微型联合重建接骨板内固定治疗髋臼后壁骨折坐位下的三维有限元分析  

Three-dimensional finite element analysis of miniplate combined with reconstruction plate internal fixation for posterior acetabular fractures

作　　者：潘昌武[1,2] 刘曦明[1] 蔡贤华[1] 王志华[3] 董鹏飞[3] 

机构地区：[1]广州军区武汉总医院骨科,430070 [2]湖北省团风县人民医院骨科,438000 [3]太原理工大学应用力学与生物医学工程研究所,030024

出　　处：《中国矫形外科杂志》2015年第2期160-164,共5页Orthopedic Journal of China

基　　金：2014年湖北省自然科学基金资助项目(编号:2014CFC1052)

摘　　要：[目的]利用三维有限元方法建立髋臼后壁2/3骨折模型,并评价微型联合重建接骨板内固定治疗髋臼后壁骨折的生物力学稳定性。[方法]建立髋臼后壁2/3骨折模型,分别模拟微型联合重建接骨板内固定(A)、重建接骨板内固定(B)、单纯2枚螺钉内固定(C)及微型接骨板内固定(D)治疗髋臼后壁骨折,并模拟站立位时,在正常载荷下对四种内固定方式进行生物力学稳定性的有限元分析。[结果]髋臼后壁四种内固定方式模型及正常骨盆模型的骨折线上各节点的位移差异有统计学意义(P<0.05),但平均位移大小关系为A<B<C<正常骨盆<D。[结论]四种内固定方式在固定髋臼后壁骨折上内固定方式差别有意义,A、B、C组内固定方式对髋臼后壁2/3骨折均具有较好的生物力学稳定性,D组不能对髋臼后壁骨折进行稳定固定,实验说明单纯微型接骨板不能对髋臼后壁骨折进行稳定固定;且A组骨折平均位移小于B组和C组,微型联合重建接骨板内固定组对髋臼后壁2/3骨折的生物力学稳定性更好。[Objective]To evaluate biomechanical properties of miniplate combined with reconstruction plate internal fixation for the treatment of posterior acetabular fractures by constructing a two- thirds posterior acetabular wall fracture model through three- dimensional finite element analysis. [Method]The two- thirds posterior acetabulum fracture model was established followed by miniplate combined with reconstruction plate internal fixation（A）,reconstruction plate internal fixation（B）,2 screw internal fixation（C）,and miniplate internal fixation（D）. The biomechanical properties of each kind of fixation were evaluated during standing position with a normal force load. [Result]There were significant differences between the different types of internal fixations and the movement of fracture lines as well as normal pelvic movement,with the result being A 〈B 〈C 〈normal model〈 D. [Conclusion]There were significant differences between the biomechanical properties in these four groups,with group A,B,and C having better biomechanical properties compared to group D,which failed to stabilize the posterior acetabular wall. Furthermore,the average movement of the fracture line in group A was less than that in group B and group C,which suggests that miniplate combined with reconstruction plate internal fixation had stronger biomechanical properties for the treatment of posterior acetabular fracture.

关 键 词：髋臼 骨折 有限元分析 

分 类 号：R687.3[医药卫生—骨科学]