MIPPO技术下LCP锁定固定减少锁钉个数后应力遮挡效应的有限元研究  

Finite element analysis of stress-shielding on lock internal fixation and use of unnecessary locking screws by LCP with MIPPO technology

作　　者：钟华[1] 岑怡彪[1] 朱智敏[1] 孔禄生[1] 廖小燕[1] 黄艳[1] 刘敬东 

机构地区：[1]广东省廉江市人民医院骨二科,524400 [2]湖南省衡阳市中心医院骨科

出　　处：《中国骨与关节损伤杂志》2012年第6期507-509,共3页Chinese Journal of Bone and Joint Injury

基　　金：湛江市科技攻关项目(2010C3110023)

摘　　要：目的比较经锁定固定减少锁钉个数后骨痂应力均值的变化,研究LCP锁定固定减少锁钉个数对应力遮挡效应的影响,为MIPPO术中应用不同类型的接骨板和固定方式提供生物力学依据。方法应用有限元法根据LCP的锁定与加压结合孔,建立胫骨上端骨折LCP锁定固定后带骨痂的三维有限元模型。对模型进行力学有限元分析,得出不同工况和内固定方式下骨痂应力情况。结果骨痂在锁定固定减少2个锁钉条件下的应力均值大于减少1个锁钉条件下的应力均值,根据配对t检验结果两者差异具有统计意义。锁定固定减少2个锁钉导致的应力遮挡率小于减少1个锁钉条件下的应力遮挡率。结论 MIPPO技术下LCP锁定固定均采用锁定钉固定时应该减少不必要的锁钉,使在提供稳定固定的同时减少应力遮挡效应,促进骨痂的生成和骨痂改建塑形,有助于骨折愈合。Objective To study the effect of stress-shielding on LCP’s lock internal fixation and the use of unnecessary locking screws by comparing the changes in stress of the callus after lock internal fixation and the use of unnecessary locking screws and provide the basis of biomechanics for the application of different types of plate and fixation methods in clinical MIPPO operation.Methods A three-dimensional finite element model of proximal tibia fracture with callus lock internal fixed was designed by the locking and compression of LCP,finite element was analyzed on the model,and stress of the model by different working condition and internal fixation was obtained.Results Under locking fixation,mean stress of callus through reducing two locked screws was greater than that through reducing one locked screw.According to the results of paired t-test,it had statistical significance.The stress shielding rate through reducing two locked screws was less than that through reducing one locked screw.Conclusion In all of the LCP locking fixation under MIPPO operation technique,the use of unnecessary locking screws should be minimized in order to reduce the effects of stress-shielding while providing a stable fixation,so as to promote formation and re-shaping of the callus and assist in fracture healing.

关 键 词：MIPPO LCP 内固定 应力遮挡 有限元分析 

分 类 号：R687.32[医药卫生—骨科学]