四种不同内固定方式治疗髋臼前柱低位骨折的有限元分析比较  

Comparison of four kinds of internal fixation for acetabular fracture of the lower anterior column： a finite element analysis

作　　者：代元元[1] 章莹[1] 夏远军[1] 谢会斌[1] 郭晓泽[1] 朱昌荣[1] 

机构地区：[1]广州军区广州总医院骨科医院,510010

出　　处：《中华创伤骨科杂志》2016年第8期702-707,共6页Chinese Journal of Orthopaedic Trauma

基　　金：广东省科技计划项目（20128060100008）;广州市科技计划项目（2012J4100039）

摘　　要：目的应用有限元分析比较4种不同内固定方式治疗髋臼前柱低位骨折的生物力学稳定性。方法取1具正常成年男性骨盆，行0．7mm薄层cT扫描获得379张CT图像。利用有限元建模软件建立拉力螺钉（A组）、重建钢板（B组）、未跨过耻骨联合皮下钢板联合锁定螺钉（C组）和跨过耻骨联合皮下钢板联合锁定螺钉（D组）固定髋臼前柱低位骨折模型。模拟站位和坐位，以相同的加载约束方式对4种骨折固定模型进行有限元分析，比较这4种内固定方式的生物力学差异。结果在站位、坐位时，髋臼前柱低位骨折线上最大位移及骨折线上各节点的平均位移A组均为最大[站位：0．558mm、（0．462±0．092）mm，坐位：0．634mm、（0．473±0．108）mm]，D组最小[站位：0．512mm、（0．425±0．083）mm，坐位：0．031mm、（0．025±0．004）mm]，B组[站位：0．513mm、（0．432±0．085）mm，坐位：0．630mm、（0．466±0．109）mm]和C组[站位：0．514mm、（0．433±0．085）mm，坐位：0．627mm、（0．464±0．107）mm]居中。D组站位和坐位骨折线上最大应力均为最大（10．519、24．879MPa），A组最小（3．254、8．954MPa），B组（4．873、9．431MPa）和C组（4．384、10．128MPa）居中。结论跨耻骨联合皮下钢板联合锁定螺钉固定髋臼前柱低位骨折的稳定性最佳，拉力螺钉最差，重建钢板与未跨过耻骨联合皮下钢板联合锁定螺钉居中。Objective To compare the biomechanical stability of 4 internal fixations in treatment of acetabular fracture of the lower anterior column through finite element analysis. Methods One normal adult male pelvis was subjected to 0.7mm thin-section CT scanning and 379 CT pictures were obtained. Finite element modeling software was used to establish internal fixation models for acetabular fracture of the lower anterior column, including lag screws （A）, anterior column reconstruction plate （B）, subcutaneous plate not crossing the pubic symphysis （C） and subcutaneous plate crossing the pubic symphysis （D）. Finite element analysis was carried out to compare the biomechanical differences among the 4 internal fixation models which were subjected to the same loading conditions at both standing and sitting positions. Results At standing and sitting positions, the maximum displacement and the mean node displacement of fracture lines were the greatest in group A （0. 558 mm and 0.462 ± 0. 092 mm at standing; O. 634 mm and 0. 473 ± 0. 108 mm at sitting）, the smallest in group D （0. 512 mm and O. 425 ± 0. 083 mm at standing; O. 031 mm and 0. 025 ± 0. 004 mm at sitting）, and in between in group B （0. 513 mm and 0. 432 ±0. 085 mm at standing; O. 630 mm and 0. 466 ± 0. 109 mm at sitting） and in group C （0. 514 mm and 0. 433±0. 085 mm at standing; 0. 627 mm and 0. 464 ± 0. 107 mm at sitting） . At both standing and sitting positions, the maximum stress at the fracture line was the greatest in group D （10. 519 MPa and 24. 879 MPa）, the smallest in group A （3. 254 MPa and 8. 954 MPa）, and in between in group B （4. 873 MPa and 9. 431 MPa） and in group C （4. 384 MPa and 10. 128 MPa）. Conclusions In treatment of acetabular fracture of the lower anterior column, subcutaneous plate crossing the pubic symphysis may result in the greatest biomeehanical stability, lag screws the smallest biomechanical stability, and anterior column reconstruction plate and subcutaneous plate not crossing th

关 键 词：髋臼 骨折 骨折固定术 内 有限元分析 

分 类 号：R687.3[医药卫生—骨科学]