基于有限元分析比较碳纤维增强聚醚醚酮复合板与钛制钢板固定胫骨中段骨折的效果  

Carbon fiber reinforced polyetheretherketone composite plate vs.titanium plate for middle tibial shaft fractures:a finite element analysis

作　　者：周凯华 陶星光 梁会 潘福根 何小健 ZHOU Kai-hua;TAO Xing-guang;LIANG Hui;PAN Fu-gen;HE Xiao-jian(Department of Orthopaedics,Qingpu Branch of Zhongshan Hospital,Fudan University,Shanghai 201100,China)

机构地区：[1]复旦大学附属中山医院青浦分院骨科,上海201700

出　　处：《中国骨与关节损伤杂志》2020年第10期1028-1032,共5页Chinese Journal of Bone and Joint Injury

基　　金：上海市卫生健康委员会科研课题(20174Y0159);蚌埠医学院自然科学类项目(BYKY2019263ZD)。

摘　　要：目的建立胫骨中段骨折接骨板内固定有限元模型,采用有限元分析方法比较碳纤维增强聚醚醚酮复合板(CFPEEK板)与纯钛接骨板的生物力学,为临床应用提供参考。方法选取1名健康成年男性志愿者进行胫骨CT扫描,获取数据建立胫骨有限元模型,模拟胫骨中段骨折并分别采用8孔纯钛接骨板和不同碳纤维增强比例的CF-PEEK板(CF30、CF50、CF60)进行固定。比较4种不同弹性模量接骨板内固定后在200、700 N轴向压缩载荷下接骨板受到的最大应力,骨折端的最大位移和骨皮质应力遮挡情况。结果在700 N轴向压缩载荷下,4组均在骨折断端部位出现最大应力,纯钛组为373.1 MPa,CF30组为568.2 MPa,CF50组为369.3 MPa,CF60组为369.5 MPa,仅CF30组超过了其最大抗拉强度。在轴向压缩载荷下,4组接骨板对侧骨折端的位移最大,接骨板下骨折端的位移最小。在200、700 N轴向载荷条件下,CF30接骨板下正常骨皮质的应力最大,应力遮挡率最小,CF50接骨板次之。结论与纯钛接骨板相比,CF50接骨板固定的骨折端微动更有利于骨痂形成和骨折愈合,而且CF50接骨板下骨皮的应力遮挡率最小,有利于降低接骨板下骨皮质骨量降低、骨吸收、置入物松动或内固定取出后再骨折风险。Objective To establish the model of middle tibial shaft fracture,and compare the low modulus carbon fiber reinforced polyetheretherketone composite plate(CF-PEEK plate)with the traditional pure titanium plate by the finite element analysis,so as to provide a reference for clinical application.Methods A healthy male volunteer was selected to get tibia CT scan.The finite element model of tibia was established by the above data to simulate tibial shaft comminuted fracture.Eighthole pure titanium,and CF-PEEK with different carbon fiber reinforcement ratios(CF30,CF50,CF60)plates were used to fix the fracture.The maximum stress of the plate,the maximum displacement of fracture and the stress shielding of cortex bone were analyzed under 200 N and 700 N axial compression.Results Under 700 N axial compression,the maximum stress of all the plates was located at the fracture site.The maximum stress was 373.1 MPa for the pure titanium plate,568.2 MPa for CF30,369.3 MPa for CF50,369.5 MPa for CF60.Only CF30 plate group exceeded its maximum tensile strength.Under the axial compression,the maximum displacement was opposite the plate,the minimal displacement was under the plate.Under the 200 N and 700 N axial compression,in the CF30 plate the stress of normal cortex was the highest and the stress shielding rate was the lowest,followed by CF50 plate.Conclusion Compared with pure titanium plate,the displacement of CF50 fracture site is more beneficial to callus formation and fracture healing.And the stress shielding of the bone cortex under the CF50 plate is the least,which is also conducive to reduce the bone mass of the bone cortex under the plate,bone absorption,loosening of the implant or internal fixation after removal.

关 键 词：碳纤维增强的聚醚醚酮复合材料 胫骨中段骨折 接骨板 内固定 有限元分析 生物力学 

分 类 号：R687.3[医药卫生—骨科学]