新型组合式锁定钢板治疗SandersⅡ型及Ⅲ型跟骨骨折的有限元分析
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1.贵州医科大学;2.上海健康医学院附属周浦医院骨科

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上海市浦东新区卫生系统重点学科群建设资助(PWZxq2017-12),上海市浦东新区卫生和计划生育委员会科技发展专项基金资助(PW2016A-21),上海市医学重点专科建设项目(ZK2019B-05)


Finite element analysis of new combined locking plate in the treatment of Sanders II and III calcaneal fractures
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1.guizhouyikedaxue;2.Zhoupu hospital Affiliated to Shanghai university of medicine &3.health Sciences

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    摘要:

    目的 应用有限元分析的方法,研究已投入临床中使用的长型(Long)组合式锁定钢板与新型短型(Short)组合式锁定钢板治疗Sanders IIa、Sanders IIb型,以及IIIab型跟骨骨折的骨折端应力分布规律及生物力学的稳定性,为临床工作提供理论依据。方法 将志愿者CT数据通过Mimics等不同软件建立Sanders IIa,IIb型及IIIab型跟骨骨折三维模型,经过条形组合式钢板的内固定材料属性赋值,同时模拟跟骨在中立位及背伸20°时的受力情况,参照人体标本实物形态,施加500N的垂直轴向载荷,应用软件分析骨折块在受力作用下的位移,相对位移,骨组织和内固定的受力情况等,分析比较条形组合式钢板固定下不同类型跟骨骨折的稳定性。结果 长、短组合式锁定钢板固定Sanders IIa、Sanders IIb型跟骨骨折中,钢板及跟骨应力集中位置基本相同,两种钢板固定同一种类型跟骨骨折中最大应力差均小于5MPa,骨折模型最大位移无明显差异。长、短组合式锁定钢板固定Sanders IIIab型跟骨骨折中,前臂钢板螺钉最高应力集中,有金属疲劳风险,最大应力差达12MPa,跟骨最大位移达9μm。结论 长型组合式锁定钢板与短型组合式锁定钢板治疗Sanders IIa及Sanders IIb型跟骨骨折无明显差异,而Sanders IIIab型跟骨骨折治疗中,长型组合式锁定钢板的固定效果优于短型组合式锁定钢板,实验的最终结果还需要进一步通过生物力学和临床研究进行论证。

    Abstract:

    Objective Finite element analysis was used to study the stress distribution and biomechanical stability of the combined Long locking plate and the new Short locking plate in the treatment of Sanders IIa, Sanders IIb and IIIab calcaneal fractures, providing theoretical basis for clinical work. Method Volunteers CT data through Mimics different software, such as establishing Sanders type IIa, IIb and calcaneal fractures IIIab type 3 d model, after the bar sectional steel plate internal fixation material attribute assignment, at the same time simulation with bone in the neutral position and force of the back stretch when 20°, the reference specimens of human physical shape, put 500N vertical axial load, application analysis of fracture under the action of a force displacement, relative displacement of bone tissue and force of the internal fixation, and so on, analysis and comparison under the bar plate fixation combined the stability of the different types of calcaneal fractures. Result In the fixation of calcaneal fractures of type Sanders IIa and type Sanders IIb with long and short combined locking plates, the stress concentration positions of the plates and calcaneal fractures were basically the same. The maximum stress difference between the two plates in the fixation of calcaneal fractures of the same type was less than 5MPa, and there was no significant difference in the maximum displacement of the fracture model.In the fixation of calcaneal fractures of type Sanders IIa and Sanders IIb with long and short combined locking plates, the maximum stress concentration of forearm plate screws is associated with the risk of metal fatigue. The maximum stress difference is up to 12MPa, and the maximum calcaneal displacement is up to 9μm. Conclusion Long combined type locking plate and short combined treatment Sanders, a locking plate type IIa and Sanders type IIb calcaneal fractures has no obvious difference, and Sanders IIIab model in the treatment of calcaneal fractures, long combined effect of locking plate fixation is better than the short type combined locking plate, but the final experiment results need further by biomechanics and clinical research.

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  • 收稿日期:2019-10-14
  • 最后修改日期:2019-12-06
  • 录用日期:2019-12-16
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