不同固定方式治疗儿童肱骨近端骨折的有限元分析
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陕西省创新能力支撑计划-科技创新团队(2020TD-036),陕西省重点产业链(群)-社会发展领域(2021ZDLSF02-11)


Finite Element Analysis on Different Internal Fixations for Treating Proximal Humeral Fractures in Children
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    摘要:

    目的 通过有限元方法比较外固定架、克氏针、弹性髓内钉固定儿童肱骨近端骨折的生物力学特性。 方法 挑选 1 名 8 岁患儿健侧肱骨 CT 数据,将图像数据导入 Mimics 21. 0 软件,建立粗略肱骨模型,再导入 Geomagic 2013 构建得到肱骨松质骨与皮质骨三维模型。 将上述模型在 SolidWorks 2018 中与外固定架、克氏针、弹性髓内钉 3 种固定物完成装配后导入 ANSYS 2019 中,模拟上肢安静以及前屈、后伸、内收、外展、内旋、外旋 7 种工况,分析肱骨远端最大位移、固定物最大应力、远端骨折面最大位移。 结果 外固定架、克氏针、弹性髓内钉固定模型肱骨远端最大位移的最小值分别出现在后伸(2. 406 mm)、外旋(0. 203 mm)、外旋(0. 185 mm)工况下。 结论 外固定架固定儿童肱骨近端骨折最不稳定,弹性髓内钉的生物力学性能优于外固定架以及克氏针固定。

    Abstract:

    Objective To compare biomechanical characteristics of external fixator, Kirschner’s wire, elastic stable intramedullary nailing (ESIN) for fixing proximal humeral fractures in children by finite element method.Methods The CT scanning data from the healthy humerus of an 8-year-old patient with proximal humeralfractures were collected, and the image data were imported in Mimics 21. 0 to establish the rough humeralmodel, which was imported in Geomagic 2013 to construct the three-dimensional (3D) model of cancellous and cortical bones of the humerus. After the model was assembled with 3 fixators ( external fixator, Kirschner’swire, ESIN), it was imported in ANSYS 2019 to simulate the upper limb under quiet, abduction, adduction, flexion, extension, external rotation, internal rotation working conditions. The maximum displacement of the distal humerus, the maximum stress of the fixture, and the maximum displacement of the distal fracture surface were analyzed. Results The minimum values of the maximum displacement of the distal humerus in models fixed by external fixator, Kirschner’s wire, ESIN appeared under extension (2. 406 mm), external rotation (0. 203 mm), external rotation (0. 185 mm) working conditions, respectively. Conclusions External fixator is the most unstable fixation of proximal humeral fractures in children, and the biomechanical performance of ESIN is better than that of external fixator and Kirschner’s wire fixation

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白桓安,陆清达,刘趁心,王晓明,杨亚婷,王 欢,颉 强.不同固定方式治疗儿童肱骨近端骨折的有限元分析[J].医用生物力学,2023,38(2):297-302

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  • 收稿日期:2022-04-02
  • 最后修改日期:2022-06-01
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  • 在线发布日期: 2023-04-25
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