前韧带加强修复结合螺钉固定用于下胫腓不稳的生物力学研究
DOI:
作者:
作者单位:

1.溧阳市人民医院;2.苏州大学骨科研究所

作者简介:

通讯作者:

中图分类号:

基金项目:


Biomechanical study of anterior ligament reinforcement and screw fixation in the treatment of tibiofibular instability
Author:
Affiliation:

1.Liyang people'2.'3.s Hospital;4.Institute of Orthopaedics, Suzhou University

Fund Project:

  • 摘要
  • |
  • 图/表
  • |
  • 访问统计
  • |
  • 参考文献
  • |
  • 相似文献
  • |
  • 引证文献
  • |
  • 资源附件
  • |
  • 文章评论
    摘要:

    目的:建立踝关节骨折固定后遗留下胫腓前韧带损伤,用锚钉加强修复结合螺钉固定的有限元模型,比较其受力及变形情况,为临床诊治提供理论依据。方法:选取1例正常男性青年的踝关节CT图像,建立踝关节骨折固定后遗留下胫腓前联合损伤有限元模型,对损伤模型置入锚钉固定为实验组,使用螺钉固定为对照组。通过有限元分析计算,观察两组模型在各种载荷工况作用下的最大应力分布和最大变形情况。结果:在垂直的载荷作用下,实验组的变形量均高于对照组6.8%,外旋载荷时达到22.6%,而内旋载荷时低5.1%;在同级载荷作用下,模型上的最大应力峰值,对照组和实验组相差不大;实验组模型的最大应力,因为锚钉固定的作用,最大应力峰值是由胫骨远端骨折固定的螺钉承担。而对照组是由钢板和下胫腓联合螺钉的坚强固定来承担;锚钉上的最大应力数值均分布在螺钉上,缝合线主要起到固定作用。结论:下胫腓螺钉及锚钉固定都能有效地治疗踝关节骨折固定后遗留下胫腓不稳,锚钉固定使得钢板上应力分散,在固定下胫腓的同时具有更大的踝穴形变能力,而且避免断钉的风险,在临床上应用前景可期。

    Abstract:

    Objective: to establish a finite element model of tibial and fibular anterior ligament injury after ankle fracture fixation, and to compare the stress and deformation of the model with bolt fixation, so as to provide theoretical basis for clinical diagnosis and treatment. Methods: a CT image of ankle joint of a normal young man was selected to establish a finite element model of anterior tibiofibular joint injury after ankle fracture fixation. The injury model was fixed with anchor screw as the experimental group and screw as the control group. Through the finite element analysis and calculation, observe the maximum stress distribution and the maximum deformation of the two models under various load conditions. Results: under the vertical load, the deformation of the experimental group was 6.8% higher than that of the control group, 22.6% under the external rotation load, and 5.1% lower under the internal rotation load; under the same level of load, the maximum stress peak of the model in the control group and the experimental group was almost the same; the maximum stress in the experimental group, because of the role of anchor fixation, the maximum stress peak was fixed by the distal tibial fracture Screw bearing. In the control group, steel plate and screws were used for rigid fixation; the maximum stress values on the anchor were all distributed on the screws, and the suture was mainly used for fixation. Conclusion: the lower tibiofibular screw and anchor screw fixation can effectively treat the tibiofibular instability caused by ankle fracture fixation. The anchor screw fixation can disperse the stress on the steel plate, and has a greater ankle deformation ability while fixing the lower tibiofibular, and avoid the risk of nail breakage. It has a promising clinical application prospect.

    参考文献
    相似文献
    引证文献
引用本文
分享
文章指标
  • 点击次数:
  • 下载次数:
  • HTML阅读次数:
  • 引用次数:
历史
  • 收稿日期:2019-12-03
  • 最后修改日期:2020-02-22
  • 录用日期:2020-02-27
  • 在线发布日期:
  • 出版日期: