SandersⅡ型跟骨骨折螺钉微创治疗的有限元优化分析
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作者Author单位AddressE-Mail
郭宗慧 GUO Zong-hui 中国科学院大学宁波华美医院骨科中心, 浙江 宁波 315010 Department of Orthopaedics Centre, Huamei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, Zhejiang, China  
颜勇卿 YAN Yong-qing 中国科学院大学宁波华美医院骨科中心, 浙江 宁波 315010 Department of Orthopaedics Centre, Huamei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, Zhejiang, China  
唐寅 TANG Yin 中国科学院大学宁波华美医院骨科中心, 浙江 宁波 315010 Department of Orthopaedics Centre, Huamei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, Zhejiang, China  
王骏杰 WANG Jun-jie 中国科学院大学宁波华美医院骨科中心, 浙江 宁波 315010 Department of Orthopaedics Centre, Huamei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, Zhejiang, China  
杨长春 YANG Chang-chun 中国科学院大学宁波华美医院骨科中心, 浙江 宁波 315010 Department of Orthopaedics Centre, Huamei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, Zhejiang, China  
庞清江 PANG Qing-jiang 中国科学院大学宁波华美医院骨科中心, 浙江 宁波 315010 Department of Orthopaedics Centre, Huamei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, Zhejiang, China gzhcmu@126.com 
期刊信息:《中国骨伤》2021年,第34卷,第2期,第137-142页
DOI:10.12200/j.issn.1003-0034.2021.02.008
基金项目:宁波市医学重点学科项目(编号:2016-F06);中国科学院大学宁波华美医院华美研究基金(编号:2017HMKY27)
中文摘要:

目的:探讨SandersⅡ型跟骨骨折微创治疗时螺钉不同固定方式后的生物力学特点。

方法:将CT扫描后的跟骨Dicom数据输入Mimics 21.0软件及Ansys 15.0软件中构建跟骨三维有限元数字模型;将此模型导入UG NX 10.0软件中,根据Sanders分型切割跟骨,建立后关节面塌陷的SandersⅡ型跟骨骨折模型;模拟跟骨骨折后微创螺钉内固定手术:将1枚螺钉自后关节面下方由外向内固定载距突,其余4枚螺钉分别自跟骨结节处根据不同方式固定跟骨,得出4种不同跟骨模型,在相同条件下分别对4种内固定模型加载,行非线性有限元分析,计算不同内固定模型的应力分布情况。

结果:在相同条件加载下,模型三在骨缝间最大位移值、跟骨最大位移值、螺钉最大等效应力值方面均较其余3种内固定模型小,且应力更分散。

结论:跟骨骨折微创螺钉内固定中,1枚载距突螺钉固定后,2枚螺钉自跟骨结节交叉固定后关节面,2枚螺钉自跟骨结节平行固定跟骰关节的固定方式更符合生物力学要求,为临床治疗提供必要的理论依据。
【关键词】跟骨  骨折  微创  有限元分析
 
Finite element optimization analysis of minimally invasive screw treatment for Sanders typeⅡcalcaneal fracture
ABSTRACT  

Objective: To explore biomechanical characteristics of minimally invasive different screw fixations in treating Sanders typeⅡcalcaneal fractures.

Methods: Dicom data of calcaneus by CT scan were input into Mimics 21.0 software and Ansys15.0 software to construct three-dimensional finite element digital model of calcaneus;this model was input into UG NX 10.0 software,and calcaneus was cut according to Sanders classification to establish Sanders typeⅡ calcaneus model with posterior articular surface collapse;then simulated minimally invasive screw internal fixation after calcaneal fracture:a screw from posterior articular surface was used to outside-in fix sustentaculum tali,other 4 screws were used to fix calcaneus by different methods through calcaneal tuberosity,and 4 different calcaneal models were obtained. Under the same conditions,4 types of internal fixation models were loaded respectively,and nonlinear finite element analysis was performed to calculate the stress distribution of different internal fixation models.

Results: Under the same condition of loading,the model 3 had smaller displacement value,maximum calcaneus displacement value and maximum equivalent stress value of the screw than other three internal fixation models,and the stress was more dispersed.

Conclusion: In minimally invasive screw internal fixation of calcaneus fracture,after 1 sustentaculum tali screw fixation,2 screws crossed fix posterior articular surface from calcaneal tuberosity,2 screws fix parallelly calcaneocuboid joint from calcaneal tuberosity are more suitable for biomechanical requirements,and could provide basic theory for clinical treatment.
KEY WORDS  Calcaneus  Fractures  Minimally invasive  Finite element analysis
 
引用本文,请按以下格式著录参考文献:
中文格式:郭宗慧,颜勇卿,唐寅,王骏杰,杨长春,庞清江.SandersⅡ型跟骨骨折螺钉微创治疗的有限元优化分析[J].中国骨伤,2021,34(2):137~142
英文格式:GUO Zong-hui,YAN Yong-qing,TANG Yin,WANG Jun-jie,YANG Chang-chun,PANG Qing-jiang.Finite element optimization analysis of minimally invasive screw treatment for Sanders typeⅡcalcaneal fracture[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(2):137~142
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