原生喙锁韧带及柔性重建后有限元仿真和实验测试  

Finite element simulation and experimental test of normal coracoclavicular ligament and flexible reconstruction

作　　者：季贵柱 郑秋 汪武祥 王冠 李文 鲁晓波 段可 李忠 杨洪彬 梁成 Ji Guizhu;Zheng Qiu;Wang Wuxiang;Wang Guan;Li Wen;Lu Xiaobo;Duan Ke;Li Zhong;Yang Hongbin;Liang Cheng(Department of Orthopedics,Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China;Sichuan Provincial Laboratory of Orthopedic Engineering,Southwest Medical University,Luzhou 646000,Sichuan Province,China;Department of Orthopedics,Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China;Clinical Medicine Research Center,Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China)

机构地区：[1]西南医科大学附属医院骨科,四川省泸州市646000 [2]西南医科大学四川省骨科置入器械研发及应用技术工程实验室,四川省泸州市646000 [3]西南医科大学附属中医院骨伤科,四川省泸州市646000 [4]西南医科大学附属医院临床医学研究中心,四川省泸州市646000

出　　处：《中国组织工程研究》2024年第5期706-711,共6页Chinese Journal of Tissue Engineering Research

基　　金：泸州-西南医科大合作项目(2020LZXNYDF02),项目负责人:王冠;泸县-西南医科大合作项目(2020LXXNYKD-01),项目负责人:鲁晓波。

摘　　要：背景:对于以喙锁韧带断裂造成的肩锁关节脱位,单束和双束重建为常见修复方式,深化研究对比二者修复的应力分布和骨折风险具有重要意义。目的:研究喙锁韧带的生物力学性能,对比单束和双束重建肩锁关节的固定效果、应力分布和破坏形式。方法:①有限元仿真分析:利用Mimics、Wrap和SolidWorks软件分别建立正常喙锁韧带、单束重建和双束重建肩锁关节模型,利用Ansys软件分析锁骨垂向受载时各模型肩胛骨和锁骨的应力和变形情况;②标本实验:取15个完整的人体肩胛骨-锁骨标本,随机分为5组处理,每组3个:A组切断肩锁韧带,保留完整的喙锁韧带;B组切断肩锁和斜方韧带,保留完整的锥状韧带;C组切断肩锁和锥状韧带,保留完整的斜方韧带;D组切断肩锁和喙锁韧带,采用单束重建修复喙锁韧带;E组切断肩锁和喙锁韧带,采用双束重建修复喙锁韧带。利用力学试验机进行力学实验,分析肩胛骨和锁骨的生物力学状态、应力分布和破坏形式。结果与结论:①有限元仿真分析:正常喙锁韧带附着标本喙突的平均应力最小,其相对于单束和双束重建模型喙突骨折的风险较小;单束和双束重建模型的喙突平均应力相当,二者骨折风险接近;②标本实验:A-E组标本的刚度分别为(26.4±3.5),(19.8±2.8),(21.3±3.2),(57.7±4.1),(46.2±2.8)N/mm,极限载荷分别为(545.5±53.7),(360.1±42.1),(250.9±44.4),(643.5±39.1),(511.9±31.7)N,D、E组标本的整体刚度高于A组(P=0.00006,0.0003),D组极限承载高于A组(P<0.05),E组极限承载和A组无差异(P>0.05);A-C组为韧带断裂,D、E组为喙突骨折;③结果显示:从生物力学角度分析,对于肩锁关节脱位中的喙锁韧带断裂,单束和双束重建均为有效的治疗技术,但均增加了骨折风险,其中双束重建分散了钢板应力、减小了钢板和骨质的接触力,但稍微降低了极限承载力,应根据临床实际情况选用单束或双�BACKGROUND:For dislocation of acromioclavicular joint induced by coracoclavicular ligament fracture,single EndoButton Plate reconstruction and double EndoButton Plates reconstruction are common repair methods.Further study on the stress distribution and fracture risk of the two repair methods is of great significance.OBJECTIVE:To study the biomechanical properties of the coracoclavicular ligament,and compare the fixation effect,stress distribution and failure mode of single and double EndoButton Plates reconstruction.METHODS:(1)Finite element simulation analysis:Mimics,Wrap and SolidWorks were used to establish normal coracoclavicular ligament,single EndoButton Plate reconstruction and double EndoButton Plates reconstruction.Ansys software was used to analyze the stress and deformation of the scapula and clavicle of each model under vertical load.(2)Sample experiment:Fifteen intact scapular-clavicle specimens were randomly grouped into five groups,with three specimens in each group.In group A,the acromioclavicular ligament was severed and the coracoclavicular ligament remained intact.In group B,acromioclavicular ligaments and trapeoid ligaments were severed,leaving intact conical ligaments.In group C,acromioclavicular ligaments and conical ligaments were cut off,and the intact traprex ligaments were retained.In group D,acromioclavicular and coracoclavicular ligaments were severed,and coracoclavicular ligaments were repaired by single EndoButton Plate reconstruction.In group E,acromioclavicular and coracoclavicular ligaments were severed,and the coracoclavicular ligaments were repaired by double EndoButton Plates reconstruction.The mechanical experiment was carried out by a mechanical testing machine to analyze the biomechanical status,stress distribution and failure patterns of the scapular-clavicle and clavicle.RESULTS AND CONCLUSION:(1)Finite element simulation analysis:The average stress of coracoclavicular ligament attached specimens was the lowest,and the risk of coracoclavicular fracture was less than that

关 键 词：喙锁韧带 柔性重建 单束重建 和双束重建 有限元分析 生物力学 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R684