下颌角不利型骨折小型钛板内固定有限元分析  

Finite element analysis of the miniplate system fixation for the treatment of mandibular angle unfavorable fracture

作　　者：赵科[1] 罗洪[1] 吴亚东[1] 黄光磊[1] 宋具昆[1] 陈昊[1] 马宗民[2] 

机构地区：[1]贵州省人民医院口腔颌面外科,贵阳550002 [2]长春吉林大学机械科学与工程学院

出　　处：《实用口腔医学杂志》2010年第6期739-742,共4页Journal of Practical Stomatology

摘　　要：目的:用三维有限元方法评价下颌角不利型骨折小型钛板坚固内固定稳定性,为下颌角骨折坚固内固定提供生物力学的理论支持。方法:建立下颌角不利型骨折的三维有限元模型,按照下颌角小型钛板外斜线单块钛板固定及下方增加一块钛板固定,分别模拟切牙咬合及健、患侧磨牙咬合,得出骨折段的相对位移情况。结果:下颌角不利型骨折,切牙功能咬合时,骨断端位移在150μm内,但在健侧及患侧磨牙功能咬合情况下,骨断端位移较大。2块小钛板固定时,骨断端相对位移量较大,需要降低咬合力至80N,1块钛板固定,骨断端相对位移量大,不能保证骨折顺利愈合。结论:下颌角不利型骨折2块小钛板固定稳定性不足,需要降低咬合力;1块小钛板张力带固定不够稳定,需要严格选择适应证。Objective：To study the feasibility of miniplate system in the treatment of unfavorable fracture of mandibular angle using finite element analysis（FEA）.Methods：In a three-dimensional computer model of mandible unfavarable fracture of mandible angle was made.Fractures were rigid internal fixed with one or two titanium miniplates.Fracture mobility and plate strain were calculated when simulated bite forces were applied on incisors,first molars on fracture side and non-fracture side respectively.The loads were transmitted only through the plates and none stress was transmitted through the fracture surfaces.Results：To mandibular unfavorable angle fractures,in the incisors bite force situation,the fractured fragment ends mobility was within 150 μm,that above 150 μm were found when molar bite force was apllied on both fracture side and non-fracture side.With the same bite force,whether single or two miniplates for the mandibular negative-type angle fracture could not ensure the stability of fractured fragments.The bite force could not be above 80 N when two miniplates were used for fixation.Conclusion：Based on the study of FEA model,two miniplates can not provide sufficient stabilization of fractured fragments for angle fractures.Single miniplate for the tension band fixation can not provide sufficient stiffness.

关 键 词：下颌骨骨折 坚固内固定 不利型骨折 有限元 

分 类 号：R782.4[医药卫生—口腔医学]