摘要
目的通过有限元实验研究分析手法复位夹板固定与切开复位克氏针内固定治疗儿童桡骨远端骨骺分离骨折的生物力学机制,为临床选择治疗方式提供科学的理论依据。方法将1名健康男性儿童的腕部CT图像导入Mimics 10.0进行影像处理,生成组成腕关节的主要骨骼及骨骺组织模型,切割赋值、实体化处理、软组织模拟后形成初步骨折模型,然后根据实际固定材料数据设计夹板固定与克氏针内固定的桡骨远端骨骺骨折的2种有限元模型。分析各模型在轴向压缩下,下尺桡关节的相对位移变化、桡骨远端骨折端位移变化情况。结果建立了正常儿童腕关节的三维有限元模型,以此为基础建立出实验所需另外2种模型;在轴向压力下,夹板固定模型下尺桡关节位移、与骨折断端位移相应数值明显小于骨折模型,2种骨折模型位移值相应数值相差不明显:克氏针固定模型下尺桡关节应力最大值0.12792 MPa,下尺桡关节位移最大值0.042508 mm;骨折断端应力最大值3.1978 MPa,骨折断端位移最大值0.071986 mm;夹板固定模型下尺桡关节应力最大值0.046189 MPa,下尺桡关节位移最大值0.031458 mm;骨折断端应力最大值2.2688 MPa,骨折断端位移最大值0.047596 mm。结论夹板干预可以增加下尺桡关节与桡骨骨折端的稳定性。夹板这一弹性固定方式在稳定性上与内固定相比效果相仿。
Objective To study and analyze the effect of manual reduction and splint fixation and open reduction and Kirschner wire internal fixation on children with distal radius epiphyseal separation fracture through finite element experiment.Methods The wrist CT image of a healthy male child was imported into Mimics 10.0 for image processing to generate the main skeleton and epiphyseal tissue model of wrist joint.After cutting and assigning values,solid processing,and soft tissue simulation,a preliminary fracture model was formed.Then,two kinds of finite element models of distal radius epiphyseal fracture fixed by splint and Kirschner wire were designed according to the actual fixation material data.The relative displacement of the lower radioulnar joint and the displacement of the distal radius fracture end of each model under axial compression were analyzed.Results The three-dimensional finite element model of normal children's wrist joint was established,and the other two models needed for the experiment were established based on this model.Under axial pressure,the displacement of the radioulnar joint and the corresponding value of the displacement of the fracture fracture end under the splint fixation model were smaller than those of the fracture model,and there was no significant difference between the corresponding values of the displacement of the two fracture models:the maximum stress of the radioulnar joint under the Kirschner wire fixation model was 0.12792 MPa,and the maximum displacement of the radioulnar joint was 0.042508 mm;The maximum stress of fracture fracture end was 3.1978 MPa,and the maximum displacement of fracture fracture end is 0.071986 mm.The maximum stress of the radioulnar joint under the splint fixation model was 0.046189 MPa,and the maximum displacement of the radioulnar joint was 0.031458 mm.The maximum stress at the fracture end was 2.2688 MPa,and the maximum displacement at the fracture end was 0.047596 mm.Conclusion Splint intervention can increase the stability of the lower radioulnar j
作者
周云帆
孟祥奇
欧炳金
钱启恒
赵煜文
ZHOU Yunfan;MENG Xiangqi;OU Bingjin;QIAN Qiheng;ZHAO Yuwen(Graduate School,Nanjing University of Chinese Medicine,Jiangsu Province,Nanjing 210000,China;Department of Orthopaedics,Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine,Jiangsu Province,Suzhou 215001,China)
出处
《中国当代医药》
CAS
2023年第17期82-86,共5页
China Modern Medicine
基金
江苏省姑苏卫生人才培养项目(GSWS2020082)。
关键词
夹板固定
儿童桡骨远端骨骺分离骨折
有限元分析
相对位移
模型构建
Clamping plate fixation
Distal radius epiphyseal separation fracture in children
Finite element analysis
Relative displacement
Model building
