[Finite element analysis of PMMA bone cement reinforced screw plate fixation for osteoporotic proximal humeral fracture].

OBJECTIVE: With the help of finite element analysis, to explore the effect of proximal humeral bone cement enhanced screw plate fixation on the stability of internal fixation of osteoporotic proximal humeral fracture. METHODS: The digital model of unstable proximal humeral fracture with metaphyseal bone defect was made, and the finite element models of proximal humeral fracture bone cement enhanced screw plate fixation and common screw plate fixation were established respectively. The stress of cancellous bone around the screw, the overall stiffness, the maximum stress of the plate and the maximum stress of the screw were analyzed. RESULTS: The maximum stresses of cancellous bone around 6 screws at the head of proximal humeral with bone cement enhanced screw plate fixation were 1.07 MPa for No.1 nail, 0.43 MPa for No.2 nail, 1.16 MPa for No.3 nail, 0.34 MPa for No.4 nail, 1.99 MPa for No.5 nail and 1.57 MPa for No.6 nail. These with common screw plate fixation were:2.68 MPa for No.1 nail, 0.67 MPa for No.2 nail, 4.37 MPa for No.3 nail, 0.75 MPa for No.4 nail, 3.30 MPa for No.5 nail and 2.47 MPa for No.6 nail. Overall stiffness of the two models is 448 N/mm for bone cement structure and 434 N/mm for common structure. The maximum stress of plate appears in the joint hole:701MPa for bone cement structure and 42 0MPa for common structure. The maximum stress of screws appeared at the tail end of No.4 nail:284 MPa for bone cement structure and 240.8 MPa for common structure. CONCLUSION: Through finite element analysis, it is proved that the proximal humerus bone cement enhanced screw plate fixation of osteoporotic proximal humeral fracture can effectively reduce the stress of cancellous bone around the screw and enhance the initial stability after fracture operation, thus preventing from penetrating out and humeral head collapsing.

Accuracy of dental implant surgery with robotic position feedback and registration algorithm: An in-vitro study.

BACKGROUND: The purpose of this study was to develop and validate a positioning method with hand-guiding and contact position feedback of robot based on a human-robot collaborative dental implant system (HRCDIS) for robotic guided dental implant surgery. METHODS: An HRCDIS was developed based on a light-weight cooperative robot arm, UR5. A three-dimensional (3D) virtual partially edentulous mandibular bone was reconstructed using the cone bone computed tomography images. After designing the preoperative virtual implant planning using the computer software, a fixation guide worn on teeth for linking and fixing positioning marker was fabricated by 3D printing. The fixation guide with the positioning marker and a resin model mimicking the oral tissues were assembled on a head phantom. The planned implant positions were derived by the coordinate information of the positioning marker. The drilling process using the HRCDIS was conducted after mimicking the experimental set-up and planning the drilling trajectory. Deviations between actual and planned implant positions were measured and analyzed. RESULTS: The head phantom experiments results showed that the error value of the central deviation at hex (refers to the center of the platform level of the implant) was 0.79 ± 0.17 mm, central deviation at the apex was 1.26 ± 0.27 mm, horizontal deviation at the hex was 0.61 ± 0.19 mm, horizontal deviation at the apex was 0.91 ± 0.55 mm, vertical deviation at the hex was 0.38 ± 0.17 mm, vertical deviation at the apex was 0.37 ± 0.20 mm, and angular deviation was 3.77 ± 1.57°. CONCLUSIONS: The results from this study preliminarily validate the feasibility of the accurate navigation method of the HRCDIS.