摘要
目的通过有限元分析比较3种内固定方式治疗髋臼后壁骨折的生物力学性能,评估不同内固定方式的稳定性。方法建立包括骨盆主要韧带及股骨上1/3的骨盆三维有限元模型,模拟骨折面积>50%的髋臼后壁骨折,髋臼后壁骨折采用后柱钢板+空心钉(空心钉组)、后柱钢板+弹簧板(弹簧板组)、后柱钢板+弹簧板+空心钉(弹簧板+空心钉组)内固定,统一用后柱钢板压住骨折块。加载不同负荷模拟站立、前屈、侧弯三种运动状态,比较分析3组骨盆各部件与内固定物的应力分布及垂直位移。结果骨盆模型生物力学传递途径与既往研究高度一致,表明模型的可靠性与内固定治疗的有效性。相同载荷下空心钉组骨盆和内固定物的应力最大。空心钉组骨折区域的最大应力、垂直位移、内固定物与骨折区域应力差值均大于弹簧板组与弹簧板+空心钉组,而弹簧板+空心钉组最小。结论上述3种内固定方式治疗髋臼后壁骨折均能取得良好的生物力学稳定性,但后柱钢板+弹簧板+空心钉内固定能改善整体的应力分布,降低再骨折和内固定断裂的风险,同时能促进骨折愈合,表现出更好的生物力学相容性。
ObjectiveTo compare the biomechanical properties of three internal fixations in treatment of acetabular posterior wall fracture by finite element analysis, and evaluate the stability of different internal fixations.MethodsA three-dimensional finite element model of the pelvis was established including the main pelvic ligament and the upper 1/3 of the femur, and posterior wall fractures with a fracture area of >50% was simulated. Three different internal fixations were used to fix acetabular posterior wall fractures, including reconstruction plate with two screws(screw group), reconstruction plate with spring plate(spring plate group), and reconstruction plate with spring plate and screw(spring plate with screw group). The reconstruction plate was used to suppress the fracture. Load different loads to simulate three motion states of standing, flexion, and bending. The stress distribution and vertical displacement of the pelvis components and internal fixations were compared and analyzed after different internal fixation treatments.ResultsThe biomechanical delivery pathway of the pelvic model was highly consistent with previous studies, indicating the reliability of the model and the effectiveness of internal fixation treatment. Under the same load,the stress of the pelvis and internal fixation of the screws group was the largest. The maximum stress, vertical displacement and the stress difference between the internal fixation and the fracture area of the screws group were greater than those of the spring plate group and the spring plate with screw group, and the spring plate with screw group was the smallest.Conclusion three different internal fixations can achieve good biomechanical stability in the treatment of acetabular posterior wall fracture.But the reconstruction plate with spring plate and screw can improve the overall stress distribution and better reduce the risk of recurring fractures and internal fixation fractures. At the same time, it can promote fracture healing and show better biomechanical compati
作者
赵季伟
何金山
周岳来
方永超
陈鹏涛
卢遥
孙浩
张文东
胡乐
ZHAO Ji-wei;HE Jin-shan;ZHOU Yue-lai;FANG Yong-chao;CHEN Peng-tao;LU Yao;SUN Hao;ZHANG Wen-dong;HU Le(Department of Trauma Center,Northern Jiangsu People’s Hospital,Yangzhou,Jiangsu 225001,China)
出处
《中国骨与关节损伤杂志》
2021年第10期1009-1013,共5页
Chinese Journal of Bone and Joint Injury
基金
江苏省卫生健康委员会医学科研面上项目(H2018022)。
关键词
髋臼后壁骨折
弹簧板
空心钉
有限元分析
生物力学
Acetabular posterior wall fracture
Spring plate
Screw
Finite element analysis
Biomechanics
