腓骨近端骨折对胫骨后外侧平台骨折影响的有限元分析  

A finite element analysis of the effect of proximal fibular fracture on posterolateral tibial plateau fractures

作　　者：高锦 贾鹏 吕飞 齐岩松 徐永胜 呼和 GAO Jin;JIA Peng;LÜFei;QI Yan-song;XU Yong-sheng;HU He(Postgraduate School,Baotou Medical College,Inner Mongolia University of Sci-ence and Technology,Baotou,Inner Mongolia,014000,China;People's Hospital of Suzhou High-tech Zone,Suzhou,Jiangsu 215011,Chi-na;Orthopaedic Center,People's Hospital of Inner Mongolia Autonomous Region,Hohhot,Inner Mongolia,010017,China)

机构地区：[1]内蒙古科技大学包头医学院研究生院,内蒙古包头014000 [2]苏州高新区人民医院,江苏苏州215011 [3]内蒙古自治区人民医院骨科中心,内蒙古呼和浩特010017

出　　处：《中国矫形外科杂志》2025年第3期249-254,共6页Orthopedic Journal of China

基　　金：内蒙古自治区自然科学基金项目(编号:2021MS08035);内蒙古自治区科技计划项目(编号:2021GG0127);国家自然科学基金项目(编号:82172444)。

摘　　要：[目的]通过有限元分析,探讨腓骨近端对胫骨后外侧平台骨折的力学影响。[方法]收集1名志愿者胫腓骨CT数据,导入SolidWorks软件,模拟3种不同胫腓骨形态,分为正常组(normal control,NC)、胫骨后外平台骨折钢板内固定腓骨完整组(posterolateral tibial plateau fracture with plate fixation and intact fibula,IF)、胫骨后外平台骨折钢板内固定腓骨骨折组(posterolateral tibial plateau fracture with plate fixation and fibular fracture,FF)。在施加250 N、500 N、1000 N轴向载荷状态下,模拟日常活动中不同受力情况下内固定受力及胫骨骨折模型的位移情况。[结果]与NC组相比,IF组与FF组钢板与螺钉的Von Mises应力随着载荷的增大显著增加(P<0.05)。在250 N、500 N、1000 N载荷下,IF组钢板[(20.3±1.5)MPa vs(28.5±1.6)MPa,P<0.001;(42.3±1.6)MPa vs(59.4±1.7)MPa,P<0.001;(90.5±7.8)MPa vs(123.3±15.9)MPa,P=0.003]及螺钉[(24.4±3.1)MPa vs(35.7±2.5)MPa,P<0.001;(50.2±7.9)MPa vs(70.30±9.6)MPa,P=0.007;(101.1±15.7)MPa vs(143.7±16.4)MPa,P=0.003]Von Mises应力均小于FF组。随着载荷的增大,两组骨折块位移及内侧胫骨平台位移均显著增加(P<0.05);在相同载荷下,IF组骨折块的位移及内侧胫骨平台位移均显著小于FF组(P<0.05)。[结论]在胫骨平台后外侧骨折中,完整的腓骨可以提升钢板、螺钉的整体轴向刚度,使外侧骨折块及内侧胫骨平台更为稳定,对骨折的愈合有促进作用。[Objective]To investigate the mechanical effect of proximal fibula on posterior lateral tibial plateau fracture by finite element analysis.[Methods]The CT data of a volunteer's tibia and fibula were collected and imported into SolidWorks software to simulate 3 conditions,including the normal control(NC),posterolateral tibial plateau fracture with plate fixation and intact fibula group(IF)and posterolateral tibial plateau fracture with plate fixation and fibular fracture(FF).Under 250 N,500 N and 1000 N axial loads,the displacement of the model of internal fixation and tibial fracture and under daily activities was measured.[Results]Compared with that of NC group,the Von Mises stress of plates and screws in IF group and FF group was significantly increased with the increase of load(P<0.05).Under loads of 250 N,500 N and 1000 N,the IF group proved significantly less than the FF group in terms Von Mises stress of the plate[(20.3±1.5)MPa vs(28.5±1.6)MPa,P<0.001;(42.3±1.6)MPa vs(59.4±1.7)MPa,P<0.001;(90.5±7.8)MPa vs(123.3±15.9)MPa,P=0.003]and the screw[(24.4±3.1)MPa vs(35.7±2.5)MPa,P<0.001;(50.2±7.9)MPa vs(70.3±9.6)MPa,P=0.007;(101.1±15.7)MPa vs(143.7±16.4)MPa,P=0.003].With the increase of load,the displacement of fracture fragment and the displacement of medial tibial plateau in both groups were significantly increased(P<0.05).Under the same load,the displacement of fracture fragment and medial tibial plateau in IF group were significantly less than the FF group(P<0.05).[Conclusion]In posterolateral tibial plateau fractures,the intact fibula does improve the overall axial stiffness of plates and screws,make lateral fracture fragment and medial tibial plateau more stable,and promote the healing of fracture.

关 键 词：腓骨近端骨折 胫骨后外侧平台骨折 有限元分析 生物力学 

分 类 号：R683.42[医药卫生—骨科学]