摘要
目的建立踝关节骨折固定后遗留下胫腓前韧带损伤,用锚钉加强修复结合螺钉固定的有限元模型,比较其受力及变形情况。方法选取1例正常男性青年志愿者踝关节CT图像,建立踝关节骨折固定后遗留下胫腓前联合损伤有限元模型,对损伤模型置入锚钉固定为实验组,使用螺钉固定为对照组。通过有限元分析计算,观察两组模型在各种载荷工况下的最大应力分布和最大变形情况。结果在垂直载荷下,实验组变形均高于对照组6.8%,外旋载荷时变形增加22.6%,而内旋载荷时变形降低5.1%;在同级载荷下,对照组和实验组模型的最大应力峰值相差不大。因为锚钉固定的作用,实验组最大应力峰值由胫骨远端骨折固定的螺钉承担,而对照组由钢板和下胫腓联合螺钉的坚强固定承担。锚钉上的最大应力均分布在螺钉上,缝合线主要起到固定作用。结论下胫腓螺钉及锚钉固定都能有效地治疗踝关节骨折固定后遗留下胫腓不稳,锚钉固定使得钢板上应力分散,在固定下胫腓的同时具有更大的踝关节形变能力,而且能避免断钉的风险。
Objective To establish the finite element( FE) model of the anterior tibiofibular ligament injury by ankle fracture fixation,so as to compare the stress and deformation of the finite element model by using anchorreinforced repair combined with screw fixation. Methods CT images of the ankle joint from a normal young male volunteer was selected to establish the FE model of the anterior tibiofibular joint injury by ankle fracture fixation.The injury models were divided into experimental group and control group,which were fixed by anchors or screws,respectively. The maximum stress distributions and the maximum deformation of the two models under various load conditions were observed through the FE analysis and calculation. Results Under the vertical load,the deformation of the experimental group was 6. 8% higher than that of the control group. The deformation increased by 22. 6% under external rotation load,while the deformation decreased by 5. 1% under internal rotation load. Under the same load,differences in the maximum peak stress on the model between the control group and the experimental group was not significant. Due to the anchor fixation,the maximum stress of the experimental group were borne by the screw that fixed the distal tibial fracture,while the maximum stress of the control group was borne by strong fixation of the steel plate and the inferior tibiofibular screw. The maximum stresses on the anchor were distributed on the screw,and the suture mainly played the role of fixing. Conclusions The lower tibiofibular screw and anchor fixation could effectively treat the tibiofibular instability left by ankle fracture fixation.The anchor fixation dispersed the stress on the steel plate,and it showed greater ankle joint deformation ability while fixing the lower tibiofibula,so as to avoid the risk of broken nails.
作者
周金华
芮玉兰
张文玺
张文
ZHOU Jinhua;RUI Yulan;ZHANG Wenxi;ZHANG Wen(Department of Orthopedics,Liyang People's Hospital of Jiangsu Province(Liyang Branch of Jiangsu People's Hospital),Liyang 213300,Jiangsu,China;Institute of Orthopaedics,Soochow University,Suzhou 215006,Jiangsu,China)
出处
《医用生物力学》
EI
CAS
CSCD
北大核心
2021年第1期48-54,共7页
Journal of Medical Biomechanics
基金
溧阳市人民医院院级课题(2019YJKT004)。
关键词
踝关节
下胫腓
锚钉
有限元分析
ankle joint
lower tibiofibula
anchor
finite element analysis
