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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(yuǎn)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(yuǎn)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(chǔ)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(xué)研究生院,北京 100029; 2.中國中醫(yī)科學(xué)院望京醫(yī)院,北京 100102; 3.首都醫(yī)科大學(xué)生物醫(yī)學(xué)工程學(xué)院,北京 100069; 4.中醫(yī)正骨技術(shù)北京市重點(diǎn)實(shí)驗(yàn)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(guān)鍵詞:
橈骨骨折;  骨折固定術(shù);  外固定器;  限定因素分析;  生物力學(xué)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(yuǎn)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(guān)節(jié)。基于CT和MRI掃描數(shù)據(jù),建立正常腕關(guān)節(jié)的三維有限元模型,并對模型有效性進(jìn)行驗(yàn)證。基于正常腕關(guān)節(jié)的三維有限元模型,建立C1、C2、C3型橈骨遠(yuǎn)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(yuǎn)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(yuǎn)端骨折有限元模型橈腕關(guān)節(jié)面的軸向最大相對位移及骨折塊的最大應(yīng)力和最大位移。結(jié)果:①正常腕關(guān)節(jié)有限元模型構(gòu)建和驗(yàn)證結(jié)果。本研究建立的正常腕關(guān)節(jié)有限元模型涉及1 094 717個(gè)單元,387 763個(gè)節(jié)點(diǎn)。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(guān)節(jié)面最大應(yīng)力為10.7 MPa; 橈骨遠(yuǎn)端關(guān)節(jié)面主要應(yīng)力分布于橈舟關(guān)節(jié)面和橈月關(guān)節(jié)面,且橈舟關(guān)節(jié)面所承受的應(yīng)力較大; 該結(jié)果與文獻(xiàn)中尸體實(shí)驗(yàn)結(jié)果一致,提示正常腕關(guān)節(jié)有限元模型構(gòu)建成功。②3種橈骨遠(yuǎn)端骨折有限元模型橈腕關(guān)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(yuǎn)端骨折有限元模型橈腕關(guān)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(yuǎn)端骨折有限元模型橈腕關(guān)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(yuǎn)端骨折有限元模型橈腕關(guān)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(yuǎn)端骨折有限元模型骨折塊的最大應(yīng)力。在軸向載荷下,C1、C2、C3型橈骨遠(yuǎn)端骨折有限元模型骨折塊的最大應(yīng)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(yuǎn)端骨折有限元模型骨折塊的最大應(yīng)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(yuǎn)端骨折有限元模型骨折塊的最大應(yīng)力依次為0.78 MPa、19.94 MPa、4.66 MPa。④3種橈骨遠(yuǎn)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(yuǎn)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(yuǎn)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(yuǎn)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(yuǎn)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.

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備注/Memo

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