动力化前路方形区钛板螺钉系统固定伴有对侧骨盆前环不稳的髋臼双柱骨折的站位有限元分析  

Finite element analysis of standing position in both-column with posterior hemi-transverse lesion fractures of the acetabulum fixed by dynamic anterior plate-screw system for quadrilateral area

作　　者：林冠林 陈庄洪[2] 蔡贤华[2] 刘曦明[2] 雷建银 王志华[3] 张宝成[1] 

机构地区：[1]南方医科大学附属武汉临床学院,武汉430070 [2]广州军区武汉总医院骨科 [3]太原理工大学

出　　处：《中华实验外科杂志》2015年第2期388-390,共3页Chinese Journal of Experimental Surgery

摘　　要：目的 利用有限元技术探讨当对侧骨盆前环不稳时,动力化前路方形区钛板螺钉系统（DAPSQ）内固定治疗髋臼双柱骨折的生物力学稳定性.方法 利用有限元分析技术建立正常人体全骨盆有限元模型并进行有限元验证,建立3种骨折内固定模型：A：DAPSQ固定右侧髋臼双柱骨折模型,左侧耻骨支完整;B：DAPSQ固定右侧髋臼双柱骨折模型,左侧耻骨上下支骨折但不予固定;C：DAPSQ固定右侧双柱骨折模型,左侧耻骨上下支骨折,但耻骨上支采用钛板固定.限制各模型的三维自由度,加载生理载荷后进行有限元计算,分析比较各内固定模型骨折端的位移及应力分布情况.结果 通过对A、B、C3组骨折模型的髋臼横向、纵向位移及应力云图分析与比较后发现,C组在骨盆环稳定时采用DAPSQ固定模型的横向及纵向位移小,符合复位标准,应力分布均匀,无明显高度集中现象.骨折线上的横向及纵向位移呈现B＞C＞A,站位下A、B、C纵向位移分别为（1.315 ±0.171）、（1.490 ±0.247）、（1.334 ±0.160） mm,站位横向位移分别为（1.185±0.700）、（1.337±0.080）、（1.198 ±0.103） mm.结论 在应用DAPSQ固定髋臼双柱骨折时,只有在确保对侧骨盆前环的稳定前提下,DAPSQ才能提供有效可靠的固定.Objective To explore biomechanical stability of fractures of the acetabulum fixed by dynamic anterior plate-screw system for quadrilateral area （DAPSQ） when pelvic ring was unstable.Methods To prepare right side of the anterior column with posterior hemi-transverse lesion fractures of the acetabulum （pelvis） by finite element analysis,DAPSQ （A）,building on the left side of the superior ramus of pubis fracture and inferior ramus of pubis model on the basis of A model,prepare two kinds of model of the left side of the superior ramus fractures of pubis with fixed （B） and titanium plate fixation （C）.Then,the same physiological load was exerted on different model respectively.At the end,the none-line solution was analyzed,analysis of the stress and displacement in model.Results After fracture fixation through the lateral and longitudinal displacement and the stress nephogram found after analysis and comparison,the transverse and longitudinal displacement is small with DAPSQ internal fixation when the stability of pelvic ring,accord with standard of reset,uniform stress distribution,no obvious phenomenon of highly concentrated,fixed intensity bigger,fixed the pelvis after more stable.But when accompanied by unstable pelvic ring road ahead for DAPSQ fracture line of vertical and horizontal displacement of the present B 〉 C 〉 A,A,B,C stations,the longitudinal displacement respectively （1.315 ±0.171）,（1.490 ±0.247）,（1.334 ±0.160） mm,lateral displacement of stations respectively （1.185 ±0.700）,（1.337 ±0.080）,（1.198 ± 0.103） mm.Conclusion The pelvic ring must be stable when treatment of anterior column with posterior hemi-transverse lesion fixed by DAPSQ.

关 键 词：骨盆环 髋臼 骨折 生物力学 有限元分析 

分 类 号：R687.3[医药卫生—骨科学]