螺钉内固定与侧方支撑钢板内固定治疗LetenneurⅢ型Hoffa骨折的有限元分析  

Finite element analysis of screw fixation versus lateral support plate fixation for Letenneur typeⅢHoffa fracture

作　　者：王腾骄 李媛[1] 薛奋勤[2] 李启超 武建康[2] WANG Teng-jiao;LI Yuan;XUE Fen-qin;LI Qi-chao;WU Jian-kang(Shanxi Medical University,Taiyuan 030606,Shanxi,China;Luliang People's Hospital,Liliang 033000,Shanxi,China)

机构地区：[1]山西医科大学,山西太原030606 [2]吕梁市人民医院,山西吕梁033000

出　　处：《生物医学工程与临床》2024年第4期466-473,共8页Biomedical Engineering and Clinical Medicine

摘　　要：目的通过建立健康成年人膝关节三维模型,用有限元方法分析比较空心拉力螺钉(A模型)与侧方支撑钢板联合螺钉(B模型)在治疗LetenneurⅢ型Hoffa骨折的生物力学差异。方法采集健康成年人膝关节薄层CT图像,通过Mimics21.0软件提取初步模型、GeomagicWrap2021软件中对模型进一步进行光滑处理、Solidworks 2023软件中建立2种LetenneurⅢ型Hoffa骨折模型中所需内固定零件,并在Solidworks2023软件中将各零件进行拼装,模拟完成骨折内固定治疗、在Ansys2021软件中对模型进行网格划分,对膝关节模型进行有效性验证后,分别对两个内固定模型模拟施加人单腿站立载荷,计算2种模型的内固定Vonmises应力分布、骨折端及螺钉移位大小。比较2种模型的生物力学效应。结果①在对胫骨上端后方施加134N向前的力后,胫骨髁间嵴向前移位4.52mm,与前人结果相似。②A模型骨块最大移位为0.452mm,大于B模型骨块最大移位(0.357mm)。③A模型中内螺钉最大应力为73.3MPa,B模型中最大应力为119MPa,B模型中螺钉应力大小整体高于A模型;在A模型中,螺钉应力大小由远及近螺钉应力呈现降低的趋势;B模型中,螺钉应力大小由远及近呈“U”形。A模型中螺钉最大移位距离为0.52mm,B模型中螺钉最大移位距离为0.69mm,A、B模型中螺钉移位趋势均为由远及近螺钉移位逐渐增大,A、B两模型中螺钉移位大小相近。结论空心拉力螺钉结合侧方钢板在治疗LetenneurⅢⅡ型Hoffa骨折中具有更好的生物力学效果,更加利于患者术后康复.Objective To establish three-dimensional model of healthy adult knee joint model,analyze and compare biomechanical differences between cannulated screw(model A)and lateral support plate combined with screw(model B)in treatment of Letenneur type II Hoffa fracture by finite element analysis method.Methods Thin-layer CT images of healthy adult knee joints were collected,the preliminary model was extracted by Mimics 21.0 software,and the model was further smoothed by Geomagic Wrap2021 software.In Solidworks 2023,the necessary internal fixation components for 2 kinds of Letenneur type II Hoffa fracture models were created,the parts were assembled in Solidworks 2023 software,and fracture internal fixation treatment was simulated.The model was meshed in Ansys 2021 software,and the validity of knee joint model was verified,the two internal fixation models were simulated to apply human single-leg standing load,the Von mises stress distribution,fracture terminal and screw displacements of the two models were calculated.The biomechanical effects of the two models were compared.Results After applying 134 N forward force to posterior upper terminal of tibia,tibial intercondylar eminence shifted forward by 4.52 mm,which was similar to the previous results.@The maximum displacement of bone fragment in Model A was 0.452 mm,which was larger than that in Model B(0.357 mm).The maximum stress of internal screw in model A was 73.3 MPa,and was 119 MPa in model B,the screw stress in model B was higher than that in model A.The screw stress in model A showed decreasing trend from distal to proximal,and screw stress in model B showed U-shaped from distal to proximal.@The maximum displacement of screw in model A was 0.52 mm,and that in model B was 0.69 mm.The trend of screw displacement in model A and model B both increased gradually from distal to proximal,and screw displacement in model A and model B were similar.Conclusion It is demonstrated that the cannulated screw combined with lateral plate show better biomechanical effect in treatm

关 键 词：Hoffa 有限元分析 空心拉力螺钉 钢板 

分 类 号：R318.01[医药卫生—生物医学工程] R687.3[医药卫生—基础医学]