摘要
背景:跟骨缺损在临床中屡见不鲜,因足跟复杂的解剖结构与运动功能使外科医生评估跟骨重建效果较为困难,而有限元分析已成为生物力学行为模拟和数值分析的有效方法之一。目的:比较Ⅱ字、V字排列腓骨瓣重建缺失跟骨的临床效果及生物力学特征。方法:采集1名50岁健康男性左足CT图像,用Mimics软件获取初步三维模型,导入Geomagic软件对模型进行修整和曲面化从而优化模型。再将模型通过Solidworks软件模拟跟骨重建并完成有限元计算前处理,最后进入Ansys软件求解。将仿真结果与既往文献结果进行对比,验证模型的有效性,再根据仿真得到的应力结果对手术效果和不同姿态下生物力学特性进行分析。结果与结论:①模型直观展现出腓骨瓣Ⅱ字、V字排列,均可以用来重建完全缺失的跟骨,能够一定程度恢复正常跟骨的长、宽、高,填补跟骨缺失的骨量;②两种重建跟骨相较正常跟骨在施加载荷后都表现出应力过于集中的趋势,正常跟骨应力多集中于跟骨结节、载距突及跟骨沟周围,而两种腓骨瓣应力多集中于骨瓣与距骨和骰骨衔接处;③两种重建跟骨与正常跟骨在不同模拟状态下最大应力值均不相同,差异有显著性意义(P<0.05);Ⅱ字相较V字腓骨瓣在不同状态下应力变化较小,更接近在相同状态时的正常跟骨;V字腓骨瓣在推离期出现局部应力过大,骨材料可能在此模拟状态下屈服,提示存在骨折的风险。
BACKGROUND:Calcaneal defects are common in clinical practice.It is difficult for surgeons to evaluate the effect of calcaneal reconstruction due to the complex anatomical structure and motor function of the heel.Finite element analysis has become an effective method for biomechanical behavior simulation and numerical analysis.OBJECTIVE:To compare the clinical effect and biomechanical characteristics of total calcaneal reconstruction with the II-shaped and V-shaped fibular flap.METHODS:CT images of one left foot of a healthy 50-year-old male were acquired.Mimics software was used to obtain the preliminary three-dimensional model.Geomagic software was used to trim and curve the model.The model was imported into Solidworks software to simulate calcaneal reconstruction and complete the pre-processing of finite element calculation.Finally,Ansys software was used to solve the problem.The simulation results were compared with previous literature results to verify the effectiveness of the model.The surgical effect and biomechanical characteristics of the foot in different gait phases based on the simulated stress results were analyzed.
作者
陈默迪
孙琪博
徐天宇
邰国梁
赵玉祥
潘朝晖
Chen Modi;Sun Qibo;Xu Tianyu;Tai Guoliang;Zhao Yuxiang;Pan Zhaohui(Department of Surgery,Weifang Medical University,Weifang 261053,Shandong Province,China;Institute of Orthopedics and Traumatology of CPLA,Hospital of CPLA 80th Group Army,Weifang 261053,Shandong Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2024年第12期1805-1809,共5页
Chinese Journal of Tissue Engineering Research
关键词
跟骨
腓骨
移植
生物力学
有限元分析
步态分析
复合组织瓣
显微外科
calcaneus
fibula
transplantation
biomechanics
finite element analysis
gait analysis
composite flap
microsurgery
