新型跗骨窦钢板内固定治疗SandersⅡ型跟骨骨折的有限元分析  

A finite element analysis on Sanders Ⅱ calcaneal fractures fixed by a sinus tarsi plate

作　　者：黄国伟[1] 姜雪峰[1] 韦山[1] 

机构地区：[1]江阴市人民医院骨科,江苏省214400

出　　处：《江苏医药》2017年第11期781-783,F0002,共4页Jiangsu Medical Journal

基　　金：无锡市卫生局卫生科研究项目(MS201533)

摘　　要：目的比较新型跗骨窦钢板与常规钢板固定跟骨关节内骨折的即刻稳定性。方法采集1例正常男性的跟骨薄层CT数据集,建立新型跗骨窦钢板与常规跟骨钢板两种内植物固定SandersⅡ型跟骨关节内骨折(舌型和压缩型)的三维有限元模型。分析四个模型在700N垂直压力下的应力分布和位移规律。结果舌型骨折模型中,跗骨窦钢板固定时跟骨结节处钢板局部高应力集中,有金属疲劳风险;常规跟骨钢板的高应力区位于钢板前下部的钉板结合部。关节面压缩型骨折模型中,跗骨窦钢板与常规跟骨钢板应力集中部位基本相同。所有骨折模型的位移主要位于距下关节,越靠近载距突位移越大。跗骨窦钢板的舌型骨折模型最大位移为0.27mm,其余三组最大位移为0.06~0.08mm。结论新型跗骨窦钢板的初始稳定性与普通跟骨钢板基本相当,可运用于跟骨骨折内固定,但不建议早期负重功能锻炼。Objective To compare the stability of internal fixation of intra-articular calcaneal fractures fixed by a sinus tarsi plate and conventional calcaneal plate.Methods A set of foot CT images from a normal male was collected to construct 3D finite element models of depression type and tongue type of calcaneal fractures（Sanders typeⅡ）,which were fixed by sinus tarsi plate and conventional calcaneal plate,respectively.The regular pattern of stress and displacement distributions in these four fracture models under vertical load of 700 N were analyzed.Results In tongue type fracture model fixed by sinus tarsi plate,the high stress of plate and screw focused at the conjunction of tuberosity of calcaneus with a risk of metal fatigue.While in conventional calcaneal plate model,the high stress of plate and screw focused on the conjunction of the inferior and forward segment of the plate.In depression type fracture model fixed by sinus tarsi plate and conventional calcaneal plate,the pattern of stress distribution was almost the same.The displacement of all four models focused on the posterior subtalar joints and a larger displacement appeared on the interior part.The maximum displacement of 0.27 mm appeared in the tongue type fracture model fixed by sinus tarsi plate,and it was 0.06-0.08 mm in the other three fixation models.Conclusion The initial stability of internal fixation of intra-articular calcaneal fractures fixed by sinus tarsi plate is similar to that fixed by conventional calcaneal plate.Early weight bearing is not suggested.

关 键 词：跟骨骨折内固定 应力 有限元分析 

分 类 号：R687[医药卫生—骨科学]