喙锁韧带不同重建方法治疗肩锁关节脱位的有限元分析  

Finite element analysis of different reconstruction methods of coracoclavicular ligament for acromioclavicular joint dislocation

作　　者：陈浩[1,2] 方加虎[3] 殷国勇[3] CHEN Hao;FANG Jia-hu;YIN Guo-yong(Nanjing Medical University,Nanjing 211166,Jiangsu,China;Department of Orthopaedics,Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine,Nanjing 210003,Jiangsu,China;Department of Orthopaedics,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China)

机构地区：[1]南京医科大学,江苏南京211166 [2]南京中医药大学附属南京医院骨科,江苏南京210003 [3]南京医科大学第一附属医院骨科,江苏南京210029

出　　处：《中国骨伤》2023年第6期543-549,共7页China Journal of Orthopaedics and Traumatology

基　　金：江苏省卫健委重点课题(编号:ZD2021001)。

摘　　要：目的:建立喙锁韧带单束重建、双束解剖重建及双束完全解剖重建有限元模型,比较其位移及受力情况,为喙锁韧带完全解剖重建临床应用提供理论依据。方法:选取1位志愿者,年龄27岁,身高178 cm,体重75 kg,行肩关节CT扫描,运用Mimics17.0、Geomagic studio 2012、UG NX 10.0、Hypermesh14.0、Abaqus 6.14软件建立喙锁韧带单束重建、双束解剖重建及双束完全解剖重建三维有限元模型,各模型分别向前载荷、向后载荷及向上载荷的载荷,记录并比较在主要受力方向上锁骨远端中点的最大位移以及不同载荷情况下重建装置的最大等效应力。结果:施加向前载荷、向后载荷,双束完全解剖重建锁骨远端中点的向前最大位移及向后最大位移最低,分别为7.76 mm和7.27 mm;施加向上载荷,双束解剖重建锁骨远端中点向上最大位移最低,为5.12 mm;施加向前、向后及向上3种不同载荷,双束重建的重建装置最大等效应力均低于单束重建;双束完全解剖重建斜方韧带重建装置最大等效应力较双束解剖重建低,为73.29 MPa,但锥状韧带重建装置的最大等效应力高于双束解剖重建。结论:喙锁韧带双束完全解剖重建能够提高肩锁关节的水平稳定性,降低斜方韧带重建装置的应力,可作为治疗肩锁关节脱位的较好方法。Objective This study aims to examine the biomechanical effects of different reconstruction methods,including single-bundle,double-bundle anatomical reconstruction,and double-bundle truly anatomical reconstruction of the coracoclavicular ligament on the acromioclavicular joint using finite element analysis,to provide a theoretical basis for the clinical application of truly anatomical coracoclavicular ligament reconstruction.Methods One volunteer,aged 27 years old,with a height of 178 cm and a weight of 75 kg,was selected for CT scanning of the shoulder joint.Three-dimensional finite element models of single-bundle reconstruction,double-bundle anatomical reconstruction,and double-bundle truly anatomical reconstruction of coracoclavicular ligament were established by using Mimics17.0,Geomagic studio 2012,UG NX 10.0,HyperMesh 14.0 and ABAQUS 6.14 software.The maximum displacement of the middle point of the distal clavicle in the main loading direction and the maximum equivalent stress of the reconstruction device under different loading conditions were recorded and compared.Results The maximum forward displacement and the maximum backward displacement of the middle point of the distal clavicle in the double-bundle truly anatomic reconstruction were the lowest,which were 7.76 mm and 7.27 mm respectively.When an upward load was applied,the maximum displacement of the distal clavicle midpoint in the double-beam anatomic reconstruction was the lowest,which was 5.12 mm.Applying three different loads forward,backward,and upward,the maximum equivalent stress of the reconstruction devices in the double-beam reconstruction was lower than that in the single-beam reconstruction.The maximum equivalent stress of the trapezoid ligament reconstruction device in the double-bundle truly anatomical reconstruction was lower than that in the double-bundle anatomical reconstruction,which was 73.29 MPa,but the maximum equivalent stress of the conoid ligament reconstruction device was higher than that of the double-bundle anatomical recon

关 键 词：肩锁关节脱位 韧带 完全解剖重建 有限元分析 

分 类 号：R684.7[医药卫生—骨科学]