形状记忆合金骑缝钉内固定在三关节融合术中的力学特性分析
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新疆大学智能制造现代产业学院

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Mechanical characterisation of shape memory alloy riding nail internal fixation in triple joint fusion surgery
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    摘要:

    目的 研究加压空心螺钉及形状记忆合金骑缝钉在三关节融合术内固定中的生物力学差异,为形状记忆合金骑缝钉的临床应用提供参考。方法 选择1例重度僵硬型马蹄足患者的足部二维CT数据,通过Mimics和Geomagic软件构建三关节融合术后模型,并利用SolidWorks2021软件建立三关节融合内固定几何模型;根据使用固定钉类型和组合方式(加压空心螺钉和形状记忆合金骑缝钉)分为A、B、C、D四种固定方案;在Abaqus软件中仿真分析模拟在中立位生理载荷下不同内固定方案模型的生物力学特性。结果 方案D内固定模型距下、距舟、跟骰关节融合面端面最大位移值分别为1.161μm,3.163μm,1.005μm,0.6194μm,0.9099μm,0.7387μm,均大于方案A、B、C内固定模型融合面端面最大位移值;方案D内固定模型距舟关节、跟骰关节融合面内外侧位移之差分别为13.10%、13.60%,与其它三种固定方案相比融合面位移更接近于平行位移;方案D内固定模型距下、距舟、跟骰关节融合面最大Von Mises应力值分别为1.291MPa,2.673MPa,3.332MPa,均大于方案A、B、C内固定模型距下、距舟、跟骰关节融合面最大Von Mises应力值。结论 应用方案D(距舟关节和跟骰关节融合面使用骑缝钉内固定,距下关节融合面使用加压空心螺钉内固定)能够使三关节融合术后内固定融合面具有稳定性并为其提供近似平行微动,产生适当的融合面应力使融合端面接触更紧密,促进骨痂生长,获得更佳的融合效果。

    Abstract:

    Objective To study the biomechanical differences between compressed hollow screws and shape memory alloy staples in internal fixation of three joint fusion surgery, and provide reference for the clinical application of shape memory alloy staples.Methods The two-dimensional CT data of the foot of a patient with severe stiffness of horseshoe foot were selected, and a model of three joint fusion was established using Mimics and Geomagic software. And SolidWorks2021 software was used to establish the geometry model of triple joint fusion internal fixation; According to the type and combination of fixed screws used (pressurized hollow screws and shape memory alloy riding nails), there are four fixation schemes: A, B, C, and D;The biomechanical characteristics of different models of internal fixation schemes under neutral physiological loading were simulated and analyzed in Abaqus software.Results The maximum displacement of the fusion surface of the internal fixation model in Scheme D was greater than the maximum displacement of the fusion surface of the compression cannulated screw internal fixation model, and the displacement difference between the fusion surface and the compression cannulated screw internal fixation model was smaller. The displacement of the fusion surface of the internal fixation model in Scheme D was close to the parallel displacement; The maximum Von Mises stress value on the fusion surface of the shape memory alloy cross stitch screw internal fixation model is greater than the maximum Von Mises stress value on the fusion surface end face of the compression hollow screw internal fixation model, making the fusion surface contact closer.Conclusion The application of Option D (internal fixation of the fused surfaces of the talonavicular and calcaneal joints with riding nails and the fused surfaces of the talonavicular joints with compression hollow screws) provides stability of the fused surfaces of the internal fixation after triple-joint fusion and provides them with near-parallel micromovement, which produces appropriate fusion stresses to make fusion end contact closer, promotes the growth of bone scabs, and achieves better fusion results.

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  • 收稿日期:2023-10-25
  • 最后修改日期:2023-11-22
  • 录用日期:2023-11-22
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