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[1]王文,蔣科衛(wèi),成永忠,等.半環(huán)形外固定支架治療C型橈骨遠端骨折的穩(wěn)定性有限元分析[J].中醫(yī)正骨,2024,36(06):1-9，36.
　WANG Wen,JIANG Kewei,CHENG Yongzhong,et al.The stability of a semi-circular external fixator in treatment of type C distal radius fractures:a finite element analysis-based biomechanical study[J].The Journal of Traditional Chinese Orthopedics and Traumatology,2024,36(06):1-9，36.
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半環(huán)形外固定支架治療C型橈骨遠端骨折的穩(wěn)定性有限元分析()
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《中醫(yī)正骨》[ISSN:1001-6015/CN:41-1162/R]

卷:
第36卷
期數(shù):
2024年06期
頁碼:
1-9，36
欄目:
基礎研究
出版日期:
2024-06-20

文章信息/Info

Title:
The stability of a semi-circular external fixator in treatment of type C distal radius fractures:a finite element analysis-based biomechanical study
作者:
王文1; 蔣科衛(wèi)2; 成永忠2; 林晴1; 尹曉冬2; 錢秀清3; 劉廣偉4
1.北京中醫(yī)藥大學研究生院,北京 100029; 2.中國中醫(yī)科學院望京醫(yī)院,北京 100102; 3.首都醫(yī)科大學生物醫(yī)學工程學院,北京 100069; 4.中醫(yī)正骨技術北京市重點實驗室,北京 100102
Author(s):
WANG Wen1; JIANG Kewei2; CHENG Yongzhong2; LIN Qing1; YIN Xiaodong2; QIAN Xiuqing3; LIU Guangwei4
1.Graduate School of Beijing University of Chinese Medicine,Beijing 100029,China2.Wangjing Hospital of CACMS,Beijing 100102,China3.School of Biomedical Engineering,Capital Medical University,Beijing 100069,China4.Beijing Key Laboratory of Orthopedics of Traditional Chinese Medicine,Beijing 100102,China
關鍵詞:
橈骨骨折;  骨折固定術;  外固定器;  限定因素分析;  生物力學現(xiàn)象
Keywords:
radius fractures;  fracture fixation;  external fixators;  finite element analysis;  biomechanical phenomena
摘要:
目的:探討半環(huán)形外固定支架治療C型橈骨遠端骨折的穩(wěn)定性。方法:選取1名健康成年男性志愿者,分別采用CT和MRI掃描腕關節(jié)。基于CT和MRI掃描數(shù)據(jù),建立正常腕關節(jié)的三維有限元模型,并對模型有效性進行驗證。基于正常腕關節(jié)的三維有限元模型,建立C1、C2、C3型橈骨遠端骨折有限元模型,制作并裝配半環(huán)形外固定支架。分別在裝配半環(huán)形外固定支架的C1、C2、C3型橈骨遠端骨折有限元模型上施加軸向、旋前及掌屈載荷,記錄不同載荷下3種橈骨遠端骨折有限元模型橈腕關節(jié)面的軸向最大相對位移及骨折塊的最大應力和最大位移。結(jié)果:①正常腕關節(jié)有限元模型構建和驗證結(jié)果。本研究建立的正常腕關節(jié)有限元模型涉及1 094 717個單元,387 763個節(jié)點。在尺骨近端施加完全約束后,對模型施加100 N的軸向載荷,橈腕關節(jié)面最大應力為10.7 MPa; 橈骨遠端關節(jié)面主要應力分布于橈舟關節(jié)面和橈月關節(jié)面,且橈舟關節(jié)面所承受的應力較大; 該結(jié)果與文獻中尸體實驗結(jié)果一致,提示正常腕關節(jié)有限元模型構建成功。②3種橈骨遠端骨折有限元模型橈腕關節(jié)面的軸向最大相對位移。在軸向載荷下,C1、C2、C3型橈骨遠端骨折有限元模型橈腕關節(jié)面的軸向最大相對位移依次為0.27 mm、0.14 mm、0.64 mm; 在旋前載荷下,C1、C2、C3型橈骨遠端骨折有限元模型橈腕關節(jié)面的軸向最大相對位移依次為0.21 mm、0.29 mm、0.36 mm; 在掌屈載荷下,C1、C2、C3型橈骨遠端骨折有限元模型橈腕關節(jié)面的軸向最大相對位移依次為0.11 mm、0.08 mm、0.24 mm。③3種橈骨遠端骨折有限元模型骨折塊的最大應力。在軸向載荷下,C1、C2、C3型橈骨遠端骨折有限元模型骨折塊的最大應力依次為5.58 MPa、20.93 MPa、40.91 MPa; 在旋前載荷下,C1、C2、C3型橈骨遠端骨折有限元模型骨折塊的最大應力依次為1.45 MPa、11.31 MPa、11.89 MPa; 在掌屈載荷下,C1、C2、C3型橈骨遠端骨折有限元模型骨折塊的最大應力依次為0.78 MPa、19.94 MPa、4.66 MPa。④3種橈骨遠端骨折有限元模型骨折塊的最大位移。在軸向載荷下,C1、C2、C3型橈骨遠端骨折有限元模型骨折塊的最大位移依次為0.63 mm、1.4 mm、1.5 mm; 在旋前載荷下,C1、C2、C3型橈骨遠端骨折有限元模型骨折塊的最大位移依次為0.10 mm、0.16 mm、0.16 mm; 在掌屈載荷下,C1、C2、C3型橈骨遠端骨折有限元模型骨折塊的最大位移依次為1.24 mm、1.15 mm、1.05 mm。結(jié)論:半環(huán)形外固定支架治療C型橈骨遠端骨折具有較好的穩(wěn)定性。
Abstract:
Objective:To explore the stability of a semi-circular external fixator in treating type C distal radius fractures.Methods:A healthy adult male volunteer was selected for wrist joint scanning by using CT and MRI,respectively.Based on the CT and MRI scanning data,a three-dimensional(3D)finite element model of the normal wrist joint was established,and the validity of the model was verified.Based on the successfully established 3D finite element model,the finite element models of type C1,C2,and C3 distal radius fractures were established,and a semi-circular external fixator was fabricated and assembled.The axial,pronation and palmarflexion loads were applied to the finite element models of type C1,C2 and C3 distal radius fractures assembled with semi-circular external fixators,respectively.The maximum relative axial displacement of the radiocarpal articular surface,and the maximum stress and maximum displacement of the fractured bone in the three finite element models under the different loads were recorded.Results:①The established 3D finite element model of normal wrist joint involved 1 094 717 elements and 387 763 nodes.The maximum stress was 10.7 MPa on the radiocarpal articular surface when a 100 N axial load was applied to the model after applying a full constraint to the proximal end of the ulna.The main stress acted on the distal radius articular surface was mainly distributed on the radionavicular and radiolunate articular surfaces,with the radionavicular articular surface experiencing greater stress.This result was consistent with the results previously reported in the cadaver experiments,indicating the successful establishment of a 3D finite element model of normal wrist joint.②The maximum relative axial displacements of the radiocarpal articular surface in the finite element models of type C1,C2,and C3 distal radius fractures were 0.27,0.14,and 0.64 mm under the axial load; 0.21,0.29,and 0.36 mm under the pronation load; and 0.11,0.08,and 0.24 mm under the palmarflexion load,respectively.③The maximum stress of the fractured bone in the finite element models of type C1,C2,and C3 distal radius fractures were 5.58,20.93,and 40.91 MPa under the axial load; 1.45,11.31,and 11.89 MPa under the pronation load; and 0.78,19.94,and 4.66 MPa under the palmarflexion load,respectively.④The maximum displacement of the fractured bone in the finite element models of type C1,C2,and C3 distal radius fractures were 0.63,1.4,and 1.5 mm under the axial load; 0.10,0.16,and 0.16 mm under the pronation load; and 1.24,1.15,and 1.05 mm under the palmarflexion load,respectively.Conclusion:The semi-circular external fixator behaves good stability in the treatment of type C distal radius fractures.

參考文獻/References:

[1] ANDO J,TAKAHASHI T,AE R,et al.Epidemiology of distal radius fracture:a regional population-based study in Japan[J].BMC Musculoskelet Disord,2023,24(1):478.
[2] 劉慶梁,高斌禮.橈骨遠端骨折的治療進展[J].骨科,2019,10(4):363-366.
[3] SANDER A L,LEIBLEIN M,SOMMER K,et al.Epidemi-ology and treatment of distal radius fractures:current concept based on fracture severity and not on age[J].Eur J Trauma Emerg Surg,2020,46(3):585-590.
[4] 中華醫(yī)學會骨科學分會創(chuàng)傷骨科學組,中華醫(yī)學會骨科學分會外固定與肢體重建學組.中國成人橈骨遠端骨折診療指南(2023)[J].中華創(chuàng)傷骨科雜志,2023,25(1):6-13.
[5] 李柿樾,卜建文,謝增如.橈骨遠端骨折的治療進展[J].實用手外科雜志,2022,36(1):97-101.
[6] 王海羽,湯立新,郭雄飛,等.內(nèi)固定與外固定橈骨遠端C2和C3型骨折的比較[J].中國矯形外科雜志,2021,29(8):684-688.
[7] 龐濤,陳紀寶,郭燕芬,等.橈骨遠端不穩(wěn)定骨折閉合復位外固定架克氏針固定[J].中國矯形外科雜志,2024,32(6):570-573.
[8] 徐永清,鐘世鎮(zhèn),徐達傳,等.腕關節(jié)韌帶的解剖學研究[J].創(chuàng)傷外科雜志,2006,8(1):52-54.
[9] 李永耀,趙勇,程灝,等.夾板彈性固定橈骨遠端FrykmanⅧ型骨折尺側(cè)柱穩(wěn)定性的有限元分析[J].中國組織工程研究,2020,24(30):4769-4774.
[10] 欽斌,黃永火,歐陽羽,等.軸向應力作用下的舟骨有限元分析[J].第三軍醫(yī)大學學報,2010,32(11):1213-1215.
[11] ALI R,ILYAS A,RIAZ H,et al.Outcome of the distal ra-dius fractures managed with across wrist external fixator vs buttress plates[J].J Ayub Med Coll Abbottabad,2023,35(1):32-36.
[12] LUDVIGSEN T,MATRE K,GUDMUNDSDOTTIR R S,et al.Surgical treatment of distal radial fractures with external fixation versus volar locking plate:a multicenter rando-mized controlled trial[J].J Bone Joint Surg Am,2021,103(5):405-414.
[13] MACCAGNANO G,NOIA G,VICENTI G,et al.A prospective observational clinical and radiological study of a modular bridging external fixator for unstable distal radius fractures[J].Malays Orthop J,2021,15(3):108-114.
[14] DÜNDAR A,CANKAYA D,KARAKUS D,et al.Volar-locking plate versus external fixator in the management of distal radius fractures:An isokinetic study[J].Ulus Travma Acil Cerrahi Derg,2022,28(8):1156-1163.
[15] 金橋,成永忠,陳亦歷,等.半環(huán)式外固定架治療C型橈骨遠端骨折21例[J].中國中醫(yī)骨傷科雜志,2022,30(5):54-58.
[16] 賀達,成永忠,趙勇,等.半環(huán)式外固定架治療C型橈骨遠端骨折[J].中國矯形外科雜志,2019,27(8):682-686.
[17] FLEIFEL D,PYTIAK A V,JIN X,et al.Biomechanics of subcutaneous locked plating versus burke plate and external fixator for comminuted distal radius fractures[J].Cureus,2023,15(5):e39142.
[18] HAJIANPOUR M A,SANO T,OUELLETTE E A,et al.Biomechanical comparison between volar plate fixator and nonbridge external wrist fixator[J].J Long Term Eff Med Implants,2020,30(2):131-134.
[19] DODDS S D,CORNELISSEN S,JOSSAN S,et al.A biomechanical comparison of fragment-specific fixation and augmented external fixation for intra-articular distal radius fractures[J].J Hand Surg Am,2002,27(6):953-964.
[20] WOLF J C,WEIL W M,HANEL D P,et al.A biomechanic comparison of an internal radiocarpal-spanning 2.4-mm locking plate and external fixation in a model of distal radius fractures[J].J Hand Surg Am,2006,31(10):1578-1586.
[21] GOSLINGS J C,FERGUSON S J,PERREN R A,et al.Biomechanical analysis of dynamic external fixation devices for the treatment of distal radial fractures[J].J Trauma,1999,46(3):407-412.
[22] 林旭,劉躍輝,吳剛,等.跨腕關節(jié)支撐鋼板外固定架治療橈骨遠端粉碎性骨折的生物力學實驗[J].西部醫(yī)學,2012,24(8):1455-1459.
[23] 姚俊銘.外固定支架與鎖定鋼板固定橈骨遠端骨折的有限元分析[D].廣州:南方醫(yī)科大學,2024.
[24] DING Y,GUAN B,LIN S,et al.Finite element analysis of non-bridged external-fixation frames for the treatment of AO A2.2 fractures of distal radius[J].Asian J Surg,2024,47(2):1075-1076.
[25] 李海波,馬寶通.指套牽引聯(lián)合手法復位外固定治療老年橈骨遠端骨折的臨床效果[J].中國中西醫(yī)結(jié)合外科雜志,2024,30(2):199-203.
[26] BLIVEN E K,GREINWALD M,HACKL S,et al.External fixation of the lower extremities:Biomechanical perspective and recent innovations[J].Injury,2019,50(Suppl 1):S10-S17.
[27] LINDAU T.Arthroscopic treatment of distal radius frac-ture[J].Chir Main,2006,25(S1):S161-S170.
[28] 苑海洋.腕關節(jié)鏡輔助治療橈骨遠端關節(jié)內(nèi)骨折的臨床研究[D].大連:大連醫(yī)科大學,2019.
[29] CHEN Y,HUANG X,CHENG Y,et al.Effects and anti-rotation stabilization of the non-bridging external fixation for pronation-abduction stage iii ankle fracture:a cadaveric study[J].Biomed Res Int,2021:9966344.
[30] 陳奕歷.撬撥復位馬蹄環(huán)型外固定架固定前柱損傷型Pilon骨折實驗研究[D].北京:中國中醫(yī)科學院,2023.

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備注/Memo

備注/Memo:
基金項目:首都臨床特色診療技術研究及轉(zhuǎn)化應用項目(Z221100007422075); 國家自然科學基金項目(82274561); 中國中醫(yī)科學院科技創(chuàng)新工程項目(CI2021A02008)
通訊作者:蔣科衛(wèi) E-mail:[email protected]
更新日期/Last Update: 1900-01-01