桡骨远端C1型骨折三种内固定方式的有限元分析  

Finite element analysis of three internal fixation plates for treating C1 type fractures of distal radius

作　　者：努尔比艳木·库尔班 乌日开西·艾依提[1] 买合木提·亚库甫 Nuerbiyanmu·Kuerban;Wurikaixi·Aiyiti;Maihemuti·Yakufu(Modern Lndustral College of Intelligent Manufacturing(School of Mechanical Engineering),Xinjiang University,Urumqi 830017,Xinjiang Uygur Autonomous Region,China;Sixth Affiliated Hospital of Xinjiang Medical University,Urumqi 830002,Xinjiang Uygur Autonomous Region,China)

机构地区：[1]新疆大学智能制造现代产业学院(机械工程学院),新疆维吾尔自治区乌鲁木齐市830017 [2]新疆医科大学第六附属医院,新疆维吾尔自治区乌鲁木齐市830002

出　　处：《中国组织工程研究》2025年第15期3110-3115,共6页Chinese Journal of Tissue Engineering Research

基　　金：新疆维吾尔自治区自然科学基金面上项目(2022D01C393),项目名称:变密度生物陶瓷/聚合物复合结构可降解骨科植入物的微结构调控研究,项目负责人:乌日开西·艾依提;“新疆地区高发疾病研究”教育部重点实验室面上项目(2023B04),项目名称:近红外二区靶向纳米探针体系用于假体周围感染(PJI)的光热治疗及动态示踪研究,项目负责人:买合木提·亚库甫。

摘　　要：背景:桡骨远端C1型骨折属于关节内不稳定型骨折,治疗上存在较大的难度。目前对桡骨远端骨折不同内固定接骨板的临床研究较少,缺乏多种内固定接骨板的生物力学对比研究,在内固定接骨板的选用上仍存在争议。目的:通过有限元分析法比较不同内固定接骨板在桡骨远端C1型骨折治疗中的生物力学特性。方法:使用一名健康女性志愿者的桡骨模型,顺序导入Mimics 21.0、Geomagic Wrap 2017、Solid Works 2021等软件进行处理,制作桡骨远端C1型骨折模型。根据厂家提供的接骨板数据,分别建立桡骨远端掌侧斜T形锁定板、桡骨远端掌侧蝶形锁定板、桡骨远端掌侧万向锁定板和螺钉的三维模型,并且和骨折模型进行装配,在ANSYS 19.0中赋予材料属性,设定各接触面相互作用关系并定义载荷及边界条件,模拟其腕关节压缩、背弯、掌屈和扭转等4种载荷工况,比较其生物力学性能。结果与结论:①3组内固定模型在4种载荷工况下,内固定模型整体位移主要集中在桡骨远端关节面上;模型在背弯、掌屈和扭转载荷工况下的最大位移是轴向载荷下位移的2-6倍,表明轴向载荷工况下内固定系统最稳定;②内固定上的应力远大于骨折块上的应力,内固定物应力主要集中于接骨板在骨折断端附近区域,其中万向锁定板和蝶形锁定板应力分布较为均匀,斜T形锁定板应力集中现象最为明显;③在压缩和扭转载荷下,骨折块的应力主要集中在螺钉孔周围,掌屈和背伸载荷下则是从桡骨远端向近端逐步扩展;在同样的载荷工况下,斜T形锁定板固定状态下骨折块应力最大,万向锁定板固定系统骨折块所受应力峰值最低,蝶形锁定板与万向锁定板固定状态下的骨折块峰值应力仅仅相差0.2-6.0 MPa;④相比于斜T形锁定板和蝶形锁定板,万向锁定板在桡骨远端C1型骨折内固定中应力分布更均匀,固定模型关节面位移更小BACKGROUND:The C1 type fracture of the distal radius is an intraarticular unstable fracture,which is difficult to treat.At present,there are few clinical studies about the comparison of the biomechanical differences of different internal fixation plates for distal radius fractures under different loading conditions,and there are still controversies in the selection of internal fixation plates.OBJECTIVE:To compare the biomechanical properties of different internal fixation plates for C1 type fractures of distal radius using a finite element analysis method.METHODS:The distal radius model of a healthy female volunteer was used,and the files were sequentially imported into Mimics 21.0,Geomagic Wrap 2017,and Solid Works 2021 for processing.The C1 type fracture of the distal radius was modeled.According to the plate data provided by the manufacturer,the volar oblique T-locking plate,volar fixed-angle anatomical plate,volar variable-angle locking plate and screws three-dimensional model were created and assembled with the fracture model.The material properties were given in ANSYS 19.0 to set up the relationship of interaction between the contact surfaces,and to define the loads and boundary conditions.Four load cases,including compression,dorsal flexion,palmar flexion and torsion,were applied to compare the biomechanical properties.RESULTS AND CONCLUSION:(1)In the three groups of internal fixation models,the overall displacement of the internal fixation model was mainly concentrated on the articular surface of the distal radius under four load conditions.The maximum displacement of the model under the dorsal,palmar and torsion load conditions was 2-6 times that of the displacement under the axial load,indicating that the internal fixation system was the most stable under the axial load condition.(2)The stress on the internal fixation was much greater than the stress on the bone fracture fragments.The stress of the internal fixation was mainly concentrated in the area that near to the fracture end of the bone plate,amon

关 键 词：桡骨远端骨折 内固定 斜T形锁定板 蝶形锁定板 万向锁定板 位移 应力 有限元分析 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R687