跟骨骨囊肿病灶范围与病理性骨折的生物力学关系分析  

Analysis on Biomechanical Relationship Between Calcaneal Cyst Lesion Size and Pathological Fracture

作　　者：李鹏飞[1,2] 徐子环 王永钦 苏志豪 孙万驹 倪明[1,2,3] LI Pengfei;XU Zihuan;WANG Yongqin;SU Zhihao;SUN Wanju;NI Ming(School of Health Science and Engineering,University of Shanghai for Science and Technology,Shanghai 200093,China;Department of Orthopedics,Shanghai Pudong New Area People’s Hospital,Shanghai 201299,China;Department of Science Development,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)

机构地区：[1]上海理工大学健康科学与工程学院,上海200093 [2]上海市浦东新区人民医院骨科,上海201299 [3]上海交通大学医学院附属瑞金医院科技发展处,上海200025

出　　处：《医用生物力学》2023年第2期303-309,共7页Journal of Medical Biomechanics

基　　金：上海市科委港澳合作项目(21410760200);生物医药科技支撑项目(22S31900700);上海市浦东新区新兴交叉学科-数字骨科项目(PWXx2020-08)。

摘　　要：目的探究跟骨孤立性骨囊肿(solitary bone cyst,SBC)病灶范围与病理性骨折的关系,为SBC治疗提供参考。方法基于CT图像建立足踝三维有限元模型,在病灶好发区构建4种梯度球型骨缺损模型,模拟不同的SBC病灶范围,分析步态周期不同时相跟骨的生物力学特征。结果在步态周期下,随着SBC范围增加,跟骨位移无明显变化,但峰值应力逐渐增大。当SBC直径超过跟骨宽度的75%时,跟骨沟和病灶下方皮质区域应力增加到正常跟骨的1.48倍和7.74倍。结论当SBC直径超过跟骨宽度的75%时,应力性骨折风险增大,可早期手术干预。跟骨沟和SBC下方骨皮质是应力集中区,可作为评估应力性骨折的重点区域。Objective To investigate the relationship between lesion size of solitary bone cyst(SBC)and pathological fracture of calcaneus,so as to provide references for the treatment of SBC.Methods The threedimensional(3D)finite element model of foot and ankle was established based on CT images.Four models with gradient spherical bone defects were constructed in the focal area to simulate different SBC lesion sizes,and the biomechanical characteristics of calcaneus in different gait phases were analyzed.Results With the increasement of SBC size,the kinematics of calcaneus did not change significantly,but the peak stress of calcaneus increased gradually.When the SBC size exceeded 75%of the calcaneal width,the stress in calcaneal sulcus and cortical bone below SBC increased by 1.48 times and 7.74 times,respectively.Conclusions The risk of pathological fracture increases when the SBC diameter exceeds 75%of the calcaneal width,and early surgical intervention should be recommended.The calcaneal sulcus and the cortex bone below SBC are stress concentration regions and can be used as important areas to evaluate pathological fractures.

关 键 词：孤立性骨囊肿 跟骨 病理性骨折 步态时相 有限元分析 

分 类 号：R318.01[医药卫生—生物医学工程]