解剖型纸质支架夹板治疗Colles骨折的有限元分析  

Finite Element Analysis of Anatomical Paper Splints Treating for Colles Fracture

作　　者：华臻[1] 陆振飞[1] 潘娅岚 马剑威 王建伟[1] 

机构地区：[1]南京中医药大学无锡附属医院,江苏无锡214071 [2]南京中医药大学 [3]上海大学

出　　处：《中国中医骨伤科杂志》2017年第7期16-20,共5页Chinese Journal of Traditional Medical Traumatology & Orthopedics

基　　金：无锡市科技发展资金项目(CSE31N1514);无锡市卫计委科研项目(Q201504)

摘　　要：目的:评判解剖型纸质支架夹板治疗Colles骨折的优越性及安全性,为解剖型纸质支架夹板的推广和改进提供生物力学依据。方法:基于一志愿者的腕部CT图像建立包括尺桡骨、腕骨、掌骨及腕关节主要韧带、关节面软骨在内的前臂及手部三维有限元模型,通过与文献对比验证模型的有效性。将上述有限元模型调整至腕关节掌屈尺偏位,分别与柳木夹板、塑形纸质支架夹板及解剖型夹板数字模型完成装配,观察三种夹板在28N载荷固定下的肢体软组织表面应力云图与峰值、骨骼表面应力云图与峰值以及皮肤表面桡骨茎突、尺骨头、大鱼际部位同一节点的应力值。结果:成功建立并验证了前臂及手部的三维有限元模型。三种夹板在掌屈尺偏位固定前臂模型,应力均集中作用于腕部周围,柳木夹板固定的肢体软组织及骨骼多处出现应力集中,尺桡骨远端、大小鱼际及骨突等部位也有较大的应力集中;塑形纸质支架夹板固定的肢体软组织应力分布较均匀,骨突、鱼际部位的应力小于柳木夹板;解剖型纸质支架夹板固定下的肢体应力分布更为均匀,骨突鱼际等易卡压部位的应力最小。结论:解剖型纸质支架夹板更贴合肢体,能有效避免局部软组织压迫,具有一定的优越性。Objective：To evaluate the superiority and safety of the anatomical paper splints treating with Colles fracture,and to provide theoretical biomechanical basis for the promotion and improvement of anatomical paper splints.Methods：Based on a volunteers wrist CT images,a three-dimensional finite element model of forearm and hand,including the radius,ulna,carpal,metacarpal,main wrist joint ligaments and articular cartilage,was established.The effectiveness of the model was verified by comparing with the literature.The above finite element model was adjusted to the wrist palm flexion and ulnar deviation,which was fitted with the willow splints,the moulding paper splints and the anatomical splints digital model.Von Mises stress,peak of limb soft tissue surface and bones surface of the three splints were observed under load of 28 N,skin surface of styloid process of radius,ulnar head and thenar part of the same unit of stress values were also observed.Results：The three-dimensional finite element model of forearm and hand was successfully established and verified.When the three kinds of splints were fixed in the palm flexion and ulnar deviation,the stresses were concentrated around the wrist.Under the same fixed load,the willow splints would produce a larger stress and more stress concentration on both limps soft tissue and bone tissue,in addition to the distal radius and ulna,thenar,hypothenar.While moulding paper splintsstress distribution was more homogeneous,and had less stress on bone protrusion and thenar part than the willow splints.The stress distribution of anatomical splints was more uniform,and producedless stress on apophyseal thenar parts which were easily compressed, with a better body fitting. Conclusion： The anatomical paper splints is more suitable for the limbs,which can avoid local soft tissue compression,with a certain degree of superiority.

关 键 词：COLLES骨折 夹板 有限元分析 刘氏骨伤 

分 类 号：R-33[医药卫生]