摘要
目的对内固定治疗的Hangman骨折有限元模型行生物力学分析,为临床工作提供基础数据。方法选取1名健康男性志愿者,对其C_(2～4)节段行螺旋CT后将数据导入Mimics14.0等软件后得到三维C_(2～4)节段颈椎实体,经分割等操作后获得Hangman骨折模型,结合三维解剖数据,通过Solidworks2013软件制作相应的椎弓根钉及钢板,模拟椎弓根钉固定、C_(2～3)钢板固定以及C_(2～4)钢板固定三种Hangman骨折内固定模型,在等值应力下对上述4种模型行有限元分析,比较其生物力学指标。结果 C_(2～3)节段:与椎弓根钉固定组、C_(2～3)钢板固定组以及C_(2～4)钢板固定组相比,Hangman骨折模型各个方向角位移均增大,以前屈和后伸运动最为显著。C_(2～3)钢板固定组和C_(2～4)钢板固定组各方向角位移差异较小,且均小于其他组;C_(3～4)节段:C_(2～4)钢板固定组各方向角位移均小于其他组,其余组间角位移差值最大为0.15°。三组固定模型其固定物于各方向应力由大到小均为C_(2～3)钢板,C_(2～4)钢板和椎弓根钉。两种钢板固定系统的主要受力部位为配套的螺钉根部,应力峰值54.73MPa,小于内固定失效强度(225MPa)。椎弓根钉的主要受力部位在穿过骨折线处以及螺钉尖。结论对于Hangman骨折,与传统C2后路椎弓根钉固定方式相比,C_(2～3)和C_(2～4)前路钢板固定弥补了其矢状面稳定性较差的缺陷,生物力学性质更加稳定,值得临床推广。
Objective To biomechanically analyze the finite element model of Hangman fracture and to provide data for clinical work. Methods A healthy male volunteer was chosen and was performed spiral CT on his cervical vertebra from the 2nd to 4th section. The 3D data was imported into Mimics 14.0 software to form cervical vertebra from the 2nd to 4th section. Then the Hangman fracture model was obtained by the segmentation and other operations. Combined with three-dimensional anatomical data,the pedicle screw and plate were made by Solidworks 2013 which could simulate three kinds of fixed model： pedicle screw fixation group, C2 -3 anterior plate fixation group and C2-4 anterior plate fixation group. The biomechanics of three kinds of fixation models and Hangman fracture model were compared. Results For the C2-3 segment, the angular displacements on each direction of the Hangman fracture model were more than other three fixation groups, especially for the flexion and extension; the angular displacements on each direction of the C2-3 and C2 -4 anterior plate fixation groups were similar and lower than other groups. For the C3-4 segment,the angular displacements on each direction of the C2-4 anterior plate fixation group were lower than other groups;and the maximum difference of angular displacement was 0. 15% between groups;the order of fixture force from high to low was C2-3 anterior plate fixation group, C2-4 anterior plate fixation group and pedicle screw fixation group, respectively. The main force site of the two kinds of plate fixation was the root of screws and the maximum value was 54. 73MPa;the main force site of pedicle screw was located through the fracture line and on the screw tip. Conclusion For Hangman fractures, the biomechanical properties of C2-3 and C2 -4 anterior plate fixation are more stable compared with traditional fixation method, which is worth application.
作者
程国芳
何宝林
王小伟
黄智勇
CHENG Guo-fang HE Bao-lin WANG Xiao-wei HUANG Zhi-yong(Sanmenxia Orthopaedic Hospital, Sanmenxia 472000, Chin)
出处
《创伤外科杂志》
2016年第10期599-601,605,共4页
Journal of Traumatic Surgery
关键词
颈椎
HANGMAN骨折
内固定
有限元模型
cervical vertebra
Hangman fracture
internal fixation
finite element model
