锁骨钩钢板与Twin Tail TightRope带袢钛板内固定治疗肩锁关节脱位的有限元分析  

Finite element analysis of clavicle hook plate and Twin Tail TightRope in treatment of acromioclavicular joint dislocation

作　　者：宋远征 庞霞 宋敏[1] 张建芳 满佳[2] 张永琪 王海峰 SONG Yuan-zheng;PANG Xia;SONG Min;ZHANG Jian-fang;MAN Jia;ZHANG Yong-qi;WANG Hai-feng(Department of Orthopaedics,Tengzhou Central People's Hospital Affiliated to Jining Medical University,Zaozhuang,Shandong 277500,China;不详)

机构地区：[1]济宁医学院附属滕州市中心人民医院创伤骨科,山东枣庄277500 [2]山东大学机械工程学院高效洁净机械制造教育部重点实验室,山东济南250061 [3]山东省立医院骨科,山东济南250021

出　　处：《中国骨与关节损伤杂志》2022年第11期1136-1140,共5页Chinese Journal of Bone and Joint Injury

基　　金：济宁医学院教师科研扶持基金(JYFC2019FKJ157)。

摘　　要：目的 采用有限元分析方法比较锁骨钩钢板与Twin Tail TightRope带袢钛板内固定治疗肩锁关节脱位的生物力学特点。方法 获取一名健康志愿者的肩关节三维CT数据,利用有限元处理软件构建正常肩锁关节模型(模型A)、锁骨钩钢板固定模型(模型B)、Twin Tail TightRope带袢钢板固定模型(模型C)。设置荷载与边界条件,观察三种模型的位移和应力分布情况。结果 这3种模型的最大位移均位于锁骨中1/3近端,最大位移排序:模型A>模型C>模型B。模型B和模型C所有测量点的位移值差异无统计学意义(P<0.05)。这3种模型的锁骨上应力主要集中在锁骨中1/3位置,模型B和模型C的应力峰值均出现在锁骨上方钢板位置,整体应力峰值排序:模型C>模型B>模型A,锁骨中点的应力值和肩胛骨的应力峰值排序:模型A>模型B>模型C。结论 锁骨钩钢板和Twin Tail TightRope带袢钛板内固定治疗肩锁关节脱位均可提供足够的生物力学稳定性,非生理性的、增加的固定强度以及固定方式的不同也带来了相应并发症发生的风险,这些结果为临床医师合理选择肩锁关节脱位固定方式以及评估术后并发症发生风险提供了生物力学证据。Objective To compare the biomechanical characteristics of clavicle hook plate and Twin Tail TightRope in thetreatment of acromioclavicular joint dislocation by finite element method.Methods Three-dimensional CT data of the shoul-der joint of a healthy volunteer was selected, and finite element processing software was used to construct a normal acromiocla-vicular joint model(model A), a clavicle hook plate fixation model(model B) and a Twin Tail Tight Rope fixation model(modelC). Loads and boundary conditions were set and the displacement and stress distribution of the three models were observed.Results The maximum displacement of the three models was located in the middle 1/3 of the clavicle, and the maximum displace-ment order was model A > model C > model B. There was no significant difference in the mean displacement values of all mea-surement points between model B and model C(P<0.05). The stress on the clavicle of the three models was mainly concentratedin the middle 1/3 of the clavicle, but the maximum stress peaks of models B and models C both appeared on the plate above theclavicle. The overall stress peak order of the three models was model C > model B > Model A, the stress value of the midpoint ofthe clavicle and the peak stress of the scapula were model A > model B > model C.Conclusion The clavicular hook plate andTwin Tail Tight Rope have similar stability in the treatment of acromioclavicular dislocation, and both provide adequate biome-chanical stability, but the non-physiological, increased fixation strength and different fixation methods also bring the risk of cor-responding complications. These results provide biomechanical evidence for clinicians to reasonably choose the fixation methodfor acromioclavicular joint dislocation and to evaluate postoperative complications.

关 键 词：肩锁关节脱位 锁骨钩钢板 双尾翼锁扣带袢钛板 内固定 有限元分析 生物力学 

分 类 号：R684.7[医药卫生—骨科学]