基于有限元分析鼻眶筛合并颧骨骨折生物力学机制  

The Biomechanical Mechanism of Naso-Orbito-Ethmoid Combined with Zygomatic Fracture:A Finite Element Study

作　　者：马莉[1,2] 李鹏起[2] 王继超 倪前伟[2] 高瞻[1,2] MA Li;LI Pengqi;WANG Jichao;NI Qianwei;GAO Zhan(School of Medicine,Shihezi University,Shihezi 832099,Xinjiang,China;Department of Oral and Maxillofacial Surgery,General Hospital of Xinjinag Military Region,Urumqi 830099,China;Department of Neurosurgery,People’s Hospital of Xinjiang Uygur Autonomous Region,Urumqi 830001,China)

机构地区：[1]石河子大学医学院,新疆石河子832099 [2]新疆军区总医院颌面外科,乌鲁木齐830099 [3]新疆维吾尔自治区人民医院神经外科,乌鲁木齐830001

出　　处：《医用生物力学》2024年第6期1066-1072,共7页Journal of Medical Biomechanics

基　　金：“天山英才”医药卫生高层次人才培养计划(TSYC202301A037)。

摘　　要：目的探究鼻眶筛合并颧骨骨折生物力学机制及面中部骨骼薄弱点,为颌面部特定区域的创伤防护提供理论依据。方法收集1名颅颌面骨骼正常的青年男性颅颌面CT数据,利用Mimics等软件三维重建人体颅颌面有限元模型,动态模拟以16 m/s及撞击部位骨折临界速度撞击鼻骨、眶下缘内侧1/3、颧骨及眶上缘内侧1/3的情景,分析面中部不同部位在不同撞击速度下力的传导方向及骨骼生物力学变化。结果不同工况下,以16 m/s初始速度撞击眶下缘内侧1/3及眶上缘内侧1/3时,鼻眶筛区及颧骨处所承受的应力会显著增高,其数值甚至超过150 MPa的阈值;而在其他工况下,并未出现鼻眶筛区和颧骨应力同时超过150 MPa的现象。结论鼻眶筛合并颧骨骨折多与高冲量的撞击相关,高速撞击眶上缘内侧1/3及眶下缘内侧1/3处时,容易发生合并骨折。眶下壁是面中部的相对薄弱点。Objective The biomechanical mechanism of naso-orbito-ethmoid(NOE)combined with zygomatic fractures and the weakness of midfacial bone were investigated,so as to provide a theoretical basis for protection against maxillofacial trauma.Methods CT data of a young male with normal cranio-maxillofacial bones were collected.Then,a human cranio-maxillofacial finite element model was reconstructed using Mimics and other software.The nasal bone,1/3 medial suborbital margin,zygomatic bone,and 1/3 medial supraorbital margin were impacted at a critical velocity of 16 m/s,and impact fractures were simulated.The direction of force conduction,biomechanical variations in the bones,and biomechanical mechanism of NOE combined with zygomatic fractures at different impact velocities in the middle of the face were analyzed.Results Under different working conditions,the stresses in the NOE region with the zygomatic bone exceeded the threshold of 150 MPa when the medial side of the 1/3 medial suborbital margin and 1/3 medial supraorbital margin were impacted at an initial velocity of 16 m/s.Under other working conditions,the stresses in the NOE region and the zygomatic bone did not exceed 150 MPa simultaneously.Conclusions NOE combined with zygomatic fractures is mostly related to high-energy impact.This occurs straightforwardly under a high-speed impact on the 1/3 medial supraorbital margin and 1/3 medial suborbital margin.The inferior orbital wall is a relatively weak area in the middle of the face.

关 键 词：鼻眶筛 颧骨骨折 有限元方法 

分 类 号：R318.01[医药卫生—生物医学工程]