跟骨载距突置钉治疗SandersⅡ型骨折的生物力学分析  

Biomechanical analysis of calcaneal sustentaculum tail sustentacular screw in treatment of Sanders type Ⅱ fractures

作　　者：唐广胜 王琪 徐垚 王冰 孙健宁 王德广 Tang Guangsheng;Wang Qi;Xu Yao;Wang Bing;Sun Jianning;Wang Deguang(Department of Human Anatomy,Department of Basic Medicine,Kangda College of Nanjing Medical University,Lianyungang 222000,China;Department of Human Anatomy,School of Basic Medicine,Xuzhou Medical University,Xuzhou 221004,China;Department of Medical Imaging,Jianhu County People’s Hospital,Yancheng 224799,China;Department of Traumatic Orthopedics,Suqian Hospital affiliated to Xuzhou Medical University,Suqian 223865,China)

机构地区：[1]南京医科大学康达学院基础医学部人体解剖学教研室,连云港222000 [2]徐州医科大学基础医学院人体解剖学教研室,徐州221004 [3]建湖县人民医院医学影像科,盐城224799 [4]徐州医科大学附属宿迁医院创伤骨科,宿迁223865

出　　处：《国际生物医学工程杂志》2024年第5期449-456,共8页International Journal of Biomedical Engineering

基　　金：江苏省高等学校基础科学(自然科学)面上基金(21KJB310001);连云港市重点研发计划(社会发展)基金(SF2249);南京医科大学康达学院人才工程“聚贤计划”(KD2024JXJH007);江苏高校“青蓝工程”资助项目。

摘　　要：目的构建应用载距突置钉治疗SandersⅡ型跟骨骨折的有限元模型,并通过有限元分析法研究其治疗SandersⅡ型跟骨骨折的有效性。方法选取南京医科大学康达学院2021—2022年第二学期人体解剖教研室教学后非影响骨质正常质量的成人完整跟骨标本1例,行Micro CT扫描获取数据,使用Mimics、Geomagic Wrap软件重建跟骨三维模型,再使用SolidWorks软件绘制内固定和骨折模型。将所得数据导入有限元分析软件进行材料赋值及网格划分得到三维有限元模型,对各个模型施加载荷及边界约束执行有限元分析计算,并提取有限元模型的应力与位移,最后对跟骨载距突试验性置钉进行验证。结果跟骨骨折三维模型外观仿真度高,形态结构完整、无缺损,与实体跟骨大小一致;手术治疗后的各骨折模型解剖复位良好,钢板贴合骨面,螺钉无突出模型以外,整个内固定无变形、损坏,网格划分清晰,数量较为均匀一致。各类型跟骨骨折模型中最大应力均位于内固定上,且整体应力在各个部件的分布均匀。各类型跟骨骨折端最大位移距离均小于0.13 mm。置钉后角度和长度均准确,克氏针尖端位于载距突内,载距突无破裂,克氏针无突出。结论应用载距突置钉方式治疗SandersⅡ型跟骨骨折具有良好的有效性。Objective To construct a finite element analysis model for the application of sustentaculum tail sustentacular screw in the treatment of calcaneal fracture of Sanders typeⅡ.The finite element analysis method was used to study the effectiveness of the simulation treatment of Sanders typeⅡcalcaneal fracture.Methods A complete adult calcaneal specimen that was not affecting the normal quality of bone after teaching in the Department of Human Anatomy,Kangda College of Nanjing Medical University from 2021 to 2022 second semester was selected.A micro CT scan was performed to obtain data.The three-dimensional model of the calcaneus was reconstructed by the software of Mimics and Geomagic Wrap.The internal fixation and fracutre model were drawn using SolidWorks software.The obtained data were imported into the finite element analysis software for material assignment and meshing to obtain a three-dimensional finite element model.The load and boundary constraints were applied to each model to perform finite element analysis and calculation,and the stress and displacement of the model were extracted.Finally,the experimental screw placement of the calcaneus loading process was verified.Results The three-dimensional model of calcaneal fracture had a high degree of appearance simulation,complete morphological structure,no defect,and was consistent with the size of the solid calcaneus.After surgical treatment,the anatomical reduction of each fracture model was good,the steel plate fit to the bone surface,and the screw did not protrude outside the model.There was no deformation or damage to the whole internal fixation,the grid division was clear,and the number was relatively uniform and consistent.The maximum stress in each type of calcaneal fracture model was in the internal fixation,and the overall stress was uniformly distributed in each component.The maximum displacement distance of each type of calcaneal fracture was less than 0.13 mm,and the angles and lengths of nails were accurate.The tip of the Kirschner wires was l

关 键 词：跟骨 骨折 载距突 三维重建 有限元分析 生物力学 

分 类 号：R687.3[医药卫生—骨科学] R318.01[医药卫生—外科学]