基于有限元模型的骨盆骨折后力学研究  

Mechanical study of pelvic fracture based on finite element model

作　　者：魏国强 车丽芳 牛晓芬 张凯 王一 史国鹏 白灵 王海燕 李筱贺 许阳阳[1] WEI Guo-qiang;CHE Li-fang;NIU Xiao-fen;ZHANG Kai;WANG Yi;SHI Guo-peng;BAI Ling;WANG Hai-yan;LI Xiao-he;XU Yang-yang(Department of Rehabilitation Medicine,People’s Hospital of Changzhi City,Changzhi Shanxi 046000,China;Department of Orthopedics,The Second Hospital of Ulan Qab City,Ulan Qab Inner Mongolia 012000,China;Department of Anatomy,School of Basic Medical Sciences,Inner Mongolia Medical University,Hohhot Inner Mongolia 010110,China;Digital Medicine Center,Inner Mongolia Medical University,Hohhot Inner Mongolia 010110,China)

机构地区：[1]长治市人民医院康复医学科,山西长治046000 [2]乌兰察布市第二医院骨科,内蒙古乌兰察布012000 [3]内蒙古医科大学基础医学院解剖教研室,内蒙古呼和浩特010110 [4]内蒙古医科大学数字医学中心,内蒙古呼和浩特010110

出　　处：《局解手术学杂志》2021年第10期841-845,共5页Journal of Regional Anatomy and Operative Surgery

基　　金：国家自然科学基金(81460330,81560348,81860383,81260269);内蒙古自治区科技计划项目(2019);内蒙古教育厅青年科技英才项目(njyt-15-b05);内蒙自治区科技计划项目(2019GG115);内蒙古自治区自然科学基金(2016MS08131,2020MS08124,2020LH08021);内蒙古医科大学后续科研项目(2020);内蒙古医科大学科技转化项目(YKD2020CGZH009);内蒙古自治区“草原英才”工程青年创新人才;内蒙古医科大学“治学”人才二类(2021)。

摘　　要：目的探讨骨盆骨折保守治疗后不同姿势下骨盆应力分布情况,以提供有关骨盆力学特征的新见解。方法利用患者螺旋CT影像资料进行三维重建,建立骨盆有限元模型,在L 5上终板施加400 N的力,固定坐骨结节,模拟患者骨盆中立位、前倾位、后倾位不同姿势,观察骨盆应力分布情况。结果骨盆前倾20°位在位置1(耻骨上支与右侧髂骨的骨折断面)、位置3(坐骨支的骨折断面)、位置4(耻骨下支的骨折断面)均明显增大,说明在此体位下对骨盆骨折断端影响最大,其次是骨盆后倾10°位与后倾20°位。应力大小次序:前倾20°位(5.25 MPa)>后倾20°位(3.63 MPa)>后倾10°位(3.38 MPa)>前倾10°位(2.18 MPa)>中立位(2.15 MPa)。结论通过建立有限元模型,对骨折位置进行应力分析,得出不同坐位姿势下力学变化趋势,可为康复训练的动作选择提供临床参考。Objective To investigate the distribution of pelvic stress under different postures after conservative treatment of pelvic fractures,in order to provide new insights on the mechanical characteristics of the pelvis.Methods Three-dimensional reconstruction was performed by using the patient’s spiral computer tomograpy(CT)image data to establish the pelvic finite element model.Apply a force of 400 N to the upper end plate of L 5 to fix the ischial tuberosity.The different postures of the patient’s pelvis in the neutral position,anterior position,and posterior position was simulated,and the distribution of pelvic stress was observed.Results The 20°anterior tilt of the pelvis increases significantly in position 1(fracture section of the superior pubic branch and right ilium),position 3(fracture section of the ischial branch),and position 4(fracture section of the inferior pubic branch),which indicated that this position has the greatest impact on the pelvis fracture end,followed by the 10°and 20°posterior tilt of the pelvic.The order of stress magnitude was:20°anterior tilt(5.25 MPa)>20°posterior tilt(3.63 MPa)>10°posterior tilt(3.38 MPa)>10°anterior tilt(2.18 MPa)>neutral position(2.15 MPa).Conclusion Through the establishment of finite element model,the stress analysis of the fracture position is carried out,and the change trend of the mechanics under different sitting postures is obtained,which can provide a clinical reference for the selection of rehabilitation training actions.

关 键 词：骨盆骨折 生物力学 有限元分析 应力 

分 类 号：R496[医药卫生—康复医学]