摘要
目的:建立旋后外旋型踝关节损伤三维有限元模型,通过外踝是否完整分析所对应的应力数据,得到后踝关节面受力的特点。方法:选取正常人旋后位非负重状态的踝关节薄层CT图像,建立包含韧带的踝关节三维数据模型,进行有效性验证后,采用有限元方法对不同程度的损伤合并外踝骨折与否进行分析,施加载荷得到不同的踝关节应力值及后踝关节面的压力分布。结果:施加载荷时,应力最大值位于胫腓前韧带胫骨附着点。通过去除胫腓前韧带,外踝保留完整,应力最大值位于胫腓后韧带胫骨附着点为271.2 MPa,后踝关节面压力最大值为2.626MPa。当构建外踝骨折后,加载同样力时,应力最大值位于腓骨骨折面为82 MPa,后踝关节面压力最大值为7.787MPa。外踝完整进一步去除胫腓后韧带,应力最大值位于距腓后韧带腓骨附着点为132.7 MPa。当构建外踝骨折后,应力最大值位于腓骨骨折面为82.72 MPa;后踝关节面压力最大值为8.022 MPa。结论:旋后外旋型踝关节损伤外踝重建对后踝关节面应力变化具有重要意义,当外踝重建完成后能够明显减小后踝关节面的压力分布,此时后踝骨折及胫腓后韧带稳定性重建意义将凸显。
Objective: To establish three-dimensional finite element model of supination and external rotation ankle injury,and to analyze the stress characteristics of the posterior malleolus articular surface based on the integrity of the lateral malleolus. Methods: Thin-layer CT images of ankle joint in supination-external rotation and non weight-bearing state of normal people were selected to establish the three-dimensional data model of ankle joint including ligaments. After validation of the model, the finite element was used to evaluate the severity of injury combined with lateral ankle fracture. The stress and pressure distribution on the posterior malleolus articular surface were recorded by application of load. Results: When the load was applied, the maximum stress was located at the tibial attachment of anterior tibiofibular ligament. When the anterior tibiofibular ligament was removed and the lateral malleolus kept intact, the maximum stress located at the tibial attachment of the posterior tibiofibular ligament was 271.2 MPa, and the maximum pressure of posterior malleolus articular surface was2.626 MPa. After the lateral malleolus fracture was constructed and the same force was loaded, the maximum stress was located at the fibular fracture surface and was 82 MPa, and the maximum pressure of posterior malleolus articular surface was7.787 MPa. When the posterior tibiofibular ligament was completely removed from the lateral malleolus, the maximum stress was located at the fibular attachment of the posterior tibiofibular ligament and was 132.7 MPa. When the lateral malleolus fracture was constructed, the maximum stress was located at the fibular fracture surface and was 82.72 MPa, and the maximum pressure of posterior malleolus articular surface was 8.022 MPa. Conclusions: The reconstruction of lateral malleolus for supination-external rotation ankle injury is of great significance for the stress change of posterior malleolus articular surface.The reconstruction of lateral malleolus can significantly reduce the pre
作者
张鑫
解品亮
费澜
邵伟荣
徐小平
沈宝良
殷勇
ZHANG Xin;XIE Pinliang;FEI Lan;SHAO Weirong;XU Xiaopin;SHEN Baoliang;YIN Yong(Department of Orthopaedics,Jiading District Central Hospital,Shanghai University of Medicine&Health Sciences,Shanghai 201800,China)
出处
《中华骨与关节外科杂志》
2021年第11期936-940,共5页
Chinese Journal of Bone and Joint Surgery
基金
上海市嘉定区卫生和计划生育委员会科研课题(JDKW-2018-W15)。
关键词
旋后外旋损伤
压力分布
压力
有限元分析
后踝
Supination-External Rotation Ankle Injury
Pressure Distribution
Pressure
Finite Element Analysis
Posterior Malleolus
