髓内钉和钢板3种固定组合治疗成人前臂双骨干骨折生物力学三维有限元分析  

Three-dimensional finite element analysis on biomechanical characteristics of three fixations of intramedullary nail and plate in the treatment of diaphyseal both-bone forearm fractures in adults

作　　者：杨振 张恩水 曾昱源 由一航 张涛[2] YANG Zhen;ZHANG Enshui;ZENG Yuyuan;YOU Yihang;ZHANG Tao(Weifang Medical University,Weifang 261053,China;不详)

机构地区：[1]潍坊医学院临床医学院,山东潍坊261053 [2]济南市中心医院关节外科

出　　处：《山东医药》2022年第36期26-31,共6页Shandong Medical Journal

基　　金：济南市科学技术局临床医学科技创新计划(202019037);济南市科学技术局科技发展计划项目(20120206)。

摘　　要：目的 采用三维有限元方法分析髓内钉和钢板3种固定组合治疗成人前臂双骨干骨折整体生物力学特征。方法 采集志愿者右前臂中立位CT影像数据,建立A3.2型前臂双骨干骨折模型,同时建立双骨钢板固定、双骨髓内钉固定、桡骨钢板尺骨髓内钉固定3种内固定组合模型。将骨折模型与内固定组合模型进行装配,最后应用Ansys软件进行加载、运算,分析不同模型的骨折线处及与骨质连接处应力,前臂远端尺桡骨的位移分布及位移峰值,前臂骨折端尺桡骨平均应力。结果 在100 N垂直载荷条件下,双骨钢板固定组合模型内固定承受载荷最大,双骨髓内钉固定组合模型和桡骨钢板尺骨髓内钉固定组合模型内固定承受载荷最小,其中桡骨钢板尺骨髓内钉固定组合模型内固定承受载荷更均匀、更分散,力的传导性更好;双骨髓内钉固定组合模型的桡骨远端位移最小,双骨钢板固定组合模型的桡骨远端位移最大。在1 000 Nmm扭转力矩条件下,双骨钢板固定组合模型内固定承受载荷最大,双骨髓内钉固定组合模型承受载荷最小,钢板、髓内钉混合固定组合模型内固定承受载荷更均匀、更分散,力的传导性更好;桡骨钢板尺骨髓内钉固定组合模型与双骨钢板固定模型位移均较小。结论 相较于双骨钢板固定组合、双骨髓内钉固定组合,桡骨钢板尺骨髓内钉固定组合对于A3.2型前臂双骨干骨折可提供更好生物力学稳定性,可以为骨折提供更好的愈合环境。Objective To analyze the overall biomechanical characteristics of three combinations of intramedullarynail and plate in the treatment of diaphyseal both-bone forearm fractures in adults by three-dimensional finite element meth-od.Methods The model of A3. 2 adult diaphyseal both-bone forearm fractures was established by using CT images ofthe right forearm in the neutral position of volunteers,the models of interosseous membrane,ligament and cartilage wereestablished,and three internal fixation combination models were established:both-bone plate fixation,both-bone intra-medullary nailing,and plate fixation of radius and intramedullary nailing of ulna. The fracture model and internal fixationcombination model were assembled. Finally,Ansys software was used to load and calculate,and we analyzed the stress atthe fracture line and the joint with the bone of different models,the displacement distribution and peak displacement of thedistal radius and ulna of the forearm,and the average stress of the radius and ulna at the forearm fracture.Results Un-der the condition of 100 N vertical load,the internal fixation load of the both-bone plate fixation model was the largest,andthe internal fixation load of the both-bone intramedullary nailing model and the plate fixation of radius and intramedullarynailing of ulna model was the smallest. The internal fixation load of the plate fixation of radius and intramedullary nailing ofulna model was more uniform and scattered,and the force conductivity was better. The distal radius displacement of theboth-bone intramedullary nailing model was the smallest,and that of the both-bone plate fixation model was the largest.Under the condition of 1000 Nmm torsion moment,the internal fixation load of the both-bone plate fixation model was the largest,the load of the both-bone intramedullary nailing model was the smallest and the internal fixation load of the plateand intramedullary nail combination model was more uniform and dispersed,and the force conductivity was the better. Thedisplacement o

关 键 词：骨折内固定材料 髓内钉 钢板 前臂骨折 有限元法 生物力学特征 

分 类 号：R318[医药卫生—生物医学工程]