利用有限元分析爱惜邦线缝合固定与带线锚钉固定髌骨下极骨折的稳定性差异  

Stability Difference Between Ethibond Thread Suture Fixation and Threaded Anchor Fixation for Inferior Pole Fracture of the Patella Using Finite Element Analysis

作　　者：张伟 马晓孟 程安源 夏平[1] 许福生 ZHANG Wei;MA Xiaomeng;CHENG Anyuan;XIA Ping;XU Fusheng(Department of Orthopedics,Wuhan No.1 Hospital,Wuhan 430030,China;Wuhan Jiayi 3D Technology Application Co.Ltd.,Wuhan 430062,China)

机构地区：[1]武汉市第一医院骨科,武汉430030 [2]武汉嘉一三维技术应用有限公司,武汉430062

出　　处：《医用生物力学》2022年第3期479-484,共6页Journal of Medical Biomechanics

基　　金：武汉市卫生计生委科研计划项目(WX20A10)。

摘　　要：目的利用有限元方法对比分析爱惜邦线缝合固定与带线锚钉缝合固定髌骨下极骨折的生物力学稳定性。方法选取1名健康成年志愿者的膝关节CT图像,建立髌骨下极骨折模型,并在此基础上建立5#爱惜邦线、带线锚钉骨折固定三维模型。其中,模型1采用5#爱惜邦线独立间断垂直缝合技术固定髌骨下极骨折,模型2在模型1基础上将两端爱惜邦尾线从髌腱下方连续锁边缝合至对侧骨折近端并收紧打结,模型3采用锚钉技术固定。分析在不同屈膝角度下各骨折固定模型的应力和位移分布。结果在0°~90°范围内,随着屈膝角度增加,最大应力和最大位移也随之增大。在同一屈膝角度下,带线锚钉固定方式的应力水平最高,爱惜邦线固定联合锁边缝合方式的应力水平最低且应力分布最均匀;单纯爱惜邦线缝合的位移形变量最大,带线锚钉固定方式的位移形变量最小。结论爱惜邦线缝合后加以髌腱周围的锁边缝合最大位移相对适中,且最大应力也相对较小,是临床中固定髌骨下极骨折的可靠方法。Objective To compare and analyze biomechanical stability of Ethibond thread suture and threaded anchor for fixing inferior pole fracture of the patella using the finite element method.Methods CT images of the knee joint from a healthy adult volunteer were selected and the inferior patella fracture model was established,then the three-dimensional(3D)models of fracture fixation with Ethibond thread suture and threaded anchor were established.Stress and displacement distributions of each fixiation model at different knee flextion angles were analyzed.Results In the range of 0°-90°,as knee flexion angle increased,the maximum stress and maximum displacement also increased.At the same knee flexion angle,threaded anchor fixation had the highest stress level,and Ethibond thread suture had the lowest stress level and the most uniform stress distributions.The displacement deformation of Ethibond thread suture was the largest,and the displacement deformation of threaded anchor fixation was the smallest.Conclusions The maximum displacement of the seam suture around patellar tendon with Ethibond suture is relatively moderate,and its maximum stress is relatively small,which is a reliable method for fixing inferior pole fracture of the patella in clinic.

关 键 词：髌骨下极骨折 爱惜邦线 带线锚钉 有限元分析 

分 类 号：R318.01[医药卫生—生物医学工程]