不同内侧柱支撑方式固定老年肱骨距缺失的肱骨近端骨折的有限元分析  

Finite element analysis of proximal humerus fractures with different medial column support in elderly patients with calerus loss

作　　者：李长飞 乔宇 LI Changfei;QIAO Yu(Department of Orthopedics,Fangshan District Liangxiang Hospital,Beijing 102400,China)

机构地区：[1]北京市房山区良乡医院骨科,北京102400

出　　处：《生命科学仪器》2023年第5期127-130,共4页Life Science Instruments

摘　　要：目的通过有限元分析比较三种不同内侧柱支撑方式固定肱骨距缺失的肱骨近端骨折的力学稳定性,为临床此类骨折的内固定选择提供参考。方法选取一名63岁老年女性肱骨近端骨折患者的右侧肱骨及左侧胫腓骨的CT平扫的影像学资料存储为DICOM格式。利用有限元分析软件重建肱骨、腓骨及骨水泥模型。利用逆向扫描及重建建立肱骨近端钛合金锁定板模型,按照肱骨距缺失的骨折形式截骨,并按照不同工况组装模型。将模型分为A、B、C三组即单纯钛合金锁定板组、钛合金锁定板联合自体腓骨植骨组、钛合金锁定板联合骨水泥组。并按螺钉数量不同分组(AE组、ACE组、全螺钉组)。利用Workbench 2021 R1做力学分析,设置各模型弹性模量、泊松比、接触方式后,计算肱骨模型的最大位移及钛合金锁定板的最大等效应力。结果A组中A1肱骨最大位移为4.6936 mm,A2肱骨最大位移为4.6065 mm,A3肱骨最大位移为4.5814 mm;A组中A1钛合金锁定板最大等效应力为238.69 MPa,A2钛合金锁定板最大等效应力为246.85 MPa,A3钛合金锁定板最大等效应力为247.33 MPa。B组中B1肱骨最大位移为2.9312 mm,B2肱骨最大位移为2.9214 mm,B3肱骨最大位移为2.9209 mm;B组中B1钛合金锁定板最大等效应力为66.037 MPa,B2钛合金锁定板最大等效应力为57.924 MPa,B3钛合金锁定板最大等效应力为57.726 MPa。C组中C1肱骨最大位移为3.3322 mm,C2肱骨最大位移为3.2777 mm,C3肱骨最大位移为3.2475 mm;C组中C1钛合金锁定板最大等效应力为240.6 MPa,C2钛合金锁定板最大等效应力为247.28 MPa,C3钛合金锁定板最大等效应力为247.84 MPa。结论在肱骨模型稳定性中,锁定板联合自体腓骨组最稳定、锁定板联合骨水泥组次之,单纯锁定板组最不稳定;随着螺钉数量增加,模型稳定性增加。在内固定断裂风险中,锁定板联合自体腓骨组风险最小,锁定板联合骨水泥组与单纯�Objective:To compare the mechanical stability of proximal humerus fractures with calerus loss by three different medial column support methods through finite element analysis,and to provide reference for the selection of internal fixation for such fractures.Methods:The imaging data of the right humerus and the left tibia and fibula of a 63-year-old female patient with proximal humerus fracture were selected and stored in DICOM format.The models of humerus,fibula and bone cement were reconstructed by finite element analysis software.The titanium alloy locking plate model of the proximal humerus was established by reverse scanning and reconstruction,and the model was assembled according to different working conditions.The model was divided into three groups:A,B and C:simple titanium alloy locking plate group,titanium alloy locking plate combined with autogenous fibula bone graft group,and titanium alloy locking plate combined with bone cement group.And group according to different numbers of screws(AE group,ACE group,all screw group).The maximum displacement of the humerus model and the maximum equivalent stress of the titanium alloy lock plate were calculated after setting the elastic modulus,Poisson's ratio and contact mode of each model by using Workbench 2021 R1 for mechanical analysis.Results:In group A,the maximum displacement of A1 humerus was 4.6936 mm,that of A2 humerus was 4.6065 mm and that of A3 humerus was 4.5814 mm.In group A,the maximum equivalent stress of A1 titanium alloy lock plate is 238.69MPa,the maximum equivalent stress of A2 titanium alloy lock plate is 246.85MPa,and the maximum equivalent stress of A3 titanium alloy lock plate is 247.33MPa.In group B,the maximum displacement of B1 humerus was 2.9312 mm,that of B2 humerus was 2.9214 mm and that of B3 humerus was 2.9209 mm.In group B,the maximum equivalent stress of B1 titanium alloy lock plate is 66.037 MPa,that of B2 titanium alloy lock plate is 57.924 MPa,and that of B3 titanium alloy lock plate is 57.726 MPa.In group C,the maximum displac

关 键 词：肱骨近端骨折 肱骨距缺失 老年 有限元分析 骨水泥 

分 类 号：R322.71[医药卫生—人体解剖和组织胚胎学]