外固定支架修复胫骨平台骨折的生物力学特点  

Biomechanical characteristics of external fixation for tibial plateau fractures

作　　者：尚红涛[1] 王泉[1] 刘斌[1] 刘伟[2] 

机构地区：[1]哈励逊国际和平医院骨科,河北省衡水市053000 [2]河北大学附属医院骨科,河北省保定市071000

出　　处：《中国组织工程研究》2016年第31期4651-4657,共7页Chinese Journal of Tissue Engineering Research

摘　　要：背景:目前有关胫骨平台骨折不同内固定方式的三维有限元模型研究较多,但是关于胫骨平台骨折外固定支架的三维有限元模型的少见报道。目的:采用三维有限元法分析外固定支架修复胫骨平台骨折的生物力学特点。方法:建立胫骨平台骨折锁定钢板固定模型和胫骨平台骨折外固定支架固定模型,采用三维有限元法分析胫骨平台骨折两种固定模型的应力分布以及位移情况。结果与结论:(1)胫骨平台骨折外固定支架固定模型组的平均位移值及最大位移值均小于胫骨平台骨折锁定钢板固定模型组,但差异无显著性意义(P>0.05);(2)胫骨平台骨折外固定支架固定模型组的X轴向位移值、Y轴向位移值均小于胫骨平台骨折锁定钢板固定模型组,但差异无显著性意义(P>0.05);(3)胫骨平台骨折锁定钢板固定的应力主要集中在螺钉和骨组织的交界处以及钢板和螺钉的交界处,最大应力值为173 MPa,明显大于胫骨平台骨折外固定支架固定模型的最大应力值86 MPa。胫骨平台骨折外固定支架固定的应力分布分散,未出现明显的应力集中情况,其中克氏钉夹具和克氏钉交界处、连接杆和螺钉的交界处的应力较其他部位的应力高,为临床上的力学薄弱环节;(4)结果表明,外固定支架固定胫骨平台骨折相对内固定而言,同样具有相似的稳定性和固定强度。BACKGROUND： Scholars have studied the three-dimensional finite element models of tibial plateau fractures with different fixation methods, but the research on three-dimensional finite element model of tibial plateau fracture fixation was not much. OBJECTIVE： To analyze the biomechanical characteristics of external fixator for tibial plateau fracture by using the three-dimensional finite element method. METHODS： The tibial plateau fracture models treated with locking plate fixation and external fixator were established. Three-dimensional finite element analysis was used to analyze the stress distribution and displacement of two kinds of models. RESULTS AND CONCLUSION： （1） The average displacement value and the maximum displacement value of tibial plateau fracture external fixator model group were smaller than that of tibial plateau fracture locking plate fixation model group, but no significant difference was found （P 〉 0.05）. （2） X axial displacement value and ~ axial displacement value were smaller in the tibial plateau fracture external fixator model group than in the tibial plateau fracture locking plate fixation model group, but no significant difference was found （P 〉 0.05）. （3） The stress of tibial plateau fracture locking plate fixation model focused on the junction of the screw and bone tissue as well as the junction of plates and screws. The maximum stress value of tibial plateau fracture locking plate fixation model （173 MPa） was greater than that of tibial plateau fracture external flxator model （86 MPa）. The stress of tibial plateau fracture external flxator model was scattered. Obvious stress concentration did not occur. The stress at the junction of the clamp and the nail and the junction of the connecting rod and screw was higher than that at other regions and was a weak link in the clinical mechanics. （4） Results showed that external fixation for tibial plateau fractures had better stability and fixing strength as compared with the internal fixation.

关 键 词：胫骨 骨折 外固定器 有限元分析 生物力学 组织工程 骨科植入物 数字化骨科 胫骨平台骨折 外固定支架 锁定钢板 有限元分析 生物力学 

分 类 号：R394.2[医药卫生—医学遗传学]