单排和双排肩袖缝合桥力学研究  

Study on the mechanical differences between single-row belt rivets and double-row suture bridge in repairing rotator cuff injury

作　　者：刘来有[1] 吕智[1] LIU Lai-you;LYU Zhi(Department of Orthopaedics,the Second Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi,China)

机构地区：[1]山西医科大学第二医院骨科,山西太原030001

出　　处：《中国骨伤》2021年第6期544-549,共6页China Journal of Orthopaedics and Traumatology

摘　　要：目的:从生物力学的角度比较分析单排带线锚钉固定修复肩袖损伤和双排缝合桥固定修复肩袖损伤的力学差异。方法:将健康成年人肩关节的CT扫描数据依次导入Mimics,Geomagics和Hypermesh中进行两种修复模型的逆向重建、材料赋属和网格划分等操作,并设计出冈上肌撕裂的情况,处理完毕后将其导入ABAQUS软件中对其施加载荷与边界条件,模拟锚钉固定修复完成后肩关节前屈15°、30°,内旋15°、30°这4种工况。比较两种修复模型在4种工况下肩袖冈上肌,带线锚钉的应力变化。结果:两种前屈工况下双排缝合桥固定模型中冈上肌所受应力值分别比单排固定修复模型中冈上肌所受应力值小8.3%和12%。两种内旋工况下,双排缝合桥固定模型中冈上肌所受应力值分别比单排固定修复模型中冈上肌所受应力值小47%和48%。结论:双排4枚锚钉之间的“负荷共享”效应使应力分布更为分散,增大了冈上肌与肱骨之间的接触面积,减小了锚钉的受力,避免了严重的应力集中现象,从生物力学角度解释了双排缝合桥固定方法的优势。Objective:To compare and analyze the mechanical differences between single-row suture anchor fixation for repairing rotator cuff injuries and double-row suture bridges for repairing rotator cuff injuries from a biomechanical perspective.Methods:The CT scan data of healthy adult shoulder joint were imported into Mimics,Geomagics and Hypermesh to carry out reverse reconstruction of two repair models,material assignment and mesh division,and the tearing of supraspinatus muscle was designed.After treatments,the load and boundary conditions were applied to the shoulder joint in ABAQUS software.The shoulder joint was fixed with four working conditions including flexion 15°,flexion 30°,internal rotation 15°and internal rotation 30°after anchor fixation and repair.The stress changes of the upper rotator cuff muscle and the anchor with thread were compared under these four conditions.Results:Under the two flexion conditions,the stress of the supraspinatus in the double row suture bridge fixation model was 8.3%and 12%less than that in the single-row suture anchor fixation,respectively.Under the two internal rotation conditions,the stress of supraspinatus in the double row suture bridge fixation model was 47%and 48%less than that in the single row fixation repair model,respectively.Conclusion:The"load sharing"effect between the two rows of four anchors makes the stress distribution more dispersed,increases the contact area between the supraspinatus muscle and the humerus,reduces the stress of the anchor,avoids the serious stress concentration phenomenon,and explains the advantages of the fixation method of the double row suture bridge from the biomechanical angle.

关 键 词：肩关节 修复外科手术 生物力学现象 

分 类 号：R684[医药卫生—骨科学]