不同内固定方式固定骶髂关节脱位的三维有限元分析  

Comparison of different kinds of internal fixation for sacroiliac joint dislocation:a finite element analysis

作　　者：吴涛[1] 程晓东[1] 崔蕴威[1] 郑占乐[1] 吕红芝[1] 张英泽[1] WU Tao;CHENG Xiao-dong;CUI Yun-wei;ZHENG Zhan-le;LYU Hong-zhi;ZHANG Ying-ze(Trauma Emergency Center of Third Hospital of Hebei Medical University,Orthopaedic Research Institution of Hebei Province,Key Laboratory of Orthopaedic Biomechanics of Hebei Province,Shijiazhuang 050051,China)

机构地区：[1]河北医科大学第三医院创伤急救中心,河北省骨科研究所,河北省骨科生物力学重点实验室,河北石家庄050051

出　　处：《河北医科大学学报》2018年第9期1026-1030,共5页Journal of Hebei Medical University

基　　金：国家自然科学基金青年基金(81702139);河北省自然科学基金青年基金(H2016206291)

摘　　要：目的应用三维有限元分析法比较3种不同内固定器械治疗骶髂关节脱位的生物力学稳定性。方法随机挑选1名健康成年男性,收集层厚1.0mm骨盆CT图像,经过Mimics 10.01、Geomagic Studio 12、SolidWorks、Abaqus 6.11-1等软件处理,构建完整的骨盆模型及骶髂关节脱位模型,分别使用2枚骶髂螺钉、可调式微创接骨板、张力带接骨板固定骨盆后环,对骶骨加载500N负荷,比较整个模型和内固定器械的整体位移值、应变值、应力分布以及脱位的缝隙分离值。结果上半身的重力经过骶骨翼、双侧骶髂关节、坐骨大切迹、髂骨弓状线到双侧髋臼。在500N垂直载荷下,固定后的模型的整体位移值依次是2枚骶髂螺钉1.377mm、可调式微创接骨板为2.517mm、张力带接骨板为5.132 mm,脱位缝隙的分离移位值依次是2枚骶髂螺钉0.887 mm、可调式微创接骨板为2.502mm、张力带接骨板为5.117mm。结论 2枚骶髂螺钉固定骶髂关节脱位的稳定性优于可调式微创接骨板的稳定性,更优于张力带接骨板的稳定性。Objective To compare the biomechanical stability of three kinds of internal fixation for sacroiliac joint dislocation by three-dimensional finite element analysis.Methods A healthy adult male was randomly seclected and the CT images of pelvis（ 1.0 mm thickness） were collected. Intact pelvis model and sacroiliac dislocation model were made using software of Mimics 10.01, Geomagic Studio 12, SolidWorks, Abaqus 6.11-1. Two iliosacral （IS） screws, the minimally invasive adjustable plate（MIAP） and the tension band plate（TBP） were used to fix the posterior pelvic ring respectively, and a loading of 500 N was put on the sacrum. Total displacement, strain value, stress distribution and the shift of dislocation gap of the whole model and internal fixator were compared.Results The stress of upper body passed through sacral wing, bilateral sacroiliac joint, the large sciatic notch, arcuate line of the iliac bone to the bilateral acetabulum. Under 500 N load, displacements of the fixed models were two IS screws model（1.377 mm）, the MIAP model（2.517 mm）, and the TBP model（5.132 mm）. The shifts of dislocation gap were two IS screws model（0.887 mm）, MIAP model（2.502 mm） and TBP model（5.117 mm）.Conclusion The stability of sacroiliac dislocation fixed with the MIAP was less than that fixed with the two IS screws, and better than that fixed with the TBP.

关 键 词：骶髂关节 内固定器 生物力学 

分 类 号：R684.7[医药卫生—骨科学]