肩袖的有限元建模及其生物力学分析  

Biomechanical analysis of a finite element model of rotator cuff

作　　者：许苑晶 杨泽政 刘至原 杨腾飞[2] 黄文杰 李宁[1] 王金武[1] 戴尅戎[1] 

机构地区：[1]上海市骨科内植物重点实验室,上海交通大学医学院附属第九人民医院骨科,上海交通大学生物医学工程学院,200011 [2]河南科技大学,郑州471023 [3]上海硅步科学仪器有限公司,201101

出　　处：《中华创伤骨科杂志》2017年第4期279-285,共7页Chinese Journal of Orthopaedic Trauma

基　　金：国家高技术研究发展“863计划”（2015AA020308）;国家自然科学基金（81572156）;上海市科委产学研医项目（14DZ1941102,15DZ1942104）;上海市卫生系统重要疾病联合攻关项目（2013ZYJB0501）;上海交通大学医学院高峰高原计划研究型医师项目（20152224）;上海市卫生系统重要薄弱学科建设项目（2015ZB04904）;上海教委重点学科建设基金（J50206）;上海交通大学医学院转化医学创新基金资助（TM201613）

摘　　要：目的建立一种可用于有限元分析的肩袖模型，旨在用于临床术前模拟不同肩袖损伤的建模以及肩袖手术模拟与修复效果的生物力学评估。方法利用1名27岁健康男性志愿者右肩Dicom格式的cT图像，建立肩胛骨、肱骨、锁骨模型；结合MRI图像与解剖知识对肩袖组织进行分离、建模；将模型导入有限元分析软件Abaqus6．12，模拟肩关节内旋30°、外旋30°、内收30°、外展30°、前屈30吸后伸30°的解剖位置，获得肩袖肌肉的应力变化。结果当肩关节前屈30°时，冈上肌、冈下肌和小圆肌、肩胛下肌平均应力分别为52．2、223．O、90．4kPa。当肩关节后伸30°时，冈上肌、冈下肌和小圆肌、肩胛下肌平均应力分别为105．0、78．2、55．7kPa，显示冈上肌的肌腱处应力较大，肱骨与肩胛骨产生应力小于前屈30°。结论该肩袖模型系统可以模拟肩关节的常见活动并获得对应的肩袖肌肉应力大小，可用于肩袖损伤模拟与手术方案仿真实验。Objective To establish a finite element model of rotator cuff which can be used to sim- ulate the rotator cuff injury and to evaluate the biomechanical effects of rotator cuff surgery. Methods The Dicom CT images of the right shoulder of a Chinese healthy volunteer were used to establish models of the scapula, humerus and clavicle. The rotator cuff structures were separated and modeled based on the MRI images and anatomical knowledge. After the rotator cuff model was introduced into the finite element analysis software Abaqus 6. 12, the anatomical positions were simulated when the shoulder was at 30° internal rotation, 30° external rotation, 30° abduction, 30° adduction, 30° flexion and 30° extension. Results When the shoulder was in 30° flexion, the average stress was 52.2 kPa on the supraspinatus, 223.0 kPa on the in- fraspinatus and the teres minor, and 90.4 kPa on the subscapularis. When the shoulder was in 30° extension, the average stress was 105.0 kPa on the supraspinatus, 78.2 kPa on the infraspinatus and the teres minor, and 55.7 kPa on the subscapularis, indicating that the muscle and tendon of the supraspinatus was subjected to greater stress and the humerus and the scapula produced less stress compared with the shoulder in 30° flexion. Conclusion Since our finite element model of the rotator cuff can simulate common activities of the shoulder joint and obtain stress values of the corresponding rotator cuff muscles, it can be used in simulation ofrotator cuff injury and its surgery.

关 键 词：有限元分析 肩 生物力学 

分 类 号：R318.01[医药卫生—生物医学工程] R687.4[医药卫生—基础医学]