复合手法治疗胸腰椎骨折(A3)的有限元研究  

Composite Manipulation in the Treatment of Thoracolumbar Vertebral Fractures(A3):A Finite Element Study

作　　者：李稳超 俞鹏飞[2] 马智佳 朱广晔 占戴昕鹏 李超[2] 李子航 唐振宇 李红卫[2] LI Wenchao;YU Pengfei;MA Zhijia;ZHU Guangye;ZHAN Daixinpeng;LI Chao;LI Zihang;TANG Zhenyu;LI Hongwei(Graduate School,Anhui University of Chinese Medicine,Hefei 230038,China;Department of Orthopedics,Suzhou Hospital of Traditional Chinese Medicine Affiliated to Nanjing University of Chinese Medicine,Jiangsu Suzhou 215008,China)

机构地区：[1]安徽中医药大学研究生院,合肥230038 [2]南京中医药大学附属苏州市中医医院骨伤科,江苏苏州215008

出　　处：《医用生物力学》2024年第5期903-909,共7页Journal of Medical Biomechanics

基　　金：江苏省老年健康科研项目(LKM2022055);江苏省中医药科技发展计划重点项目(ZD202326);苏州市卫生健康委员会科技项目(LCZX202113)。

摘　　要：目的通过有限元方法分析多种手法治疗胸腰椎骨折(A3),探讨复合手术法治疗胸腰椎骨折(A3)可行性及优势。方法通过对胸腰椎骨折(A3)进行三维重建,在模型上分别采用模拟过伸体位复位、单纯按压复位、过伸体位下按压复位以及复合手法进行加载,观察模型的应力分布以及骨折椎体位移情况。结果复合手法等效应力为111.88 MPa,大于其他手法,且复合手法的应力更能集中于椎体前柱以及中柱;复合手法应力峰值为122.53 MPa,大于其他手法,集中分布于骨折椎体的骨折区域;复合手法骨折位移为3.94 mm,大于其他手法,位移分布由后柱向前中柱递减;复合手法下骨折椎体前纵韧带、横突间韧带应力最大,而过伸体位复位、单纯按压复位、过伸体位下按压复位,关节囊韧带的应力最大。结论复合手法治疗胸腰椎骨折(A3)相对于其他手法复位具有明显优势,是当前治疗胸腰椎骨折(A3)的合理方案。Objective To analyze thoracolumbar vertebral fractures(A3)treated by multiple manipulations using the finite element method and to explore the feasibility and advantages of the composite surgical method for treating thoracolumbar vertebral fractures(A3).Methods For three-dimensional reconstruction of thoracolumbar vertebral fractures(A3),the model was loaded with simulated hyperextension posture restoration,simple press restoration,press restoration under hyperextension posture,and composite manipulation.Subsequentially,the stress distribution of the model and displacement of the fractured vertebral body were observed.Results The equivalent stress under composite manipulation was 111.88 MPa,which was greater than that under other manipulations,and the stress under composite manipulation was more concentrated in the anterior and middle columns of the vertebral body.The peak stress under composite manipulation was 122.53 MPa,which was greater than that under other manipulations,and the stress was centrally distributed in fracture region of the fractured vertebral body.The fracture displacement under composite manipulation was 3.94 mm,which wasgreater than that under other manipulations,and the displacement distribution decreased from the posteriorcolumn to the anterior mid-column.The anterior longitudinal and intertransverse interligamentous ligaments of thefractured vertebral body experienced the greatest stress under composite manipulation,and the joint capsuleligaments experienced the greatest stress under hyperextension postural restoration,simple press restoration,and press restoration under the hyperextension posture.Conclusions Compound manipulation for treatingthoracolumbar vertebral fractures(A3)has obvious advantages over other manipulative restorations and is areasonable program for the current treatment of thoracolumbar vertebral fractures(A3).

关 键 词：胸腰椎骨折 手法复位 复合手法 有限元分析 

分 类 号：R318.01[医药卫生—生物医学工程]