| 四种步态负载下髋臼记忆内固定系统治疗髋臼后壁骨折的三维有限元分析 |
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Received:March 22, 2007
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| 作者 | Author | 单位 | Unit | E-Mail |
| 汪光晔 |
WANG Guang-Ye |
第二军医大学附属长海医院骨科,上海200433 |
Department of Orthopaedics,the Affiliated Changhai Hospital of the Second Military Medical University,Shanghai 200433,China |
wangguangye@126.com |
| 张春才 |
ZHANG Chun-cai |
第二军医大学附属长海医院骨科,上海200433 |
Department of Orthopaedics,the Affiliated Changhai Hospital of the Second Military Medical University,Shanghai 200433,China |
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| 禹宝庆 |
YU Bao-qing |
第二军医大学附属长海医院骨科,上海200433 |
Department of Orthopaedics,the Affiliated Changhai Hospital of the Second Military Medical University,Shanghai 200433,China |
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| 王家林 |
WANG Jia-lin |
第二军医大学附属长海医院骨科,上海200433 |
Department of Orthopaedics,the Affiliated Changhai Hospital of the Second Military Medical University,Shanghai 200433,China |
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| 许硕贵 |
XU Shuo-gui |
第二军医大学附属长海医院骨科,上海200433 |
Department of Orthopaedics,the Affiliated Changhai Hospital of the Second Military Medical University,Shanghai 200433,China |
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| 苏佳灿 |
SU Jia-can |
第二军医大学附属长海医院骨科,上海200433 |
Department of Orthopaedics,the Affiliated Changhai Hospital of the Second Military Medical University,Shanghai 200433,China |
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| 牛云飞 |
NIU Yun-fei |
第二军医大学附属长海医院骨科,上海200433 |
Department of Orthopaedics,the Affiliated Changhai Hospital of the Second Military Medical University,Shanghai 200433,China |
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| 张鹏 |
ZHANG Peng |
第二军医大学附属长海医院骨科,上海200433 |
Department of Orthopaedics,the Affiliated Changhai Hospital of the Second Military Medical University,Shanghai 200433,China |
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| 期刊信息：《中国骨伤》2007年20卷，第7期，第448-451页 |
| DOI：doi:10.3969/j.issn.1003-0034.yyyy.nn.zzz |
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目的:运用三维有限元法分析髋臼后壁骨折ATMFS(髋臼三维记忆内固定系统)内固定在4种步态负载情况下(脚跟着地相、单腿站立位开始相、单腿站立位中期相、单腿站立位结束相)的应力分布和骨折端移位及头臼接触应力与接触面积变化,为髋臼后壁骨折的ATMFS内固定治疗提供参考。
方法:利用PATRAN2005R2软件建立包含头臼作用力及所有跨髋肌肉收缩力的完整髋臼、后壁骨折及ATMFS坚强内固定的三维有限元模型,在模型上对髋臼后壁骨折在4种步态负载情况下,对ATMFS固定及无固定2种方法的工作情况进行有限元分析,并以完整髋臼为对照,分析4种步态下骨折断面的应力、骨折端移位、头臼接触应力及接触面积,评价ATMFS内固定方法固定的效果。
结果:①骨折未固定时接触面积最小,并在骨折边缘形成应力集中(峰值10.9MPa);随着骨折复位ATMFS固定,接触面积增大,接触压力随之减小,应力集中趋于缓和。②ATMFS所产生的记忆聚合应力,致髋臼软骨下骨发生收缩变形(1.93×10-6～3.48×10-5m),使髋臼的负重顶区更多地参与了头臼之间接触。③ATMFS固定时4步态生理负载下,骨折端移位分别为0.0319、0.0477、0.0372、0.0289mm,所有移位均在安全范围内。④ATMFS固定时,各步态中骨折断面主要为记忆压应力,接近于生理载荷,仅近髋臼窝边缘处骨折面表现为张应力。
结论:髋臼后壁骨折ATMFS固定牢固可靠,能有效地降低头臼间的接触应力,增加接触面积,维持骨折断面接近正常生理载荷的记忆应力,有效促进骨折愈合,是临床中值得推广的一种新方法。 |
| [关键词]:髋臼后壁骨折 ATMFS固定 有限元分析 接触应力 接触面积 |
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| Three-dimensional finite element analysis of acetabular tri-dimensional memory fixation system (ATMFS) for the treatment of acetabular posterior wall fracture under four kinds of different gait conditions |
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Abstract:
Objective: Finite element method was ulsed to analyze the stress distribution,the translation of fracture segment,contact area and contact force with ATMFS fixation under four kinds of different gait conditions(heelstrike phase,beginning left single support phase,halfway left single support phase,end left single support phase),so as to provide the reference for ATMFS internal fixation in clinic.
Methods: The three-dimensional finite element models of complete acetabulum,acetabuluar posterior wall fracture and the fracture with ATMFS fixation was established with PATRAN 2005 R2 software.The posterior wall fractures without fixation or with ATMFS fixation was analyzed with model under four kinds of gait conditions.The fracture stree translation of fractwre segment,contact area and force were analyzed to evaluate the effect of the ATMFS fixation methods.
Results: ① When the fracture was not fixed,the contact area was the least,and there was an obvious stress concentration at the fracture line.After the posterior wall of the acetabulum fracture was reduced and fixed by ATMFS,the contact area increased and at the same time the peak stress in the acetabular cartilage diminished accordingly.② The memory stress generated by ATMFS caused contracting deformation of the acetabular subchondral bone (1.93×10-6-3.48×10-5m),then more loading roof participated in the contact surface.③ Under the 4 gaits,when fixed with ATMFS,the translation of fracture segment accordingly was 0.031 9,0.047 7,0.037 2,0.028 9 mm respectively,and all of them were in safe area.④ During the gait, the stress of fracture was memory stress,which was near to physiological load and tensile stress presented only near the acetabular margin.
Conclusion: Fixation of posterior wall of the acetabulum with ATMFS has the advantages of good stability and fitness.The satisfactory stress distribution of the femoral head promte the facture healing.It is valuable for clinical application. |
| KEYWORDS:Acetabular posterior wall fracture Acetabular tri-dimensional memory fixation sysytem Element analysis Contact force Contact area |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 汪光晔,张春才,禹宝庆,王家林,许硕贵,苏佳灿,牛云飞,张鹏.四种步态负载下髋臼记忆内固定系统治疗髋臼后壁骨折的三维有限元分析[J].中国骨伤,2007,20(7):448~451 |
| 英文格式: | WANG Guang-Ye,ZHANG Chun-cai,YU Bao-qing,WANG Jia-lin,XU Shuo-gui,SU Jia-can,NIU Yun-fei,ZHANG Peng.Three-dimensional finite element analysis of acetabular tri-dimensional memory fixation system (ATMFS) for the treatment of acetabular posterior wall fracture under four kinds of different gait conditions[J].zhongguo gu shang / China J Orthop Trauma ,2007,20(7):448~451 |
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