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    Biomechanical Effect of Ankle Ligament Injury in AO Type 44B2.1 Lateral Malleolus Fractures After Lateral Plate Fixation A Finite Element Analysis
    (Amer Podiatric Med Assoc, 2024) Olcar, Haci Ali; Mutu, Halil Burak; Ozer, Alaettin; Kuru, Tolgahan; Aydin, Davut; Korkmaz, Murat
    Background: Distal fibula fractures at the ankle level are common and are usually accompanied by ligament injuries. This study aims to evaluate the effects of ankle ligament ruptures on ankle joints, fracture instability, and plate stress after distal fibula fracture fixed with a plate created by finite element analysis modeling and loading applied to ligament rupture models that may accompany this fracture. Methods: A finite element model consisting of three-dimensional fibula, tibia, foot bones, and ankle ligaments was designed to investigate the effects of ligament injuries accompanying plate-detected AO type 44B2.1 fractures on fracture detection, fixation material, and ankle joints. Then, the results were evaluated by modeling ligament rupture in six different ways. Results: In the modeling where the deltoid and talofibular ligaments are broken together, instability is highest in the ankle (2.31 mm) and fracture line (0.15 mm). The rupture of the anterior and posterior tibiofibular ligaments associated with syndesmosis caused less instability in the fracture and ankle than the single-ligament rupture models of both the deltoid and talofibular ligaments. Conclusions: In the finite element modeling of AO type 44B2.1 fractures detected with plate, the importance and potential effects of often-overlooked ankle ligament injuries are pointed out. Note that when treating ankle injuries, the ankle should be treated as a whole, with both bone and soft tissue. In some cases, the fracture may represent the visible tip of the iceberg. (J Am Podiatr Med Assoc 114(4), 2024; doi:10.7547/22-214)
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    Computational Mechanical Analysis of AO 44A1, 44B1, and 44C1 Fractures with Finite Element Modeling: Evaluation of Screw, Plate, and Kirschner Wire Fixation
    (Amer Podiatric Med Assoc, 2024) Olcar, Haci Ali; Ozer, Alaettin; Mutu, Halil Burak; Yurdakul, Goker; Kuru, Tolgahan; Aydin, Davut; Korkmaz, Murat
    Background: The aim of this study was to create AO 44A1, 44B1, and 44C1 fractures using finite element analysis to determine the stability of Kirschner wire, intramedullary screw, and plate-screw fixation methods in fracture. Methods: Using finite element analysis, the postreduction behavior of AO 44A1, 44B1, and 44C1 fractures with Kirschner wire, intramedullary screw, and plate-screw fixation methods was analyzed and compared in terms of displacement and stress. Results: The lowest amount of displacement was provided with the intramedullary screw method in AO 44A1 and 44B1 fractures and with the 4-mm Kirschner wire method in AO 44C1 fractures. The total displacement of the intramedullary screw system used for fixation in AO 44A1, 44B1, and 44C1 fractures was lower. Conclusions: According to finite element analysis results, the lowest amount of displacement was obtained with intramedullary screw fixation in AO 44A1 and 44B1 fractures, and 4mm Kirschner wire fixation was achieved in AO 44C1 fractures. (J Am Podiatr Med Assoc 114(1), 2024 doi:10.7547/22-155)
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    Original Research The biomechanical analysis of first metatarsocuneiform arthrodesis using the finite element method: A comparison of plate osteosynthesis in different positions
    (Bayrakol Medical Publisher, 2024) Olcar, Haci Ali; Ozer, Alaettin; Mutu, Halil Burak; Kuru, Tolgahan; Yurdakul, Goker; Aydin, Davut; Korkmaz, Murat
    Aim: The aim of this study was to compare plate positions in Lapidus arthrodesis in terms of displacement and plate stress. Material and Methods: In this study, the Lapidus arthrodesis was performed in a computerised environment using a finite element foot model with differentially positioned plates. The arthrodesis (Lapidus arthrodesis) was applied to the first metatarsocuneiform joint with 2 proximal 2 distal 3.5 mm screws using a 4 -hole plate in three different directions: medial, dorsal and plantar. Results: Displacement in the arthrodesis area and stress on the fixation material, the plate, were evaluated. After loading, the plantar plate arthrodesis model produced more total displacement (1, 97121 mm) and stress (2242 MPa) than other arthrodesis models. On the other hand, the dorsal plate arthrodesis model has less total displacement (1, 20479 mm) and stress (1253 MPa) than other arthrodesis models. In the volar, dorsal and medial finite element models, it was concluded that the least displacement and plate stress were in the dorsal plate application. Discussion: In the finite element study, complications can be seen more frequently in Lapidus arthrodesis performed with plantar and medial plates compared to Lapidus arthrodesis performed with dorsal plates. Therefore, Lapidus arthrodesis performed with a dorsal plate may be more stable.