcester Polytechnic Institute, 2009.
[31] http://www.klsmartinnorthamerica.com/products/implants/sternal/sternal-talon/ [Online].
[32] H. Kun and Y. Xiubin;“Median sternotomy closure: review and update research”,Journal of Medical Colleges of PLA,No. 2, pp. 112-117,2009.
[33] D. H. Song, R. F. Lohman, J. D. Renucci, V. Jeevanandam, and J. Raman;“Primary sternal plating in high-risk patients prevents mediastinitis”,European journal of cardio-thoracic surgery,No. 2, pp. 367-372,2004.
[34] K. A. Egol, E. N. Kubiak, E. Fulkerson, F. J. Kummer, and K. J. Koval;“Biomechanics of locked plates and screws”,Journal of orthopaedic trauma,No. 8, pp. 488-493,2004.
[35] S. R. S. Battula, "Experimental and numerical evaluation of the pullout strength of self-tapping bone screws in normal and osteoporotic bone," University of Akron, 2007.
[36] http://www.tradeindia.com/fp827537/Canulated-Cancellous-Screw-Hex.html [Online].
[37] http://www.mjsurgical.com/simple-plate-and-screw-page-two.htm [Online].
[38] http://www.biomet.com/microfixation/products.cfm?pdid=9&majcid=37&prodid=205 [Online].
[39] http://www.smith-nephew.com/us/professional/products/all-products/vlp-foot [Online].
[40] http://www.klsmartinnorthamerica.com/products/implants/maxillofacial/titanium-peek-osteosynthesis/mandible/threadlock-ts-system/ [Online].
[41] http://www.synthes.com/sites/NA/Products/Spine/AnteriorColumnPlating/Pages/The-Cervical-Spine-Locking-Plate-%28CSLP%29.aspx [Online].
[42] http://www.synthes.com/sites/NA/Products/CMF/Thorax/Pages/Sternal-ZipFix-System.aspx [Online].
[43] M. Grapow, L. F. Melly, F. S. Eckstein, and O. T. Reuthebuch;“A new cable-tie based sternal closure system: description of the device, technique of implantation and first clinical evaluation”,J Cardiothorac Surg,No. pp. 59,2012.
[44] D. Williams, A. McNamara, and R. Turner;“Potential of polyetheretherketone (PEEK) and carbon-fibre-reinforced PEEK in medical applications”,Journal of materials science letters,No. 2, pp. 188-190,1987.
[45] S. M. Kurtz and J. N. Devine;“PEEK biomaterials in trauma, orthopedic, and spinal implants”,Biomaterials,No. 32, pp. 4845-4869,2007.
[46] C. Schimmer, W. Reents, S. Berneder, P. Eigel, O. Sezer, H. Scheld, K. Sahraoui, B. Gansera, O. Deppert, and A. Rubio;“Prevention of sternal dehiscence and infection in high-risk patients: a prospective randomized multicenter trial”,The Annals of thoracic surgery,No. 6, pp. 1897-1904,2008.
[47] H. S. Soroff, A. R. Hartman, E. Pak, D. H. Sasvary, and S. B. Pollak;“Improved sternal closure using steel bands: Early experience with three-year follow-up”,The Annals of thoracic surgery,No. 4, pp. 1172-1176,1996.
[48] S. Bhattacharya, I. Sau, M. Mohan, K. Hazari, R. Basu, and A. Kaul;“Sternal bands for closure of midline sternotomy leads to better wound healing”,Asian Cardiovascular and Thoracic Annals,No. 1, pp. 59-63,2007.
[49] N. Price, N. H. Kim, B. Wilcox, and B. Hatcher;“design study on stability and safety of median sternotomy fixation”,Stress (MPa),No. pp. 67.
[50] R. Bruhin, U. A. Stock, J.-P. Drücker, T. Azhari, J. Wippermann, J. M. Albes, D. Hintze, S. Eckardt, C. Könke, and T. Wahlers;“Numerical simulation techniques to study the structural response of the human chest following median sternotomy”,The Annals of thoracic surgery,No. 2, pp. 623-630,2005.
[51] http://biomedical.materialise.com/orthopaedic-reverse-engineering [Online].