下颌骨骨折沿张力带坚固内固定有限元分析  

Finite element analysis for tension band fixation of mandibular fracture

作　　者：张伟[1] 吴亚东[1] 于子莹[1] 刘麒麟[1] 于立明[1] 

机构地区：[1]吉林大学口腔医院口腔颌面外科,吉林长春130041

出　　处：《吉林大学学报（医学版）》2006年第5期862-865,共4页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅资助课题(20030423-01)

摘　　要：目的:提供下颌骨骨折坚固内固定生物力学的理论支持。方法:选用牙列完整的成年男性志愿者1例,以眶耳平面为基准平面进行螺旋CT扫描,从髁突到颏部连续横断扫描73层。选择骨组织窗观察断层,用Photoshop7·0读取每层骨组织边界坐标值,将坐标值输入SolidWorks2002有限元软件中,建立下颌体骨折的三维有限元模型,按照Champy的下颌骨骨折理想固定线进行小型钛板固定,分别模拟切牙咬合及健、患侧磨牙咬合条件下,获得骨断端的相对位移情况,用三维有限元方法评价下颌骨骨折小型钛板沿张力带坚固内固定稳定性。结果:下颌骨正中联合及下颌体骨折沿张力带坚固内固定,在功能咬合时,骨断端相对位移均在150μm内;骨折线倾斜角度>20°时,在健侧磨牙咬合时牙槽舌侧的x轴方向上的位移>150μm。结论:两块小型钛板下颌骨正中联合或下颌体骨折坚固内固定,骨折段稳定。当骨折线近中倾斜角度>20°时,小型夹板坚固内固定的稳定性就可能不能保证骨折顺利愈合。Objective To provide theoretical support for mandibular rigid internal fixation. Methods One of adult male complete dentition was chosen, and then using Frankfort horizonal plane as benchmark , CT scanning was done from condylar process to mental region, 73 lamella in all. Using Photoshop 7.0 analysis bone tissue window fault, and coordinate value was load into Solid Works 2002 definite software , then in a three-dimensional computer model of mandible, fracture mobility and plate strain were calculated for bite forces applied on incisors, fracture side and non-fracture side first molars. Simulated mandibular body and symphysis fractures were rigid internal fixed with two titanium miniplates. Fracture without interfragmentary contact were study. The loads were transmitted only through the plates and none stress was transmitted through the fracture surfaces. This computer-based study with finite element analysis （FEA） was done to estimate the stability of tention band fixation of mandibular fractures. Results With two miniplates, the symphysis and body fracture mobility were lower than 150 μm. To mandibular body fractures which had angle of more than 20 degrees with mesial surface, at both the incisors bite force and fracture molar force situation, the fracture mobility was also lower than 150 μm, but the fracture mobility above 150 μm was calculated at non-fracture molar bite forces, Conclusion From a mechanical point of view, based on the FEA model, two titanium miniplates are suitable for symphysis and body fractures. However two miniplates can not provide sufficient stabilizations for mandibular body fractures which have angle of more than 20 degrees with mesial surface . Suitable indications should be selected when miniplates are fixed mandibular angle fractures.

关 键 词：下颌骨折 骨折固定术 内 骨折固定术 应力 物理 

分 类 号：R782.4[医药卫生—口腔医学]