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不同髓内固定方法治疗老年耻骨上支骨折的有限元分析
Hits: 2447   Download times: 698   Received:December 20, 2020    
作者Author单位UnitE-Mail
郑永泽 ZHENG Yong-ze 广州中医药大学第一临床医学院, 广东 广州 510405 Department of Orthopaedics Trauma, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Lingnan Medical Research Center, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, Guangdong, China  
陈心敏 CHEN Xin-min 广州中医药大学第一临床医学院, 广东 广州 510405 Department of Orthopaedics Trauma, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Lingnan Medical Research Center, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, Guangdong, China  
郑利钦 ZHENG Li-qin 广州中医药大学第一临床医学院, 广东 广州 510405 Department of Orthopaedics Trauma, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Lingnan Medical Research Center, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, Guangdong, China  
李木生 LI Mu-sheng 广州中医药大学第一临床医学院, 广东 广州 510405 Department of Orthopaedics Trauma, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Lingnan Medical Research Center, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, Guangdong, China  
梁子毅 LIANG Zi-yi 广州中医药大学第一临床医学院, 广东 广州 510405 Department of Orthopaedics Trauma, the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine, Lingnan Medical Research Center, Guangzhou University of Traditional Chinese Medicine, Guangzhou 510405, Guangdong, China  
林梓凌 LIN Zi-ling 广州中医药大学第一附属医院创伤骨科 广州中医药大学岭南医学研究中心, 广东 广州 510405 13600460045@139.com 
期刊信息:《中国骨伤》2021年34卷,第7期,第665-669页
DOI:10.12200/j.issn.1003-0034.2021.07.015
基金项目:国家自然科学基金面上项目(编号:81673996)


目的:通过有限元分析评价弹性髓内钉治疗耻骨上支骨折的生物力学稳定性,并与空心螺钉髓内固定的稳定性进行比较。

方法:选取1位志愿者骨盆CT数据,运用逆向工程软件重建骨盆三维模型并截骨模拟耻骨上支骨折,分别与不同内植物进行装配得到空心钉模型、单弹性钉模型和双弹性钉模型,在ANSYS软件中进行网格划分、材料赋值、加载载荷等步骤后提交运算。

结果:弹性钉模型骨盆整体移位较空心钉模型小,其中双弹性钉模型整体位移最小,但空心钉模型内植物位移最小,单弹性钉模型内植物位移最大;空心钉固定应力虽小但存在明显的应力集中,弹性钉应力大但无明显应力集中,尤其双弹性钉应力分布较为均匀且骨盆整体应力最小。

结论:3种固定方式均能有效改善骨盆前环稳定性,空心钉固定、双弹性钉固定的总体生物力学性能无明显差距,均优于单弹性钉固定。弹性钉固定同时具有微创手术的优势及良好的生物力学稳定性,可作为治疗耻骨上支骨折较好的手术方法。
[关键词]:有限元分析  耻骨  骨折  骨折固定术,髓内
 
Finite element analysis of different intramedullary fixation methods for the treatment of senile pubic ramus fractures
Abstract:

Objective: To evaluate the biomechanical stability of elastic intramedullary nail in the treatment of pubic ramus fractures by finite element analysis,and to compare the stability of elastic intramedullary nail with cannulated screw intramedullary fixation.

Methods: The CT data of the pelvis of a volunteer were selected,and the three-dimensional model of the pelvis was reconstructed by reverse engineering software and the fracture of the pubic ramus fractures was simulated by osteotomy. The hollow nail model,single elastic nail model and double elastic nail model were assembled with different implants respectively. The mesh division,material assignment loading and other steps were carried out in the ANSYS software,and then the calculation was submitted.

Results: The overall displacement of the pelvis of the elastic nail model was smaller than that of the cannulated screw model,in which the double elastic nail model had the smallest overall displacement,but the cannulated screw model had the smallest plant displacement and the single elastic nail model had the largest plant displacement. Although the stress of cannulated screw was small,there was obvious stress concentration,the stress of elastic nail was large,but there was no obvious stress concentration,especially the stress distribution of double elastic nail was more uniform and the overall stress of pelvis was the smallest.

Conclusion: All the three fixation methods can effectively improve the stability of the anterior ring of the pelvis. Among them,there is no significant difference in the overall biomechanical properties of hollow nail fixation and double elastic nail fixation,which is better than that of single elastic nail fixation. Elastic nail fixation has the advantages of minimally invasive surgery and good biomechanical stability,so it can be used as a better surgical method for the treatment of pubic ramus fractures.
KEYWORDS:Finite element analysis  Pubic bone  Fracture fixation,intramedullary
 
引用本文,请按以下格式著录参考文献:
中文格式:郑永泽,陈心敏,郑利钦,李木生,梁子毅,林梓凌.不同髓内固定方法治疗老年耻骨上支骨折的有限元分析[J].中国骨伤,2021,34(7):665~669
英文格式:ZHENG Yong-ze,CHEN Xin-min,ZHENG Li-qin,LI Mu-sheng,LIANG Zi-yi,LIN Zi-ling.Finite element analysis of different intramedullary fixation methods for the treatment of senile pubic ramus fractures[J].zhongguo gu shang / China J Orthop Trauma ,2021,34(7):665~669
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