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Der vorliegende Artikel fokussiert sich auf die weibliche Belastungsinkontinenz als Insuffizienz der Speicherfunktion der Blase, auch wenn im klinischen Alltag die Harninkontinenz der Frau häufig verschiedene Ursachen hat und insbesondere eine Belastungsinkontinenz im Alter und bei neurologischer Komorbidität nur selten isoliert vorkommt.
Das kleine Becken der Frau ist sowohl als Funktions- als auch als strukturelle Einheit zu betrachten. Dabei unterliegen bei der Frau Blase, Harnröhre, Gebärmutter und Enddarm sowie die muskulären und ligamentösen Strukturen des kleinen Beckens durch Fertilitätsphase, mögliche Schwangerschaften, Geburten und Menopausen-Phase, über das „normale Altern“ hinaus, gravierenden Veränderungen.
This article focuses on female stress incontinence in the form of pelvic floor dysfunction and urethral sphincter deficiency, although isolated stress incontinence accounts for less than half of all incontinence cases. Especially in women of old age and those with neurological comorbidities, the causes of incontinence are mostly multifactorial. Also it has to be considered that the female bladder, urethra, uterus and rectum as well as the muscular and ligamentous structures of the female pelvis minor are affected by phases of fertility, possible pregnancies, births and menopause in addition to the normal ageing process.
The load-carrying capacity or the safety against plastic limit states are the central questions in the design of structures and passive components in the apparatus engineering. A precise answer is most simply given by limit and shakedown analysis. These methods can be based on static and kinematic theorems for lower and upper bound analysis. Both may be formulated as optimization problems for finite element discretizations of structures. The problems of large-scale analysis and the extension towards realistic material modelling will be solved in a European research project. Limit and shakedown analyses are briefly demonstrated with illustrative examples.
A generalized shear-lag theory for fibres with variable radius is developed to analyse elastic fibre/matrix stress transfer. The theory accounts for the reinforcement of biological composites, such as soft tissue and bone tissue, as well as for the reinforcement of technical composite materials, such as fibre-reinforced polymers (FRP). The original shear-lag theory proposed by Cox in 1952 is generalized for fibres with variable radius and with symmetric and asymmetric ends. Analytical solutions are derived for the distribution of axial and interfacial shear stress in cylindrical and elliptical fibres, as well as conical and paraboloidal fibres with asymmetric ends. Additionally, the distribution of axial and interfacial shear stress for conical and paraboloidal fibres with symmetric ends are numerically predicted. The results are compared with solutions from axisymmetric finite element models. A parameter study is performed, to investigate the suitability of alternative fibre geometries for use in FRP.
Three-dimensional (3D) full-field measurements provide a comprehensive and accurate validation of finite element (FE) models. For the validation, the result of the model and measurements are compared based on two respective point-sets and this requires the point-sets to be registered in one coordinate system. Point-set registration is a non-convex optimization problem that has widely been solved by the ordinary iterative closest point algorithm. However, this approach necessitates a good initialization without which it easily returns a local optimum, i.e. an erroneous registration. The globally optimal iterative closest point (Go-ICP) algorithm has overcome this drawback and forms the basis for the presented open-source tool that can be used for the validation of FE models using 3D full-field measurements. The capability of the tool is demonstrated using an application example from the field of biomechanics. Methodological problems that arise in real-world data and the respective implemented solution approaches are discussed.
Surgical reconstruction of the interosseous membrane (IOM) could restore longitudinal forearm stability to avoid persisting disability due to capituloradial and ulnocarpal impingement in Essex Lopresti lesions. This biomechanical study aimed to assess longitudinal forearm stability of intact specimens, after sectioning of the IOM and after reconstruction with a TightRope construct using either a single or double bundle technique.
While plate fixation of proximal ulna fractures might lead to superior clinical results compared to tension band wiring, regular plates represent an established risk factor for wound complications. The olecranon double plates (Medartis, Basel, CH) might decrease complications related to the osteosynthesis because of their low profile and better anatomical fit. This study aimed to evaluate the biomechanical performance and clinical results of the olecranon double plates.