1、中国组织工程研究 2013, Vol. 17 Issue (4): 612-619 DOI: 10.3969/j.issn.2095-4344.2013.04.008骨与关节生物力学不同运动步态下锁定加压钢板固定胫骨干骨折的有限元分析Finite element analysis of different tibial shaft fracture fixed by Locking compression plate under different movement gait全文: PDF 摘要 背景：目前有限元分析广泛应用于人体骨折内固定模型的力学分析，但大多研究局限于静态下，动态下的骨折模
2、型有限元分析尚未见报道。目的：通过三维有限元分析来探讨锁定加压钢板固定胫骨干不同类型骨折在不同运动步态下的应力分布情况。方法：利用 CT 扫描获得正常成人胫腓骨及足部的薄层扫描图像；运用相关软件建立其三维模型，在此模型上模拟出胫骨中段横行、斜行、粉碎性、螺旋形4 种类型骨折，并与锁定钢板进行装配生成实验模型，各组模型加载相同的轴向压缩载荷 600 N。通过有限元分析软件 Ansys 12.0 分别测定各组模型在落地相、中立相、离地相三种步态下的应力分布情况。结果与结论：在步态下，胫骨在骨折各组中的应力分布由小到大均为：落地相中立相离地相。锁定钢板在胫骨中段横行、斜行、粉碎性骨折中的应力分布由小
3、到大均为：中立相落地相 离地相；在胫骨中段螺旋形骨折中应力分布由小到大为：离地相中立相 落地相；提示在运动步态中，钢板和胫骨均在离地相受力最大。钢板的应力集中在中间或边缘；而胫骨的应力分布在骨折线以上靠近近端，骨折线以下靠近骨折线。就胫骨整体而言，呈现两端集中，中间分散的状态。关键词 ： 骨关节植入物； 骨与关节三维有限元； 胫骨； 锁定加压钢板； 运动步态； 有限元分析； 应力分布； 内固定； 阈值； 网格划分； 弹性模量； 生物力学； 省级基金； 骨关节植入物图片文章； Abstract：BACKGROUND: In recent years, the finite element ana
4、lysis has been widely used in the mechanical analysis of human fracture internal fixation model, but studies on the finite element analysis are often under the static state, the reports on the finite element analysis under physiological state are few.OBJECTIVE: To explore the stress distribution of
5、different tibial shaft fractures fixed by locking compression plate under different movement gaits through three-dimensional finite element analysis.METHODS: CT scan was performed to obtain the thin layer scanning image of normal adult tibiofibula and foot; three-dimensional models were established
6、by relative software, and then transverse, oblique, spiral, comminuted fractures were imitated on the models and combined with the locking plate to generate the experimental models. The models in each group were subjected to the same axial compression load of 600 N. The stress distribution of the mo
7、dels under heel-strike phase, the midstance phase and the push-off phase was analyzed with software Ansys 12.0.RESULTS AND CONCLUSION: Under this experimental model, the stress distribution of tibia in four groups from small to large was heel-strike phase midstance phase push-off phase; the stress d
8、istribution of locking compression plate in the tibial transverse, oblique and comminuted fractures from small to large was the midstance phase the heel-strike phase the push-off phase; stress distribution of locking compression plate in the tibial spiral fracture group from small to large was the p
9、ush-off phase the midstance phase the heel-strike phase. Under the physiological state, the largest stress of the locking compression plate and the tibia were in the push-off phase. The stress distribution of the locking compression plate focused on the middle or edge of itself; while the stress dis
10、tribution of the tibia focused on the proximal end above the fracture line and on the end under the fracture line. From the overall of the tibia, the stress distribution focused on both ends, and scattered on the middle.Key words： bone and joint implants; three-dimensional finite element analysis of
11、 bone and joint; tibia; locking compression plate; movement gaits; finite element analysis; stress distribution; internal fixation; threshold; Hyper Mesh; modulus of elasticity; biomechanics; provincial grants-supported paper; photographs-containing paper of bone and joint implants;收稿日期: 2012-11-10
12、研究亮点:1 课题运用三维有限元分析方法，研究基于运动步态下不同类型胫骨干骨折的应力分布情况，旨在明确骨干及接骨板在动态下的受力特点，弥补既往研究中动态下的钢板应力分布数据的缺失。分析多种骨折类型下的应力分布，为临床工作及指导患者康复锻炼提供理论依据。2 实验利用 CT 扫描获得正常成人胫腓骨及足部的薄层扫描图像，运用相关软件建立其三维模型，在此模型上模拟出胫骨中段横行、斜行、粉碎性、螺旋形 4 种类型骨折，并与锁定钢板进行装配生成实验模型，通过有限元分析软件Ansys12.0 分别测定胫骨中段横行、斜行、粉碎性、螺旋形骨折模型在落地相、中立相、离地相 3 种步态下的应力分布情况。3 实验结果
13、显示，落地相时钢板的应力集中区域靠近骨折线以上的钢板边缘；中立相时钢板的应力集中区域均匀分布在靠近骨折线上下；离地相时，钢板的应力集中区域分布在骨折线以下的钢板边缘。4 胫骨中段横行、斜行、粉碎性、螺旋形骨折模型在落地相、中立相、离地相3 种步态下，骨折线以上应力集中区域靠近胫骨近端，在骨折线以下应力集中区域靠近骨折线，呈现两端集中，中间分散的状态。5 胫骨中段横行、斜行、粉碎性、螺旋形骨折模型在落地相、中立相、离地相3 种步态下，腓骨均处于完整状态，与生理状态下腓骨受到的应力接近。6 实验结果初步探讨了虚拟模型中胫骨及锁定钢板的应力分布特点，但尚未将应力分析进一步精确到螺钉，未能详细讨论各螺钉的受力特点，及不同钢板长度和不同螺钉数目搭配的效果。
