| 骨质疏松性肱骨近端骨折PMMA骨水泥强化螺钉钢板固定的有限元分析 |
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投稿时间：2021-06-20
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| 作者 | Author | 单位 | Address | E-Mail |
| 王伟斌 |
WANG Wei-bin |
中国科学院大学宁波华美医院, 浙江 宁波 315010 |
Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, Zhejiang, China |
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| 袁欣华 |
YUAN Xin-hua |
中国科学院大学宁波华美医院, 浙江 宁波 315010 |
Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, Zhejiang, China |
13566562481@163.com |
| 扶青松 |
FU Qing-song |
中国科学院大学宁波华美医院, 浙江 宁波 315010 |
Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, Zhejiang, China |
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| 韩欣攸 |
HAN Xin-you |
中国科学院大学宁波华美医院, 浙江 宁波 315010 |
Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo 315010, Zhejiang, China |
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| 期刊信息：《中国骨伤》2023年，第36卷，第3期，第262-267页 |
| DOI：10.12200/j.issn.1003-0034.2023.03.013 |
| 基金项目:宁波市自然科学基金(编号:2016A610145;2016A610142) |
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中文摘要:
目的:借助有限元分析的方法探讨肱骨近端聚甲基丙烯酸甲酯(polymethyl methacrylate,PMMA)骨水泥强化螺钉钢板固定对骨质疏松性肱骨近端骨折内固定稳定性的影响。
方法:制作肱骨近端2部分骨折伴干骺端骨缺损的不稳定肱骨近端骨折数字化模型,分别建立肱骨近端骨水泥强化螺钉钢板固定及普通螺钉钢板固定的有限元模型,分析螺钉周围松质骨应力、整体刚度、钢板最大应力及螺钉最大应力。
结果:肱骨近端骨水泥强化螺钉钢板固定的头端6枚螺钉周围松质骨最大应力分别为:1号钉1.07 MPa,2号钉0.43 MPa,3号钉1.16 MPa,4号钉0.34 MPa,5号钉1.99 MPa,6号钉1.57 MPa,普通螺钉钢板固定为:1号钉2.68 MPa,2号钉0.67 MPa,3号钉4.37 MPa,4号钉0.75 MPa,5号钉3.30 MPa、6号钉2.47 MPa。两组模型的整体刚度分别为:骨水泥结构448 N/mm、普通结构434 N/mm。钢板的最大应力均出现在结合孔:骨水泥结构701 MPa、普通结构420 MPa。螺钉的最大应力均出现在4号钉的尾端:骨水泥结构284 MPa、普通结构240.8 MPa。
结论:通过有限元分析的方法证实肱骨近端PMMA骨水泥强化螺钉钢板固定骨质疏松性肱骨近端骨折能有效减少螺钉周围松质骨应力,增强骨折术后初始稳定性,从而防止螺钉穿出及肱骨头塌陷的发生。 |
| 【关键词】肱骨近端骨折 骨水泥 螺钉强化 有限元分析 |
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| Finite element analysis of PMMA bone cement reinforced screw plate fixation for osteoporotic proximal humeral fracture |
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ABSTRACT
Objective With the help of finite element analysis,to explore the effect of proximal humeral bone cement enhanced screw plate fixation on the stability of internal fixation of osteoporotic proximal humeral fracture.
Methods The digital model of unstable proximal humeral fracture with metaphyseal bone defect was made,and the finite element models of proximal humeral fracture bone cement enhanced screw plate fixation and common screw plate fixation were established respectively. The stress of cancellous bone around the screw,the overall stiffness,the maximum stress of the plate and the maximum stress of the screw were analyzed.
Results The maximum stresses of cancellous bone around 6 screws at the head of proximal humeral with bone cement enhanced screw plate fixation were 1.07 MPa for No.1 nail,0.43 MPa for No.2 nail,1.16 MPa for No.3 nail,0.34 MPa for No.4 nail,1.99 MPa for No.5 nail and 1.57 MPa for No.6 nail. These with common screw plate fixation were:2.68 MPa for No.1 nail,0.67 MPa for No.2 nail,4.37 MPa for No.3 nail,0.75 MPa for No.4 nail,3.30 MPa for No.5 nail and 2.47 MPa for No.6 nail. Overall stiffness of the two models is 448 N/mm for bone cement structure and 434 N/mm for common structure. The maximum stress of plate appears in the joint hole:701MPa for bone cement structure and 42 0MPa for common structure. The maximum stress of screws appeared at the tail end of No.4 nail:284 MPa for bone cement structure and 240.8 MPa for common structure.
Conclusion Through finite element analysis,it is proved that the proximal humerus bone cement enhanced screw plate fixation of osteoporotic proximal humeral fracture can effectively reduce the stress of cancellous bone around the screw and enhance the initial stability after fracture operation,thus preventing from penetrating out and humeral head collapsing. |
| KEY WORDS Proximal humeral fracture Bone cement Screw reinforcement Finite element analysis |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 王伟斌,袁欣华,扶青松,韩欣攸.骨质疏松性肱骨近端骨折PMMA骨水泥强化螺钉钢板固定的有限元分析[J].中国骨伤,2023,36(3):262~267 |
| 英文格式: | WANG Wei-bin,YUAN Xin-hua,FU Qing-song,HAN Xin-you.Finite element analysis of PMMA bone cement reinforced screw plate fixation for osteoporotic proximal humeral fracture[J].zhongguo gu shang / China J Orthop Trauma ,2023,36(3):262~267 |
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