有限元法分析不同内固定方法治疗复杂性骨盆骨折的力学稳定性  

Mechanical stability of different internal fixations for complex pelvic fractures by finite element analysis

作　　者：王叙进[1] 方诗元[1] 徐磊[1] 杨家照 Wang Xu-jin;Fang Shi-yuan;Xu Lei;Yang Jia-zhao(Department of Orthopedics,Anhui Provincial Hospital,Hefei 230022,Anhui Province,Chin)

机构地区：[1]安徽省立医院骨科,安徽省合肥市230022

出　　处：《中国组织工程研究》2018年第27期4354-4358,共5页Chinese Journal of Tissue Engineering Research

基　　金：安徽省公益性研究联动计划项目(15011d04022)~~

摘　　要：背景:切开复位内固定可用于不同类型骨盆骨折治疗中,有助于降低并发症发生率,但是其固定效果缺乏力学验证。目的:对不同内固定方法治疗复杂性骨盆骨折的力学稳定性进行有限元分析。方法:选择健康男性1名作为观察对象,采用64排螺旋CT常规扫描,层厚1 mm,获得二维CT数据,以医学数字成像、通信格式进行存储。利用Mimics、Geomagic studio及Abaqus软件完成志愿者骨盆有限元模型,建立复杂骨盆骨折有限元模型,分别置入3种不同的内固定器械,完成不同内固定方法治疗骨盆骨折的模型,内固定完成后模拟向骶骨施加500 N垂直负荷,计算相应的力学参数,比较不同内固定方法治疗复杂性骨盆骨折的力学稳定性。结果与结论:(1)志愿者CT数据下建模后,正常的骨盆三维有限元模型测量点a点位移为0.53 mm,应力负荷正常生理,并且骶髂关节受力位移与既往有限元生物力学分析相似,课题建立的有限元模型成功;(2)在模型加载500 N垂直负荷下,螺钉固定受最大应力为440.85 MPa,集中在复杂性骨盆骨折部位;重建接骨板最大受力为1 332.56 MPa,位于钉板结合部位;外支架最大受力为1 834.85 MPa,位于钉板结合部位;(3)在模型加载500 N垂直负荷下,螺钉固定应变、整体位移、分离位移值均低于重建接骨板和外支架(P<0.05);重建接骨板应变、整体位移、分离位移值均低于外支架(P<0.05);(4)提示3种内固定物相比,采用螺钉内固定治疗复杂性骨盆骨折能获得更优的稳定性;利用有限元分析能反映不同内固定方法治疗复杂性骨盆骨折力学的稳定性,临床治疗时应根据每位患者的实际情况选择合适的内固定方法,开展个体化治疗。BACKGROUND： Open reduction and internal fixation can be used for different types of pelvic fractures, which can reduce the incidence of complications. However, there is a lack of mechanical study on its fixation effect. OBJECTIVE： To investigate the mechanical stability of different kinds of internal fixations for complex pelvic fractures by finite element analysis. METHODS： One healthy man was selected. Two-dimensional CT data were obtained by 64-slice spiral CT scan. The data were obtained by medical digital imaging and stored by communication format. The finite element model of the pelvis was established using the software of Mimics, Geomagic studio and Abaqus, and the finite element model of the complex pelvic fracture was established. Three kinds of internal fixators were implanted to treat the pelvic fracture, and then 500 N vertical load was applied to the sacrum. The corresponding mechanical parameters were calculated, and the mechanical stability of different internal fixation methods was compared. RESULTS AND CONCLUSION： （1） The displacement of a point in the normal three-dimensional finite element model of pelvis was 0.53 mm, and the stress load was normal, the force displacement of the sacroiliac joint was similar to the previous finite element biomechanical analysis, suggesting that the finite element model was established successfully. （2） Under the vertical load of 500 N, the maximal stress of screw fixation was 440.85 MPa, which was concentrated on the fracture parts. The maximum stress of the reconstructed bone plate was 1 332.56 MPa, concentrating on the nail-plate connection. The maximum force of the outer stent was 1 834.85 MPa, concentrating on the nail-plate connection. （3） Under the vertical load of 500 N, the order of strain distribution, overall displacement, and separation displacement values was as follows： screw fixation 〈 reconstructed bone plate 〈 outer stent （all P 〈 0.05）. （4） These results indicate that the screw fixation obtains the best stabil

关 键 词：螺钉内固定技术 切开复位内固定 骨盆骨折 64排螺旋CT 骨盆有限元模型 内固定器械 力学稳定性 力学参数 

分 类 号：R318[医药卫生—生物医学工程]