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Remy F, Godio-Raboutet Y, Captier G, Burgart P, Bonnaure P, Thollon L, Guyot L. Characterization of the very young child's palatal vault growth pattern: how do its size and shape evolve? Eur J Paediatr Dent 2023; 2:1. [PMID: 37184237 DOI: 10.23804/ejpd.2023.1663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
AIM This study aimed to characterise the palatal vault evolution during the first years of life, both in terms of shape and size. MATERIALS The study sample was composed of 168 healthy children aged less than 4 years. Twenty-one measurements of distances and 6 angles were taken from 7 fixed landmarks set on the palatal vaults 3D surfaces reconstructed from CT-scans. To analyse only the shape evolution, the "sizefree" log-shape ratio of those measurements were computed and the global shape of the palatal vault and their transversal curve were plotted. Statistical analyses were performed to highlight the shape and size differences separately. CONCLUSION The shape and size evolution of the palatal vault during the first years of life was not only correlated with deciduous dentition development. We assumed that the progressive orofacial muscles activation and tongue movements in the oral cavity may also explain these results as they induced strains on the palatal vault, warping it in various ways.
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Affiliation(s)
- F Remy
- Aix-Marseille University, University Gustave Eiffel, LBA, Marseille,France - YooMed, Montpellier, France
| | - Y Godio-Raboutet
- Aix-Marseille University, University Gustave Eiffel, LBA, Marseille,France - YooMed, Montpellier, France
| | - G Captier
- Department of Plastic Pediatric Surgery, Lapeyronie Hospital, Montpellier University, Montpellier, France
| | | | | | - L Thollon
- Aix-Marseille University, University Gustave Eiffel, LBA, Marseille,France
| | - L Guyot
- Aix-Marseille University, University Gustave Eiffel, LBA, Marseille,France - Department of Oral-Maxillofacial, Plastic and Reconstructive Surgery, A.P.-H.M., Conception Hospital, Marseille, France
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Tailhan JL, Kurtz T, Godio-Raboutet Y, Rossi P, Thollon L. Macrocrack propagation in a notched shaft segment of human long bone: Experimental results and mechanical aspects. J Mech Behav Biomed Mater 2022; 128:105132. [DOI: 10.1016/j.jmbbm.2022.105132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 12/14/2021] [Accepted: 02/11/2022] [Indexed: 10/19/2022]
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Gagnon C, Godio-Raboutet Y, Piercecchi MD, Thollon L. Modeling one-handed grip strangulation: Intentionality of the gesture and age influence. Leg Med (Tokyo) 2021; 53:101962. [PMID: 34482161 DOI: 10.1016/j.legalmed.2021.101962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/26/2021] [Accepted: 08/21/2021] [Indexed: 10/20/2022]
Abstract
Strangulation is a violent act which can be lethal and is often studied in forensic context. The neck includes several anatomical elements that can evolve with aging. We therefore created a numerical human neck model including the main anatomical elements and simulated one-handed grip strangulation cases. In addition, we created 3 models each representing age groups: 20-30 years old, 30-50 years old and over 50 years old. The main changes between the different age groups are the ossification of the cartilages and the muscles mechanical properties. Several initial and boundary conditions have been tested to perform a realistic simulation of one-handed grip strangulation. Stress analysis and fracture observation were compared with the grip strength of an average man, 552 N, to look at the intentionality of the gesture. In each age group, the results show no model fracture for a force of 552 N. It is necessary to reach a minimum of 1406 N before observing a first fracture on the hyoid bone. However, it is possible to get stresses on the hyoid bone and on the thyroid cartilage way before 552 N. It thus appears that the force created by one-handed grip strangulation is not sufficient to cause fractures of the bony elements of the neck, but it remains sufficient to compress the larynx and at least reduce airflow.
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Affiliation(s)
- C Gagnon
- Aix Marseille Univ, Univ Gustave Eiffel, LBA, Marseille, France.
| | | | - M D Piercecchi
- Aix-Marseille Univ, CNRS, EFS, ADES, Faculté de médecine Secteur Nord, Marseille, France; APHM, CHU Timone, Service de Médecine Légale et Droit de la santé, Marseille, France
| | - L Thollon
- Aix Marseille Univ, Univ Gustave Eiffel, LBA, Marseille, France
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Tuchtan L, Delteil C, Godio-Raboutet Y, Kolopp M, Léonetti G, Thollon L, Piercecchi-Marti MD. Sudden death after facial impacts: Is the brainstem involved? Morphologie 2021; 106:217-223. [PMID: 34400063 DOI: 10.1016/j.morpho.2021.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 07/02/2021] [Accepted: 07/25/2021] [Indexed: 11/28/2022]
Abstract
Three deaths following facial impacts in the presence of witnesses and resulting in brain lesions that were visualized only on pathological examination were studied at the forensic medicine institute of Marseille. Craniofacial impacts, even of low intensity, received during brawls may be associated with brain lesions ranging from a simple knock-out to fatal injuries. In criminal cases that are brought to court, even by autopsy it is still difficult to establish a direct link between the violence of the impact and the injuries that resulted in death. During a facial impact, the head undergoes a movement of violent forced hyperextension. Death may thus be secondary to the transmission of forces to the brain, either by a mechanism involving nerve conduction that may be termed a reflex mechanism (for example by vagal hyperstimulation) or by injury to the central nervous system (axonal damage). In such situations, autopsy does not make it possible to determine the cause of death, but only to suspect it in a context of voluntary violence in the presence of witnesses, with or without violent injury observed on external examination or on superficial incisions to determine the extent of bruises or hematoma. Systemic and comprehensive investigation involving pathology and toxicology is essential in any medicolegal case for positive interpretation and discrimination of other causes of death.
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Affiliation(s)
- L Tuchtan
- Forensic Department, APHM, Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France; CNRS, EFS, ADES, Aix-Marseille University, 27, avenue Jean-Moulin, 13385 Marseille, France.
| | - C Delteil
- Forensic Department, APHM, Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France; CNRS, EFS, ADES, Aix-Marseille University, 27, avenue Jean-Moulin, 13385 Marseille, France
| | - Y Godio-Raboutet
- IFSTTAR, LBA, Aix-Marseille University, boulevard Pierre-Bramard, 13015 Marseille, France; iLab - Spine (International Laboratory - Spine Imaging and Biomechanics), boulevard Pierre-Bramard, 13015 Marseille, France
| | - M Kolopp
- Forensic Department, APHM, Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France
| | - G Léonetti
- Forensic Department, APHM, Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France; CNRS, EFS, ADES, Aix-Marseille University, 27, avenue Jean-Moulin, 13385 Marseille, France
| | - L Thollon
- IFSTTAR, LBA, Aix-Marseille University, boulevard Pierre-Bramard, 13015 Marseille, France; iLab - Spine (International Laboratory - Spine Imaging and Biomechanics), boulevard Pierre-Bramard, 13015 Marseille, France
| | - M-D Piercecchi-Marti
- Forensic Department, APHM, Hôpital de la Timone, 264, rue Saint-Pierre, 13385 Marseille, France; CNRS, EFS, ADES, Aix-Marseille University, 27, avenue Jean-Moulin, 13385 Marseille, France
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Remy F, Bonnaure P, Moisdon P, Burgart P, Godio-Raboutet Y, Thollon L, Guyot L. Preliminary results on the impact of simultaneous palatal expansion and mandibular advancement on the respiratory status recorded during sleep in OSAS children. J Stomatol Oral Maxillofac Surg 2020; 122:235-240. [PMID: 32777308 DOI: 10.1016/j.jormas.2020.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/17/2020] [Indexed: 11/17/2022]
Abstract
INTRODUCTION The study aimed to evaluate the evolution of the respiratory status during sleep of OSAS children treated with a custom-made device combining maxillary expansion and mandibular advancement. MATERIAL AND METHODS Sleep studies were performed before and after the treatment for 103 children presenting an initial OSAS and Class II malocclusion. Sleep questionnaires were also addressed to parents several years after the end of the treatment to evaluate its long-term effects. RESULTS After nine months of treatment, the sleep breathing quality significantly improved: the Apnea/Hypopnea Index systematically decreased ≤5. According to the sleep questionnaires results, 84% of the patients did not show any loud or troubled breathing several years after the end of the treatment. DISCUSSION Simultaneous maxillary expansion and mandibular advancement induced an increase of the oral space in the three spatial dimensions, helping in the significant improvement of the OSAS symptoms, with long-terms effects on the sleep breathing quality.
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Affiliation(s)
- F Remy
- Aix-Marseille Univ, Univ Gustave Eiffel, LBA, Marseille, France; YooMed, Montpellier, France.
| | | | | | | | | | - L Thollon
- Aix-Marseille Univ, Univ Gustave Eiffel, LBA, Marseille, France
| | - L Guyot
- Department of Oral-Maxillofacial, Plastic and Reconstructive Surgery, A.P.-H.M., North University Hospital, Marseille, France; Aix-Marseille Univ, CNRS, EFS, ADES, Marseille, France
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Gagnon C, Boismery S, Godio-Raboutet Y, Tuchtan L, Bartoli C, Adalian P, Chaumoitre K, Piercecchi-Marti MD, Thollon L. Biomechanical study of the thyroid cartilage: A model of bi-digital strangulation. Forensic Sci Int 2019; 302:109891. [PMID: 31400616 DOI: 10.1016/j.forsciint.2019.109891] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 07/01/2019] [Accepted: 07/04/2019] [Indexed: 11/25/2022]
Abstract
The presence of fracture on neck elements is an indication of violence. Both the hyoid bone and the larynx can be damaged by a strangulation mechanism. Thyroid cartilage, more specifically, may present lesions in response to this mechanical stress. These lesions result in fractures at the bases of the horns of the thyroid cartilage. This study focuses on the thyroid cartilage behavior in cases of bi-digital strangulation, using an anthropometric and biomechanical approach. To develop a biomechanical model, we performed an anthropometric study taking into account 14 distances measurements as well as 3 measurements of angles. These measures allowed us to determine a significant sexual dimorphism between individuals. Then, we define 6 morphologies models, composed of 3 females and 3 males individuals. In order to visualize the ossification of the cartilage, each model has been tested with bone properties. Strangulation cases were simulated by applying an imposed velocity of 0.4m/s then 1m/s. We observed different behaviors of the thyroid cartilage according to the sex and the morphology.
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Affiliation(s)
- C Gagnon
- Aix Marseille Univ, IFSTTAR, LBA, UMR_T 24, 13916 Marseille, France.
| | - S Boismery
- Aix Marseille Univ, IFSTTAR, LBA, UMR_T 24, 13916 Marseille, France.
| | - Y Godio-Raboutet
- Aix Marseille Univ, IFSTTAR, LBA, UMR_T 24, 13916 Marseille, France.
| | - L Tuchtan
- Aix-Marseille Univ, CNRS, EFS, ADES, Faculté de médecine Secteur Nord, Marseille, France; APHM, CHU Timone, Service de Médecine Légale et Droit de la santé, Marseille, France.
| | - C Bartoli
- Aix-Marseille Univ, CNRS, EFS, ADES, Faculté de médecine Secteur Nord, Marseille, France; APHM, CHU Timone, Service de Médecine Légale et Droit de la santé, Marseille, France.
| | - P Adalian
- Aix-Marseille Univ, CNRS, EFS, ADES, Faculté de médecine Secteur Nord, Marseille, France.
| | - K Chaumoitre
- Aix-Marseille Univ, CNRS, EFS, ADES, Faculté de médecine Secteur Nord, Marseille, France; APHM, Hôpital Nord, Service de radiologie, Marseille, France.
| | - M-D Piercecchi-Marti
- Aix-Marseille Univ, CNRS, EFS, ADES, Faculté de médecine Secteur Nord, Marseille, France; APHM, CHU Timone, Service de Médecine Légale et Droit de la santé, Marseille, France.
| | - L Thollon
- Aix Marseille Univ, IFSTTAR, LBA, UMR_T 24, 13916 Marseille, France.
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Cogoluenhes L, Evin M, Forodighasemabadi A, Wei W, Thollon L, Llari M. A modelisation of quantification of head and neck risks associated with tackles in rugby union. Comput Methods Biomech Biomed Engin 2019. [DOI: 10.1080/10255842.2020.1714910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- L. Cogoluenhes
- Aix-Marseille Univ, IFSTTAR, Marseille, France
- iLabSpine International Associated Laboratory Marseille-Montréal, Marseille-Montréal, France-Canada
| | - M. Evin
- Aix-Marseille Univ, IFSTTAR, Marseille, France
- iLabSpine International Associated Laboratory Marseille-Montréal, Marseille-Montréal, France-Canada
| | - A. Forodighasemabadi
- Aix-Marseille Univ, IFSTTAR, Marseille, France
- iLabSpine International Associated Laboratory Marseille-Montréal, Marseille-Montréal, France-Canada
- CRMBM UMR 7339 AMU/CNRS, Marseille, France
| | - W. Wei
- Aix-Marseille Univ, IFSTTAR, Marseille, France
- iLabSpine International Associated Laboratory Marseille-Montréal, Marseille-Montréal, France-Canada
| | - L. Thollon
- Aix-Marseille Univ, IFSTTAR, Marseille, France
- iLabSpine International Associated Laboratory Marseille-Montréal, Marseille-Montréal, France-Canada
| | - M. Llari
- Aix-Marseille Univ, IFSTTAR, Marseille, France
- iLabSpine International Associated Laboratory Marseille-Montréal, Marseille-Montréal, France-Canada
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Foletti JM, Martinez V, Haen P, Godio-Raboutet Y, Guyot L, Thollon L. Finite element analysis of the human orbit. Behavior of titanium mesh for orbital floor reconstruction in case of trauma recurrence. J Stomatol Oral Maxillofac Surg 2018; 120:91-94. [PMID: 30453103 DOI: 10.1016/j.jormas.2018.11.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 10/22/2018] [Accepted: 11/11/2018] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The authors' main purpose was to simulate the behavior of a titanium mesh implant (TMI) used to reconstruct the orbital floor under the stress of a blunt trauma. MATERIALS AND METHODS The orbital floor of a previously validated finite element model (FEM) of the human orbit was numerically fractured and reconstructed by a simplified TMI. Data from a CT scan of the head were computed with MICMICS (Materialise, Louvain, Belgium) software to re-create the skull's geometry. The meshing production, the model's properties management and the simulations of blunt traumas of the orbit were conducted on HYPERWORKS® software (Altair Engineering, Detroit, MI, USA). Some of the elements of the orbital floor were selected and removed to model the fracture; these elements were duplicated, their characteristics being changed by those of titanium to create a TMI covering this fracture. A 3D FEM composed of 640,000 elements was used to perform 21 blunt trauma simulations on the reconstructed orbit. RESULTS In 90.4% (19/21) of the tests conducted, the TMI, whether free from any bony attachment or screwed to the orbital rim, has tended to move in the orbit and/or to deform. DISCUSSION In the event of traumatic recurrence, which is not rare, TMIs may deform in a "blow-in" motion and threaten intra-orbital structures.
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Affiliation(s)
- J M Foletti
- Aix Marseille université, AP-HM, IFSTTAR, LBA, hôpital de la Conception, service de chirurgie maxillo-faciale, 13015 Marseille, France.
| | - V Martinez
- Aix Marseille université, IFSTTAR, LBA, 13015 Marseille, France.
| | - P Haen
- Aix Marseille université, HIA Laveran, service de chirurgie maxillo-faciale, 13013 Marseille, France.
| | - Y Godio-Raboutet
- Aix Marseille université, IFSTTAR, LBA, 13015 Marseille, France.
| | - L Guyot
- AP-HM, CNRS, EFS, hôpital de la Conception, service de chirurgie maxillo-faciale, 13015 Marseille, France.
| | - L Thollon
- Aix Marseille université, IFSTTAR, LBA, 13015 Marseille, France.
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Guevara Perez SV, de la Rosa Castolo G, Thollon L, Behr M. A 3D characterization method of geometric variation in edentulous mandibles. Morphologie 2018; 102:255-262. [PMID: 30197034 DOI: 10.1016/j.morpho.2018.08.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 08/15/2018] [Accepted: 08/16/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE The aim of this study was to perform an exploratory analysis of the morphological variations of mandibles at diverse states of edentulousness using tridimensional geometric morphometrics. METHODS Twelve cadaveric mandibles were selected and divided in three groups: dentate (G1), partially edentate (G2) and totally edentate (G3). CT scans, segmentation and digital reconstruction of 3D surfaces of each specimen was made. Thirteen landmarks were defined; the measurement error was determined and 3D morphometrics exploratory analysis by principal components (PCs) and PC scores was performed. RESULTS The principal shape variations in G2 and G3 compared to G1 can be summarized as follows: (1) decrease in the mid body mandibular height of 24% in G2 and 41% in G3, (2) decrease of symphysis height of 16% in G2 and 37% in G3, (3) a decrease in posterior mandibular height of 30% in both G1 and G2, (4) a deeper sigmoid notch also in both groups and finally (5) a widening of 7.7% in the cross sectional morphology on the symphysis in G3. CONCLUSIONS The 3D morphometric methods, combined with surface morphing tools confirmed the main patterns of bone changes in edentulous mandibles, referenced in the literature. The average 3D mandibular morphologies of each edentulousness state group was also defined. These methods could offer more accurate definition of shape variations, which is critical in a clinical context. This study provides clinicians with highlights of 3D morphological mandibular variations at different states of edentulism and not only in 2D projections as they are currently described. The 3D surface model for each group in PDF3D file format, are include in supplementary material.
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Affiliation(s)
- S V Guevara Perez
- Oral Health Deptartment, Universidad Nacional de Colombia, 111321 Bogota, Colombia; Aix-Marseille Université , IFSTTAR, LBA UMR T24, 13385 Marseille cedex 5, France
| | - G de la Rosa Castolo
- Aix-Marseille Université , IFSTTAR, LBA UMR T24, 13385 Marseille cedex 5, France
| | - L Thollon
- Aix-Marseille Université , IFSTTAR, LBA UMR T24, 13385 Marseille cedex 5, France
| | - M Behr
- Aix-Marseille Université , IFSTTAR, LBA UMR T24, 13385 Marseille cedex 5, France
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Frémondière P, Thollon L, Marchal F. [The emergence of obstetrical mechanism: From Lucy to Homo sapiens]. Gynecol Obstet Fertil Senol 2017; 45:164-171. [PMID: 28256409 DOI: 10.1016/j.gofs.2017.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 01/23/2017] [Indexed: 06/06/2023]
Abstract
The evolutionary history of modern birth mechanism is now a renewed interest in obstetrical papers. The purpose of this work is to review the literature in paleo-obstetrical field. Our analysis focuses on paleo-obstetrical hypothesis, from 1960 to the present day, based on the reconstruction of fossil pelvis. Indeed, these pelvic reconstructions usually provide an opportunity to make an obstetrical assumption in our ancestors. In this analysis, we show that modern birth mechanism takes place during the emergence of our genus 2 million years ago. References are made to human specificities related to obstetrical mechanism: exclusive bipedalism, increase of brain size at birth, metabolic cost of the pregnancy and deep trophoblastic implantation.
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Affiliation(s)
- P Frémondière
- CNRS, EFS, ADES UMR 7268, Aix-Marseille université, faculté de médecine, secteur Nord, boulevard Pierre-Dramard, 13916 Marseille, France; Département de Maïeutique de Montpellier, institut de biologie, université de Montpellier, 4, boulevard Henri-IV, 34000 Montpellier, France.
| | - L Thollon
- IFSTTAR, LBA UMRT 24, Aix-Marseille université, faculté de médecine, secteur Nord, boulevard Pierre-Dramard, 13916 Marseille, France
| | - F Marchal
- Département de Maïeutique de Montpellier, institut de biologie, université de Montpellier, 4, boulevard Henri-IV, 34000 Montpellier, France
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Frémondière P, Thollon L, Adalian P, Delotte J, Marchal F. Which Foetal-Pelvic Variables Are Useful for Predicting Caesarean Section and Instrumental Assistance? Med Princ Pract 2017; 26:359-367. [PMID: 28538223 PMCID: PMC5768136 DOI: 10.1159/000477732] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 05/23/2017] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To assess the variables useful to predict caesarean delivery (CD) and instrumental assistance, through the analysis of a large number of foetal-pelvic variables, using discriminant analysis. MATERIALS AND METHODS One hundred and fourteen pregnant women were included in this single-centre prospective study. For each mother-foetus pair, 43 pelvic and 18 foetal variables were measured. Partial least squares-discriminant analysis was performed to identify foetal-pelvic variables that could statistically separate the 3 delivery modality groups: spontaneous vaginal delivery (SVD), CD, and instrument-assisted delivery (IAD). RESULTS For the SVD versus CD model, voluminous foetuses and women with a narrow pelvic inlet had a greater risk for requiring CD. The most efficient variables for discrimination were the transverse diameter and foetal weight. The antero-posterior inlet and obstetric conjugate were considered in this model, with the former being a useful variable but not the latter. For the SVD versus IAD model, the most important variables were the foetal variables, particularly the bi-parietal diameter. Women with a reduced antero-posterior outlet diameter and a narrow pubic arch were more at risk of requiring an IAD. CONCLUSION The antero-posterior inlet was an efficient variable unlike the obstetric conjugate. The obstetric conjugate diameter should no longer be considered a useful variable in estimating the arrest of labour. Antero-posterior inlet diameter was a sagittal variable that should be taken into account. The comparison of sub-pubic angle and bi-parietal and antero-posterior outlet diameters was useful in identifying a risk of requiring instrumental assistance.
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Affiliation(s)
- P. Frémondière
- Department of Obstetrics and Gynecology, St Joseph Hospital, Marseille, France
- Physical Anthropology Laboratory (UMR 7268, Droit, Éthique et Santé ADÉS-AMU/CNRS/EFS), Marseille, France
- *Pierre Frémondière, UMR 7268 Faculté de Médecine, Secteur Nord Batiment A, CS80011 Bd Pierre Dramard, FR-13344 Marseille Cedex 15 (France), E-Mail
| | - L. Thollon
- Applied Biomechanics Laboratory (UMR-T24), Marseille, France
| | - P. Adalian
- Physical Anthropology Laboratory (UMR 7268, Droit, Éthique et Santé ADÉS-AMU/CNRS/EFS), Marseille, France
| | - J. Delotte
- Department of Obstetrics and Gynecology, l'Archet Hospital, Nice, France
| | - F. Marchal
- Physical Anthropology Laboratory (UMR 7268, Droit, Éthique et Santé ADÉS-AMU/CNRS/EFS), Marseille, France
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Auriault F, Thollon L, Pérès J, Behr M. Adverse fetal outcome in road accidents: Injury mechanism study and injury criteria development in a pregnant woman finite element model. Accid Anal Prev 2016; 97:96-102. [PMID: 27596046 DOI: 10.1016/j.aap.2016.08.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 08/06/2016] [Accepted: 08/25/2016] [Indexed: 06/06/2023]
Abstract
This study documents the development of adverse fetal outcome predictors dedicated to the analysis of road accidents involving pregnant women. To do so, a pre-existing whole body finite element model representative of a 50th percentile 26 weeks pregnant woman was used. A total of 8 accident scenarios were simulated with the model positioned on a sled. Each of these scenarios was associated to a risk of adverse fetal outcome based on results from real car crash investigations involving pregnant women from the literature. The use of airbags and accidents involving unbelted occupants were not considered in this study. Several adverse fetal outcome potential predictors were then evaluated with regard to their correlation to this risk of fetal injuries. Three predictors appeared strongly correlated to the risk of adverse fetal outcome: (1) the intra uterine pressure at the placenta fetal side area (r=0.92), (2) the fetal head acceleration (HIC) (r=0.99) and (3) area of utero-placental interface over a strain threshold (r=0.90). Finally, sensitivity analysis against slight variations of the simulation parameters was performed and assess robustness of these criteria.
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Affiliation(s)
- F Auriault
- Aix-Marseille Univ, IFSTTAR, LBA UMR_T24, F-13016, France.
| | - L Thollon
- Aix-Marseille Univ, IFSTTAR, LBA UMR_T24, F-13016, France
| | - J Pérès
- Aix-Marseille Univ, IFSTTAR, LBA UMR_T24, F-13016, France
| | - M Behr
- Aix-Marseille Univ, IFSTTAR, LBA UMR_T24, F-13016, France
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Auriault F, Brandt C, Chopin A, Gadegbeku B, Ndiaye A, Balzing MP, Thollon L, Behr M. Pregnant women in vehicles: Driving habits, position and risk of injury. Accid Anal Prev 2016; 89:57-61. [PMID: 26809074 DOI: 10.1016/j.aap.2016.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 01/09/2016] [Accepted: 01/10/2016] [Indexed: 06/05/2023]
Abstract
This study proposed to broadly examine vehicle use by pregnant women in order to improve realism of accident simulations involving these particular occupants. Three research pathways were developed: the first consisted in a questionnaire survey examining the driving habits of 135 pregnant women, the second obtained measurements of 15 pregnant women driving position in their own vehicle from the 6th to the 9th month of pregnancy by measuring distances between body parts and vehicle parts, and the third examined car accidents involving pregnant occupants. Results obtained indicate that between 90% and 100% of pregnant women wore their seat belts whatever their stage of pregnancy, although nearly one third of subjects considered the seat belt was dangerous for their unborn child. The measurements obtained also showed that the position of the pregnant woman in her vehicle, in relation to the various elements of the passenger compartment, changed significantly during pregnancy. In the studied accidents, no correlation was found between the conditions of the accident and the resulting fetal injury. Results reveal that pregnant women do not modify significantly the seat setting as a function of pregnancy stage. Only the distance between maternal abdomen and steering wheel change significantly, from 16 cm to 12 cm at 6 and 9 month respectively. Pregnant women are mainly drivers before 8 months of pregnancy, passengers after that. Car use frequency falls down rapidly from 6 to 9 months of pregnancy. Real crashes investigations indicate a low rate of casualties, i.e. 342 car accidents involving pregnant women for a period of 9 years in an approximately 1.7 million inhabitants area. No specific injury was found as a function of stage of pregnancy.
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Affiliation(s)
- F Auriault
- Aix-Marseille Université, IFSTTAR, LBA UMR_T24, F-13916 Marseille, France.
| | - C Brandt
- Ecole Universitaire de Maïeutique Marseille Méditerranée, F-13916 Marseille, France
| | - A Chopin
- Ecole Universitaire de Maïeutique Marseille Méditerranée, F-13916 Marseille, France
| | - B Gadegbeku
- IFSTTAR, TS2, UMRESTTE UMR_T9405, F-69500 Bron, France; Université de Lyon, F-69622 Lyon, France; Université Lyon 1, F-69373 Lyon, France
| | - A Ndiaye
- IFSTTAR, TS2, UMRESTTE UMR_T9405, F-69500 Bron, France; Université de Lyon, F-69622 Lyon, France; Université Lyon 1, F-69373 Lyon, France
| | - M-P Balzing
- Ecole Universitaire de Maïeutique Marseille Méditerranée, F-13916 Marseille, France
| | - L Thollon
- Aix-Marseille Université, IFSTTAR, LBA UMR_T24, F-13916 Marseille, France
| | - M Behr
- Aix-Marseille Université, IFSTTAR, LBA UMR_T24, F-13916 Marseille, France
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Auriault F, Thollon L, Behr M. Development of a Gravid Uterus Model for the Study of Road Accidents Involving Pregnant Women. J Biomech Eng 2015; 138:2473565. [PMID: 26592419 DOI: 10.1115/1.4032055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Indexed: 11/08/2022]
Abstract
Car accident simulations involving pregnant women are well documented in the literature and suggest that intra-uterine pressure could be responsible for the phenomenon of placental abruption, underlining the need for a realistic amniotic fluid model, including fluid-structure interactions (FSI). This study reports the development and validation of an amniotic fluid model using an Arbitrary Lagrangian Eulerian formulation in the LS-DYNA environment. Dedicated to the study of the mechanisms responsible for fetal injuries resulting from road accidents, the fluid model was validated using dynamic loading tests. Drop tests were performed on a deformable water-filled container at acceleration levels that would be experienced in a gravid uterus during a frontal car collision at 25 kph. During the test device braking phase, container deformation induced by inertial effects and FSI was recorded by kinematic analysis. These tests were then simulated in the LS-DYNA environment to validate a fluid model under dynamic loading, based on the container deformations. Finally, the coupling between the amniotic fluid model and an existing finite-element full-body pregnant woman model was validated in terms of pressure. To do so, experimental test results performed on four postmortem human surrogates (PMHS) (in which a physical gravid uterus model was inserted) were used. The experimental intra-uterine pressure from these tests was compared to intra uterine pressure from a numerical simulation performed under the same loading conditions. Both free fall numerical and experimental responses appear strongly correlated. The relationship between the amniotic fluid model and pregnant woman model provide intra-uterine pressure values correlated with the experimental test responses. The use of an Arbitrary Lagrangian Eulerian formulation allows the analysis of FSI between the amniotic fluid and the gravid uterus during a road accident involving pregnant women.
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Studer AS, Kahn CJF, Bege T, Thollon L, Loundou A, Chaumoître K, Coze S, Berdah S, Brunet C. An anatomic and morphometric analysis of splenic variability using 3D reconstruction and spatial orientation from computed tomography. Ann Anat 2015. [PMID: 26204553 DOI: 10.1016/j.aanat.2015.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
INTRODUCTION In terms of frequency, the spleen is the first organ affected in abdominal trauma, resulting even today in a high rate of mortality (10%). Nevertheless, very few studies have investigated splenic quantitative morphometry as to shape and spatial orientation. Therefore, we analysed healthy spleen variability in order to integrate it in its environment and to correlate its morphometric parameters to anthropometric characteristics. METHODS Ninety abdominopelvic CT-scans performed on patients over 16 years with no splenic pathology were retrospectively selected among a Mediterranean population. Three age groups ([16-30], [30-60] and [over 60 years]), equally distributed among genders, were created. Parameters, such as volume, characteristic checkpoints, orientation, and morphology, were measured on the spleen, the 11th thoracic vertebra and the 10th ribs in three-dimensional reconstructions. Anthropometric parameters were characterised by waist circumference, costo-xiphoid angle, abdominal height and chest depth. RESULTS Observed variations in splenic morphology were divided into three groups: cupped (66.7%), coiled (17.8%), and flat (15.5%). Splenic morphometry tends to be abdominal-shaped (54.5%) or dorsal-shaped (45.5%). The mean of the angle between the main axis of the spleen and the CT-scan horizontal axis was 40±14°. Correlations were highlighted between volume and gender (p<0.05), splenic morphology and liver morphometry (p<0.05) as well as between orientation of hilar surface and splenic morphometry (p<0.01). Moreover, the spleen is more horizontal in women (p<0.05), in the elderly (p<0.05) and in the obese (p<0.01). CONCLUSION This study defines three groups based on shape and highlights correlations between parameters describing healthy splenic variability and its anthropometric characteristics, which are of great importance for numerical modelling in splenic studies.
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Affiliation(s)
- A-S Studer
- Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France.
| | - C J F Kahn
- Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France
| | - T Bege
- Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France; AP-HM, Department of General and Digestive Surgery, North Hospital, Marseille, France
| | - L Thollon
- Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France
| | - A Loundou
- Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France; Department of Public Health and Biostatistics, Faculty of Medicine, Aix Marseille University, Assistance Publique - Hôpitaux de Marseille, Marseille, France
| | - K Chaumoître
- AP-HM, Department of Imaging and Interventional Radiology, North Hospital, Marseille, France
| | - S Coze
- AP-HM, Department of Imaging and Interventional Radiology, North Hospital, Marseille, France
| | - S Berdah
- Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France; AP-HM, Department of General and Digestive Surgery, North Hospital, Marseille, France
| | - C Brunet
- Aix-Marseille Université, IFSTTAR, LBA UMR T24, 13916 Marseille, France; AP-HM, Department of General and Digestive Surgery, North Hospital, Marseille, France
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Auriault F, Thollon L, Peres J, Delotte J, Kayvantash K, Brunet C, Behr M. Virtual traumatology of pregnant women: The PRegnant car Occupant Model for Impact Simulations (PROMIS). J Biomech 2014; 47:207-13. [DOI: 10.1016/j.jbiomech.2013.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2013] [Revised: 09/17/2013] [Accepted: 09/17/2013] [Indexed: 11/16/2022]
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Auriault F, Thollon L, Peres J, Delotte J, Kayvantash K, Brunet C, Behr M. The PROMIS model to highlight the importance of the foetus to the validation of a pregnant woman model. Comput Methods Biomech Biomed Engin 2013; 16 Suppl 1:182-3. [PMID: 23923900 DOI: 10.1080/10255842.2013.815868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- F Auriault
- Aix-Marseille Univ, LBA, F-13015 Marseille, France.
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Bronsard N, Serre T, Staccini P, Hovorka I, Thollon L, Padovani B, de Peretti F, Signoli M, Tropiano P. [Biometric and biomechanic analysis of lumbar posterior facets based on a CT-scan database]. Morphologie 2013; 97:19-28. [PMID: 23375579 DOI: 10.1016/j.morpho.2012.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AIM OF THE STUDY Our knowledge on anatomy of lumbar spine is based on few cadaver's study with old and few subjects. CT-scan is very precise for lumbar facet's morphology. We have analysed 400 subjects. The aim of this study is to measure different distances, angles and circles to better understand the mechanical function of the lumbar facets. PATIENTS AND METHODS We have analysed 720 CT-scan. We had 217 men and 183 women with 59 years of mean age. We used native slices of 1.25 mm thick from L1 to S1. We created transversal plan and we put different mark point. We took their coordinates and we have calculated different distances, angles and mechanical circles. We have compared different axis of rotation of the facets. RESULTS From L1 to S1, the facets goes near to the posterior wall and far from themselves. Moreover, the posterior angle between both facets increase down to the sacrum. The radius of the left side circle and the right one are very closed in 50% of the cases but the three radius are close only in 10% of cases. CONCLUSION This study based on 400 subjects shows that there is not a unique axis of rotation for both lumbar posterior facets. We have had only 50% of symmetry between both sides whatever the level studied.
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Affiliation(s)
- N Bronsard
- Service de chirurgie orthopédique et traumatologique, hôpital Saint-Roch, université de Nice, PC traumatologie 3e étage, ascenseur D, 5, rue Pierre-Dévoluy, 06000 Nice, France.
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Bréaud J, Montoro J, Lecompte JF, Valla JS, Loeffler J, Baqué P, Brunet C, Thollon L. Posterior urethral injuries associated with motorcycle accidents and pelvic trauma in adolescents: analysis of urethral lesions occurring prior to a bony fracture using a computerized finite-element model. J Pediatr Urol 2013; 9:62-70. [PMID: 22204757 DOI: 10.1016/j.jpurol.2011.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 12/03/2011] [Indexed: 10/14/2022]
Abstract
UNLABELLED Adolescent males involved in motorcycle accidents are particularly at risk for pelvic injury, which may provoke a posterior urethral injury. The aim of this study was to develop a model to analyze the association between injuries and fractures of the pelvic ring and the risk of posterior urethral injury. METHOD Based on experience with traffic accident modeling, a computerized finite-element model was extrapolated from a computerized tomography scan of a 15-year-old boy. The anatomic structures concerned in urethral and pelvic ring trauma were isolated, rendered in 3D and given biomechanical properties. The model was verified according to available experiments on pelvic ring trauma. RESULTS To apply the model, we recreated three impact mechanisms on the pelvic ring: lateral impact, antero-posterior impact and a real car‒motorcycle accident situation (postero-lateral impact). In all three situations, stretching of the posterior urethra was identified prior to bony fracture visualization. CONCLUSION Application of this model allowed us to analyze precisely the link between trauma of the pelvic ring and lesions of the posterior urethra. The results should help to establish guidelines for urethral catheterization in male adolescents in cases of pelvic trauma, even when no bony fracture is present, in order to prevent iatrogenic worsening of a misdiagnosed posterior urethral trauma.
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Affiliation(s)
- J Bréaud
- Service de Chirurgie Infantile, Hôpitaux Pédiatriques de Nice, France.
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Bréaud J, Baqué P, Loeffler J, Colomb F, Brunet C, Thollon L. Posterior urethral injuries associated with pelvic injuries in young adults: computerized finite element model creation and application to improve knowledge and prevention of these lesions. Surg Radiol Anat 2011; 34:333-9. [PMID: 22116405 DOI: 10.1007/s00276-011-0900-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Accepted: 11/07/2011] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Young adult males involved in motorcycle accidents are particularly at risk for posterior urethral injury whenever pelvic injury occurs. Posterior urethral injuries remain problematic because their diagnosis may be missed, and during the initial treatment response the urethral injury can be aggravated by urethral catheterization. Few anatomical and clinical tools exist that establish a correlation between injuries and fractures of the pelvic ring and the risk of posterior urethral injury. METHOD Based on experience with traffic accident modeling, a computerized finite element model was conceived integrating the specific anatomic structures concerned. This model was extrapolated from a CAT scan of a young adult. The anatomic structures concerned in urethral and pelvic ring trauma (PRT) were isolated, placed in 3D and given biomechanical properties. The model was verified according to available experiments on PRT. RESULTS To apply the model, we recreated a lateral impact mechanism on the pelvic ring. Stretching between the prostatic and membranous portions of the urethra (before and after visualization of a pelvic fracture) as well as timing of injury was studied. CONCLUSION The model's application permitted us to analyze precisely the link between lateral impact trauma of the pelvic ring and lesions of the posterior urethra and to identify an urethra stretching prior to visualization of a pelvic fracture. Utilization of the model with other mechanisms of injury should allow for better comprehension of this associated trauma, improved prevention, iatrogenic aggravation of, and care for, these serious injuries.
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Affiliation(s)
- J Bréaud
- Service de Chirurgie Infantile, Hôpitaux Pédiatriques de Nice, 57 avenue de la Californie, 06200 Nice, France.
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Dorez M, Delotte J, Behr M, Thollon L, Tillier Y, Azuar P, Bongain A, Brunet C. [Experimental research on mechanical behavior of human placenta]. Gynecol Obstet Fertil 2010; 38:429-432. [PMID: 20576559 DOI: 10.1016/j.gyobfe.2010.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
OBJECTIVES Determination of mechanical properties of human placenta. PATIENTS AND METHODS Realisation of an experimental study using 80 human placentas and modelisation of this study using a finite element numerical model. Using the inverse analysis method, research of the parameters of placenta's behavior. RESULTS Hyper-Visco-Elastic law written by Ogden, optimized for placenta with parameters: mu(1)=0.0001881Mpa, mu(2)=-0.000240Mpa, mu(3)=mu(4)=0Mpa and alpha(1)=2, alpha(2)=-8, alpha(3)=alpha(4)=0 in static condition. DISCUSSION AND CONCLUSION The parameters enable an approach of the mechanical behavior of the placenta. They could be used in numerical modelisation.
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Affiliation(s)
- M Dorez
- reproduction et de médecine foetale, hôpital Archet, Nice, France
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Arnoux PJ, Serre T, Cheynel N, Thollon L, Behr M, Baque P, Brunet C. Liver injuries in frontal crash situations a coupled numerical - experimental approach. Comput Methods Biomech Biomed Engin 2008; 11:189-203. [PMID: 18297497 DOI: 10.1080/10255840802298836] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
From clinical knowledge, it has been established that hepatic traumas frequently lead to lethal injuries. In frontal or lateral crash situations, these injuries can be induced by pure deceleration effects or blunt trauma due to belt or steering wheel impact. Concerning the liver under frontal decelerations, how could one investigate organ behaviour leading to the injury mechanisms? This work couples experimental organ decelerations measurements (with 19 tests on cadaver trunks) and finite element simulation, provides a first analysis of the liver behaviour within the abdomen. It shows the influence of the liver attachment system that leads to liver trauma and also torsion effects between the two lobes of the liver. Injury mechanisms were evaluated through the four phases of the liver kinematics under frontal impact: (1) postero-anterior translation, (2) compression and sagittal rotation, (3) rotation in the transverse plane and (4) relaxation.
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Affiliation(s)
- P J Arnoux
- Laboratoire de Biomécanique Appliquée, UMRT 24 Faculté de Médecine-INRETS, Université de la Méditerranée, Marseille, France.
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Arnoux PJ, Serre T, Cheynel N, Thollon L, Behr M, Baque P, Brunet C. Liver injuries in frontal crash situations a coupled numerical—experimental approach. Comput Methods Biomech Biomed Engin 2008. [DOI: 10.1080/10255840701553471] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Delotte J, Behr M, Thollon L, Arnoux PJ, Baque P, Bongain A, Brunet C. [Pregnant woman and road safety: a numerical approach. Application to a restrained third trimester pregnant woman in frontal impact]. ACTA ACUST UNITED AC 2007; 36:577-81. [PMID: 17446007 DOI: 10.1016/j.jgyn.2007.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2006] [Revised: 02/12/2007] [Accepted: 03/16/2007] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The goal of our work is the development of a numerical model of pregnant woman in driving position. We present an application to the study of injury mechanisms during a frontal car crash for a seat belt restrained pregnant woman in driving position. MATERIALS AND METHODS We integrated a digital representation of a pregnant uterus, foetus and placenta in a previous existing numerical model of non pregnant Human body in driving position, the Humos model. The realization of a numerical simulation of a frontal car crash enabled us to analyze the part played by the safety belt in the organic traumatisms. RESULTS Three phases were highlighted. The first phase consists of a translation forwards of the pregnant uterus during the impact. The second phase is a rotation forwards in the sagittal plan of the pregnant uterus with for axis of rotation the posterior wall of the pubis. The third phase is a vertical adjustment coupled to a translation of the uterus towards the back. This translation leads the uterus to impact the spine. CONCLUSION The development of a pregnant numerical model in the field of accidentology allows the analysis of organic traumatisms. That makes it possible to study the role played by the existing safety systems. This model might make it possible to develop safety systems specific to the pregnant woman.
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Affiliation(s)
- J Delotte
- Laboratoire de biomécanique appliquée, UMRT 24 INRETS/université de la Méditerranée, faculté de médecine secteur Nord, boulevard Pierre-Dramard, 13916 Marseille, France.
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Masson C, Thollon L, Cesari D, Brunet C. Effects of static high compression on human foot-ankle: biomechanical response and injuries. Surg Radiol Anat 2006; 28:46-53. [PMID: 16195810 DOI: 10.1007/s00276-005-0043-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2004] [Accepted: 08/08/2005] [Indexed: 05/04/2023]
Abstract
To reduce road-traffic fatalities, significant improvements have been seen in the protection of vital body parts. Attention is now focused on serious injuries, which cause disability or impairment as lower limb injuries. The numerical models developed to have a better understanding of injury parameters are evaluated from human responses to load. For this objective, mechanical characterisation tests have been performed on nine human foot/ankle specimens. The responses of three foot contact points during various static loads of the tibia were studied. After each test, an autopsy was performed and the associated injuries were noticed. These tests allowed quantification of the tibia compressive force in relation to foot and ankle deformations up to injury level.
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Affiliation(s)
- C Masson
- Laboratoire de Biomécanique Appliquée, URA INRETS, Faculté de Médecine Secteur Nord, Université de la Méditerranée, Boulevard Pierre Dramard, Marseille Cedex 20, France.
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Abstract
OBJECTIVE In pedestrian traumas, lower limb injuries occur under lateral shearing and bending at the knee joint level. One way to improve injury mechanisms description and consequently knee joint safety is to evaluate the ultimate shearing and bending levels at which ligaments start being injured. METHODS As such data cannot easily and accurately be recorded clinically or during experiments, we show in this article how numerical simulation can be used to estimate such thresholds. This work was performed with the Lower Limb Model for Safety (LLMS) in pure lateral bending and shearing conditions, with an extended range of impact velocities. RESULTS One result concerns the ultimate knee lateral bending angle and shearing displacement measurements for potential failure of ligaments (posterior cruciate, medial collateral, anterior cruciates and tibial collateral). They were evaluated to be close to 16 degrees and 15 mm, respectively. CONCLUSION The lower leg model used in this study is an advanced FE model of the lower limb, validated under various situations. Its accurate anatomical description allows a wide range of applications. According to the validity domain of the model, it offered a valuable tool for the numerical evaluation of potential injuries and the definition of injury risk criterion for knee joint.
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Affiliation(s)
- P J Arnoux
- Laboratoire de Biomécanique Appliquée, Université de la Méditerranée, Marseille, France.
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Tropiano P, Thollon L, Arnoux PJ, Huang RC, Kayvantash K, Poitout DG, Brunet C. Using a finite element model to evaluate human injuries application to the HUMOS model in whiplash situation. Spine (Phila Pa 1976) 2004; 29:1709-16. [PMID: 15303012 DOI: 10.1097/01.brs.0000135840.92373.5c] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN In the field of numerical simulation, the finite element method provides a virtual tool to study human tolerance and postulate on potential trauma under crash situations, particularly in case of whiplash trauma. OBJECTIVES To show how medical and biomechanical interpretations of numerical simulation can be used to postulate on human injuries during crash situations. This methodology was applied to whiplash trauma analysis. A detailed analysis of kinematics of joints, stress level in hard tissues, and strain level in soft tissues was used to postulate on chronology and patterns of injury. Data were compared with published biomechanical and clinical studies of whiplash. SUMMARY OF BACKGROUND DATA Although many in vitro and in vivo studies have been conducted to investigate whiplash cervical injury, and despite the number of finite element models developed to simulate the biomechanical behavior of the cervical spine, to date, there are only limited finite element models reported in the literature on the biomechanical response of the whole cervical spine in these respects. METHODS A complete finite element model of the human body (HUMOS) build in a sitting position in a car environment was created to investigate injury mechanisms and to provide data for automotive safety improvements. It includes approximately 50,000 elements, including descriptions of all bones, ligaments, tendons, skin, muscles, and internal organs. A 15-g whiplash injury was simulated with the HUMOS model. The model predicted cervical motion segment kinematics, deformations of disks and ligaments, and stresses in bone. Model output was then compared with experimental and clinical whiplash literature. RESULTS In term of kinematics during the chronology of whiplash, two injury phases were identified: the first was hyperextension of the lower cervical spine (C6-C7 and C5-C6) and mild flexion of the upper cervical spine(C0-C4). The amount of upper cervical flexion was 15 degrees from C0 to C4. The second phase was hyperextension of the entire cervical spine. Potential patterns of ligamentous injuries were observed; the anterior longitudinal ligament experienced the most strain (30%) at the lower cervical spine at the time of lower cervical extension and the interspinous ligament experienced the most strain (60%) at the time of upper cervical flexion. Von Mises stresses in bone do not exceed 15 Mpa, which is largely under injury levels reported in the literature. CONCLUSIONS.: This study reports a methodology to describe and postulate on human injuries based on finite element model analysis. The output of the HUMOS model in the context of whiplash shows a strong correlation with clinical and experimental reported data. HUMOS shows promise for the modeling of other types of trauma as well.
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Affiliation(s)
- P Tropiano
- Laboratoire de Biomécanique Appliquée, UMRT24 INRETS/University of Méditerranée Faculty of Medicine. Fac. Médecine Nord, Marseille, France.
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Behr M, Arnoux PJ, Serre T, Bidal S, Kang HS, Thollon L, Cavallero C, Kayvantash K, Brunet C. A human model for road safety: from geometrical acquisition to model validation with radioss. Comput Methods Biomech Biomed Engin 2003; 6:263-73. [PMID: 12959760 DOI: 10.1080/10255840310001606080] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
In order to investigate injury mechanisms, and to provide directions for road safety system improvements, the HUMOS project has lead to the development of a 3D finite element model of the human body in driving position. The model geometry was obtained from a 50th percentile adult male. It includes the description of all compact and trabecular bones, ligaments, tendons, skin, muscles and internal organs. Material properties were based on literature data and specific experiments performed for the project. The validation of the HUMOS model was first achieved on isolated segments and then on the whole model in both frontal and lateral impact situations. HUMOS responses were in good agreement with the experimental data used in the model validation and offers now a wide range of applications from crash simulation, optimization of safety systems, to biomedical and ergonomics.
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Affiliation(s)
- M Behr
- Laboratoire de Biomécanique Appliquée (LBA), UMRT24 INRETS/Univ. Mediterranée, Fac. Médecine Nord, Bd. P. Dramard, 13916 Marseille, France.
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